Korean J healthc assoc Infect Control Prev.  2022 Jun;27(1):28-34. 10.14192/kjicp.2022.27.1.28.

Burnout among Healthcare Workers during COVID-19 Pandemic

• Hwang S
• Kwon KT

• KMID: 2530823
• DOI: http://doi.org/10.14192/kjicp.2022.27.1.28

Abstract

As the novel coronavirus infection (COVID-19) continues to spread, the burnout of healthcare workers responding to COVID-19 cases is becoming a serious problem. This study reviewed the literature on the burnout among healthcare workers during the COVID-19 pandemic. Risk factors for burnout included fear and anxiety, depression, and stress caused by the thought that COVID-19 could be transmitted to the workers themselves, lack of experience in treating COVID-19, and excessive workload. The burden of wearing personal protective equipment might also be a risk factor for burnout. To prevent burnout of healthcare workers during an outbreak of infectious diseases such as COVID-19, strategies and systems such as providing education and training for novel virus diseases, securing reserve medical personnel, and preparing an appropriate compensation system are absolutely necessary. Additionally, comprehensive plans for an adequate healthcare response to tackling emerging infectious diseases need to be established at the national and local Government levels and in individual medical institutions.

Keyword

Burnout; COVID-19; Health personnel; Emotional exhaustion

Reference

1. Freudenberger HJ. 1974; Staff burn-out. J Soc Issues. 30:159–65. DOI: 10.1111/j.1540-4560.1974.tb00706.x. PMID: 17823059.

2. Fontes FF, Herbert J. 2020. Freudenberger and the making of burnout as a psychopathological syndrome. Memorandum. 37:doi: 10.35699/1676-1669.2020.19144. DOI: 10.35699/1676-1669.2020.19144.

3. Maslach C, Jackson SE. 1981; The measurement of experienced burnout. J Organ Behav. 2:99–113. DOI: 10.1002/job.4030020205.

4. Aust B, Rugulies R, Skakon J, Scherzer T, Jensen C. 2007; Psychosocial work environment of hospital workers: validation of a comprehensive assessment scale. Int J Nurs Stud. 44:814–25. DOI: 10.1016/j.ijnurstu.2006.01.008. PMID: 16542661.

5. Garcia CL, Abreu LC, Ramos JLS, Castro CFD, Smiderle FRN, Santos JAD, et al. 2019; Influence of burnout on patient safety: systematic review and meta-analysis. Medicina (Kaunas). 55:553. DOI: 10.3390/medicina55090553. PMID: 31480365. PMCID: PMC6780563.

6. Cox T, Kuk G, Leiter MP. Schaufeli WB, Maslach C, Marek T, editors. 2017. Burnout, health, work stress, and organizational healthiness. Professional burnout: recent developments in theory and research. Taylor & Francis;Washington, D.C.: p. 177–193. DOI: 10.4324/9781315227979-14. PMID: 28822614. PMCID: PMC6588538.

7. Wong EL, Wong SY, Kung K, Cheung AW, Gao TT, Griffiths S. 2010; Will the community nurse continue to function during H1N1 influenza pandemic: a cross-sectional study of Hong Kong community nurses? BMC Health Serv Res. 10:107. DOI: 10.1186/1472-6963-10-107. PMID: 20433691. PMCID: PMC2907760.

8. Kim JS, Choi JS. 2016; Factors influencing emergency nurses' burnout during an outbreak of Middle East Respiratory Syndrome Coronavirus in Korea. Asian Nurs Res. 10:295–9. DOI: 10.1016/j.anr.2016.10.002. PMID: 28057317. PMCID: PMC7104920.

9. Doulougeri K, Georganta K, Montgomery A. 2016; "Diagnosing" burnout among healthcare professionals: can we find consensus? Cogent Med. 3:1. DOI: 10.1080/2331205X.2016.1237605.

10. Mind Garden. The problem with cut-offs for the Maslach Burnout Inventory. https://www.mindgarden.com/documents/MBI-Cutoff-Caveat.pdf. (Updated on 14 May 2022).

11. Demerouti E, Bakker AB, Vardakou I, Kantas A. 2003; The convergent validity of two burnout instruments: a multitrait-multimethod analysis. Eur J Psychol Assess. 19:12–23. DOI: 10.1027//1015-5759.19.1.12.

12. Demerouti E, Mostert K, Bakker AB. 2010; Burnout and work engagement: a thorough investigation of the independency of both constructs. J Occup Health Psychol. 15:209–22. DOI: 10.1037/a0019408. PMID: 20604629.

