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Xiong Q, Luo F, Chen Y, Duan Y, Huang J, Liu H, Jin P, Li R. Factors influencing fatigue, mental workload and burnout among Chinese health care workers during public emergencies: an online cross-sectional study. BMC Nurs 2024; 23:428. [PMID: 38918772 PMCID: PMC11197284 DOI: 10.1186/s12912-024-02070-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVES The purpose of this study was to investigate fatigue, mental workload, and burnout among health care workers (HCWs) and explore the possible underlying factors. MATERIALS AND METHODS An online cross-sectional survey design was used to collect data from HCWs in Chongqing, China. The online survey included the Fatigue Severity Scale, NASA Task Load Index, and Chinese version of the Maslach Burnout Inventory-General Survey to assess fatigue, mental workload, and burnout, respectively, and was conducted from February 1 to March 1, 2023. RESULTS In this study, the incidence of fatigue and burnout among HCWs was 76.40% and 89.14%, respectively, and the incidence of moderate to intolerable mental workloads was 90.26%. Work-family conflict, current symptoms, number of days of COVID-19 positivity, mental workload, burnout and reduced personal accomplishment were significantly associated with fatigue. Mental workload was affected by fatigue and reduced personal accomplishment. Furthermore, burnout was influenced by marital status and fatigue. Moreover, there was a correlation among mental workload, fatigue, and burnout. CONCLUSIONS Fatigue, mental workload and burnout had a high incidence and were influenced by multiple factors during COVID-19 public emergencies in China.
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Affiliation(s)
- Qian Xiong
- The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400042, China
| | - Feng Luo
- The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400042, China.
| | - Yue Chen
- The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400042, China.
| | - Yi Duan
- The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400042, China
| | - Jie Huang
- The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400042, China
| | - Hong Liu
- The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400042, China
| | - Pengjuan Jin
- The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400042, China
| | - Rong Li
- The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400042, China
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Gotra M, Lindberg K, Jasinski N, Scarisbrick D, Reilly S, Perle J, Miller L, Mahoney Iii J. Changes in the Clinical Practice of Mental Health Service Providers Throughout the COVID-19 Pandemic: Longitudinal Questionnaire Study. JMIR Form Res 2024; 8:e50303. [PMID: 38683653 PMCID: PMC11060325 DOI: 10.2196/50303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic impacted the practices of most mental health providers and resulted in a rapid transition to providing telemental health services, changes that were likely related to stay-at-home policies as well as increased need for services. OBJECTIVE The aim of this study was to examine whether these changes to practice have been sustained over time throughout the course of the COVID-19 pandemic and whether there are differences among mental health provider type and setting. We hypothesized that there would be an increase in the number of patients seen in person after the initial surge of the pandemic in spring 2020 and subsequent discontinuation of stay-at-home policies, though with continued implementation of telemental health services across settings. METHODS This study surveyed 235 of the 903 mental health providers who responded to a survey in spring 2020 (Time point 1) and at a 1-year follow-up in spring 2021 (Time point 2). Differences in practice adjustments, factors related to telemental health, and number of patients seen were examined across provider type (social worker, psychologist, neuropsychologist) and setting (academic medical center [AMC], community mental health, private practice, and Veterans Affairs hospital). RESULTS From Time point 1 to Time point 2, there was a small but significant increase in the overall number of providers who were implementing telehealth (191/235, 81% to 204/235, 87%, P=.01) and there was a significant decline in canceled or rescheduled appointments (25%-50% in 2020 to 3%-7% in 2021, P<.001). Psychologists and providers working at AMCs reported decreased difficulty with telehealth implementation (P<.001), and providers working at AMCs and in private practice settings indicated they were more likely to continue telehealth services beyond spring 2021 (P<.001). The percent of time working remotely decreased overall (78% to 59%, P<.001), which was most notable among neuropsychologists and providers working at an AMC. There was an overall increase in the average number of patients seen in person per week compared with earlier in the pandemic (mean 4.3 to 8.7, P<.001), with no change in the number of patients seen via telehealth (mean 9.7 to 9.9, P=.66). CONCLUSIONS These results show that the rapid transition to telemental health at the onset of the COVID-19 pandemic in spring 2020 was sustained over the next year, despite an overall increase in the number of patients seen in person. Although more providers reported returning to working on-site, over 50% of providers continued to use a hybrid model, and many providers reported they would be more likely to continue telemental health beyond spring 2021. This suggests the continued importance and reliance on telemental health services beyond the acute pandemic phase and has implications for future policies regulating the availability of telemental health services to patients.
