1
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Appelbom S, Nordström A, Finnes A, Wicksell RK, Bujacz A. Healthcare worker burnout during a persistent crisis: a case-control study. Occup Med (Lond) 2024; 74:297-303. [PMID: 38738440 PMCID: PMC11165371 DOI: 10.1093/occmed/kqae032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND During the immediate outbreak of the COVID-19 pandemic, burnout symptoms increased among healthcare workers. Knowledge is needed on how early symptoms developed during the persistent crisis that followed the first pandemic wave. AIMS To investigate if high levels of burnout symptoms during the first pandemic wave led to high burnout and depressive symptoms up to a year later, and if participation in psychological support was related to lower levels of symptoms. METHODS A longitudinal case-control study followed 581 healthcare workers from two Swedish hospitals. Survey data were collected with a baseline in May 2020 and three follow-up assessments until September 2021. The case group was participants reporting high burnout symptoms at baseline. Logistic regression analyses were performed separately at three follow-ups with case-control group assignment as the main predictor and burnout and depression symptoms as outcomes, controlling for frontline work, changes in work tasks and psychological support participation. RESULTS One out of five healthcare workers reported high burnout symptoms at baseline. The case group was more likely to have high burnout and depressive symptoms at all follow-ups. Participation in psychological support was unrelated to decreased burnout and depressive symptoms at any of the follow-ups. CONCLUSIONS During a persistent crisis, healthcare organizations should be mindful of psychological reactions among staff and who they place in frontline work early in the crisis. To better prepare for future healthcare crises, preventive measures on burnout are needed, both at workplaces and as part of the curricula in medical and nursing education.
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Affiliation(s)
- S Appelbom
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - A Nordström
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - A Finnes
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - R K Wicksell
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Pain Clinic, Capio St Göran Hospital, Stockholm, Sweden
| | - A Bujacz
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Briles B, Kahl A, Anaissie J, Brettmann L, Pathak U, Staggers KA, Popat S, Agrawal A, Rose S, Taylor J. Levels and drivers of burnout during the COVID-19 pandemic among a diverse group of resident physicians. Postgrad Med 2024; 136:44-51. [PMID: 38193442 DOI: 10.1080/00325481.2024.2303974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 01/04/2024] [Indexed: 01/10/2024]
Abstract
OBJECTIVES Evidence has shown significant impacts of the COVID-19 pandemic on physicians. We hypothesized that these effects would impact surgical and non-surgical resident education differently, with non-surgical specialties being more heavily impacted by frontline work and surgical specialties losing elective cases. METHODS We examined well-being and burnout among resident physicians in surgical and non-surgical specialties during the peak of the COVID-19 pandemic using the Mayo Physician Well-Being Index (WBI). RESULTS Completed surveys were received from 110 residents, 55% of whom were in a surgical training program. 35% of respondents were identified as 'at risk' for burnout. Increased demands from work (adj. OR 3.79, 95% CI 1.50, 9.59, p = 0.005) was associated with an increased likelihood for being 'at risk' compared to those without increased demands. Odds of having increased stress level were higher amongst residents with fear/anxiety of the unknown (adj. OR 4.21, 95% CI 1.63, 10.90, p = 0.003) and more demands outside work (adj. OR 10.54, 95% CI 2.63, 42.16, p = 0.001) but lower amongst residents with more time for studying (OR 0.23, 95% CI 0.09, 0.64, p = 0.005). Risk for burnout was not significantly different between surgical and non-surgical specialties when adjusting for increased demands from work (adj. OR 1.43, 95% CI 0.60, 3.37, p = 0.0.418). CONCLUSION Perceived effects of the COVID-19 pandemic upon residents' educational experience was mixed: reduced clinical volume had a negative impact, while increased time for study was perceived favorably. These findings suggest potential strategies and targets to mitigate the stress and burnout of a future crisis, whether large or small, among surgical and non-surgical trainees.
