Burnout, psychopathology and purpose in life in healthcare workers during COVID-19 pandemic

Compassion Fatigue in a Cohort of South Italian Nurses and Hospital-Based Clinical Social Workers Following COVID-19: A Cross-Sectional Survey

Background/Objective: The COVID-19 pandemic has led to a significant increase in the workloads of healthcare workers (HCWs). The fear of contracting the new virus with the frequent medical consequences has affected their mental health. As a result, they are at high risk of compassion fatigue (CF). In this multicentric study, as a primary objective, we evaluate the incidence and/or prevalence of CF in a cohort of Italian nurses and HCWs (hospital-based clinical social workers of neurological patients) who have contracted SARS-CoV-2 infection. Our secondary aim is to evaluate the difference in experiencing CF between subjects with and without long-term COVID. Methods: In this study, 101 HCWs attending three different neurorehabilitation settings (the Neurorehabilitation Unit of the "Bonino Pulejo" Neurolesi Center of Messina, the Neurorehabilitation Department of Crotone, and the Psychiatric Unit of the University Hospital of Messina) were enrolled from May 2021 to May 2023. Data were collected through self-administered semi-structured interviews. Results: We observed high percentages of CF difficulties in both nurses and HCWs, related to mood alteration in 57.7%, headaches in 44.4%, and fatigue in 62%. Higher percentages were found in individuals with long-term COVID-19, including mood alteration in 93.9%, headache in 88.6%, and memory-related problems in 98.5%. Conclusions: The complexity of a patient's care pathway, especially in chronic disease situations, requires an enormous commitment that can lead to burnout and CF, which should be considered to initiate preventive interventions aimed at helping "those who help", for the well-being of patients, healthcare teams, and healthcare organizations.

Impact of Effort-Reward Imbalance and Burnout on the Compliance with Standard Precautions among Nurses and Midwives in Lebanese Hospitals

BACKGROUND

Effort-reward imbalance (ERI) refers to the situation where there is a mismatch between the effort that healthcare workers (HCWs) put into their work and the rewards they receive in return. Burnout, on the other hand, is a psychological syndrome characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. This study aimed to assess the impact of ERI and burnout on the compliance with standard precautions (SPs) among nurses and midwives in Lebanese hospitals under the economic crisis and after the COVID-19 pandemic.

METHODS

Cross-sectional correlational study, based on self-administered questionnaire data, measuring the compliance with SPs, ERI, and burnout, in addition to the relationship between these factors, was performed among 409 nurses and midwives, working in Lebanese hospitals.

RESULTS

ERI was significantly associated with exposure to burnout among nurses and midwives, and burnout was found to be a significant predictor of nurses and midwives' self-reported adherence with SPs.

CONCLUSIONS

This study highlights the contribution of ERI and burnout to the chain of infection by decreased adherence to infection control SPs of nurses and midwives.

Development and validation of a nomogram for predicting high-burnout risk in nurses

AIM

To develop a predictive model for high-burnout of nurses.

DESIGN

A cross-sectional study.

METHODS

This study was conducted using an online survey. Data were collected by the Chinese Maslach Burnout Inventory-General Survey (CMBI-GS) and self-administered questionnaires that included demographic, behavioural, health-related, and occupational variables. Participants were randomly divided into a development set and a validation set. In the development set, multivariate logistic regression analysis was conducted to identify factors associated with high-burnout risk, and a nomogram was constructed based on significant contributing factors. The discrimination, calibration, and clinical practicability of the nomogram were evaluated in both the development and validation sets using receiver operating characteristic (ROC) curve analysis, Hosmer-Lemeshow test, and decision curve analysis, respectively. Data analysis was performed using Stata 16.0 software.

RESULTS

A total of 2750 nurses from 23 provinces of mainland China responded, with 1925 participants (70%) in a development set and 825 participants (30%) in a validation set. Workplace violence, shift work, working time per week, depression, stress, self-reported health, and drinking were significant contributors to high-burnout risk and a nomogram was developed using these factors. The ROC curve analysis demonstrated that the area under the curve of the model was 0.808 in the development set and 0.790 in the validation set. The nomogram demonstrated a high net benefit in the clinical decision curve in both sets.

CONCLUSION

This study has developed and validated a predictive nomogram for identifying high-burnout in nurses.

RELEVANCE TO CLINICAL PRACTICE

The nomogram conducted by our study will assist nursing managers in identifying at-high-risk nurses and understanding related factors, helping them implement interventions early and purposefully.