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Affiliation(s)
- Milena Gotra
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
| | | | - Nicholas Jasinski
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
| | - David Scarisbrick
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
| | - Shannon Reilly
- Department of Neurology, University of Virginia Health, Charlottesville, VA, United States
| | - Jonathan Perle
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
| | - Liv Miller
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
| | - James Mahoney Iii
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
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Molnár L, Zana Á, Stauder A. Stress and burnout in the context of workplace psychosocial factors among mental health professionals during the later waves of the COVID-19 pandemic in Hungary. Front Psychiatry 2024; 15:1354612. [PMID: 38600983 PMCID: PMC11004466 DOI: 10.3389/fpsyt.2024.1354612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Background While literature is abundant on the negative mental health impact of the COVID-19 outbreak, few studies focus on the Central and Eastern European region. Objectives We examined stress, burnout, and sleeping troubles among mental health professionals in the context of psychosocial risk factors related to participation in COVID care during the fourth and fifth waves. Materials and methods Mental health professionals (N=268) completed an online cross-sectional survey in Hungary, between November 2021 and April 2022. Of the respondents, 58.2% directly participated in COVID care. The main data collection instrument was the Copenhagen Psychosocial Questionnaire (COPSOQ II), including 20 subscales on work-related psychosocial factors and 3 outcome scales (stress, burnout, and sleeping troubles). We added a question on competence transgression, and items on sociodemographic and professional background. Results Participation in COVID care was associated with higher work pace (59.08 versus 49.78), more role conflicts (55.21 versus 45.93), lower scores on the influence at work (38.18 versus 51.79), predictability (44.71 versus 57.03), reward (55.82 versus 65.03), role clarity (70.19 versus 75.37), social support from supervisor (59.24 versus 65.55), job satisfaction (54.36 versus 62.84), trust regarding management (55.89 versus 67.86), justice and respect (44.51 versus 54.35) scales. Among those involved in COVID care, only the stress score was higher (47.96 vs. 42.35) in the total sample; however, among psychiatrists, both stress (52.16 vs. 38.60) and burnout scores (58.30 vs. 47.06) were higher. Stepwise multiple regression revealed that work-family conflict, emotional demands and workplace commitment were independent predictors of higher stress and burnout scores; furthermore, competence transgression had a significant effect on stress, and being a psychiatric specialist had a significant effect on burnout. These models explained 40.5% of the variance for stress and 39.8% for burnout. Conclusion During the fourth and fifth waves, although COVID care was more well-organized, psychiatrists, as specialist physicians responsible for the quality of the care, were still experiencing challenges regarding their competence and influence at work, which may explain their increased levels of stress and burnout.
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Affiliation(s)
- László Molnár
- Doctoral School of Semmelweis University Budapest, Budapest, Hungary
| | - Ágnes Zana
- Institute of Behavioural Sciences, Semmelweis University Budapest, Budapest, Hungary
| | - Adrienne Stauder
- Institute of Behavioural Sciences, Semmelweis University Budapest, Budapest, Hungary
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Qin Z, He Z, Yang Q, Meng Z, Lei Q, Wen J, Shi X, Liu J, Wang Z. Prevalence and correlators of burnout among health professionals during different stages of the COVID-19 pandemic in China. Front Psychiatry 2023; 14:1156313. [PMID: 37181868 PMCID: PMC10169669 DOI: 10.3389/fpsyt.2023.1156313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/24/2023] [Indexed: 05/16/2023] Open
Abstract
Background Persistently increased workload and stress occurred in health professionals (HPs) during the past 3 years as the COVID-19 pandemic continued. The current study seeks to explore the prevalence of and correlators of HPs' burnout during different stages of the pandemic. Methods Three repeated online studies were conducted in different stages of the COVID-19 pandemic: wave 1: after the first peak of the pandemic, wave 2: the early period of the zero-COVID policy, and wave 3: the second peak of the pandemic in China. Two dimensions of burnout, emotional exhaustion (EE) and declined personal accomplishment (DPA), were assessed using Human Services Survey for Medical Personnel (MBI-HSMP), a 9-item Patient Health Questionnaire (PHQ-9), and a 7-item Generalized Anxiety Disorder (GAD-7) to assess mental health conditions. An unconditional logistic regression model was employed to discern the correlators. Results There was an overall prevalence of depression (34.9%), anxiety (22.5%), EE (44.6%), and DPA (36.5%) in the participants; the highest prevalence of EE and DPA was discovered in the first wave (47.4% and 36.5%, respectively), then the second wave (44.9% and 34.0%), and the third wave had the lowest prevalence of 42.3% and 32.2%. Depressive symptoms and anxiety were persistently correlated with a higher prevalence risk of both EE and DPA. Workplace violence led to a higher prevalence risk of EE (wave 1: OR = 1.37, 95% CI: 1.16-1.63), and women (wave 1: OR = 1.19, 95% CI: 1.00-1.42; wave 3: OR =1.20, 95% CI:1.01-1.44) and those living in a central area (wave 2: OR = 1.66, 95% CI: 1.20-2.31) or west area (wave 2: OR = 1.54, 95% CI: 1.26-1.87) also had a higher prevalence risk of EE. In contrast, those over 50 years of age (wave 1: OR = 0.61, 95% CI: 0.39-0.96; wave 3: OR = 0.60, 95% CI: 0.38-0.95) and who provided care to patients with COVID-19 (wave 2: OR = 0.73, 95% CI: 0.57-0.92) had a lower risk of EE. Working in the psychiatry section (wave 1: OR = 1.38, 95% CI: 1.01-1.89) and being minorities (wave 2: OR = 1.28, 95% CI: 1.04-1.58) had a higher risk of DPA, while those over 50 years of age had a lower risk of DPA (wave 3: OR = 0.56, 95% CI: 0.36-0.88). Conclusion This three-wave cross-sectional study revealed that the prevalence of burnout among health professionals was at a high level persistently during the different stages of the pandemic. The results suggest that functional impairment prevention resources and programs may be inadequate and, as such, continuous monitoring of these variables could provide evidence for developing optimal strategies for saving human resources in the coming post-pandemic era.
