Burnout among Health Care Professionals during COVID-19

The Importance of Autonomy and Performance Goals in Perceived Workload Among Behavioral Health Providers

OBJECTIVE

The authors sought to assess workplace characteristics associated with perceived reasonable workload among behavioral health care providers in the Veterans Health Administration.

METHODS

The authors evaluated perceived reasonable workload and workplace characteristics from the 2019 All Employee Survey (AES; N=14,824) and 2019 Mental Health Provider Survey (MHPS; N=10,490) and facility-level staffing ratios from Mental Health Onboard Clinical Dashboard data. Nine AES and 15 MHPS workplace predictors of perceived reasonable workload, 11 AES and six MHPS demographic predictors, and facility-level staffing ratios were included in mixed-effects logistic regression models.

RESULTS

In total, 8,874 (59.9%) AES respondents and 5,915 (56.4%) MHPS respondents reported having a reasonable workload. The characteristics most strongly associated with perceived reasonable workload were having attainable performance goals (average marginal effect [AME]=0.10) in the AES and ability to schedule patients as frequently as indicated (AME=0.09) in the MHPS. Other AES characteristics significantly associated with reasonable workload included having appropriate resources, support for personal life, skill building, performance recognition, concerns being addressed, and no supervisor favoritism. MHPS characteristics included not having collateral duties that reduce care time, staffing levels not affecting care, support staff taking over some responsibilities, having spirit of teamwork, primary care-mental health integration, participation in performance discussions, well-coordinated mental health care, effective veteran programs, working at the top of licensure, and feeling involved in improving access. Facility-level staffing ratios were not significantly associated with perceived reasonable workload.

CONCLUSIONS

Leadership may consider focusing resources on initiatives that support behavioral health providers' autonomy to schedule patients as clinically indicated and develop attainable performance goals.

The Feasibility and Impact of an Asynchronous Interprofessional Well-Being Course on Burnout in Health Care Professionals

Background

Well-being initiatives are essential components in fostering an engaged workforce and creating an effective health care ecosystem. Health care professional (HCP) burnout is widespread and has worsened since the COVID-19 pandemic. In 2014, with Health Resources and Services Administration funding support, the Andrew Weil Center for Integrative Medicine created an online course for HCP well-being. It was subsequently studied in medical residents and revised in 2020. In this study, we explore the impact of the course across larger systems, as well as the long-term impact on HCPs.

Methods

The Health Care Professional Well-Being course is 4.5 hours of interactive online education that explores personal well-being, promoters and detractors of well-being, and systemic factors that influence the overall impact of well-being in health care systems. Participants were recruited through institutional members of the Academic Consortium for Integrative Medicine and Health and were randomized to either active or waitlist control groups. Assessments were taken pre-course, 1-month post-course, and 6-months post-course in the areas of burnout, compassion, resiliency, and lifestyle behaviors.

Results

Burnout measures of depersonalization and emotional exhaustion showed a significant improvement amongst active participants, sustained for 6 months after the course. However, no significant improvement in either the resiliency or the compassion measurements was noted for the active group. Initially, the active group showed improvement in personal accomplishment; however, both groups showed a decline overall. Most noteworthy, a large number of active participants demonstrated adoption of new health-promoting behavior; 95% incorporated at least 1 new lifestyle behavior learned from the course.

Conclusion

This study of a brief, asynchronous, online well-being course with interprofessional HCPs, demonstrates that the course is associated with improvement in individual burnout measures and can educate HCPs about healthy behaviors and a framework for professional engagement.

The psychometric properties of the Burnout Assessment Tool in Norway: A thorough investigation into construct-relevant multidimensionality

OBJECTIVE

The World Health Organization recognizes burnout as an occupational issue. Nevertheless, accurately identifying employee burnout remains a challenging task. To complicate matters, current measures of burnout have demonstrated limitations, prompting the development of the Burnout Assessment Tool (BAT). Given these circumstances, conducting an in-depth examination of the BAT's construct-relevant multidimensionality is crucial.

