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Liu N, Plouffe RA, Liu JJW, Nouri MS, Saha P, Gargala D, Davis BD, Nazarov A, Richardson JD. Determinants of burnout in Canadian health care workers during the COVID-19 pandemic. Eur J Psychotraumatol 2024; 15:2351782. [PMID: 38775008 PMCID: PMC11123547 DOI: 10.1080/20008066.2024.2351782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 04/24/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Health care workers (HCWs) are among the most vulnerable groups to experience burnout during the coronavirus (COVID-19) pandemic. Understanding the risk and protective factors of burnout is crucial in guiding the development of interventions; however, the understanding of burnout determinants in the Canadian HCW population remains limited.Objective: Identify risk and protective factors associated with burnout in Canadian HCWs during the COVID-19 pandemic and evaluate organizational factors as moderators in the relationship between COVID-19 contact and burnout.Methods: Data were drawn from an online longitudinal survey of Canadian HCWs collected between 26 June 2020 and 31 December 2020. Participants completed questions pertaining to their well-being, burnout, workplace support and concerns relating to the COVID-19 pandemic. Baseline data from 1029 HCWs were included in the analysis. Independent samples t-tests and multiple linear regression were used to evaluate factors associated with burnout scores.Results: HCWs in contact with COVID-19 patients showed significantly higher likelihood of probable burnout than HCWs not directly providing care to COVID-19 patients. Fewer years of work experience was associated with a higher likelihood of probable burnout, whereas stronger workplace support, organizational leadership, supervisory leadership, and a favourable ethical climate were associated with a decreased likelihood of probable burnout. Workplace support, organizational leadership, supervisory leadership, and ethical climate did not moderate the associations between contact with COVID-19 patients and burnout.Conclusions: Our findings suggest that HCWs who worked directly with COVID-19 patients, had fewer years of work experience, and perceived poor workplace support, organizational leadership, supervisory leadership and ethical climate were at higher risk of burnout. Ensuring reasonable work hours, adequate support from management, and fostering an ethical work environment are potential organizational-level strategies to maintain HCWs' well-being.
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Affiliation(s)
- Nancy Liu
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
| | - Rachel A. Plouffe
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Jenny J. W. Liu
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Maede S. Nouri
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
| | - Priyonto Saha
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
| | - Dominic Gargala
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
| | - Brent D. Davis
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
- Department of Computer Science, Western University, London, Canada
| | - Anthony Nazarov
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
| | - J. Don Richardson
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
- St. Joseph’s Operational Stress Injury Clinic, Parkwood Institute, St. Joseph’s Health Care London, London, Canada
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Fronteira I, Mathews V, Dos Santos RLB, Matsumoto K, Amde W, Pereira A, de Oliveira APC, Craveiro I, Chança R, Boniol M, Ferrinho P, Poz MRD. Impacts for health and care workers of Covid-19 and other public health emergencies of international concern: living systematic review, meta-analysis and policy recommendations. HUMAN RESOURCES FOR HEALTH 2024; 22:10. [PMID: 38273317 PMCID: PMC10809470 DOI: 10.1186/s12960-024-00892-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Health and care workers (HCW) faced the double burden of the SARS-CoV-2 pandemic: as members of a society affected by a public health emergency and as HWC who experienced fear of becoming infected and of infecting others, stigma, violence, increased workloads, changes in scope of practice, among others. To understand the short and long-term impacts in terms of the COVID-19 pandemic and other public health emergencies of international concern (PHEICs) on HCW and relevant interventions to address them, we designed and conducted a living systematic review (LSR). METHODS We reviewed literature retrieved from MEDLINE-PubMed, Embase, SCOPUS, LILACS, the World Health Organization COVID-19 database, the ClinicalTrials.org and the ILO database, published from January 2000 until December 2021. We included quantitative observational studies, experimental studies, quasi-experimental, mixed methods or qualitative studies; addressing mental, physical health and well-being and quality of life. The review targeted HCW; and interventions and exposures, implemented during the COVID-19 pandemic or other PHEICs. To assess the risk of bias of included studies, we used the Johanna Briggs Institute (JBI) Critical Appraisal Tools. Data were qualitatively synthetized using meta-aggregation and meta-analysis was performed to estimate pooled prevalence of some of the outcomes. RESULTS The 1013 studies included in the review were mainly quantitative research, cross-sectional, with medium risk of bias/quality, addressing at least one of the following: mental health issue, violence, physical health and well-being, and quality of life. Additionally, interventions to address short- and long-term impact of PHEICs on HCW included in the review, although scarce, were mainly behavioral and individual oriented, aimed at improving mental health through the development of individual interventions. A lack of interventions addressing organizational or systemic bottlenecks was noted. DISCUSSION PHEICs impacted the mental and physical health of HCW with the greatest toll on mental health. The impact PHEICs are intricate and complex. The review revealed the consequences for health and care service delivery, with increased unplanned absenteeism, service disruption and occupation turnover that subvert the capacity to answer to the PHEICs, specifically challenging the resilience of health systems.