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Affiliation(s)
- Brenna Briles
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Alyssa Kahl
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - James Anaissie
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Lindsay Brettmann
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Ujval Pathak
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | - Shreeya Popat
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Anoop Agrawal
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Stacey Rose
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Jennifer Taylor
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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Sekulovski M, Mileva N, Chervenkov L, Peshevska-Sekulovska M, Vasilev GV, Vasilev GH, Miteva D, Tomov L, Lazova S, Gulinac M, Velikova T. Endothelial Dysfunction and Pregnant COVID-19 Patients with Thrombophilia: A Narrative Review. Biomedicines 2023; 11:2458. [PMID: 37760899 PMCID: PMC10525846 DOI: 10.3390/biomedicines11092458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/22/2023] [Accepted: 09/02/2023] [Indexed: 09/29/2023] Open
Abstract
Pregnancy with SARS-CoV-2 infection can raise the risk of many complications, including severe COVID-19 and maternal-fetal adverse outcomes. Additionally, endothelial damage occurs as a result of direct SARS-CoV-2 infection, as well as immune system, cardiovascular, and thrombo-inflammatory reactions. In this narrative review, we focus on endothelial dysfunction (ED) in pregnancy, associated with obstetric complications, such as preeclampsia, fetal growth retardation, gestational diabetes, etc., and SARS-CoV-2 infection in pregnant women that can cause ED itself and overlap with other pregnancy complications. We also discuss some shared mechanisms of SARS-CoV-2 pathophysiology and ED.
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Affiliation(s)
- Metodija Sekulovski
- Department of Anesthesiology and Intensive Care, University Hospital Lozenetz, 1 Kozyak Str., 1407 Sofia, Bulgaria
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
| | - Niya Mileva
- Medical Faculty, Medical University of Sofia, 1 Georgi Sofiiski Str., 1431 Sofia, Bulgaria;
| | - Lyubomir Chervenkov
- Department of Diagnostic Imaging, Medical University Plovdiv, Bul. Vasil Aprilov 15A, 4000 Plovdiv, Bulgaria;
| | - Monika Peshevska-Sekulovska
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Department of Gastroenterology, University Hospital Lozenetz, 1407 Sofia, Bulgaria
| | - Georgi Vasilev Vasilev
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Clinic of Endocrinology and Metabolic Disorders, UMHAT “Sv. Georgi”, 4000 Plovdiv, Bulgaria
| | - Georgi Hristov Vasilev
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Laboratory of Hematopathology and Immunology, National Specialized Hospital for Active Treatment of Hematological Diseases, “Plovdivsko Pole“ Str., 6, 1756 Sofia, Bulgaria
| | - Dimitrina Miteva
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Department of Genetics, Faculty of Biology, Sofia University “St. Kliment Ohridski”, 8 Dragan Tzankov Str., 1164 Sofia, Bulgaria
| | - Latchezar Tomov
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Department of Informatics, New Bulgarian University, Montevideo 21 Str., 1618 Sofia, Bulgaria
| | - Snezhina Lazova
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Pediatric Clinic, University Hospital “N. I. Pirogov,” 21 “General Eduard I. Totleben” Blvd; 1606 Sofia, Bulgaria
- Department of Healthcare, Faculty of Public Health “Prof. Tsekomir Vodenicharov, MD, DSc”, Medical University of Sofia, Bialo More 8 Str., 1527 Sofia, Bulgaria
| | - Milena Gulinac
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Department of General and Clinical Pathology, Medical University of Plovdiv, Bul. Vasil Aprilov 15A, 4000 Plovdiv, Bulgaria
| | - Tsvetelina Velikova
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
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Maunder RG, Rosen B, Heeney ND, Jeffs LP, Merkley J, Wilkinson K, Hunter JJ, Johnstone J, Greenberg RA, Wiesenfeld LA. Relationship between three aspects of resilience-adaptive characteristics, withstanding stress, and bouncing back-in hospital workers exposed to prolonged occupational stress during the COVID-19 pandemic: a longitudinal study. BMC Health Serv Res 2023; 23:703. [PMID: 37380994 DOI: 10.1186/s12913-023-09731-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 06/21/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND The term resilience is used to refer to multiple related phenomena, including: (i) characteristics that promote adaptation to stressful circumstances, (ii) withstanding stress, and (iii) bouncing back quickly. There is little evidence to understand how these components of resilience are related to one another. Skills-based adaptive characteristics that can respond to training (as opposed to personality traits) have been proposed to include living authentically, finding