METHOD

This study focuses on both the original 23-item BAT and the short 12-item version, using modern factor analytic methods to investigate reliability, validity, and measurement invariance in a representative sample from Norway (n = 493; 49.54% women).

RESULTS

Our findings revealed that the bifactor exploratory structural equation modeling solution (burnout global factor and four specific burnout component factors) best explained the data for both BAT versions. All factors demonstrated adequate omega coefficients, with the global factor showing exceptional strength. Both BAT versions correlated highly with each other and with another burnout measure, suggesting convergent validity. Furthermore, both BAT versions achieved full (strict) measurement invariance based on gender. Finally, our results showed that burnout acts as a mediator in our proposed job demands-resources model as preliminary evidence of predictive validity.

CONCLUSIONS

The study validates the Burnout Assessment Tool in the Norwegian context. The study supports the reliability, validity, and unbiased nature of the tool across genders. The findings also reinforce the importance of job demands and resources, along with burnout as a key mediator, in understanding workplace dynamics in accordance with job demands-resources theory.

Person-organization fit and job burnout of researchers during the COVID-19 pandemic: Heterogeneity in eleven countries

To manage the negative impact of job burnout for the researchers, especially during COVID-19 pandemic, is not easy. Thus, it is essential for educational institutions to provide them with the support they need to improve the person-organization (P-O) fit. Drawing upon the data from the Nature's Global Survey initiated in 2021, this paper analyzed 2,424 effective samples from eleven countries in the world to investigate how P-O fit impacts researchers' job burnout in different countries and their career stages during the COVID-19 pandemic. The findings show that both organizational support and P-O fit have significantly assisted researchers in all career stages to reduce job burnout. Moreover, P-O fit has a greater inhibitory effect on job burnout than organizational support. However, when resources are relatively scarce in some developing countries, it is more important to provide organizational support for researchers. Therefore, in order to improve the efficiency of organizational support and reduce researchers' job burnout, those aspects which are less fit but helpful should be increased appropriately. Moreover, it implies that it would be significant to emphasize the differentiated and career-stage-sensitive resources and support to researchers in different countries in the post-pandemic era to improve researchers' well-being and organizational performance.

Burnout and Life Satisfaction among Healthcare Workers Related to the COVID-19 Pandemic (Silesia, Poland)

Background

The phenomenon of burnout among healthcare workers during the COVID-19 pandemic is a widespread problem with several negative consequences for the healthcare system. The many stressors of the pandemic have led to an increased development of anxiety and depressive disorders in many healthcare workers. In addition, some manifested symptoms of the so-called postpandemic stress syndrome and the emergence of occupational burnout syndrome, commonly referred to as "COVID-19 burnout." The aim of this study was to assess the burnout and life satisfaction of healthcare workers during the COVID-19 pandemic.

Materials and Methods

The study was conducted in 2020-2022 among medical staff working in hospitals in Silesia, Poland. The instruments used to assess life satisfaction and burnout were the Satisfaction with Life Scale (SWLS) and the Maslach Burnout Inventory (MBI), which assesses three dimensions: emotional exhaustion (EE), depersonalisation (DEP), and sense of reduced professional accomplishment (SRPA).

Results

The study group included 900 participants. There were 300 physicians (mean age 38 ± 7 years), 300 nurses (mean age 35 ± 6 years), and 300 paramedics (mean age 31 ± 5 years). Life satisfaction as measured by the SWLS was lowest among nurses and paramedics in 2021 and among doctors in 2022. Male respondents and those with fewer years of work had higher levels of life satisfaction. People with more years of work had higher scores in EE and DEP and lower scores in SRPA (p = 0.001). We found a negative correlation between life satisfaction and EE (p = 0.001), DEP (p = 0.001), and SRPA (p = 0.002).

Conclusions

The results highlight the need for further research into the causes of burnout among medical professionals and the need for effective interventions to promote well-being and prevent burnout in this group.