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Affiliation(s)
- Zhengshan Qin
- Department of Preventive Medicine, School of Public Health at Zunyi Medical University, Zunyi, China
| | - Zhehao He
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan, China
| | - Qinglin Yang
- Department of Preventive Medicine, School of Public Health at Zunyi Medical University, Zunyi, China
| | - Zeyu Meng
- Department of Preventive Medicine, School of Public Health at Zunyi Medical University, Zunyi, China
| | - Qiuhui Lei
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan, China
| | - Jing Wen
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Xiuquan Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jun Liu
- Department of Preventive Medicine, School of Public Health at Zunyi Medical University, Zunyi, China
| | - Zhizhong Wang
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan, China
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China
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Crocker KM, Gnatt I, Haywood D, Butterfield I, Bhat R, Lalitha ARN, Jenkins ZM, Castle DJ. The impact of COVID-19 on the mental health workforce: A rapid review. Int J Ment Health Nurs 2023; 32:420-445. [PMID: 36461629 PMCID: PMC9878253 DOI: 10.1111/inm.13097] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 12/04/2022]
Abstract
The COVID-19 pandemic led to significant adaptations to healthcare. Provision of mental healthcare in a changing environment presented healthcare workers with unique challenges and demands, including changes in workload and expectations. To inform current and future healthcare service responses, and adaptations, the current review aimed to collate and examine the impact of the pandemic on mental healthcare workers (MHWs). We conducted a rapid systematic review to examine the overall impact of the COVID-19 pandemic on MHWs. Searches were conducted in Ovid Medline and PsycInfo and restricted to articles published from 2020. Inclusion criteria specified articles written in English, published in peer-reviewed journals, and that examined any outcome of the impact of COVID-19 on MHWs; 55 articles fulfilled these criteria. Outcomes were categorized into 'work-related outcomes' and 'personal outcomes'. Mental healthcare workers worldwide experienced a range of work-related and personal adversities during the pandemic. Key work-related outcomes included increased workload, changed roles, burnout, decreased job satisfaction, telehealth challenges, difficulties with work-life balance, altered job performance, vicarious trauma and increased workplace violence. Personal outcomes included decreased well-being, increased psychological distress and psychosocial difficulties. These outcomes differed between inpatient, outpatient and remote settings. The COVID-19 pandemic significantly altered the delivery of mental healthcare and MHWs experienced both work-related and personal adversities during the COVID-19 pandemic. With the continuation of changes introduced to healthcare in the initial stages of the pandemic, it will be important to maintain efforts to monitor negative outcomes and ensure supports for MHWs, going forward.
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Affiliation(s)
- Kaitlyn M Crocker
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Inge Gnatt
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia.,Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Darren Haywood
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia.,School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Ingrid Butterfield
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Ravi Bhat
- Department of Rural Health, University of Melbourne, Shepparton, Victoria, Australia
| | | | - Zoe M Jenkins
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - David J Castle
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Stefanatou P, Xenaki LA, Karagiorgas I, Ntigrintaki AA, Giannouli E, Malogiannis IA, Konstantakopoulos G. Fear of COVID-19 Impact on Professional Quality of Life among Mental Health Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9949. [PMID: 36011583 PMCID: PMC9408175 DOI: 10.3390/ijerph19169949] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
UNLABELLED Several studies have examined the impact of the COVID-19 pandemic on healthcare workers' mental health, but only a few have investigated its detrimental effect on the mental well-being of mental health workers (MHWs). BACKGROUND The current study aimed to explore the effect of the fear of COVID-19 (FCV-19) on professional quality of life dimensions, namely compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) in MHWs above and beyond sociodemographic and professional factors. METHODS Hierarchical linear regression models were employed to examine the relationship of extreme FCV-19 with CS, BO, and STS in MHWs (n = 224), after considering sociodemographic variables as potential confounding factors. Extreme FCV-19 was operationalized as a binary variable with a cut-off score of ≥16.5 considered as extreme fear. RESULTS We found that extreme FCV-19 in MHWs is linked with increased compassion fatigue (BO and STS), and this relationship is exacerbated by younger age in regard to BO and by female gender concerning STS. CS remains unaffected by severe FCV-19, and it is higher in older participants. CONCLUSION Organizational support is required to protect MHWs' mental well-being and ensure the quality of care they provide during prolonged crises, such as the COVID-19 pandemic. Measures that intensify a sense of safety, protection, and control against COVID-19 infections in mental health services should be included in the recommendations that may reduce BO and STS among MHWs.
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