Assessment of the Relationship between Nurses' Perception of Ethical Climate and Job Burnout in Intensive Care Units

OBJECTIVES

To determine the relationship between ethical climate and burnout in nurses working in Intensive Care Units (ICUs).

METHODS

This cross-sectional and multi-center study was conducted among 212 nurses working in adult ICUs of six hospitals affiliated to Shiraz University of Medical Sciences, Iran in 2019. The participants were selected using systematic random sampling technique. Data was collected using valid instruments of Olson's Hospital Ethical Climate Survey (HECS) and Maslach Burnout Inventory (MBI).

RESULTS

Ethical climate was favorable (3.5±0.6). The intensity (32.2±12.4) and frequency (25.5±12.4) of burnout were high. Ethical climate had significant and inverse relationships with frequency of burnout (r =-0.23, p=0.001) and with intensity of burnout (r=-0.186, p=0.007). Ethical climate explained 5.9% of burnout. Statistically significant relationships were also found between these factors: age with ethical climate (p=0.001), work shifts with burnout (p=0.02), and gender and with intensity frequency of burnout in ICU nurses (p=0.038). The results of Spearman correlation coefficient showed significant and inverse relationships between ethical climate and job burnout (r=-0.243, p < 0.001).

CONCLUSIONS

Nurses in ICUs perceived that ethical climate was favorable however, burnout was high. Therefore, burnout can be affected by many factors and it is necessary to support ICU nurses since they undertake difficult and complicated task. It is recommended to assess factors that increase burnout and adopt specific measures and approaches to relieve nursing burnout.

Evaluation of Work Satisfaction, Stress, and Burnout Among US Internal Medicine Physicians and Trainees

This study uses the Mini Z 2.0 survey to assess burnout among male and female members of the American College of Physicians who are internists and internal medicine trainees.

What are the Predictors of Burn out in Nigerian Bankers? A Case Study of Bankers in Enugu, Nigeria

BACKGROUND

In developing countries such as Nigeria, due to globalization and the deteriorating economy, workers are especially vulnerable to burnout. The pressure on bank employees from tight deadlines and unrealistic targets may predispose them to burnout. Burnout has been shown to occur in workers because of failure to cope with occupational stress, especially in the banking sector which requires intensive communication and interaction with service recipients.

OBJECTIVE

The aim of this study was to assess the prevalence and determinants of occupational burnout in bankers in Enugu Metropolis, Nigeria.

METHODS

A cross-sectional analytical study was carried out among 370 Bankers in Enugu state, Nigeria. The Copenhagen burnout inventory was used to assess personal, work and clientrelated burnout.

RESULTS

Majority of the bankers had all three components of burnout. Client related burnout was experienced more among female bankers (P=0.022), those that had spent five years or less on the job (P=0.021), bankers aged thirty-five years or less (P=0.013) and bankers who were married (P=0.018).Only bankers that had spent less than five years on the job (P=0.037) experienced personal burnout and no factor was found to be associated with work related burnout. Predictors of client-related burnout were age of 35 years or less, work experience of 5 years or less and being female.

CONCLUSION

Prevalence of burnout is very high among the bankers that were studied. The management of these banks should create measures aimed at reducing the risk of exposure to burnout.

Resident assistant secondary trauma and burnout associated with student nonsuicidal self-injury

Objective: To determine whether or not encountering students struggling with nonsuicidal self-injury (NSSI) put resident assistants (RAs) at greater risk of burnout or secondary traumatic stress. Participants: One hundred and fifty-five RAs at three Midwest public university campuses between March and April 2016. Methods: RAs participated in an anonymous online survey that collected demographics, information on RAs' experiences and thoughts related to their work, RAs' exposure to NSSI struggle of a resident, and measurements of compassion satisfaction, burnout, and secondary traumatic stress. Results: RAs who encountered resident NSSI demonstrated significantly higher levels of burnout and secondary traumatic stress than RAs who did not encounter resident NSSI. Conclusion: College students struggle with NSSI can significantly affect the people around them. Residence life administration and college counseling centers should provide training, support, and supervision to RAs in a way that addresses and reduces the RAs' potential distress.

Association of Sleep Disorders With Physician Burnout

This cross-sectional study evaluates the association between sleep disorders and burnout symptoms among faculty and staff at a large teaching hospital.

