Prevalence of Burnout, Depression, Anxiety, Stress, and Hopelessness Among Healthcare Workers in COVID-19 Pandemic in Turkey

The interaction of occupational stress and job burnout on depressive symptoms in railway workers in Fuzhou city

BACKGROUND

To explore the relationship between occupational stress, burnout and depressive symptoms among railroad workers in Fuzhou, and to analyze the interaction of burnout and occupational stress on depressive symptoms.

METHODS

In this study, 861 railway employees of Fuzhou railway bureau were randomly selected from January to April, 2022. Occupational stress inventory revised edition (OSI-R), China job burnout inventory (CMBI) and Symptom Checklist-90 (SCL-90) were used to investigate the occupational stress, job burnout and depressive symptoms of railway workers. Interactions associated with depressive symptoms were assessed by linear hierarchical regression analysis and SPSS macros (PROCESS).

RESULTS

Occupational stress, job burnout and depressive symptoms accounted for 50.58%, 93.47%, and 11.19% of the study population, respectively. There were intergroup differences between age, marriage status, and length of service (P < 0.05). Occupational stress and job burnout are the main risk factors for depressive symptoms (OR: 2.01, 95% CI: 1.17-3.45; 1.94, 1.69-2.23, respectively). More importantly, further analysis of the interaction between occupational stress and job burnout showed that those with high levels of job burnout had a high-risk effect on depressive symptoms at high levels of occupational stress.

CONCLUSION

Occupational stress and job burnout are risk factors for depressive symptoms among railroad workers in Fuzhou City. The interaction of job burnout and occupational stress increases the risk of depressive symptoms.

Prevalence and sociodemographic factors of depression, anxiety and stress in Saudi Arabia: a survey of respiratory therapists

Background

Depression, anxiety and stress are prevalent among healthcare providers but limited data is available regarding respiratory therapists (RTs). This study aimed to assess the prevalence of depression, anxiety and stress, and identify the associated sociodemographic factors among RTs in Saudi Arabia.

Methods

A cross-sectional online survey was distributed to RTs in Saudi Arabia. Data were summarized using frequency and percentages. Stress, anxiety, and depression prevalence rates were expressed as proportions with 95% confidence intervals (CI). The associated factors of stress, anxiety, and depression were subjected to logistic regression.

Results

Overall, 988 (91%) RTs, 661 (66.9%) males, completed the online survey. The prevalence (95% CI) of depression, anxiety and stress among RTs was 81.3% (0.787, 0.837), 89.6% (0.875, 0.914), and 45.5% (0.424, 0.487), respectively. RT staff who were ≥41 years old, divorced, widowed or separated, or had > 10 years of clinical experience were more likely to experience stress. RTs who were (divorced, widowed or separated), did not live with their family, were current smokers, or worked the night shift were more likely to experience anxiety. RTs who were (divorced, widowed or separated), were current smokers, had >10 years of clinical experience were more likely to experience depression.

Conclusion

Stress, anxiety and depression are prevalent among RTs. Several sociodemographic factors are associated with the incidence of stress, anxiety and depression.

Perceived precarious life: a SEM model for re-dimensioning of precarious work and its impact on mental health

Introduction

Precarious work is one of the most studied concepts related to work, and its effects have been analyzed in relation to variables such as mental health and wellbeing. However, there is a tendency to atomise the analysis of precarious work, without understanding that people's working life is intertwined with other areas of their life.

Objective

Faced with this situation, this paper presents the concept of perceived precarious life, which is aligned with contemporary models of social inclusion and exclusion. Thus, perceived precarious life comprises variables of labor precariousness, social support and hopelessness in the family economic situation.

Methods

To test this idea, a structural equation model (SEM) is presented, which tests the structure of the construct of perceived precarious life by relating it to mental health and coping strategies.

Results

After testing the fit of the model in both men and women, a SEM path analysis is designed between the variables, observing that perceived precarious life has an effect on mental health (β = 0.635, p < 0.01). This relationship is mediated by unproductive coping strategies (β = 0.142, p < 0.01).

Conclusion

This model exposes a broad and integrated conceptualization of precariousness, combining aspects of work, relationships and hopelessness, which allows for an understanding of the integral experience of precariousness.

The impact of pandemics on healthcare providers' workloads: A scoping review

AIMS

To review and synthesize available evidence exploring the impact of pandemics on direct healthcare providers' workloads in the acute care setting.

DESIGN

Scoping review.