work that aligns with purpose and values, maintaining perspective in the face of adversity, managing stress, interacting cooperatively, staying healthy, and building supportive networks. While these characteristics can be measured at a single time-point, observing responses to stress (withstanding and bouncing back) require multiple, longitudinal observations. This study's aim is to determine the relationship between these three aspects of resilience in hospital workers during the prolonged, severe stress of the COVID-19 pandemic. METHODS We conducted a longitudinal survey of a cohort of 538 hospital workers at seven time-points between the fall of 2020 and the spring of 2022. The survey included a baseline measurement of skills-based adaptive characteristics and repeated measures of adverse outcomes (burnout, psychological distress, and posttraumatic symptoms). Mixed effects linear regression assessed the relationship between baseline adaptive characteristics and the subsequent course of adverse outcomes. RESULTS The results showed significant main effects of adaptive characteristics and of time on each adverse outcome (all p < .001). The size of the effect of adaptive characteristics on outcomes was clinically significant. There was no significant relationship between adaptive characteristics and the rate of change of adverse outcomes over time (i.e., no contribution of these characteristics to bouncing back). CONCLUSIONS We conclude that training aimed at improving adaptive skills may help individuals to withstand prolonged, extreme occupational stress. However, the speed of recovery from the effects of stress depends on other factors, which may be organizational or environmental.
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Affiliation(s)
- Robert G Maunder
- Sinai Health, 600 University Ave., Toronto, M5G 1X5, Canada.
- Department of Psychiatry, University of Toronto, Toronto, Canada.
| | - Benjamin Rosen
- Sinai Health, 600 University Ave., Toronto, M5G 1X5, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | - Lianne P Jeffs
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
| | - Jane Merkley
- Sinai Health, 600 University Ave., Toronto, M5G 1X5, Canada
| | - Kate Wilkinson
- Sinai Health, 600 University Ave., Toronto, M5G 1X5, Canada
| | - Jonathan J Hunter
- Sinai Health, 600 University Ave., Toronto, M5G 1X5, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Jennie Johnstone
- Sinai Health, 600 University Ave., Toronto, M5G 1X5, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | | | - Lesley A Wiesenfeld
- Sinai Health, 600 University Ave., Toronto, M5G 1X5, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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5
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Costin A, Roman AF, Balica RS. Remote work burnout, professional job stress, and employee emotional exhaustion during the COVID-19 pandemic. Front Psychol 2023; 14:1193854. [PMID: 37325768 PMCID: PMC10267312 DOI: 10.3389/fpsyg.2023.1193854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 05/09/2023] [Indexed: 06/17/2023] Open
Abstract
Many studies have investigated how organizational support systems, remote work adaptation, and control over scheduling reduced psychological burnout and occupational stress, thus improving employee wellbeing during the COVID-19 pandemic. This systematic literature review has analyzed significant published peer-reviewed evidence concerning how remote employees lacking constant organizational support during the COVID-19 outbreak experienced escalated job demands, professional strain, low satisfaction and performance, and increased burnout. Throughout February 2023, a quantitative literature review covering scholarly databases such as the Web of Science, Scopus, and ProQuest was performed, with the following search terms: "COVID-19" + "remote work burnout," "COVID-19" + "professional job stress," and "COVID-19" + "employee emotional exhaustion." By inspecting research published between 2020 and 2022, a total of 311 articles satisfied the eligibility criteria. Excluding sources in PRISMA terms, 44 empirical sources were finally selected. Methodological quality assessment tools such as Assessing the Methodological Quality of Systematic Reviews (AMSTAR), Appraisal tool for Cross-Sectional Studies (AXIS), Mixed Methods Appraisal Tool (MMAT), and Systematic Review Data Repository (SRDR) were employed. Data visualization tools (VOSviewer and Dimensions), integrating layout algorithms and bibliometric mapping, were harnessed. The scope of this study does not include how taking breaks and time management in a psychologically safe environment prevented remote work burnout and increased productivity during the COVID-19 pandemic. Subsequent analyses should be developed on how remote work time and stress management-by using burnout assessment tools-will result in coherent workplace behaviors and processes, meeting organizational expectations and reducing emotional stress and workplace pressure.