13. Peterson U, Demerouti E, Bergström G, Åsberg M, Nygren Å. 2008; Work characteristics and sickness absence in burnout and nonburnout groups: a study of Swedish health care workers. Int J Stress Manag. 15:153–72. DOI: 10.1037/1072-5245.15.2.153.

14. Kristensen TS, Borritz M, Villadsen E, Christensen KB. 2005; The Copenhagen Burnout Inventory: a new tool for the assessment of burnout. Work Stress. 19:192–207. DOI: 10.1080/02678370500297720.

15. Creedy DK, Sidebotham M, Gamble J, Pallant J, Fenwick J. 2017; Prevalence of burnout, depression, anxiety and stress in Australian midwives: a cross-sectional survey. BMC Pregnancy Childbirth. 17:13. DOI: 10.1186/s12884-016-1212-5. PMID: 28068942. PMCID: PMC5223536.

16. Norman SB, Feingold JH, Kaye-Kauderer H, Kaplan CA, Hurtado A, Kachadourian L, et al. 2021; Moral distress in frontline healthcare workers in the initial epicenter of the COVID-19 pandemic in the United States: relationship to PTSD symptoms, burnout, and psychosocial functioning. Depress Anxiety. 38:1007–17. DOI: 10.1002/da.23205. PMID: 34293236. PMCID: PMC8426909.

17. Hernandez JM, Munyan K, Kennedy E, Kennedy P, Shakoor K, Wisser J. 2021; Traumatic stress among frontline American nurses during the COVID-19 pandemic: a survey study. Traumatology (Tallahass Fla). 27:413–8. DOI: 10.1037/trm0000320.

18. Prasad K, McLoughlin C, Stillman M, Poplau S, Goelz E, Taylor S, et al. 2021; Prevalence and correlates of stress and burnout among U.S. healthcare workers during the COVID-19 pandemic: a national cross-sectional survey study. EClinicalMedicine. 35:100879. DOI: 10.1016/j.eclinm.2021.100879. PMID: 34041456. PMCID: PMC8141518.

19. Rohland BM, Kruse GR, Rohrer JE. 2004; Validation of a single-item measure of burnout against the Maslach Burnout Inventory among physicians. Stress Health. 20:75–9. DOI: 10.1002/smi.1002.

20. Miller AG, Roberts KJ, Smith BJ, Burr KL, Hinkson CR, Hoerr CA, et al. 2021; Prevalence of burnout among respiratory therapists amidst the COVID-19 pandemic. Respir Care. 66:1639–48. DOI: 10.4187/respcare.09283. PMID: 34272344.

21. Choudhury A, Singh M, Khurana DK, Mustafi SM, Ganapathy U, Kumar A, et al. 2020; Physiological effects of N95 FFP and PPE in healthcare workers in COVID intensive care unit: a prospective cohort study. Indian J Crit Care Med. 24:1169–73. DOI: 10.5005/jp-journals-10071-23671. PMID: 33446967. PMCID: PMC7775948.

22. Lan J, Song Z, Miao X, Li H, Li Y, Dong L, et al. 2020; Skin damage among health care workers managing coronavirus disease-2019. J Am Acad Dermatol. 82:1215–6. DOI: 10.1016/j.jaad.2020.03.014. PMID: 32171808. PMCID: PMC7194538.

23. Sasangohar F, Jones SL, Masud FN, Vahidy FS, Kash BA. 2020; Provider burnout and fatigue during the COVID-19 pandemic: lessons learned from a high-volume intensive care unit. Anesth Analg. 131:106–11. DOI: 10.1213/ANE.0000000000004866. PMID: 32282389. PMCID: PMC7173087.

24. Denning M, Goh ET, Tan B, Kanneganti A, Almonte M, Scott A, et al. 2021; Determinants of burnout and other aspects of psychological well-being in healthcare workers during the Covid-19 pandemic: a multinational cross-sectional study. PLoS One. 16:e0238666. DOI: 10.1371/journal.pone.0238666. PMID: 33861739. PMCID: PMC8051812.

25. Luceño-Moreno L, Talavera-Velasco B, García-Albuerne Y, Martín-García J. 2020; Symptoms of posttraumatic stress, anxiety, depression, levels of resilience and burnout in Spanish health personnel during the COVID-19 pandemic. Int J Environ Res Public Health. 17:5514. DOI: 10.3390/ijerph17155514. PMID: 32751624. PMCID: PMC7432016.