DATA SOURCES

A review of English research articles published up to August 2022 that examined the impact of pandemics on healthcare providers' workloads was undertaken. Studies were identified by searching four electronic databases: Medline (EBSCO), CINAHL (EBSCO), Web of Science and PsychInfo (EBSCO). Fifty-five studies met the inclusion criteria.

REVIEW METHODS

The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses Scoping Review checklist.

RESULTS

Healthcare workers experience an increase in workload pressures during a pandemic. This included patients requiring more care, undertaking non-normal work activities, increase in work content including changes to documentation, increase in demand and skills required, an increase in overtime and hours of work per week and higher patient-to-nurse ratios. The review also highlighted changes to the work environment and worsened work environments, including staffing shortages.

CONCLUSION

Focused efforts from health organizations to prioritize supportive conditions, policies focused on improved work environments, staffing adequacy and fair and reasonable workloads will enhance retention of the current workforce and future planning for pandemics.

IMPACT

Understanding workload challenges faced by frontline health professionals during the pandemic can improve planning, including policies and procedures, and resource allocation for future pandemic or emergency situations. In addition, extended periods of high workloads can impact staff retention. As many countries return to life after COVID-19, it is important that healthcare organizations examine staff pressures and identify ways to support staff moving forward. This will be vital for the future sustainability of the workforce.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

The longitudinal study of subjective wellbeing and absenteeism of healthcare workers considering post-COVID condition and the COVID-19 pandemic toll

Experts have warned against the pandemic burden on healthcare workers early on, however little is known about the evolution of this burden with time, in addition to the long-term effects of post-COVID symptoms in healthcare workers. Staff at the Geneva University Hospitals in Switzerland had an online follow-up in July and December 2021, on their physical and mental health, quality of life and functional capacity using validated scales. Descriptive analyses compared the prevalence of symptoms, functional impairment and quality of life in SARS-CoV-2 positive and negative individuals at baseline and at follow-up. Out of the initial n = 3,083 participants that answered at baseline in July 2021, n = 900 (mean age of 46.4 years, 70.1% women) completed the follow-up in December 2021. With time, more individuals reported fatigue (+ 9.4%), headache (+ 9.0%), insomnia (+ 2.3%), cognitive impairment (+ 1.4%), stress/burnout (+ 8.8%), pain (+ 8.3%), digestive symptoms (+ 3.6%), dyspnea (+ 1.0%), and cough (+ 7.7%) compared to baseline, with a differentially larger increase in symptoms in the SARS-CoV-2 negative group. Individuals had more functional impairment (12.7% at baseline and 23.9% at follow-up), with more absenteeism and worsening quality of life. Healthcare workers are potentially suffering from long term consequences of the pandemic burden, calling for urgent action and solutions.

Anxiety and Depression Levels and Coping Strategies among Polish Healthcare Workers during the COVID-19 Pandemic

During the COVID-19 pandemic, medical staff were commonly exposed to stress, work under pressure, and long shifts, and may have experienced a fear of infecting loved ones or a fear for their own health. All of these factors may have increased the likelihood that healthcare workers will experience the symptoms of depression, anxiety, or other mental health disorders. In this cross-sectional study, a group of respondents was gathered from the employees of 78 hospitals in Poland. A questionnaire was completed electronically by 282 people, aged between 20 and 78 years. The study used the Hospital Anxiety and Depression Scale (HADS) and the MiniCOPE questionnaire to examine anxiety and depression symptoms, and coping strategies, respectively. With age, the respondents declared fewer symptoms of anxiety and tended to have milder symptoms of depression. Participants with chronic illnesses, mood disorders, or anxiety disorders also reported higher levels of anxiety and depression symptoms. More than 20% of healthcare workers felt the need to consult with a psychologist. In the entire group of healthcare professionals surveyed, the most commonly used strategies for coping with stress were "denial", "psychoactive drug and alcohol use", and "cessation of activities", while the least used strategy was "acceptance". Given the most commonly used strategies in the surveyed group of healthcare professionals, they may be predictors for a deterioration in mental state in the long run. The obtained results also suggest that it is likely that pre-existing health problems had a greater impact on the mental health of medical staff during the COVID-19 pandemic than the profession itself. Therefore, taking care of the well-being and mental health of healthcare workers should be a priority for employers.