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Affiliation(s)
- Alina Costin
- Center of Research Development and Innovation in Psychology, Faculty of Educational Sciences Psychology and Social Work, Aurel Vlaicu University of Arad, Arad, Romania
| | - Alina Felicia Roman
- Center of Research Development and Innovation in Psychology, Faculty of Educational Sciences Psychology and Social Work, Aurel Vlaicu University of Arad, Arad, Romania
| | - Raluca-Stefania Balica
- Department of Education and Communication Sciences, University of Craiova, Craiova, Romania
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6
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DiMaggio C, Susser E, Frangos S, Abramson D, Andrews H, Hoven C, Ryan M, Li G. The New York State COVID-19 Healthcare Personnel Study: One-Year Follow-up of Physicians, Nurse Practitioners, and Physician Assistants, 2020-2021. Public Health Rep 2023:333549231155473. [PMID: 36905312 PMCID: PMC10009497 DOI: 10.1177/00333549231155473] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
OBJECTIVES The COVID-19 Healthcare Personnel Study is a longitudinal survey to assess the changing impact of the COVID-19 pandemic on the New York State health care workforce. We analyzed results from a follow-up survey of physicians, nurse practitioners, and physician assistants on the availability of equipment and personnel, work conditions, physical and mental health of participants, and impact of the pandemic on commitment to their profession. METHODS We conducted an online survey of all licensed New York State physicians, nurse practitioners, and physician assistants in April 2020 (N = 2105) and a follow-up survey in February 2021 (N = 978). We analyzed changes in item responses from baseline to follow-up. We calculated survey-adjusted paired t tests and odds ratios (ORs) using survey-adjusted generalized linear models controlling for age, sex, region of practice, and hospital versus non-hospital-based practice. RESULTS Twenty percent of respondents expressed continuing concern about personnel shortages at both baseline and follow-up. Respondents reported working approximately 5 more hours on average during a 2-week period at follow-up compared with baseline (78.1 vs 72.6 hours; P = .008). For 20.4% (95% CI, 17.2%-23.5%) of respondents, mental health issues had become persistent. More than one-third (35.6%; 95% CI, 31.9%-39.4%) of respondents reported that they thought about leaving their profession more often than once per month. The association between persistent mental and behavioral health issues and contemplating leaving one's profession was significant (OR = 2.7; 95% CI, 1.8-4.1; P < .001). CONCLUSIONS Interventions such as decreasing the number of hours worked, ensuring health care professionals do not work directly with patients while ill, and addressing shortages of personal protective equipment can help address concerns of the health care workforce.
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Affiliation(s)
- Charles DiMaggio
- Department of Surgery, Grossman School of Medicine, New York University, New York, NY, USA
| | - Ezra Susser
- Mailman School of Public Health, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Spiros Frangos
- Department of Surgery, Grossman School of Medicine, New York University, New York, NY, USA
| | - David Abramson
- School of Global Public Health, New York University, New York, NY, USA
| | - Howard Andrews
- Data Coordinating Center (DCC), Irving Medical Center, Columbia University, New York, NY, USA
| | - Christina Hoven
- Mailman School of Public Health, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Megan Ryan
- Mailman School of Public Health, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Guohua Li
- Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
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7
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Dinapoli L, Ferrarese D, Belella D, Carnevale S, Camardese G, Sani G, Chieffo DPR. Psychological treatment of traumatic memories in COVID-19 survivors. Clin Psychol Psychother 2023; 30:225-233. [PMID: 35916065 DOI: 10.1002/cpp.2771] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/31/2022] [Accepted: 07/24/2022] [Indexed: 02/03/2023]
Abstract
The COVID-19 pandemic, which has affected a significant number of individuals worldwide, is generating serious mental health issues. Recovered COVID-19 patients have experienced traumatic events related to their symptoms, isolation, possible hospitalization, bereavement, fear of infecting loved ones and the physical consequences of COVID-19. One effective psychological treatment for these patients is Eye Movement Desensitization and Reprocessing (EMDR). The aim of this paper is to describe the therapeutic intervention and effects of EMDR in a pool of COVID-19 survivors referred to an integrated psychological/psychiatric outpatient service. Twelve patients, comprising of nine males and three females, underwent EMDR psychotherapy from October 2020 to February 2022. Each patient received 8-16 weekly treatment sessions. The standard EMDR protocol of eight stages was administered to enable desensitization and reprocessing of four main targets: first positive swab, hospitalization, isolation and fear for relatives' health. Efficacy of EMDR was demonstrated by the significant improvement at clinical scale for subjective distress caused by traumatic events. For the therapists, carrying out these treatments was an intense and challenging experience. In fact, the perceived distance between therapist and patient was less defined than in other hospital settings because the pandemic affects everyone equally. However, with the widespread availability of vaccines and although the pandemic is still ongoing with the emergence of new variants, a window of improvement in the mental health landscape is starting to open up.
