COVID-19 and burnout in healthcare personnel: A review of the literature

Jordan Pekevski, PhD

doi:10.5055/jem.0620

Authors

Jordan Pekevski, PhD https://orcid.org/0000-0003-1175-7204

DOI:

https://doi.org/10.5055/jem.0620

Keywords:

COVID-19, burnout, mental health

Abstract

Healthcare personnel have been providing care to individuals affected by coronavirus disease 2019 (COVID-19) for well over a year. They have been faced with numerous challenges during this time. Burnout was a problem for healthcare providers even prior to the pandemic, but the increased challenges of the pandemic are likely to raise the burnout rates in this population. This study provides information on burnout and the effects of previous epidemics and the current pandemic on burnout and mental health of healthcare providers. Lastly, information on interventions is presented, including organizational and individual interventions.

Author Biography

Jordan Pekevski, PhD

VA Western Colorado Health Care System, Grand Junction, Colorado

References

A timeline of COVID-19 developments in 2020. Am J Managed Care. Published January 1, 2021. Available at https://www.ajmc.com/view/a-timeline-of-covid19-developments-in-2020. Accessed February 11, 2021.

Wu PE, Styra R, Gold WL: Mitigating the psychological effects of COVID-19 on health care workers. CMAJ. 2020; 192(17): E459-E460. DOI:10.1503/cmaj.200519.

Upadhyay P: Healthcare workers and burnout during COVID-19 pandemic. J Lumbini Med Coll. 2020; 8(1): 178-180. DOI:10.22502/jlmc.v8i1.380.

Busch I, M, Moretti F, Mazzi M, Wu A, W, Rimondini M: What We Have Learned from Two Decades of Epidemics and Pandemics: A Systematic Review and Meta-Analysis of the Psychological Burden of Frontline Healthcare Workers. Psychother Psychosom. 2021; 90: 178-190. DOI:10.1159/000513733

Kreh A, Brancaleoni R, Magalini SC, et al.: Ethical and psychosocial considerations for hospital personnel in the COVID-19 crisis: Moral injury and resilience. PloS One. 2021; 16(4): e0249609-e0249609. DOI:10.1371/journal.pone.0249609.

World Health Organization: Burn-out an “occupational phenomenon”: International Classification of Diseases. Published May 28, 2019. Available at https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-internationalclassification-of-diseases. Accessed February 14, 2021.

Maslach C, Schaufeli WB, Leiter MP: Job burnout. Annu Rev Psychol. 2001; 52: 397-422. DOI:10.1146/annurev.psych.52.1.397.

Lubbadeh T: Job burnout: A general literature review. Int Rev Manag Mark. 2020; 10: 7-15. DOI:10.32479/irmm.9398.

Salvagioni DAJ, Melanda FN, Mesas AE, et al.: Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PloS One. 2017; 12(10): e0185781. DOI:10.1371/journal.pone.0185781.

Busch IM, Moretti F, Mazzi M, et al.: What we have learned from two decades of epidemics and pandemics: A systematic review and meta-analysis of the psychological burden of frontline healthcare workers. Psychother Psychosom. Published online February 1, 2021; 90: 178-190. DOI:10.1159/000513733.

Hu D, Kong Y, Li W, 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. DOI:10.1016/j.eclinm.2020.100424.

Ruiz-Fernández MD, Ramos-Pichardo JD, Ibáñez-Masero O, et al.: Compassion fatigue, burnout, compassion satisfaction and perceived stress in healthcare professionals during the COVID-19 health crisis in Spain. J Clin Nurs. 2020;29(21-22): 4321-4330. DOI:10.1111/jocn.15469.

Algunmeeyn A, El-Dahiyat F, Altakhineh MM, et al.: Understanding the factors influencing healthcare providers’ burnout during the outbreak of COVID-19 in Jordanian hospitals. J Pharm Policy Pract. 2020; 13: 53. DOI:10.1186/s40545-020-00262-y.

Choi MY: Mental and physical factors influencing wellbeing among South Korean emergency workers. Int J Environ Res Public Health. 2020; 18(1): 70. DOI:10.3390/ijerph18010070.

Barello S, Palamenghi L, Graffigna G: Stressors and resources for healthcare professionals during the COVID-19 pandemic: Lesson learned from Italy. Front Psychol. 2020; 11: 2179. DOI:10.3389/fpsyg.2020.02179.

Giusti EM, Pedroli E, D’Aniello GE, et al.: The psychological impact of the COVID-19 outbreak on health professionals: A cross-sectional study. Front Psychol. 2020; 11: 1684. DOI:10.3389/fpsyg.2020.01684.