Individuals' Coping Styles and Levels of Depression, Anxiety, and Stress During the COVID-19 Pandemic in Turkey: A Web-Based Cross-Sectional Study

This cross-sectional study aimed to determine the correlation between the coping styles and depression, anxiety, and stress levels of individuals living in Turkey during the COVID-19 pandemic. The study was conducted using an online questionnaire (Socio-demographic Form; Depression, Anxiety, and Stress Scale-21; Coping Styles Scale) and it included 483 individuals. Descriptive statistics, ANOVA, Independent Samples t-test, Kolmogorov-Smirnov, Hosmer-Lemeshow and Scheffe tests, Pearson Correlation, and Binary Logistic Regression analyzes were used to analyze the data. There was a negative correlation between the participants' self-confident and optimistic coping styles mean scores and their depression, anxiety, and stress mean scores. There was a positive correlation between the participants' helpless, submissive, and seeking social support coping styles mean scores and their depression, anxiety, and stress mean scores. The regression analysis revealed that using the helpless coping style increased the depression, anxiety, and stress levels of the participants while using the optimistic coping style and visiting a physician during the pandemic decreased them. In addition, seeking social support coping style increased the level of depression while the testing during the pandemic increased stress levels. As a result, it is recommended to strengthen society's psychological resilience and expand mental health support services for such mental illnesses.

Hopelessness and burnout in Italian healthcare workers during COVID-19 pandemic: the mediating role of trait emotional intelligence

Objective

The study aims to assess the impact of COVID-19 on healthcare workers' work-related stress during the first wave of the pandemic in Italy. The main objective is to investigate the existence of a positive correlation between hopelessness and burnout, assuming that burnout may be a risk factor for the development of hopelessness, and to analyze the role that trait Emotional Intelligence (TEI) and changes in workload could have in this relationship. Furthermore, evaluate any significant differences in burnout and hopelessness levels in the function of some demographic variables, such as gender, professional profiles, and different working zones of Italy, to better understand how the diverse diffusion of pandemic had affected Italian healthcare workers.

Methods

An online survey was used to collect data between April and June, 2020, with 562 responses among nurses (52.1%) and physicians (47.9%). Demographics and changes in workload and work conditions were collected through an ad hoc questionnaire. The Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), The Beck Hopelessness Scale (BHS), and the Link Burnout Questionnaire (LBQ) were used to assess Trait Emotional Intelligence (TEI), hopelessness, and burnout, respectively.

Results

Correlation analysis showed a significant positive relationship between hopelessness and each burnout dimension. TEI showed negative correlations both with burnout dimensions and hopelessness. Significant differences in burnout and hopelessness levels emerged as a function of some demographic variables such as gender, professional profiles (nurses or physicians), and different working zone of Italy (northern or southern). Results showed that TEI partially mediated the relationship between hopelessness and every burnout dimension, while the interaction of changes in workload was non-significant.

Discussion

The mediating role of TEI in the burnout-hopelessness relationship partly explains the protective role that individual factors had on healthcare workers' mental health. Our findings support the need to integrate considerations on both psychological risk and protective factors into COVID-19 care, including the monitoring of psychological symptoms and social needs, especially among healthcare workers.

Teachers’ demographic and occupational attributes predict feelings of hopelessness during the COVID-19 pandemic

The outbreak of the COVID-19 pandemic has resulted in many emotional consequences for teachers, including feelings of isolation, loneliness, and hopelessness. However, evidence on the prevalence of hopelessness and the associated factors in teachers during the pandemic is limited. The purpose of this research was to examine the prevalence of hopelessness in public school teachers and identify risk factors associated with it. A sample of 168 teachers aged 25–49 years participated in the study by completing the Socio-Demographic Questionnaire, the Beck Hopelessness Scale (BHS), and the Multi-Dimensional Scale of Perceived Social Support (MSPSS). The results revealed a moderate level of experienced hopelessness in teachers. Hopelessness prevalence was also significantly different across teacher gender (males = 79%), age groups (&gt;40 = 77%), socioeconomic status (poor socioeconomic status = 70%), educational level (high school teachers = 79%), professional experience (experienced teachers = 82%), and perceived social support (low perceived social support = 79%). The results of a logistic regression analysis confirmed the effects of these demographic and occupational attributes on hopelessness by explaining ~71% of the variance in hopelessness feelings. Higher odds ratios were associated with age, socioeconomic status, and perceived social support, signifying the prominence of these factors in predicting hopelessness. The study contributes to identifying and screening teachers at risk of hopelessness in public schools and recommends promoting collegial/superior support as well as a positive school climate as the protective factors against hopelessness.

