Beyond the Outbreak of COVID-19: Factors Affecting Burnout in Nurses in Iran

Depicting occupational trauma concepts impacting nurse well-being during the COVID-19 pandemic

PURPOSE

The purpose of this concept delineation was to differentiate similar concepts impacting nurse well-being during the COVID-19 pandemic, including: compassion fatigue, burnout, moral injury, secondary traumatic stress, and second victim.

METHODS

A total of 63 articles were reviewed for concept delineation. Morse's (1995) approach to concept delineation was utilized to analyse the articles.

RESULTS

Concepts were described interchangeably but were found to present themselves in a sequence. A nurse may experience moral injury, leading to a second victim experience, synonymous with secondary traumatic stress, then compassion fatigue and/or burnout that can be acute or chronic in nature. An Occupational Trauma Conceptual Model was created to depict how these concepts interact based on concept delineation findings.

CONCLUSION

Nurses are experiencing long-lasting occupational trauma and future intervention research should centre on optimizing nurse well-being to ensure the sustainability of nursing profession.

Predictive factors of occupational stress among nurses during the COVID-19 pandemic: a cross-sectional study in Kashan, Iran

BACKGROUND

Considering the severe and sudden changes in the job conditions of nurses during the covid-19 pandemic, the increase in job tensions during this critical period and its consequences on the quantity and quality of nursing care, this study aims to investigate the job stress of nurses during the covid-19 pandemic and its predictors in Iran.

METHODS

This cross-sectional study was conducted on 400 nurses in 'Kashan', Iran, who were randomly selected using stratified sampling. Data were collected using two questionnaires on occupational stress and potential related factors. The data were analyzed in SPSS version 16.

RESULTS

The results showed that the occupational stress of nurses in Iran was at a medium to high level with a mean and standard deviation of 103.773 ± 15.742 (scale of 34-136). Factors such as satisfaction with physical health, quality of work life, satisfaction with the availability of facilities, sense of coherence, education level, work experience, job burnout, male gender, being native, and workplace were predictors of occupational stress and explained 23.3% of the variance in occupational stress score. The highest contribution was related to satisfaction with physical health.

CONCLUSION

Considering the consequences of occupational stress for nurses, it is crucial for health and nursing authorities to take these factors into consideration in policy-making and planning.

Middle-Range Theory of Occupational Stress in Health Professionals

Introduction

Occupational stress affects health professionals; however, no literature was found on the middle-range theory for this outcome in health professionals.

Methods

Methodological study for the theoretical validation of a nursing diagnosis using the theoretical framework of Walker and Avant and the Betty Neuman systems models. The research was conducted in five stages: comprehension of the system model; selection and review of studies; development of the conceptual-theoretical-empirical structure; elaboration of a diagram and proposition of a nursing diagnosis; and evaluation of the empirical adequacy of the theory and validity of the system model. These steps were conducted using a scoping review and a sample of 138 articles selected in the Scopus, Web of Science, MEDLINE/PubMed, CINAHL, PsycINFO, LILACS, Science Direct, Cochrane Library, and Google Scholar databases. A data extraction instrument was developed, and study variables (attributes, antecedents, and clinical consequences) were analyzed using descriptive statistics (absolute and relative frequencies) and presented in tables.

Results

The middle-range theory comprised 16 concepts, 20 propositions, and one diagram. A total of 15 related factors, 29 defining characteristics, six at-risk populations, and one associated condition were indicated to propose the nursing diagnosis for occupational stress.

Conclusion

The middle-range theory supported elaborating elements to propose a nursing diagnosis for occupational stress.