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Affiliation(s)
- Loredana Dinapoli
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Daniele Ferrarese
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,UOC di Medicina Interna e Gastroenterologia, Area di Gastroenterologia e Oncologia Medica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Daniela Belella
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,UOC di Medicina Interna e Gastroenterologia, Area di Gastroenterologia e Oncologia Medica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Stefania Carnevale
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Centro Integrato di Senologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Giovanni Camardese
- UOC Psichiatria Clinica e d'urgenza, Dipartimento di Scienze dell'invecchiamento, neurologiche, ortopediche e della testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Gabriele Sani
- UOC Psichiatria Clinica e d'urgenza, Dipartimento di Scienze dell'invecchiamento, neurologiche, ortopediche e della testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Daniela Pia Rosaria Chieffo
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Istituto di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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8
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Cyr S, Marcil MJ, Houchi C, Marin MF, Rosa C, Tardif JC, Guay S, Guertin MC, Genest C, Forest J, Lavoie P, Labrosse M, Vadeboncoeur A, Selcer S, Ducharme S, Brouillette J. Evolution of burnout and psychological distress in healthcare workers during the COVID-19 pandemic: a 1-year observational study. BMC Psychiatry 2022; 22:809. [PMID: 36539718 PMCID: PMC9763813 DOI: 10.1186/s12888-022-04457-2] [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: 02/07/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Long-term psychological impacts of the COVID-19 pandemic on healthcare workers remain unknown. We aimed to determine the one-year progression of burnout and mental health since pandemic onset, and verify if protective factors against psychological distress at the beginning of the COVID-19 pandemic (Cyr et al. in Front Psychiatry; 2021) remained associated when assessed several months later. METHODS We used validated questionnaires (Maslach Burnout Inventory, Hospital Anxiety and Depression and posttraumatic stress disorder [PTSD] Checklist for DSM-5 scales) to assess burnout and psychological distress in 410 healthcare workers from Quebec, Canada, at three and 12 months after pandemic onset. We then performed multivariable regression analyses to identify protective factors of burnout and mental health at 12 months. As the equivalent regression analyses at three months post-pandemic onset had already been conducted in the previous paper, we could compare the protective factors at both time points. RESULTS Prevalence of burnout and anxiety were similar at three and 12 months (52% vs. 51%, p = 0.66; 23% vs. 23%, p = 0.91), while PTSD (23% vs. 11%, p < 0.0001) and depression (11% vs. 6%, p = 0.001) decreased significantly over time. Higher resilience was associated with a lower probability of all outcomes at both time points. Perceived organizational support remained significantly associated with a reduced risk of burnout at 12 months. Social support emerged as a protective factor against burnout at 12 months and persisted over time for studied PTSD, anxiety, and depression. CONCLUSIONS Healthcare workers' occupational and mental health stabilized or improved between three and 12 months after the pandemic onset. The predominant protective factors against burnout remained resilience and perceived organizational support. For PTSD, anxiety and depression, resilience and social support were important factors over time.
