Burnout and Mental Health of COVID-19 Frontline Healthcare Workers: Results from an Online Survey
-
Mohammad Babamiri
,
Saeed Bashirian
,
Salman khazaei
,
Mohammad Sadegh Sohrabi
,
Rashid Heidarimoghadam
,
Alireza Mortezapoor
,
Sepide Zareian
Abstract
Objective: The COVID-19 pandemic has been prolonged and healthcare workers have become exhausted. The purpose of this study was to investigate burnout and its relationship with mental health in COVID-19 frontline healthcare workers.
Method: This cross-sectional study was carried out in all hospitals where patients with COVID-19 were admitted in Hamedan, Iran. With the census method and considering the inclusion criteria, 924 COVID-19 frontline healthcare workers participated in this study. Data were collected using a web-based survey consisting of demographic characteristics, GHQ-28, and Maslach Burnout Inventory. Statistical analysis was performed using Stata 14.
Results: The results showed that the main cause of concern and stress in employees was that it was not clear how long this situation would continue. The results regarding burnout and mental health showed that 29.33% of participants were high in emotional exhaustion (EE), 10.93% were high in depersonalization (DP), 34.31% were low in personal accomplishment (PA), 50.4% had physical symptoms, 50.2% had anxiety and insomnia symptoms, 62.2% had social dysfunction and 17.5% had depression symptoms. The results of the multivariate logistic regression showed that EE had the greatest role in reducing mental health of employees with OR = 6.92 for moderate EE and OR = 39.42 for high EE (P < 0.001).
Conclusion: COVID-19 frontline healthcare workers are at risk for burnout and poor mental health. Health policies should be implemented to help reduce burnout in healthcare workers. Also, person-directed and organizational-directed interventions to rejuvenate these employees seem necessary.
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14. Visser MR, Smets EM, Oort FJ, De Haes HC. Stress, satisfaction and burnout among Dutch medical specialists. Cmaj. 2003;168(3):271-5.
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16. Koutsimani P, Montgomery A, Georganta K. The Relationship Between Burnout, Depression, and Anxiety: A Systematic Review and Meta-Analysis. Front Psychol. 2019;10:284.
17. Babamiri M, Siegrist J, Zemestani M. The Factorial Structure and Psychometric Properties of the Persian Effort-Reward Imbalance Questionnaire. Saf Health Work. 2018;9(3):334-8.
18. Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry. 2016;15(2):103-11.
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21. Ghaderi S, Rezagholy P, Tawana H, Nouri B. The Relationship between Occupational Burnout and Intention to Leave in Nurses Working in Training Hospitals in Sanandaj, Iran. J Nursing, Midwifery and Paramedical Faculty. 2019;4(3):25-34.
22. Nazifi M, Mokarami HR, Akbaritabar A, Faraji Kujerdi M, Tabrizi R, Rahi A. Reliability, validity and factor structure of the persian translation of general health questionnire (ghq-28) in hospitals of kerman university of medical sciences. Journal of Fasa University of Medical Sciences. 2014;3(4):336-42.
23. Maslach C, Jackson SE, Leiter MP. MBI: Maslach burnout inventory. Sunnyvale, CA: CPP, Incorporated; 1996.
24. Moalemi S, Kavosi Z, Beygi N, Deghan A, Karimi A, Parvizi MM. Evaluation of the Persian Version of Maslach Burnout Inventory-Human Services Survey among Iranian Nurses: Validity and Reliability. Galen Med J. 2018;7:e995.
25. Maslach C, Jackson S, Leiter M, Zalaquett C, Wood R. Evaluating stress: a book of resources, Vol 2. USA: Scarecrow education; 1998.
26. Giusti EM, Pedroli E, D'Aniello GE, Stramba Badiale C, Pietrabissa G, Manna C, et al. The Psychological Impact of the COVID-19 Outbreak on Health Professionals: A Cross-Sectional Study. Front Psychol. 2020;11:1684.
27. Hu D, Kong Y, Li W, Han Q, Zhang X, Zhu LX, et al. 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. 2020;24:100424.
28. López-López IM, Gómez-Urquiza JL, Cañadas GR, De la Fuente EI, Albendín-García L, Cañadas-De la Fuente GA. Prevalence of burnout in mental health nurses and related factors: a systematic review and meta-analysis. Int J Ment Health Nurs. 2019;28(5):1032-41.