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Affiliation(s)
- Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal.
- National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, NOVA University of Lisbon, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.
| | - Verona Mathews
- School of Public, Health University of the Western Cape, South Africa, Private Bag X17, Bellville, 7535, Republic of South Africa
| | - Ranailla Lima Bandeira Dos Santos
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Osvaldo Cruz, Rua Leopoldo Bulhões, 1480 - Manguinhos, Rio de Janeiro, Brazil
| | - Karen Matsumoto
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Woldekidan Amde
- School of Public, Health University of the Western Cape, South Africa, Private Bag X17, Bellville, 7535, Republic of South Africa
| | - Alessandra Pereira
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Ana Paula Cavalcante de Oliveira
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Isabel Craveiro
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
| | - Raphael Chança
- Instituto Nacional de Cancer, Ministério da Saúde, Rua Marquês de Pombal, 125, Centro, Rio de Janeiro, RJ, 20230240, Brazil
| | - Mathieu Boniol
- Health Workforce Department, World Health Organization, Av. Appia 20, 1202, Geneva, Switzerland
| | - Paulo Ferrinho
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
| | - Mario Roberto Dal Poz
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
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Tesfaye Y, Alemu B, Soboka M, Girma S, Reinhard MA, Rek S, Adorjan K, Zhelyazkova A, Padberg F, Jobst A, Abera M. Mental health problems during the COVID-19 pandemic among residents of Jimma town: a cross-sectional study. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01674-y. [PMID: 37715069 DOI: 10.1007/s00406-023-01674-y] [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: 04/11/2023] [Accepted: 08/08/2023] [Indexed: 09/17/2023]
Abstract
The COVID-19 pandemic presents an unprecedented challenge to community wellbeing and mental health. However, quantifiable information on the extent of mental health problems and associated factors due to the pandemic is still lacking in low-income countries. Thus, this study aimed to investigate the levels of depression, anxiety, and stress and their association with risk and resilience factors among residents of Jimma town in Southwestern Ethiopia. A community-based cross-sectional study was conducted between October 2021 and November 2021. Data were collected from 1196 adult Jimma town residents selected through multi-stage sampling. The following scales were used for the cross-sectional assessment of depressions, anxiety and stress and their associations: depression, anxiety, and stress-21(DASS-21), World Health Organization (WHO) wellbeing, University of California, Los Angeles Loneliness Scale (UCLA), Childhood trauma questionnaire, and brief resilience scales. A pre-tested, interviewer-completed questionnaire was used for data collection. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with depression, anxiety, and stress. Odds ratios consistent with 95% CI were used to report the presence of an association between risk and resilience factors and the outcome variable at a P-value < 0.05. Overall, 963 (80.53%) respondents had divergent DASS-21 score findings. Specifically, 27.68%, 31.52% and 21.32% experienced depression, anxiety, and stress respectively. Higher DASS-21 scores were associated with the presence of one or more COVID-19 risk factors for anyone close to the participants (AOR = 1.53, 95% CI 1.03-2.27), feelings of stress/burden (β = 1.09, 95% CI 1.07-1.12), positive coping (β = 1.044, 95% CI 1.01-1.07), loneliness (β = 1.063, 95% CI 1.04-1.08), and childhood trauma (β = 1.03, 95% CI 1.01-1.04). In contrast, lower DASS-21 scores were associated with beliefs about the necessity of solidarity-based behavior (β = 0.94, 95% CI 0.90-0.98), resilience (β = 0.92, 95% CI 0.87-0.97) and wellbeing (β = 0.90, 95% CI 0.87-0.94). In the course of the COVID-19 pandemic in 2021, symptoms of depression, anxiety, and stress in the study community were prevalent, and associated with numerous risk and resilience factors. Although causality cannot be inferred, these findings underscore the importance of strengthening mental health services and may guide COVID-19 prevention and treatment strategies.