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Affiliation(s)
- Samuel Cyr
- grid.482476.b0000 0000 8995 9090Research Centre, Montreal Heart Institute, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada ,grid.14848.310000 0001 2292 3357Faculty of Pharmacy, Université de Montréal, P.O. Box 6128, Downtown Branch, Montreal, Québec, H3C 3J7 Canada
| | - Marie-Joelle Marcil
- grid.482476.b0000 0000 8995 9090Research Centre, Montreal Heart Institute, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada ,grid.14848.310000 0001 2292 3357Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, Québec, H3C 3J7 Canada
| | - Cylia Houchi
- grid.482476.b0000 0000 8995 9090Research Centre, Montreal Heart Institute, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada ,grid.14848.310000 0001 2292 3357Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, Québec, H3C 3J7 Canada
| | - Marie-France Marin
- grid.14848.310000 0001 2292 3357Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, Québec, H3C 3J7 Canada ,grid.38678.320000 0001 2181 0211Department of Psychology, UQAM, 100 Sherbrooke Street West, Montréal, Québec, H2X 3P2 Canada ,grid.414210.20000 0001 2321 7657Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montreal, Québec, H1N 3V2 Canada
| | - Camille Rosa
- Montreal Health Innovations Coordinating Centre, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada
| | - Jean-Claude Tardif
- grid.482476.b0000 0000 8995 9090Research Centre, Montreal Heart Institute, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada ,grid.14848.310000 0001 2292 3357Faculty of Medicine, Université de Montréal, P.O. Box 6128, Downtown Branch, Montreal, Québec, H3C 3J7 Canada
| | - Stéphane Guay
- grid.14848.310000 0001 2292 3357Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, Québec, H3C 3J7 Canada ,grid.414210.20000 0001 2321 7657Centre d’étude sur le Trauma, Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montreal, Québec, H1N 3V2 Canada
| | - Marie-Claude Guertin
- Montreal Health Innovations Coordinating Centre, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada
| | - Christine Genest
- grid.414210.20000 0001 2321 7657Centre d’étude sur le Trauma, Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montreal, Québec, H1N 3V2 Canada ,grid.14848.310000 0001 2292 3357Faculty of Nursing, Université de Montréal, Marguerite-d’Youville Pavilion, P.O. Box 6128, Downtown Branch, Montreal, Québec, H3C 3J7 Canada
| | - Jacques Forest
- Department of Organization and Human Resources, ESG UQAM, P.O. Box 8888, Downtown Branch, Montreal, Québec, H3C 3P8 Canada
| | - Patrick Lavoie
- grid.482476.b0000 0000 8995 9090Research Centre, Montreal Heart Institute, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada ,grid.14848.310000 0001 2292 3357Faculty of Nursing, Université de Montréal, Marguerite-d’Youville Pavilion, P.O. Box 6128, Downtown Branch, Montreal, Québec, H3C 3J7 Canada
| | - Mélanie Labrosse
- grid.14848.310000 0001 2292 3357Faculty of Medicine, Université de Montréal, P.O. Box 6128, Downtown Branch, Montreal, Québec, H3C 3J7 Canada ,grid.411418.90000 0001 2173 6322Department of Pediatrics, Division of Emergency Medicine, Centre Hospitalier Universitaire Sainte-Justine, 3175 Côte-Sainte-Catherine Road, Montreal, Québec, H3T 1C5 Canada
| | - Alain Vadeboncoeur
- grid.482476.b0000 0000 8995 9090Research Centre, Montreal Heart Institute, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada ,grid.14848.310000 0001 2292 3357Faculty of Medicine, Université de Montréal, P.O. Box 6128, Downtown Branch, Montreal, Québec, H3C 3J7 Canada
| | - Shaun Selcer
- grid.482476.b0000 0000 8995 9090Research Centre, Montreal Heart Institute, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada ,grid.14848.310000 0001 2292 3357Faculty of Medicine, Université de Montréal, P.O. Box 6128, Downtown Branch, Montreal, Québec, H3C 3J7 Canada
| | - Simon Ducharme
- grid.412078.80000 0001 2353 5268Department of Psychiatry, Douglas Mental Health University Institute, McGill University, 6875 LaSalle Boulevard, Verdun, Québec, H4H 1R3 Canada ,grid.416102.00000 0004 0646 3639McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University St, Montreal, Québec, H3A 2B4 Canada
| | - Judith Brouillette
- Research Centre, Montreal Heart Institute, 5000 Belanger street, Montreal, Québec, H1T 1C8, Canada. .,Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, Québec, H3C 3J7, Canada.