An Investigation of Prevalence and Predictors of Disengagement and Exhaustion in Pharmacy Students

Objective. To determine the prevalence of burnout in first, second, and third professional year (P1, P2, and P3) pharmacy students at a single institution and identify predictors of higher burnout scores. Methods. A 31-question anonymous online survey was developed and administered to a total of 390 P1, P2, and P3 students at the University of Kentucky College of Pharmacy. The survey consisted of a modified version of the 16-question Oldenburg Burnout Inventory (OLBI) and 14 additional questions related to demographic and co-curricular and extracurricular related questions. Descriptive and inferential statistical analyses were conducted as appropriate to determine differences among the variables studied and to identify predictive variables of disengagement and emotional exhaustion. Results. Seventy-five percent of invited students participated in the study. Results of the analyses showed that P1 students had significantly lower engagement scores than both P2 and P3 students, and that P2 students were significantly less exhausted than P1 and P3 students. There was a lack of correlation between burnout scores and students' postgraduate goals, curricular involvement, and work responsibilities. Married students reported being significantly less exhausted than unmarried students. Conclusion. This study added to the growing evidence that pharmacy students have relatively high rates of disengagement and emotional exhaustion. Because the variables expected to contribute to burnout were not found to be predictive in this study, further analyses examining the positive and negative predictive factors associated with burnout scores in pharmacy students are needed. Identifying these factors would allow targeted interventions to be made early in the academic careers of students most susceptible to burnout.

Impact of COVID-19 on endoscopy trainees: an international survey

BACKGROUND AND AIMS

Although coronavirus disease 2019 (COVID-19) has affected endoscopy services globally, the impact on trainees has not been evaluated. We aimed to assess the impact of COVID-19 on procedural volumes and on the emotional well-being of endoscopy trainees worldwide.

METHODS

An international survey was disseminated over a 3-week period in April 2020. The primary outcome was the percentage reduction in monthly procedure volume before and during COVID-19. Secondary outcomes included potential variation of COVID-19 impact between different continents and rates and predictors of anxiety and burnout among trainees.

RESULTS

Across 770 trainees from 63 countries, 93.8% reported a reduction in endoscopy case volume. The median percentage reduction in total procedures was 99% (interquartile range, 85%-100%), which varied internationally (P < .001) and was greatest for colonoscopy procedures. Restrictions in case volume and trainee activity were common barriers. A total of 71.9% were concerned that the COVID-19 pandemic could prolonged training. Anxiety was reported in 52.4% of respondents and burnout in 18.8%. Anxiety was independently associated with female gender (odds ratio [OR], 2.15; P < .001), adequacy of personal protective equipment (OR, 1.75; P = .005), lack of institutional support for emotional health (OR, 1.67; P = .008), and concerns regarding prolongation of training (OR, 1.60; P = .013). Modifying existing national guidelines to support adequate endoscopy training during the pandemic was supported by 68.9%.

CONCLUSIONS

The COVID-19 pandemic has led to restrictions in endoscopic volumes and endoscopy training, with high rates of anxiety and burnout among endoscopy trainees worldwide. Targeted measures by training programs to address these key issues are warranted to improve trainee well-being and support trainee education.

Occupational Burnout Among Nigerians: The Need for Urgent Intervention

EDITORIAL.

Burnout syndrome and metabolic syndrome: a cross-sectional population-based study

In the population of Primary Health Care Nursing (PHC) professionals, the association between Burnout Syndrome (BS) and Metabolic Syndrome (MS) has not been investigated. The objective was to evaluate the association between BS and MS among PHC Nursing Professionals. A cross-sectional, multicenter, population-based study was conducted in the state of Bahia, Brazil, with 1,125 professionals. The prevalence of BS and MS corresponded to 18.3% and 24.4%, respectively. The prevalence in women of BS was 16.4% and of MS 23.7%, in men 31.6% for BS and 29.4% for MS. Men with BS are 3.23 times more likely to develop MS, and women 1.48 times more. BS was associated between men and women and exhibited a good discriminatory predictive power.

Family Medicine Faculty Time Allocation and Burnout: A Residency Research Network of Texas Study

BACKGROUND

Burnout among graduate medical education (GME) faculty is a well-documented phenomenon, but few studies have explored the relationship between faculty time allocation and burnout.

OBJECTIVE

Our objectives were to (1) characterize time allocation of academic family physicians, (2) measure the difference between actual versus preferred time spent on various tasks, and (3) examine this difference in relation to burnout.