29. Gulalp B, Karcioglu O, Sari A, Koseoglu Z. Burnout: need help? J Occup Med Toxicol. 2008;3:32.
30. Evans M, Fisher EB. Social Isolation and Mental Health: The Role of Nondirective and Directive Social Support. Community Ment Health J. 2021.
31. Ye Z, Yang X, Zeng C, Wang Y, Shen Z, Li X, et al. Resilience, Social Support, and Coping as Mediators between COVID-19-related Stressful Experiences and Acute Stress Disorder among College Students in China. Appl Psychol Health Well Being. 2020;12(4):1074-94.
32. Babamiri M, Alipour N, Heidarimoghadam R. Research on reducing burnout in health care workers in critical situations such as the COVID-19 outbreak. Work. 2020;66(2):379-80.
33. Salvagioni DAJ, Melanda FN, Mesas AE, González AD, Gabani FL, Andrade SM. Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLoS One. 2017;12(10):e0185781.
34. Liebensteiner MC, Khosravi I, Hirschmann MT, Heuberer PR, Thaler M. Massive cutback in orthopaedic healthcare services due to the COVID-19 pandemic. Knee Surg Sports Traumatol Arthrosc. 2020;28(6):1705-11.
35. Leocani L, Diserens K, Moccia M, Caltagirone C. Disability through COVID-19 pandemic: neurorehabilitation cannot wait. Eur J Neurol. 2020;27(9):e50-e1.
36. Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun. 2020;88:901-7.
37. Moazzami B, Razavi-Khorasani N, Dooghaie Moghadam A, Farokhi E, Rezaei N. COVID-19 and telemedicine: Immediate action required for maintaining healthcare providers well-being. J Clin Virol. 2020;126:104345.
38. Dinibutun SR. Factors Associated with Burnout Among Physicians: An Evaluation During a Period of COVID-19 Pandemic. J Healthc Leadersh. 2020;12:85-94.
39. Koutsimani P, Montgomery A, Georganta K. The Relationship Between Burnout, Depression, and Anxiety: A Systematic Review and Meta-Analysis. Front Psychol. 2019;10:284.
40. Kim JS, Choi JS. Factors Influencing Emergency Nurses' Burnout During an Outbreak of Middle East Respiratory Syndrome Coronavirus in Korea. Asian Nurs Res (Korean Soc Nurs Sci). 2016;10(4):295-9.
41. Templeton K, Bernstein CA, Sukhera J, Nora LM, Newman C, Burstin H, et al. Gender-based differences in burnout: Issues faced by women physicians. NAM Perspect. 2019;5(1):1-16.
42. Shahriarirad R, Erfani A, Ranjbar K, Bazrafshan A, Mirahmadizadeh A. The mental health impact of COVID-19 outbreak: a Nationwide Survey in Iran. Int J Ment Health Syst. 2021;15(1):19.
43. Heidarimoghadam R, Mohammadfam I, Babamiri M, Soltanian AR, Khotanlou H, Sohrabi MS. What do the different ergonomic interventions accomplish in the workplace? A systematic review. Int J Occup Saf Ergon. 2020:1-25.
2. Santarone K, McKenney M, Elkbuli A. Preserving mental health and resilience in frontline healthcare workers during COVID-19. Am J Emerg Med. 2020;38(7):1530-1.
3. Lee SH, Juang YY, Su YJ, Lee HL, Lin YH, Chao CC. Facing SARS: psychological impacts on SARS team nurses and psychiatric services in a Taiwan general hospital. Gen Hosp Psychiatry. 2005;27(5):352-8.
4. Styra R, Hawryluck L, Robinson S, Kasapinovic S, Fones C, Gold WL. Impact on health care workers employed in high-risk areas during the Toronto SARS outbreak. J Psychosom Res. 2008;64(2):177-83.
5. Chan SS, Leung GM, Tiwari AF, Salili F, Leung SS, Wong DC, et al. The impact of work-related risk on nurses during the SARS outbreak in Hong Kong. Fam Community Health. 2005;28(3):274-87.