Lasalvia A, Amaddeo F, Porru S, et al.: Levels of burn-out among healthcare workers during the COVID-19 pandemic and their associated factors: A cross-sectional study in a tertiary hospital of a highly burdened area of north-east Italy. BMJ Open. 2021; 11(1): e045127. DOI:10.1136/bmjopen-2020-045127.

Orrù G, Marzetti F, Conversano C, et al.: Secondary traumatic stress and burnout in healthcare workers during COVID-19 outbreak. Int J Environ Res Public Health. 2021; 18(1): 337. DOI:10.3390/ijerph18010337.

Barello S, Palamenghi L, Graffigna G: Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic. Psychiatry Res. 2020; 290: 113129. DOI:10.1016/j.psychres.2020.113129.

Cai H, Tu B, Ma J, et al.: Psychological impact and coping strategies of frontline medical staff in Hunan between January and March 2020 during the outbreak of coronavirus disease 2019 (COVID‑19) in Hubei, China. Med Sci Monit Int Med J Exp Clin Res. 2020; 26: e924171. DOI:10.12659/MSM.924171.

Xiao H, Zhang Y, Kong D, et al.: The effects of social support on sleep quality of medical staff treating patients with coronavirus disease 2019 (COVID-19) in January and February 2020 in China. Med Sci Monit Int Med J Exp Clin Res. 2020; 26: e923549. DOI:10.12659/MSM.923549.

Wang QQ, Kaelber DC, Xu R, et al.: COVID-19 risk and outcomes in patients with substance use disorders: Analyses from electronic health records in the United States. Mol Psychiatry. Published online September 14, 2020: 1-10. DOI:10.1038/s41380-020-00880-7.

Mantri S, Lawson JM, Wang Z, et al.: Prevalence and predictors of moral injury symptoms in health care professionals. J Nerv Ment Dis. 2021; 209(3): 174-180. DOI:10.1097/NMD.0000000000001277.

Trumello C, Bramanti SM, Ballarotto G, et al.: Psychological adjustment of healthcare workers in Italy during the COVID-19 pandemic: Differences in stress, anxiety, depression, burnout, secondary trauma, and compassion satisfaction between frontline and non-Frontline professionals. Int J Environ Res Public Health. 2020; 17(22): 8358. DOI:10.3390/ijerph17228358.

Kang L, Ma S, Chen M, et al.: Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study. Brain Behav Immun. 2020; 87: 11-17. DOI:10.1016/j.bbi.2020.03.028.

Shechter A, Diaz F, Moise N, et al.: Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic. Gen Hosp Psychiatry. 2020; 66: 1-8. DOI:10.1016/j.genhosppsych.2020.06.007.

Awa WL, Plaumann M, Walter U: Burnout prevention: A review of intervention programs. Patient Educ Couns. 2010; 78(2): 184-190. DOI:10.1016/j.pec.2009.04.008.

Pijpker R, Vaandrager L, Veen EJ, et al.: Combined interventions to reduce burnout complaints and promote return to work: A systematic review of effectiveness and mediators of change. Int J Environ Res Public Health. 2019; 17(1): 55. DOI:10.3390/ijerph17010055.

Restauri N, Sheridan AD: Burnout and posttraumatic stress disorder in the coronavirus disease 2019 (COVID-19) pandemic: Intersection, impact, and interventions. J Am Coll Radiol JACR. 2020; 17(7): 921-926. DOI:10.1016/j.jacr.2020.05.021.

Maslach C, Leiter MP: Understanding the burnout experience: Recent research and its implications for psychiatry. World Psychiatry Off J World Psychiatr Assoc WPA. 2016; 15(2): 103-111. DOI:10.1002/wps.20311.

De Hert S: Burnout in healthcare workers: Prevalence, impact and preventative strategies. Local Reg Anesth. 2020; 13: 171-183. DOI:10.2147/LRA.S240564.

Hamilton A, Sala G, Qureshi O, et al.: Stories from the field: Mapping innovation in mental health during the COVID-19 pandemic. Intervention. 2020; 18(2): 159. DOI:10.4103/INTV.

INTV_22_20.

Zerbini G, Ebigbo A, Reicherts P, et al.: Psychosocial burden of healthcare professionals in times of COVID-19: A survey conducted at the University Hospital Augsburg. Ger Med Sci GMS E-J. 2020; 18: Doc05. DOI:10.3205/000281.