METHODS

From January to March 2017, family medicine GME faculty across Texas completed anonymous online surveys for burnout (Maslach Burnout Inventory) and occupational stress (Primary Care Provider Stress Checklist). They also reported the percentage of time they actually versus prefer to allocate across 5 categories of tasks: direct patient care, nondirect clinical duties, teaching, administration, and research. Difference scores between actual and preferred time allocation were calculated and correlated with burnout and stress scores.

RESULTS

Of the faculty physicians surveyed, 53% provided complete responses (103 of 195). On average they engaged in their preferred amount of time on direct patient care (30% of their time) and administrative duties (15%). Meanwhile, faculty preferred to increase time spent teaching (37% to 41%, P = .002) and conducting research (4% to 7%, P ≤ .001), while reducing time spent on nondirect clinical duties (14% to 7%, P < .001). Those with higher misalignment in their weekly schedules reported higher levels of professional burnout and occupational stress.

CONCLUSIONS

Many family medicine GME faculty spent 20% or more of their time in a manner incongruent with their preferences, which may place them at higher risk for burnout and occupational stress.

Psychological effects of nurses and midwives due to COVID-19 outbreak: The case of Turkey

PURPOSE

The study was carried out to determine the psychological impact levels of nurses and midwives due to the COVID-19 outbreak.

METHODS

The research is planned in a descriptive type. Nurses and midwives working in any health institution in Turkey constituted the population of the research. The questionnaire form of the study was shared on social media tools between 01 and 14 April 2020 and a total of 758 nurses and midwives were included in the study sample. Personal Information Form, State-Trait Anxiety Inventory and Intolerance of Uncertainty Scale were used as data collection tools.

RESULTS

Participants who attended the study were 56.9% of nurses and 43.1% of midwives. Approximately half of the nurses and midwives (48.8%) participating in our study contacted the patient with suspected COVID-19, and 29.8% provided care to the patient diagnosed with COVID-19. Nurses and midwives were scored 52.75 ± 9.80 for State Anxiety, 44.87 ± 7.92 for Trait Anxiety Inventory and 35.16 ± 9.42 for Intolerance of Uncertainty Scale. It has been determined that 54.5% of nurses and midwives have been making their lives worse since the outbreak started, 62.4% had difficulties in dealing with the uncertain situation in the outbreak, 42.6% wanted psychological support and 11.8% had alienated from their profession. It was determined that there was a difference between scale scores and difficulties in work, family and private life due to COVID-19.

CONCLUSION

As a result, it is seen that the midwives and nurses in our country have high psychological effects due to the COVID-19 outbreak.

Understanding the Psychological Impact of COVID-19 Pandemic on Patients With Cancer, Their Caregivers, and Health Care Workers in Singapore

PURPOSE

The coronavirus disease 2019 (COVID-19) pandemic has had a global impact, and Singapore has seen 33,000 confirmed cases. Patients with cancer, their caregivers, and health care workers (HCWs) need to balance the challenges associated with COVID-19 while ensuring that cancer care is not compromised. This study aimed to evaluate the psychological effect of COVID-19 on these groups and the prevalence of burnout among HCWs.

METHODS

A cross-sectional survey of patients, caregivers, and HCWs at the National Cancer Centre Singapore was performed over 17 days during the lockdown. The Generalized Anxiety Disorder-7 and Maslach Burnout Inventory were used to assess for anxiety and burnout, respectively. Self-reported fears related to COVID-19 were collected.

RESULTS

A total of 624 patients, 408 caregivers, and 421 HCWs participated in the study, with a response rate of 84%, 88%, and 92% respectively. Sixty-six percent of patients, 72.8% of caregivers, and 41.6% of HCWs reported a high level of fear from COVID-19. The top concern of patients was the wide community spread of COVID-19. Caregivers were primarily worried about patients dying alone. HCWs were most worried about the relatively mild symptoms of COVID-19. The prevalence of anxiety was 19.1%, 22.5%, and 14.0% for patients, caregivers, and HCWs, respectively. Patients who were nongraduates and married, and caregivers who were married were more anxious. The prevalence of burnout in HCWs was 43.5%, with more anxious and fearful HCWs reporting higher burnout rates.

CONCLUSION

Fears and anxiety related to COVID-19 are high. Burnout among HCWs is similar to rates reported prepandemic. An individualized approach to target the specific fears of each group will be crucial to maintain the well-being of these vulnerable groups and prevent burnout of HCWs.