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9
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Nishimura Y, Miyoshi T, Hagiya H, Otsuka F. Prevalence of psychological distress on public health officials amid COVID-19 pandemic. Asian J Psychiatr 2022; 73:103160. [PMID: 35594688 PMCID: PMC9098654 DOI: 10.1016/j.ajp.2022.103160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES While the coronavirus disease 2019 (COVID-19) pandemic has led to increased burnout among frontline healthcare workers (HCWs), little research has been done regarding the potential psychological burden among public health officials who have worked tirelessly to tackle the pandemic from an administrative perspective. This study aimed to determine the prevalence of burnout, depression, and job-related stress in Japanese public health officers amid the COVID-19 pandemic. METHODS We conducted an anonymous, self-administered web-based cross-sectional survey including basic demographics, work-related questions, the Maslach Burnout Inventory, Patient Health Questionnaire-9, Utrecht Work Engagement Scale-3, and Brief Job Stress Questionnaire. 100 public health officers working in the public health centers (PHCs) in Okayama, Japan, answered the survey in December 2021 when the 5th surge in the number of COVID-19 was over. RESULTS The prevalence of burnout, depression, and job-related stress was 27%, 43%, and 62%, respectively. The multivariate logistic analysis demonstrated that females, public health nurses, and those who suffered from a lack of support from their workplaces were significantly associated with psychological distress. CONCLUSIONS While we tend to focus on mitigation plans to help alleviate burnout of frontline HCWs, more focus is needed to help public health officers, and public health nurses, in particular, to alleviate their psychological distress and job-related stress to prevent further staff shortages and secure sustainable health systems.
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Affiliation(s)
- Yoshito Nishimura
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan; Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI 96813, USA.
| | - Tomoko Miyoshi
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan
| | - Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan
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10
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Maunder RG, Heeney ND, Hunter JJ, Strudwick G, Jeffs LP, Ginty L, Johnstone J, Kiss A, Loftus CA, Wiesenfeld LA. Trends in burnout and psychological distress in hospital staff over 12 months of the COVID-19 pandemic: a prospective longitudinal survey. J Occup Med Toxicol 2022; 17:11. [PMID: 35614505 PMCID: PMC9132565 DOI: 10.1186/s12995-022-00352-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The mental health effects of healthcare work during the COVID-19 pandemic have been substantial, but it is not known how long they will persist. This study aimed to determine if hospital workers' burnout and psychological distress increased monotonically over 1 year, during which waves of case numbers and hospitalizations waxed and waned, or followed some other pattern. METHODS A prospective longitudinal survey was conducted at four time-points over 1 year in a cohort of 538 hospital workers and learners, which included validated measures of burnout (emotional exhaustion scale of Maslach Burnout Inventory) and psychological distress (K6). Repeated measures ANOVA tested changes over time and differences between subjects by occupational role, age and ethnic group. The direction and magnitude of changes over time were investigated by plotting rates of high scores (using cut-offs) at each time-point compared to case rates of COVID-19 in the city in which the study took place. RESULTS There were significant effects of occupational role (F = 11.2, p < .001) and age (F = 12.8, p < .001) on emotional exhaustion. The rate of high burnout was highest in nurses, followed by other healthcare professionals, other clinical staff, and lowest in non-clinical staff. Peak rates of high burnout occurred at the second or third measurement point for each occupational group, with lower rates at the fourth measurement point. Similarly to the results for emotional exhaustion, rates of high psychological distress peaked at the spring 2021 measurement point for most occupational groups and were higher in nurses than in other healthcare professionals. CONCLUSIONS Neither emotional exhaustion nor psychological distress was rising monotonically. Burnout and psychological distress were consistently related to occupational role and were highest in nurses. Although emotional exhaustion improved as the case rate of COVID-19 decreased, rates of high emotional exhaustion in nurses and other healthcare professionals remained higher than was typically measured in hospital-based healthcare workers prior to the pandemic. Ongoing monitoring of healthcare workers' mental health is warranted. Organizational and individual interventions to support healthcare workers continue to be important.