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Affiliation(s)
- Yonas Tesfaye
- Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia.
| | - Bezaye Alemu
- Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Matiwos Soboka
- Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Shimelis Girma
- Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Matthias A Reinhard
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Stefanie Rek
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Kristina Adorjan
- Center for International Health, Ludwig Maximilian University, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Ana Zhelyazkova
- Institut für Notfallmedizin und Medizinmanagement (INM), Klinikum der, Universität München LMU München, Munich, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Andrea Jobst
- Center for International Health, Ludwig Maximilian University, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Mubarek Abera
- Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
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Workneh F, Worku A, Assefa N, Berhane Y. Change in depression during the COVID-19 pandemic among healthcare providers in Addis Ababa, Ethiopia. PeerJ 2023; 11:e15053. [PMID: 37065689 PMCID: PMC10100826 DOI: 10.7717/peerj.15053] [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: 10/10/2022] [Accepted: 02/21/2023] [Indexed: 04/18/2023] Open
Abstract
Background The COVID-19 pandemic has increased mental health problems among healthcare workers globally. However, studies from low- and middle-income countries on this matter were minimal. This study assessed the change in depression prevalence during the first year of the COVID-19 pandemic and associated factors among healthcare providers in Addis Ababa, Ethiopia. Methods We conducted surveys among healthcare workers in Addis Ababa at two-time points, September 2020 and October 2021. A total of 577 study participants were randomly selected based on registers obtained from professional associations. Computer-assisted telephone interviewing technique was used for data collection. The Patient Health Questionnaire (PHQ-9) was used to screen for depression. Multivariable logistic regression analysis was performed to identify potential factors associated with depression. Result The prevalence of depression among healthcare workers was 2.3% (95% CI [1.1-4.8]) in Time 1 and 6.5% (95% CI [4.1-10.1]) in Time 2; nearly a three-fold increase in Time 2 compared to Time 1. The most frequently reported symptoms at both times based on the PHQ-9 item were having poor energy, sleep problem, and anhedonia, while reported suicidal ideation was less than 5%. Depression showed a positive and significant association with a positive COVID-19 test result (AOR 7.25 95% CI [1.32-39.4]) in Time 1, and with being a female healthcare provider (AOR 3.96 95% CI [1.08-14.51]) and lack of COVID-19 related policy or guidelines at the workplace (AOR 3.22 95% CI [1.11-9.35]) in Time 2. Conclusion The prevalence of depression among healthcare workers tripled during the first year of the COVID-19 pandemic. Panic reaction to positive COVID-19 test result seems to have a negative effect at the beginning while lack of disease-specific prevention guidelines and comprehensive psychological interventions for healthcare providers had an adverse effect on the mental health of health workers.
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Affiliation(s)
- Firehiwot Workneh
- Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yemane Berhane
- Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
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Oyat FWD, Oloya JN, Atim P, Ikoona EN, Aloyo J, Kitara DL. The psychological impact, risk factors and coping strategies to COVID-19 pandemic on healthcare workers in the sub-Saharan Africa: a narrative review of existing literature. BMC Psychol 2022; 10:284. [PMID: 36457038 PMCID: PMC9714392 DOI: 10.1186/s40359-022-00998-z] [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: 09/03/2022] [Accepted: 11/22/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The ongoing COVID-19 pandemic has significantly impacted the physical and mental health of the general population worldwide, with healthcare workers at particular risk. The pandemic's effect on healthcare workers' mental well-being has been characterized by depression, anxiety, work-related stress, sleep disturbances, and post-traumatic stress disorder. Hence, protecting the mental well-being of healthcare workers (HCWs) is a considerable priority. This review aimed to determine risk factors for adverse mental health outcomes and protective or coping measures to mitigate the harmful effects of the COVID-19 crisis among HCWs in sub-Saharan Africa. METHODS We performed a literature search using PubMed, Google Scholar, Cochrane Library, and Embase for relevant materials. We obtained all articles published between March 2020 and April 2022 relevant to the subject of review and met pre-defined eligibility criteria. We selected 23 articles for initial screening and included 12 in the final review. RESULT A total of 5,323 participants in twelve studies, predominantly from Ethiopia (eight studies), one from Uganda, Cameroon, Mali, and Togo, fulfilled the eligibility criteria. Investigators found 16.3-71.9% of HCWs with depressive symptoms, 21.9-73.5% with anxiety symptoms, 15.5-63.7% experienced work-related stress symptoms, 12.4-77% experienced sleep disturbances, and 51.6-56.8% reported PTSD symptoms. Healthcare workers, working in emergency, intensive care units, pharmacies, and laboratories were at higher risk of adverse mental health impacts. HCWs had deep fear, anxious and stressed with the high transmission rate of the virus, high death rates, and lived in fear of infecting themselves and families. Other sources of fear and work-related stress were the lack of PPEs, availability of treatment and vaccines to protect themselves against the virus. HCWs faced stigma, abuse, financial problems, and lack of support from employers and communities. CONCLUSION The prevalence of depression, anxiety, insomnia, and PTSD in HCWs in sub-Saharan Africa during the COVID-19 pandemic has been high. Several organizational, community, and work-related challenges and interventions were identified, including improvement of workplace infrastructures, adoption of correct and shared infection control measures, provision of PPEs, social support, and implementation of resilience training programs. Setting up permanent multidisciplinary mental health teams at regional and national levels to deal with mental health and providing psychological support to HCWs, supported with long-term surveillance, are recommended.