Domains of Physical and Mental Workload in Health Work and Unpaid Domestic Work by Gender Division: A Study with Primary Health Care Workers in Brazil

Various studies indicate that workload metrics can be used to assess inequities in the division of labor according to gender and in the mental health of health care professionals. In most studies, the workload is portrayed in a way that does not integrate the different fields of work, that is, work in health services and unpaid domestic work. The objective was to determine the effects of the workload domains of health work and unpaid domestic work according to the gender division of health professionals working in primary health care (PHC), and to analyze the workload as an inducer of anxiety disorders and episodes of depression. This cross-sectional study consisted of 342 health care professionals recruited for interview at primary health care units in the extreme south of Rio Grande do Sul, Brazil. Sociodemographic and occupational variables, workload in PHC and unpaid domestic work, and dichotomies of anxiety disorders and episodes of depression were considered. Poisson and multivariate linear regression models were used for data analysis. Cohen's standardized effect size was used to assess the magnitude of the difference between women and men in terms of workload. The female professionals presented higher scores in terms of PHC work and unpaid domestic work and higher proportions of episodes of depression and anxiety disorders compared to males. The male professionals showed that anxiety disorders presented a medium standardized effect size on domestic workload and the level of frustration with family involvement was higher in those with episodes of depression. The results illustrate that the workload metric is an important indicator of female vulnerability to working conditions in PHC and in the family environment.

Hospital Outdoor Spaces as Respite Areas for Healthcare Staff During the COVID-19 Pandemic

The COVID-19 pandemic has created considerable implications for healthcare staff around the globe. During the pandemic, the frontline healthcare workers experience intense anxiety, stress, burnout, and psychological breakdown, with severe implications on their mental and physical well-being. In addition to these implications, anxiety and stress can hinder their productivity and ability to perform their duties efficiently. The literature indicates that hospital gardens and contact with nature can help alleviate psychological distress among hospital staff. However, few studies investigated the role of outdoor spaces as areas for respite and work breaks in healthcare facilities during the pandemic. The present opinion paper highlights the challenges of job stress and psychological distress health workers face during the pandemic. This article also underscores the role of hospital outdoor spaces and garden facilities in coping with the challenges. While other measures to reduce stress among hospital staff and ensure their health and safety are important, hospital administrators and relevant government agencies should also emphasize the provision of gardens and open spaces in healthcare facilities. These spaces can act as potential areas for respite for hospital staff to help them cope with the stress and anxiety accumulated through working under crises.

The Relationship between Exercise and Mental Health Outcomes during the COVID-19 Pandemic: From the Perspective of Hope

The unexpected outbreak of COVID-19 triggered fear and anxiety in the general population. Exercise was one of the most widely promoted methods to improve body function when socially restricted. This study aims to examine the role of exercise in relieving stressful mental health outcomes (anxiety and depressive symptoms) during the COVID-19 pandemic and explore the underlying mechanism from the perspective of hope, using a combination of goal-directed planning (pathways) and motivation (agency). A cross-sectional online survey recruiting 2390 Chinese participants was conducted during the COVID-19 pandemic in China. A series of questions and scales, including the self-designed exercise questionnaire, the Adult Dispositional Hope Scale, the Generalized Anxiety Disorder Scale-7 and the Patient Health Questionnaire-9, were used to measure exercise, hope, anxiety symptoms and depressive symptoms, respectively. A structural equation model was constructed to test the hypothesis that exercise benefits mental health outcomes through the mediating role of hope. Our results showed that exercise relieved stressful mental health outcomes via three paths: one direct path (β = −0.077, 95% CI = (−0.138, −0.017), p < 0.01), one indirect path through hope of pathways thinking (β = −0.046, 95% CI = (−0.064, −0.027), p < 0.001) and another indirect path through hope of agency thinking (β = −0.060, 95% CI = (−0.081, −0.039), p < 0.001). Our results showed that exercise could alleviate stressful mental health outcomes by promoting both hope of pathway thinking and agency thinking. It provided practical insights into psychological prevention and intervention by means of exercise during the COVID-19 pandemic.

Burnout in Pharmacy professionals during COVID-19 outbreak

BACKGROUND AND AIM

COVID-19 pandemic has had a significant global impact on the economic, social, and public health sectors. The most severe consequences were felt firsthand in health systems and by their professionals, exposing them to greater physical and mental health risks, which need to be properly evaluated.  This study aims to assess burnout levels in pharmacy professionals in the context of the COVID-19 pandemic.

METHODS

We collected data (N = 250), from pharmacy professionals (mean age of 34.24 years) (SD=8.99) who worked in different areas during the pandemic period using the Burnout Copenhagen Burnout Inventory (CBI).

RESULTS

There was an increase in weekly working hours after the onset of the COVID-19 pandemic and a decrease in the number of rest days per month. Most participants believe that their health status after the start of the pandemic is a little worse (44.4%). According to the CBI, the dimension with the highest average value of the Burnout subscale is related to the customer/user dimension (53.07), followed by the Work (44.60) and Personal (44.22) dimension.