Shah K, Chaudhari G, Kamrai D, et al.: How essential is to focus on physician’s health and burnout in coronavirus (COVID-19) pandemic? Cureus. 2020; 12(4): e7538. DOI:10.7759/cureus.7538.

Heath C, Sommerfield A, von Ungern-Sternberg BS: Resilience strategies to manage psychological distress among healthcare workers during the COVID-19 pandemic: A narrative review. Anaesthesia. 2020; 75(10): 1364-1371. DOI:10.1111/anae.15180.

Dimitriu MCT, Pantea-Stoian A, Smaranda AC, et al.: Burnout syndrome in Romanian medical residents in time of the COVID-19 pandemic. Med Hypotheses. 2020; 144: 109972. DOI:10.1016/j.mehy.2020.109972.

Morgantini LA, Naha U, Wang H, et al.: Factors contributing to healthcare professional burnout during the COVID-19 pandemic: A rapid turnaround global survey. PloS One. 2020;15(9):e0238217. DOI:10.1371/journal.pone.0238217.

Leiter MP, Laschinger HKS, Day A, et al.: The impact of civility interventions on employee social behavior, distress, and attitudes. J Appl Psychol. 2011; 96(6): 1258-1274. DOI:10.1037/a0024442.

Leiter MP, Day A, Oore DG, et al.: Getting better and staying better: Assessing civility, incivility, distress, and job attitudes one year after a civility intervention. J Occup Health Psychol. 2012; 17(4): 425-434. DOI:10.1037/a0029540.

Gregory ST, Menser T, Gregory BT: An organizational intervention to reduce physician burnout. J Healthc Manag Am Coll Healthc Exec. 2018; 63(5): 338-352. DOI:10.1097/JHM-D-16-00037.

Dunn PM, Arnetz BB, Christensen JF, et al.: Meeting the imperative to improve physician well-being: Assessment of an innovative program. J Gen Intern Med. 2007; 22(11): 1544-1552. DOI:10.1007/s11606-007-0363-5.

Reid RJ, Coleman K, Johnson EA, et al.: The Group Health medical home at year two: Cost savings, higher patient satisfaction, and less burnout for providers. Health Aff Proj Hope. 2010; 29(5): 835-843. DOI:10.1377/hlthaff.2010.0158.

Le Blanc PM, Hox JJ, Schaufeli WB, et al.: Take care! The evaluation of a team-based burnout intervention program for oncology care providers. J Appl Psychol. 2007; 92(1): 213-227. DOI:10.1037/0021-9010.92.1.213.

Pekevski J: First responders and psychological first aid. J Emerg Manag. 2013; 11(1): 39-48. DOI:10.5055/jem.2013.0126.

Schreiber M, Cates DS, Formanski S, et al.: Maximizing the resilience of healthcare workers in multi-hazard events: Lessons from the 2014-2015 Ebola response in Africa. Mil Med. 2019; 184(Suppl 1): 114-120. DOI:10.1093/milmed/usy400.

Edrees H, Connors C, Paine L, et al.: Implementing the RISE second victim support programme at the Johns Hopkins Hospital: A case study. BMJ Open. 2016; 6(9): e011708. DOI:10.1136/bmjopen-2016-011708.

Callahan K, Christman G, Maltby L: Battling burnout: Strategies for promoting physician wellness. Adv Pediatr. 2018; 65(1): 1-17. DOI:10.1016/j.yapd.2018.03.001.

Naczenski LM, Vries JD de, Hooff MLM van, et al.: Systematic review of the association between physical activity and burnout. J Occup Health. 2017; 59(6): 477-494. DOI:10.1539/joh.17-0050-RA.

Goodman MJ, Schorling JB: A mindfulness course decreases burnout and improves well-being among healthcare providers. Int J Psychiatry Med. 2012; 43(2): 119-128. DOI:10.2190/PM.43.2.b.

Waris Nawaz M, Imtiaz S, Kausar E: Self-care of frontline health care workers: During COVID-19 pandemic. Psychiatr Danub. 2020; 32(3-4): 557-562. DOI:10.24869/psyd.2020.557.

Maunder RG, Lancee WJ, Mae R, et al: Computer-assisted resilience training to prepare healthcare workers for pandemic influenza: A randomized trial of the optimal dose of training. BMC Health Serv Res. 2010; 10: 72. DOI:10.1186/1472-6963-10-72.

Blake H, Bermingham F, Johnson G, et al.: Mitigating the psychological impact of COVID-19 on healthcare workers: A digital learning package. Int J Environ Res Public Health. 2020; 17(9): 51. DOI:10.3390/ijerph17092997.