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Affiliation(s)
| | - Johnson Nyeko Oloya
- Uganda Medical Association (UMA), UMA-Acholi Branch, Gulu City, Uganda ,grid.461230.20000 0004 0512 5494Moroto Regional Referral Hospital, Moroto, Uganda
| | - Pamela Atim
- Uganda Medical Association (UMA), UMA-Acholi Branch, Gulu City, Uganda ,St. Joseph’s Hospital, Kitgum District, Uganda
| | | | - Judith Aloyo
- Uganda Medical Association (UMA), UMA-Acholi Branch, Gulu City, Uganda ,Rhites-N, Acholi, Gulu City, Uganda
| | - David Lagoro Kitara
- Uganda Medical Association (UMA), UMA-Acholi Branch, Gulu City, Uganda ,grid.442626.00000 0001 0750 0866Faculty of Medicine, Department of Surgery, Gulu University, P.O. Box 166, Gulu City, Uganda ,grid.38142.3c000000041936754XHarvard University, Cambridge, USA
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Damerdji F, Rotsaert M, Wacquier B, Hein M, Loas G. Prevalence and Relationships between Alexithymia, Anhedonia, Depression and Anxiety during the Belgian COVID-19 Pandemic Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15264. [PMID: 36430003 PMCID: PMC9691107 DOI: 10.3390/ijerph192215264] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
Alexithymia and anhedonia are associated with psychiatric disorders, such as depression and anxiety. The COVID-19 pandemic lead to a significant deterioration in the mental health of the population. It is therefore important to examine the effects of lockdown on alexithymia and anhedonia and their relationships with anxiety and depression. We compared the scores and characteristics of 286 patients divided into two groups: one before lockdown (group 1, N = 127), the other during the progressive lockdown release (group 2, N = 159). The groups were homogeneous in terms of age, sex ratio, socio-professional categories, and somatic and psychiatric comorbidities. The groups were compared on the Toronto Alexithymia Scale (TAS-20) measuring alexithymia, the Beck Depression Inventory (BDI-II) measuring depression, the anhedonia subscale of the BDI-II measuring state-anhedonia and the State Trait Anxiety Inventory (STAI) measuring state and trait anxiety. The ratio of alexithymic subjects in group 1 is 22.83% to 33.33% in group 2 (p-value = 0.034). This suggests a significant increase in the number of alexithymic patients after lockdown. We did not observe any difference in the proportion of depressed and anxious subjects before or after lockdown. Among the different scales, higher scores were only found on the cognitive factor of alexithymia on group 2 comparatively to group 1. This study indicates an increase in the proportion of alexithymic subjects following lockdown. Unexpectedly, this was unrelated to depression, anxiety or anhedonia levels, which remained stable. Further studies are needed to confirm this result and to evaluate precisely which factors related to the lockdown context are responsible for such an increase.
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Affiliation(s)
- Farah Damerdji
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
| | - Marianne Rotsaert
- Department of Psychology & Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
| | - Benjamin Wacquier
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
| | - Matthieu Hein
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
| | - Gwenolé Loas
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
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