Associations between job demands, job resources and patient-related burnout among physicians: results from a multicentre observational study

OBJECTIVES

To investigate associations of job demands and resources with patient-related burnout among physicians.

DESIGN

Multicentre observational study.

SETTING

Fifty medical departments at 14 (academic and non-academic) hospitals in the Netherlands.

PARTICIPANTS

Four hundred sixty-five physicians (71.6% response rate), comprising 385 (82.8%) medical specialists and 80 (17.2%) residents.

MAIN OUTCOME MEASURES

Job demands (workload and bureaucratic demands), job resources (participation in decision making, development opportunities, leader's inspiration, relationships with colleagues and patients)-measured with the validated Questionnaire of Experience and Evaluation of Work and Physician Worklife Survey-and patient-related burnout, measured using the validated Copenhagen Burnout Inventory.

RESULTS

Patient-related burnout was positively associated with workload (b=0.36; 95% CI, 0.25 to 0.48; p<0.001) and negatively associated with development opportunities (b=-0.18; 95% CI, -0.27 to -0.08; p<0.001) and relationships with patients (b=-0.12; 95% CI, -0.22 to -0.03; p=0.01). Relationships with patients moderated the association between bureaucratic demands and patient-related burnout (b=-0.15; 95% CI, -0.27 to -0.04; p=0.01).

CONCLUSIONS

Physicians with high workloads and few development opportunities reported higher levels of patient-related burnout. Those with positive patient relationships were less likely to experience patient-related burnout, even in the presence of excessive bureaucracy. Therefore, positive physician-patient relationships may be supported to reduce the likelihood of physicians' patient-related burnout. However, the specific support needed to effectively reduce patient-related burnout may vary per healthcare context and thus requires intensified research across healthcare systems and settings.

Physician Wellness During a Pandemic

INTRODUCTION

We are currently in the midst of the coronavirus disease 2019 (COVID-19) pandemic. Research into previous infectious disease outbreaks has shown that healthcare workers are at increased risk for burnout during these dire times, with those on the front lines at greatest risk. The purpose of this prospective study was to determine the effect that the COVID-19 pandemic has had on the wellness of emergency physicians (EP).

METHODS

A survey was sent to 137 EPs in a multi-hospital network in eastern Pennsylvania. We compared 10 primary and two supplemental questions based on how the physicians had been feeling in the prior 2-3 weeks (COVID-19 period) to the same questions based on how they were feeling in the prior 4-6 months (pre-COVID-19 period).

RESULTS

We received 55 responses to the survey (40.1% response rate). The study found that during the pandemic, EPs felt less in control (p-value = 0.001); felt decreased happiness while at work (p-value 0.001); had more trouble falling asleep (p-value = 0.001); had an increased sense of dread when thinking of work needing to be done (p-value = 0.04); felt more stress on days not at work (p-value <0.0001); and were more concerned about their own health (p-value <0.0001) and the health of their families and loved ones (p-value <0.0001).

CONCLUSION

This study showed a statistically significant decrease in EP wellness during the COVID-19 pandemic when compared to the pre-pandemic period. We need to be aware of evidence-based recommendations to help mitigate the risks and prevent physician burnout.

Latent Profiles of Burnout, Self-Esteem and Depressive Symptomatology among Teachers

Burnout is a reality in the teaching profession. Specifically, teaching staff usually have higher burnout rates. The present study aims to analyze the different burnout profiles and to verify if there were differences between burnout profiles in depressive symptomatology and in the self-esteem of the teachers at school. The total number of participants was 210 teachers from 30 to 65 years. The first scale was the Maslach burnout inventory, the second scale was the Self-Rating depression scale and the third scale was the Rosenberg Self-Esteem Scale . The latent class analysis identified three burnout profiles: the first group with a high level of emotional exhaustion, low personal accomplishment and depersonalization (high burnout); the second group with low emotional exhaustion, low depersonalization and high personal accomplishment (low burnout) and the third group with low depersonalization, low emotional exhaustion and low personal accomplishment (moderate burnout). The results revealed that there were differences in depressive symptomatology (group 1 obtained higher scores than group 2 and group 3) and self-esteem (group 2 obtained higher scores than group 1). The psychological balance and health of teachers depend on preventing the factors that have been associated with this syndrome.