6. Chong MY, Wang WC, Hsieh WC, Lee CY, Chiu NM, Yeh WC, et al. Psychological impact of severe acute respiratory syndrome on health workers in a tertiary hospital. Br J Psychiatry. 2004;185:127-33.
7. Khalid I, Khalid TJ, Qabajah MR, Barnard AG, Qushmaq IA. Healthcare Workers Emotions, Perceived Stressors and Coping Strategies During a MERS-CoV Outbreak. Clin Med Res. 2016;14(1):7-14.
8. Kim Y, Seo E, Seo Y, Dee V, Hong E. Effects of Middle East Respiratory Syndrome Coronavirus on post-traumatic stress disorder and burnout among registered nurses in South Korea. Int J Healthc. 2018;4(2):27-33.
9. Maunder R, Hunter J, Vincent L, Bennett J, Peladeau N, Leszcz M, et al. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. Cmaj. 2003;168(10):1245-51.
10. Maunder RG, Lancee WJ, Balderson KE, Bennett JP, Borgundvaag B, Evans S, et al. Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerg Infect Dis. 2006;12(12):1924-32.
11. Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatry. 2009;54(5):302-11.
12. Zhu Z, Xu S, Wang H, Liu Z, Wu J, Li G, Miao J, Zhang C, Yang Y, Sun W, Zhu S. COVID-19 in Wuhan: Sociodemographic characteristics and hospital support measures associated with the immediate psychological impact on healthcare workers. EClinicalMedicine. 2020;24(1):1-11.
13. Mirkamali K, Ahmadizad A, Kazemzadeh S, Varmaghani M. Determining the Relationship Between Job Burnout and Employee Productivity. Iran J Ergon. 2019;7(1):37-44.
14. Visser MR, Smets EM, Oort FJ, De Haes HC. Stress, satisfaction and burnout among Dutch medical specialists. Cmaj. 2003;168(3):271-5.
15. Heidarimoghadam R, Saidnia H, Joudaki J, Mohammadi Y, Babamiri M. Does mental workload can lead to musculoskeletal disorders in healthcare office workers? Suggest and investigate a path. Cogent Psychol. 2019;6(1):1-8.
16. Koutsimani P, Montgomery A, Georganta K. The Relationship Between Burnout, Depression, and Anxiety: A Systematic Review and Meta-Analysis. Front Psychol. 2019;10:284.
17. Babamiri M, Siegrist J, Zemestani M. The Factorial Structure and Psychometric Properties of the Persian Effort-Reward Imbalance Questionnaire. Saf Health Work. 2018;9(3):334-8.
18. Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry. 2016;15(2):103-11.
19. Maslach C, Jackson SE, Leiter MP. MBI: Maslach burnout inventory: CPP, Incorporated Sunnyvale, CA; 1996.
20. Abdi masooleh F, Kaviani H, Khaghanizade M, Momeni Araghi A. The relationship between burnout and mental health among nurses. Tehran Univ Med J. 2007;65(6):65-75.
21. Ghaderi S, Rezagholy P, Tawana H, Nouri B. The Relationship between Occupational Burnout and Intention to Leave in Nurses Working in Training Hospitals in Sanandaj, Iran. J Nursing, Midwifery and Paramedical Faculty. 2019;4(3):25-34.
22. Nazifi M, Mokarami HR, Akbaritabar A, Faraji Kujerdi M, Tabrizi R, Rahi A. Reliability, validity and factor structure of the persian translation of general health questionnire (ghq-28) in hospitals of kerman university of medical sciences. Journal of Fasa University of Medical Sciences. 2014;3(4):336-42.
23. Maslach C, Jackson SE, Leiter MP. MBI: Maslach burnout inventory. Sunnyvale, CA: CPP, Incorporated; 1996.
24. Moalemi S, Kavosi Z, Beygi N, Deghan A, Karimi A, Parvizi MM. Evaluation of the Persian Version of Maslach Burnout Inventory-Human Services Survey among Iranian Nurses: Validity and Reliability. Galen Med J. 2018;7:e995.
25. Maslach C, Jackson S, Leiter M, Zalaquett C, Wood R. Evaluating stress: a book of resources, Vol 2. USA: Scarecrow education; 1998.