Mental health and work-related factors in healthcare workers in a pandemic - meta-analysis

Due to the SARS-CoV-2 pandemic, healthcare workers worldwide faced major challenges in the form of psychological stress. The aim of this systematic literature review and meta-analysis is to identify mental health consequences and associated work-related factors in healthcare workers during a pandemic and to quantify the influence of associated work-related factors on mental health consequences. A systematic literature search according to PRISMA was conducted on 5 August 2021 using the databases PubMed Central and APA PsychInfo. The included studies investigated the mental health consequences and associated work-related factors in healthcare workers in a pandemic. In addition, we performed a risk of bias analysis to assess the study quality of the included studies using the JBI checklists. Random-effect models and pooled effect estimators were used for the meta-analysis. The Chi2 and I2 statistics were used to identify the statistical heterogeneity. Additional sensitivity analysis was performed. From a total of 3,910 publications, 43 studies met the inclusion criteria. These studies provided 15 stress consequences and 20 stress factors. The most frequently reported stress factors were 'contact with COVID-19 patients', 'no education or training in handling infectious diseases' and 'insufficient protective equipment'. Anxiety, stress, and depression were the most common outcomes identified. Analyses showed an increase in anxiety scores among HCWs who cared for COVID-19 patients, as well as a rise in depressive symptoms due to inadequate or no personal protective equipment. In this review, various pandemic-associated stress factors and stress consequences of healthcare workers were observed. With the results, criteria for effective measures and interventions can be developed to minimize the risk of stress consequences.

Evaluating the impact of coronavirus disease on burnout among healthcare workers using maslach burnout inventory tool: A systematic review

Background

Burnout has been prevalent among healthcare workers (HCWs). However, the effect of the Coronavirus Disease (COVID-19) pandemic on this phenomenon in HCWs is unclear.

Objective

This systematic review aims to evaluate the impact of COVID-19 on burnout of HCWs using Maslach Burnout Inventory (MBI).

Methods

A systematic search was performed on PubMed database for articles published between 1 December 2019 and 30 June 2021. Search strategy combined terms for HCWs, COVID-19, burnout, and MBI. The main outcome of interest was burnout, including both mean prevalence and MBI scores for high emotional exhaustion (EE), high depersonalisation (DP) and low personal accomplishment (PA).

Results

Four cohort studies, 90 cross-sectional studies and one randomised-controlled trial were included for review. Only one cohort study compared burnout data among HCWs before and during COVID-19. It reported a statistically significant increase in mean EE and PA scores from 21.9 to 24.8 ( p = .001), and 42.7 to 48.7 ( p = .001), respectively. The remaining studies only evaluated burnout data during COVID-19 but were missing burnout data prior to the pandemic for comparison. Across these studies, the overall mean prevalence of burnout among HCWs was 39.95%, with mean MBI EE scores of 22.07, DP scores of 7.83, and PA scores of 32.53. Burnout outcomes were generally comparable across specific healthcare professions such as doctors and nurses.

Conclusion

Whilst quality research elucidating the effect of pandemic on burnout is lacking, current burnout prevalence among HCWs during COVID-19 is notable.

Association Between Dimensions of Professional Burnout and Turnover Intention Among Nurses Working in Hospitals During Coronavirus Disease (COVID-19) Pandemic in Iran Based on Structural Model

Purpose

This study was done to assess the dimensions of professional burnout and turnover intention among nurses working in hospitals during the coronavirus disease 2019 (COVID-19) pandemic in Iran based on a structural model.

Methods

This cross-sectional study was performed among 170 nurses working in two referral hospitals of COVID-19 in Tehran Province, Iran, from September to December 2020. Data were collected using the sociodemographic form, Maslach Burnout Inventory (MBI), and Turnover Intention Questionnaire. Data were analyzed with SPSS and Amos software version 22 using independent t-test, ANOVA, and structural equation model.

Results

The mean scores for burnout in emotional fatigue, depersonalization, and personal accomplishment dimensions were 25.38 ± 7.55, 9.47 ± 4.40, and 34.94 ± 7.80, respectively, moreover for the turnover intention, the score was 6.51 ± 3.17. The reduced personal accomplishment was identified as a positive predictor of turnover intention (p = 0.01). Work position and interest in attending the organization were significantly correlated with the turnover intention (p < 0.05).