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Affiliation(s)
- Robert G Maunder
- Sinai Health, Room 915, 600 University Ave, Toronto, Ontario, M5G 1X5, Canada. .,Department of Psychiatry, University of Toronto, Toronto, Canada.
| | - Natalie D Heeney
- Sinai Health, Room 915, 600 University Ave, Toronto, Ontario, M5G 1X5, Canada
| | - Jonathan J Hunter
- Sinai Health, Room 915, 600 University Ave, Toronto, Ontario, M5G 1X5, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Gillian Strudwick
- Centre for Addiction and Mental Health, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Lianne P Jeffs
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
| | - Leanne Ginty
- Sinai Health, Room 915, 600 University Ave, Toronto, Ontario, M5G 1X5, Canada
| | - Jennie Johnstone
- Sinai Health, Room 915, 600 University Ave, Toronto, Ontario, M5G 1X5, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Alex Kiss
- Department of Research Design and Biostatistics, Sunnybrook Research Institute, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Carla A Loftus
- Sinai Health, Room 915, 600 University Ave, Toronto, Ontario, M5G 1X5, Canada
| | - Lesley A Wiesenfeld
- Sinai Health, Room 915, 600 University Ave, Toronto, Ontario, M5G 1X5, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
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11
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Nishimura Y, Miyoshi T, Sato A, Hasegawa K, Hagiya H, Kosaki Y, Otsuka F. Burnout of Healthcare Workers Amid the COVID-19 Pandemic: A Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111581. [PMID: 34770095 PMCID: PMC8582846 DOI: 10.3390/ijerph182111581] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 12/28/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has posed a significant challenge to the modern healthcare system and led to increased burnout among healthcare workers (HCWs). We previously reported that HCWs who engaged in COVID-19 patient care had a significantly higher prevalence of burnout (50.0%) than those who did not in November 2020 (period 1). We performed follow-up surveys in HCWs in a Japanese national university hospital, including basic demographics, whether a participant engaged in care of COVID-19 patients in the past 2 weeks, and the Maslach Burnout Inventory in February 2021 (period 2) and May 2021 (period 3). Periods 1 and 3 were amid the surges of COVID-19 cases, and period 2 was a post-surge period with a comparatively small number of COVID-19 patients requiring hospitalization. Response rates to the surveys were 33/130 (25.4%) in period 1, 36/130 (27.7%) in period 2, and 56/162 (34.6%) in period 3, respectively. While no consistent tendency in the prevalence of burnout based on variables was observed throughout the periods, the prevalence of burnout tends to be higher in periods 1 and 3 in those who engaged in COVID-19 patient care in the last 2 weeks (50.0%, 30.8%, 43.1% in period 1, 2, and 3, respectively). Given the prolonged pandemic causing stigmatization and hatred against HCWs leading to increased prevalence of burnout, high-level interventions and supports are warranted.
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Affiliation(s)
- Yoshito Nishimura
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan; (T.M.); (K.H.); (H.H.); (F.O.)
- Department of Medicine, John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI 96822, USA
- Correspondence:
| | - Tomoko Miyoshi
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan; (T.M.); (K.H.); (H.H.); (F.O.)
| | - Asuka Sato
- Center for Graduate Medical Education, Okayama University Hospital, Okayama 7008558, Japan;
| | - Kou Hasegawa
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan; (T.M.); (K.H.); (H.H.); (F.O.)
| | - Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan; (T.M.); (K.H.); (H.H.); (F.O.)
| | - Yoshinori Kosaki
- Center for Education in Medicine and Health Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan;
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan; (T.M.); (K.H.); (H.H.); (F.O.)
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