CONCLUSIONS

The levels of Burnout of pharmacy professionals are more accentuated in the Burnout dimension related to the client/user and the average values ​​of the various Burnout subscales are higher in Pharmacy Technicians than in Pharmacists.

Evaluation of burnout among stay-behind healthcare workers during the current Omicron wave of COVID-19 in Taizhou, China

BACKGROUND

Since February 2022, a new Omicron wave of COVID-19 emerged in Shanghai, China. Many healthcare workers came to Shanghai from hospitals of other parts of China as aid workers. Hospitals in areas with mild COVID-19 outbreaks will inevitably be understaffed, it is likely to cause job burnout of stay-behind healthcare workers. Stay-behind healthcare workers were those who had not been dispatched to support COVID-19 prevention and control in other regions. This study was designed to evaluate the burnout among stay-behind healthcare workers in the current COVID-19 Omicron wave in Taizhou, China.

METHODS

A population-based, anonymous, cross-sectional online survey was designed in the Wen-Juan Xing platform. The survey was sent to all stay-behind healthcare workers of the hospital (n = 1739) from April 29 to May 3, 2022. The Maslach Burnout Inventory-General Survey (MBI-GS) was used for the burnout survey. For univariate analysis, the χ² test and one way ANOVA were used to assess differences in categorical variables and continuous variables, respectively. The effect of independent associated risk factors on each type of burnout was examined using the multinomial logistic regression model.

RESULTS

A total of 434 participants completed the survey invitation effectively. A total of 71.2% of stay-behind healthcare workers experienced burnout during COVID-19, including 54.8% experiencing mild to moderate burnout and 16.4% experiencing severe burnout. Night shift, depression, social support, positive coping and number of children appeared to be significantly related to mild to moderate burnout. Night shift, depression, social support, positive coping, number of children, professional title, and anxiety appeared to be significantly related to severe burnout.

CONCLUSION

Job burnout among stay-behind healthcare workers was an important problem during the current Omicron wave of COVID-19. Night shift, depression, social support, positive coping, and number of children were associated with mild to moderate and severe burnout. Anxiety and professional title were associated with severe burnout.

A systematic review and meta analysis on burnout in physicians during the COVID-19 pandemic: A hidden healthcare crisis

OBJECTIVE

This systematic review and meta-analysis aims to explore overall prevalence of burnout among physicians during early and late COVID-19 pandemic and geographical differences in burnout.

METHODS

This review was registered prospectively with PROSPERO (CRD42022327959). A comprehensive search of several databases, including Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, PsycINFO, and Scopus, spanning from December 2019 to May 2022 was conducted. Eligible studies included physicians or medical professionals including physicians that worked directly or indirectly with COVID-19 patients, whilst reporting burnout outcomes using a validated scale. Literature that did not include physicians or did not occur in a hospital setting were excluded. Literature including medical students were also excluded.

RESULTS

Forty-five observational studies were included, all of which were cross-sectional studies. The pooled estimate of overall prevalence of burnout was 54.60% (95% CI: 46.7, 62.2). Mean emotional exhaustion, depersonalization, and personal accomplishment was found to be 22.06% (95% CI: 18.19, 25.94), 8.72 (95% CI: 6.48, 10.95) and 31.18 (95% CI: 27.33, 35.03) respectively. Frontline workers displayed higher rates of burnout than second-line healthcare workers (HCW) (OR: 1.64, 95% CI: 1.13, 2.37). Studies from the early pandemic period reported burnout prevalence of 60.7% (95% CI: 48.2, 72) compared to a prevalence of 49.3% (95% CI: 37.7, 60.9) from the late pandemic period. Geographically, burnout was highest amongst Middle East and North Africa (MENA) studies (66.6%, 95% CI: 54.7, 78.5), followed by Europe (48.8%, 95% CI: 40.3, 57.3) and then South America (42%, 95% CI: -0.4, 84.4). Lastly, burnout prevalence overall (OR = 0.77, 95% CI: 0.36, 1.67) emotional exhaustion (MD = -0.36, 95% CI: -4.64, 3.91), depersonalization (MD = -0.31, 95% CI: -1.80, 1.18), and personal accomplishment (MD = 0.55, 95% CI: -0.73, 1.83) were found comparable between physicians and nurses.

CONCLUSION

COVID-19 has had significant consequences on HCW burnout. Further research is needed to examine early signs of burnout and to develop effective coping strategies.