REPORTING METHOD

The study adhered to the relevant EQUATOR reporting guidelines: TRIPOD Checklist for Prediction Model Development and Validation.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Suicide risk and associated factors in healthcare workers seeking psychological support during COVID-19: a cross-sectional study

Healthcare workers have been one of the groups most severely affected by the COVID-19 pandemic, leaving them with serious psychological effects. Some of these effects have not been treated promptly, leading to further psychological symptoms. The objective of this study was to evaluate suicide risk in healthcare workers seeking psychological help during the COVID-19 pandemic, and factors associated with this risk on participants that were searching for treatment during the COVID-19 pandemic. This is a cross-sectional study analyzing data from 626 Mexican healthcare workers seeking psychological help due to the COVID-19 pandemic through the www.personalcovid.com platform. Before they entered treatment, the Plutchik Suicide Risk Scale, the Depression Scale of the Center for Epidemiologic Studies, the Pittsburgh Sleep Quality Index, and the Professional Quality of Life Measure, were administered. Results: 49.4% (n = 308) presented suicide risk. The most severely affected groups were nurses (62%, n = 98) and physicians (52.7%, n = 96). Predictors of suicide risk in healthcare workers were secondary traumatic stress, high depressive affect, low positive affect, emotional insecurity and interpersonal problems, and medication use. Conclusions: The suicidal risk detected was high, found mostly in nurses and doctors. This study suggests the presence of psychological effects on healthcare workers, despite the time that has elapsed since the onset of the pandemic.

Evolution of psychopathology, purpose in life, and moral courage in healthcare workers during the COVID-19 pandemic: a longitudinal study

Introduction

Almost 2 years and five infection waves after the COVID-19 pandemic started, healthcare workers continued dealing with the pandemic situation and facing the health consequences and the mental health disorders it caused. This study aimed to evaluate the onset and progression of psychopathology as well as the role of predictor variables such as purpose in life and moral courage among healthcare workers during this time.

Materials and methods

This was a longitudinal prospective study carried out with 45 Spanish healthcare workers who answered two questionnaires, the first questionnaire in April-May 2020 (T1) and the second questionnaire in September-October 2021 (T2).

Results

Although 29.5% of the sample considered that their mental health had improved over this time, almost half of them (47.7%) said it had not changed, while 22.7% reported a decline in their mental health from the first time they were asked. Specifically, 46.8% presented anxiety, 23.4% depression, and 42.6% acute stress at T1, and 38.3% had anxiety, 17% depression, and 27.7% post-traumatic stress disorder at T2. Despite this, there were no differences between T1 and T2 anxiety scores (p = 0.53), although there was a decrease in depression (p = 0.03) and acute stress (p = 0.02) scores. Predictor variable outcomes such as purpose in life (p = 0.88) and moral courage (p = 0.86; p = 0.38) did not change over time, but when modelling the data, purpose in life predicted psychopathology at T1, which in turn affected the psychopathology results at T2.

Conclusion

This study showed that, although psychopathology decreased over the months, its prevalence remained high. Even though the purpose in life predicted psychopathology at T1, it seems that once the psychopathology is established (T2), the factors that would improve it would be different from the protective factors that prevented its establishment, which become secondary.

Beliefs, attitudes and feelings about work among healthcare workers and teachers during the fifth wave of COVID-19

OBJECTIVE

To compare the beliefs, attitudes and feelings about work of healthcare professionals (HCPs) and teachers living in the Canary Islands (Spain) during the COVID-19 pandemic.

METHODS

The study had two parts. In Part 1, the Delphi technique was used to adapt a questionnaire. Part 2 was a cross-sectional, comparative study, performed from August 31st to October 25th, 2021 using the questionnaire online distributed to samples of HCPs and teachers. The questionnaire had three dimensions each separated into three sections (i.e., beliefs [coping ability, prevention and organisation]; attitudes [risks, commitments, and obligations]; feelings about work [burnout, support and work satisfaction]).

RESULTS

In total 1423 questionnaires were available for analysis, 640 from teaching staff and 783 from HCPs. Significant differences were found in eight of the nine sections. HCPs had a more positive attitude towards work compared with teachers, but had more negative beliefs and feelings about work. In addition, by comparison with teachers, HCPs were more committed to their work, more predisposed to take risks and fulfill their obligations, even though our sample of teachers felt more supported and satisfied at work.

CONCLUSIONS

Our results show that the pandemic caused a greater negative impact on job satisfaction of HCPs compared with teachers because they felt less supported by their superiors, which had a greater impact on their psychological health.