Conclusions

There is an immediate need to prepare nurses to cope better with the COVID-19 outbreak. Work-related stressors during the COVID-19 pandemic have led to an increase in nurses' burnout and turnover intention. Identifying and managing the factors related to professional burnout will make it possible to prevent the nurses' turnover intention in such critical situations.

Status and Influencing Factors of Social Media Addiction in Chinese Medical Care Professionals: A Cross-Sectional Survey

Background

In modern society, social media addiction (SMA) has become a serious problem in many countries, including China. Almost every medical care professional has their own social media account. They are also at risk for SMA, but no SMA studies in Chinese medical care professionals have been published. This study aims to investigate the status and influencing factors of SMA among Chinese medical care professionals.

Methods

A cross-sectional study was conducted among 519 physicians and nurses from two randomly selected hospitals using a questionnaire that included the Social Networking Service Addiction Scale (SNSAS), Maslach's Burnout Inventory-General Survey (MBI-GS), the General Self-efficacy Scale (GSES), and eight demographic datasets.

Results

This study's findings showed that most of the participants' (357,68.79%) scores reached 2.5 points (half of the highest possible score), indicating that SMA scores of Chinese medical care professionals were relatively high. Significant differences in SMA scores by age (p < 0.01), marital status (p < 0.01), professional title (p < 0.01), and working years (p < 0.01) were found. Income satisfaction (p < 0.01) and sleep quality (p < 0.05) were negatively correlated with SMA. The GSES score was not correlated with SMA (p = 0.377). Burnout significantly positively affected SMA (p < 0.01).

Conclusion

Our study found that the SMA scores of Chinese medical care professionals were relatively high. To reduce the SMA level of the medical care population, we should first start with reducing burnout, enabling medical care professionals to achieve sufficient sleep, increasing medical staff income, and providing more opportunities for promotion.

The association between fear of COVID-19 and mental health: The mediating roles of burnout and job stress among emergency nursing staff

Aim

This current study examined the mediation roles of burnout and job stress in the association between fear of COVID‐19 and mental health among emergency nurses.

Design

Cross‐sectional survey.

Methods

A total of 516 emergency nurses with a mean age of 41.18 (SD = 8.24), mostly females (76.16%) and married (78.9%) responded to measures on fear of COVID‐19, burnout, job stress and mental health between 15 September and 7 November 2020.

Results

There was a significantly direct effect between (a) fear of COVID‐19 and mental health, (b) fear of COVID‐19 and mediators (burnout and job stress) and (c) mediators (burnout and job stress) and mental health. Also, there was a significantly indirect effect between fear of COVID‐19 and mental health through job stress, burnout or both.

Conclusions

Fear of COVID‐19 directly and indirectly influenced the mental health of emergency nurses. Therefore, hospital authorities should provide sufficient resources to allay the fears of nurses during this COVID‐19 pandemic period.

Exploring Global Research Trends in Burnout among Nursing Professionals: A Bibliometric Analysis

Nursing professionals are constantly exposed to several risk factors and high levels of stress that can affect their mental, emotional, and physical health, which can trigger burnout syndrome. This article aims to use bibliometric analysis to investigate burnout research trends among nursing professionals worldwide and to compare the contributions of different countries/institutions, scientific journals, authors, keywords, and citations. A bibliometric study was performed using the Scopus and Web of Science databases, in the period up to November 2021, aiming to search original and review articles in the English language regarding burnout in nursing professionals. The analysis was performed with a sample of 1406 articles. The most cited article indicated that 43% of nurses had high burnout scores, and a similar percentage were dissatisfied with their work. The most productive and most cited country in the world was the United States of America. Regarding the 10 most cited documents, there were no studies that could provide interventions to reduce burnout in nursing professionals, which can result in a need to develop studies on prevention capable of mitigating the problem, in view of the impacts generated on their mental, emotional, and physical health.