Stress and occupational burnout in a population of Polish doctors - Organizational-professional and non-professional-social predictors

INTRODUCTION AND OBJECTIVE

Numerous studies have found that doctors are exposed to stress and burnout at work. In consequence, these processes lead to a decrease in the quality of life. The study aimed to determine whether professional burnout, understood as a cognitive existential process, is related to stress at work and if any of the four dimensions of burnout are its predictor. The study also analyzed relations between organizational-professional and non-professional-social factors and burnout and stress at work.

MATERIAL AND METHODS

318 doctors (210 women, 108 men), aged 27 - 8, participated in the study. Link Burnout Questionnaire (LBQ) was used to measure burnout, and the Perceived Stress Scale (PSS-10) to measure the variable describing the current level of stress.

RESULTS

Occupational burnout is related to stress. Two of its symptoms: exhaustion and lack of a sense of professional effectiveness, are important predictors for the sense of stress experienced by the examined group of doctors. The individuals who are in a partner relationship (but not marriage) experienced a stronger sense of non-professional effectiveness than those who were single. Being in an informal relationship is related to the level of stress and lack of a sense of professional effectiveness. The level of stress, as well as all burnout indicators, are connected with the function of a team leader and having passion. The frequency of taking leave and using social networks is related to the level of stress and burnout.

CONCLUSIONS

Problems related to burnout in doctors, and therefore people professionally involved in helping and treating, must not be underestimated, as evidenced by the results of the presented study Professional burnout of doctors leads to somatic and psychological problems. Doctors suffering from occupational burnout need support and psychological assistance the same as any other professional group.

Burnout level and associated factors in a sub-Saharan African medical setting: prospective cross-sectional survey

BACKGROUND

Burnout in the hospital environment is a problem that affects care and training. Often explored in the high-income medical context, burnout is poorly studied in low and middle-income countries characterized by a precarious hospital situation and a high stake linked to the Millennium Development Goals. The aim of our study was to determine in medical practitioners, in a sub-Saharan African country's medical context, the burnout level and associated factors.

METHODS

A prospective cross-sectional study by using a self-administered Likert-scale questionnaire addressed to doctors and doctoral medical students in Gabon. Maslach Burnout Inventory scale has been used. Burnout symptoms were defined by high level in at least one of the 3 dimensions. Severe burnout defined by high level in all dimensions. Explored factors: socio-demographic and psychometric. Multiple logistic regression has been performed.

RESULTS

Among 104 participants, severe burnout prevailed at 1.9% (95% CI: 0.2-6.8%) and burnout symptoms at 34.6% (95% CI: 25, 6-44.6%). The associated factors with burnout symptoms: age (OR = 0.86, p = 0.004), clinical activity in a university hospital center (OR = 5.19, p = 0.006), the easy access to the hospital (OR = 0.59, p = 0.012), number of elderly dependents living with the practitioner (OR = 0.54, p = 0.012), place of residence (same borough where the hospital is located: OR = 4.09, p = 0.039) and to be favorable to traditional medicine (OR = 1.82, p = 0.087). Nagelkerke's R-squared:53.1%.

CONCLUSION

In Gabon, middle-income country, almost one practitioner in two has burnout symptoms. The young age, the university hospital center, the difficulty to access to hospital and to live in the borough where the hospital is located increase the probability of burnout symptoms. These results must put question to relevant authorities regarding health and medical education, to set up: a public transport for practitioners, an optimal primary health care system, a regulation of medical tasks in hospitals, a training in clinical supervision.

Case for hospital nurse-to-patient ratio legislation in Queensland, Australia, hospitals: an observational study

OBJECTIVES

To determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio legislation targeting medical-surgical wards, and if so, the extent to which nurse staffing variation was associated with poor outcomes for patients and nurses.

DESIGN

Analysis of cross-sectional data derived from nurse surveys linked with admitted patient outcomes data.

SETTING

Public hospitals in Queensland.

PARTICIPANTS

4372 medical-surgical nurses and 146 456 patients in 68 public hospitals.

MAIN OUTCOME MEASURES

30-day mortality, quality and safety indicators, nurse outcomes including emotional exhaustion and job dissatisfaction.