26. Giusti EM, Pedroli E, D'Aniello GE, Stramba Badiale C, Pietrabissa G, Manna C, et al. The Psychological Impact of the COVID-19 Outbreak on Health Professionals: A Cross-Sectional Study. Front Psychol. 2020;11:1684.
27. Hu D, Kong Y, Li W, Han Q, Zhang X, Zhu LX, et al. 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. 2020;24:100424.
28. López-López IM, Gómez-Urquiza JL, Cañadas GR, De la Fuente EI, Albendín-García L, Cañadas-De la Fuente GA. Prevalence of burnout in mental health nurses and related factors: a systematic review and meta-analysis. Int J Ment Health Nurs. 2019;28(5):1032-41.
29. Gulalp B, Karcioglu O, Sari A, Koseoglu Z. Burnout: need help? J Occup Med Toxicol. 2008;3:32.
30. Evans M, Fisher EB. Social Isolation and Mental Health: The Role of Nondirective and Directive Social Support. Community Ment Health J. 2021.
31. Ye Z, Yang X, Zeng C, Wang Y, Shen Z, Li X, et al. Resilience, Social Support, and Coping as Mediators between COVID-19-related Stressful Experiences and Acute Stress Disorder among College Students in China. Appl Psychol Health Well Being. 2020;12(4):1074-94.
32. Babamiri M, Alipour N, Heidarimoghadam R. Research on reducing burnout in health care workers in critical situations such as the COVID-19 outbreak. Work. 2020;66(2):379-80.
33. Salvagioni DAJ, Melanda FN, Mesas AE, González AD, Gabani FL, Andrade SM. Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLoS One. 2017;12(10):e0185781.
34. Liebensteiner MC, Khosravi I, Hirschmann MT, Heuberer PR, Thaler M. Massive cutback in orthopaedic healthcare services due to the COVID-19 pandemic. Knee Surg Sports Traumatol Arthrosc. 2020;28(6):1705-11.
35. Leocani L, Diserens K, Moccia M, Caltagirone C. Disability through COVID-19 pandemic: neurorehabilitation cannot wait. Eur J Neurol. 2020;27(9):e50-e1.
36. Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun. 2020;88:901-7.
37. Moazzami B, Razavi-Khorasani N, Dooghaie Moghadam A, Farokhi E, Rezaei N. COVID-19 and telemedicine: Immediate action required for maintaining healthcare providers well-being. J Clin Virol. 2020;126:104345.
38. Dinibutun SR. Factors Associated with Burnout Among Physicians: An Evaluation During a Period of COVID-19 Pandemic. J Healthc Leadersh. 2020;12:85-94.
39. Koutsimani P, Montgomery A, Georganta K. The Relationship Between Burnout, Depression, and Anxiety: A Systematic Review and Meta-Analysis. Front Psychol. 2019;10:284.
40. Kim JS, Choi JS. Factors Influencing Emergency Nurses' Burnout During an Outbreak of Middle East Respiratory Syndrome Coronavirus in Korea. Asian Nurs Res (Korean Soc Nurs Sci). 2016;10(4):295-9.
41. Templeton K, Bernstein CA, Sukhera J, Nora LM, Newman C, Burstin H, et al. Gender-based differences in burnout: Issues faced by women physicians. NAM Perspect. 2019;5(1):1-16.
42. Shahriarirad R, Erfani A, Ranjbar K, Bazrafshan A, Mirahmadizadeh A. The mental health impact of COVID-19 outbreak: a Nationwide Survey in Iran. Int J Ment Health Syst. 2021;15(1):19.
43. Heidarimoghadam R, Mohammadfam I, Babamiri M, Soltanian AR, Khotanlou H, Sohrabi MS. What do the different ergonomic interventions accomplish in the workplace? A systematic review. Int J Occup Saf Ergon. 2020:1-25.
| Files | ||
| Issue | Vol 17 No 2 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v17i2.8903 | |
| Keywords | ||
| Burnout COVID-19 Healthcare Mental Health | ||
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How to Cite
1.
Babamiri M, Bashirian S, khazaei S, Sohrabi MS, Heidarimoghadam R, Mortezapoor A, Zareian S. Burnout and Mental Health of COVID-19 Frontline Healthcare Workers: Results from an Online Survey. Iran J Psychiatry. 2022;17(2):136-143.