26. Geoffroy PA, Le Goanvic V, Sabbagh O, Richoux C, Weinstein A, Dufayet G, et al. 2020; Psychological support system for hospital workers during the Covid-19 outbreak: rapid design and implementation of the Covid-Psy hotline. Front Psychiatry. 11:511. DOI: 10.3389/fpsyt.2020.00511. PMID: 32670100. PMCID: PMC7326137.

27. Hu D, Kong Y, Li W, Han Q, Zhang X, Zhu LX, et al. 2020; Frontline nurses' burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: a large-scale cross-sectional study. EClinicalMedicine. 24:100424. DOI: 10.1016/j.eclinm.2020.100424. PMID: 32766539. PMCID: PMC7320259.

28. Huo L, Zhou Y, Li S, Ning Y, Zeng L, Liu Z, et al. 2021; Burnout and its relationship with depressive symptoms in medical staff during the COVID-19 epidemic in China. Front Psychol. 12:616369. DOI: 10.3389/fpsyg.2021.616369. PMID: 33746836. PMCID: PMC7969997.

29. Tan BYQ, Kanneganti A, Lim LJH, Tan M, Chua YX, Tan L, et al. 2020; Burnout and associated factors among health care workers in Singapore during the COVID-19 pandemic. J Am Med Dir Assoc. 21:1751–8.e5. DOI: 10.1016/j.jamda.2020.09.035. PMID: 33256955. PMCID: PMC7534835.

30. Matsuo T, Kobayashi D, Taki F, Sakamoto F, Uehara Y, Mori N, et al. 2020; Prevalence of health care worker burnout during the coronavirus disease 2019 (COVID-19) pandemic in Japan. JAMA Netw Open. 3:e2017271. DOI: 10.1001/jamanetworkopen.2020.17271. PMID: 32749466. PMCID: PMC7403916.

31. Greenglass ER, Burke RJ, Fiksenbaum L. 2001; Workload and burnout in nurses. J Community Appl Soc Psychol. 11:211–5. DOI: 10.1002/casp.614.

32. Xiaoming Y, Ma BJ, Chang CL, Shieh CJ. 2014; Effects of workload on burnout and turnover intention of medical staff: a study. Stud Ethno Med. 8:229–37. DOI: 10.1080/09735070.2014.11917638.

33. Portoghese I, Galletta M, Coppola RC, Finco G, Campagna M. 2014; Burnout and workload among health care workers: the moderating role of job control. Saf Health Work. 5:152–7. DOI: 10.1016/j.shaw.2014.05.004. PMID: 25379330. PMCID: PMC4213899.

34. Wen J, Cheng Y, Hu X, Yuan P, Hao T, Shi Y. 2016; Workload, burnout, and medical mistakes among physicians in China: a cross-sectional study. Biosci Trends. 10:27–33. DOI: 10.5582/bst.2015.01175. PMID: 26961213.

35. Jihn CH, Kim B, Kim KS. 2021; Predictors of burnout in hospital health workers during the COVID-19 outbreak in South Korea. Int J Environ Res Public Health. 18:11720. DOI: 10.3390/ijerph182111720. PMID: 34770231. PMCID: PMC8582777.

36. Maslach C, Jackson SE, Leiter MP. Zalaquett CP, Wood RJ, editors. 1997. Maslach burnout inventory: third edition. Evaluating stress: a book of resources. Scarecrow Education;Lanham: p. 191–218.

37. Hwang S, Kwon KT, Lee SH, Kim Y, Kim SW, Chang HH, et al. 2022; Predictors of healthcare workers' burnout during COVID-19 pandemic: analysis of a large-scale nationwide survey in Korea. Infect Chemother. 54(Suppl 1):S331–2. DOI: 10.14192/kjicp.2022.27.1.28.

38. Hong E, Jung A, Woo K. 2022; A cross-sectional study on public health nurses' disaster competencies and influencing factors during the COVID-19 pandemic in Korea. BMC Public Health. 22:731. DOI: 10.1186/s12889-022-13091-2. PMID: 35413863. PMCID: PMC9005315.

39. Chor WPD, Ng WM, Cheng L, Situ W, Chong JW, Ng LYA, et al. 2021; Burnout amongst emergency healthcare workers during the COVID-19 pandemic: a multi-center study. Am J Emerg Med. 46:700–2. DOI: 10.1016/j.ajem.2020.10.040. PMID: 33129643. PMCID: PMC7584488.

40. Sikaras C, Ilias I, Tselebis A, Pachi A, Zyga S, Tsironi M, et al. 2022; Nursing staff fatigue and burnout during the COVID-19 pandemic in Greece. AIMS Public Health. 9:94–105. DOI: 10.3934/publichealth.2022008. PMID: 35071671. PMCID: PMC8755962.