RESULTS

Medical-surgical nurse-to-patient ratios before implementation of ratio legislation varied significantly across hospitals (mean 5.52 patients per nurse; SD=2.03). After accounting for patient characteristics and hospital size, each additional patient per nurse was associated with 12% higher odds of 30-day mortality (OR=1.12; 95% CI 1.01 to 1.26). Each additional patient per nurse was associated with poorer outcomes for nurses including 15% higher odds of emotional exhaustion (OR=1.15; 95% CI 1.07 to 1.23) and 14% higher odds of job dissatisfaction (OR=1.14; 95% CI 1.02 to 1.28), as well as higher odds of concerns about quality of care (OR=1.12; 95% CI 1.01 to 1.25) and patient safety (OR=1.32; 95% CI 1.11 to 1.57).

CONCLUSIONS

Before ratios were implemented, nurse staffing varied considerably across Queensland hospital medical-surgical wards and higher nurse workloads were associated with patient mortality, low quality of care, nurse emotional exhaustion and job dissatisfaction. The considerable variation across hospitals and the link with outcomes suggests that taking action to improve staffing levels was prudent.

Burnout in medical students

Only a small number of studies have examined the relationship between medical students and burnout syndrome. In Salzburg, Paracelsus Private Medical University (PMU) offers a 5‑year medical program instead of the regular 6 years of medical studies. Due to the tight schedule and heavy workload, the stress level of students is high. The purpose of this study was to determine whether PMU students show burnout symptoms. Three surveys were conducted: at the beginning of the academic year (T1, December 2009), at the end of the academic year (T2, June 2010), and at the beginning of the following academic year (T3, December 2010). For the assessment of burnout, the Maslach Burnout Inventory (emotional exhaustion, depersonalization or cynicism, and low personal accomplishment) was used, as well as the Six Factors Theory of Burnout (workload, control, reward, community, fairness, and values) and for comparison, the Austrian norms developed by Unterholzer. Burnout rate was calculated by a combined measure of the three components. The results show a significant difference from the norm means in emotional exhaustion, depersonalization/cynicism, and low personal accomplishment. With regard to areas of work life, all values are below the means, indicating high workload, high external control, low reward, low feeling of community, and low fairness—except values, i.e., motivation of the students. The mean overall burnout frequency turned out to be 47.8 ± 11.0%, whereas females have slightly higher burnout rates than males. An increasing linear trend with burnout rates was seen from the youngest to the oldest class. In addition, the estimated burnout rate increased within the academic term, as T2 had the highest rate, followed by T3, and the lowest rate was seen in T1. In conclusion, burnout in medical students is frequent and significantly related to heavy workload and other factors of worklife, necessitating changes of academic and organizational settings of medical curricula.

Factors contributing to healthcare professional burnout during the COVID-19 pandemic: A rapid turnaround global survey

Background

Healthcare professionals (HCPs) on the front lines against COVID-19 may face increased workload and stress. Understanding HCPs’ risk for burnout is critical to supporting HCPs and maintaining the quality of healthcare during the pandemic.

Methods

To assess exposure, perceptions, workload, and possible burnout of HCPs during the COVID-19 pandemic we conducted a cross-sectional survey. The main outcomes and measures were HCPs’ self-assessment of burnout, indicated by a single item measure of emotional exhaustion, and other experiences and attitudes associated with working during the COVID-19 pandemic.

Findings

A total of 2,707 HCPs from 60 countries participated in this study. Fifty-one percent of HCPs reported burnout. Burnout was associated with work impacting household activities (RR = 1·57, 95% CI = 1·39–1·78, P<0·001), feeling pushed beyond training (RR = 1·32, 95% CI = 1·20–1·47, P<0·001), exposure to COVID-19 patients (RR = 1·18, 95% CI = 1·05–1·32, P = 0·005), and making life prioritizing decisions (RR = 1·16, 95% CI = 1·02–1·31, P = 0·03). Adequate personal protective equipment (PPE) was protective against burnout (RR = 0·88, 95% CI = 0·79–0·97, P = 0·01). Burnout was higher in high-income countries (HICs) compared to low- and middle-income countries (LMICs) (RR = 1·18; 95% CI = 1·02–1·36, P = 0·018).

Interpretation

Burnout is present at higher than previously reported rates among HCPs working during the COVID-19 pandemic and is related to high workload, job stress, and time pressure, and limited organizational support. Current and future burnout among HCPs could be mitigated by actions from healthcare institutions and other governmental and non-governmental stakeholders aimed at potentially modifiable factors, including providing additional training, organizational support, and support for family, PPE, and mental health resources.