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Determinants of burnout and other aspects of psychological well-being in healthcare workers during the Covid-19 pandemic: A multinational cross-sectional study.

ABSTRACT: The Covid-19 pandemic has placed unprecedented pressure on healthcare systems and workers around the world. Such pressures may impact on working conditions, psychological wellbeing and perception of safety. In spite of this, no study has assessed the relationship between safety attitudes and psychological outcomes. Moreover, only limited studies have examined the relationship between personal characteristics and psychological outcomes during Covid-19. From 22nd March 2020 to 18th June 2020, healthcare workers from the United Kingdom, Poland, and Singapore were invited to participate using a self-administered questionnaire comprising the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory (OLBI) and Hospital Anxiety and Depression Scale (HADS) to evaluate safety culture, burnout and anxiety/depression. Multivariate logistic regression was used to determine predictors of burnout, anxiety and depression. Of 3,537 healthcare workers who participated in the study, 2,364 (67%) screened positive for burnout, 701 (20%) for anxiety, and 389 (11%) for depression. Significant predictors of burnout included patient-facing roles: doctor (OR 2.10; 95% CI 1.49-2.95), nurse (OR 1.38; 95% CI 1.04-1.84), and 'other clinical' (OR 2.02; 95% CI 1.45-2.82); being redeployed (OR 1.27; 95% CI 1.02-1.58), bottom quartile SAQ score (OR 2.43; 95% CI 1.98-2.99), anxiety (OR 4.87; 95% CI 3.92-6.06) and depression (OR 4.06; 95% CI 3.04-5.42). Significant factors inversely correlated with burnout included being tested for SARS-CoV-2 (OR 0.64; 95% CI 0.51-0.82) and top quartile SAQ score (OR 0.30; 95% CI 0.22-0.40). Significant factors associated with anxiety and depression, included burnout, gender, safety attitudes and job role. Our findings demonstrate a significant burden of burnout, anxiety, and depression amongst healthcare workers. A strong association was seen between SARS-CoV-2 testing, safety attitudes, gender, job role, redeployment and psychological state. These findings highlight the importance of targeted support services for at risk groups and proactive SARS-CoV-2 testing of healthcare workers.

SUBMITTER: Denning M

PROVIDER: S-EPMC8051812 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:IntroductionThis study examined the psychological wellbeing of Healthcare Workers (HCWs) during COVID-19 in a mental health setting, associations of psychosocial wellbeing with coping style, and ways that organisations can mitigate the psychosocial burden on HCWs.MethodsThirty-seven Mental HCWs (MHCWs) from infected and non-infected wards (control group), were recruited and assessed at three timepoints. Psychological wellbeing, perceived cohesion, and coping style (Brief-COPE) were assessed. Reports on individual coping and feedback on the organisation were collected through in-depth interview. Comparison between infected and non-infected wards, as well as comparison of psychosocial measures and perceived cohesion, across the three timepoints were made. As there were no significant changes in coping styles across the timepoints, Timepoint 1 (T1) coping style was used to correlate with the psychosocial measures across all timepoints. Thematic analysis was used for qualitative data.ResultsMHCWs from infected wards reported significantly higher levels of stress, χ2(1) = 6.74, p = 0.009, effect size: medium (ε2 = 0.198), and more severe sleep disturbance (PSQI), χ2(1) = 6.20, p = 0.013, effect size: medium (ε2 = 0.182), as compared to the control group at T2. They also engaged in more problem-focused coping (T2 and T3) and emotion-focused coping (T2). As expected, negative coping style was correlated with negative outcomes except problem-focused coping that was correlated with both negative (sleep disturbance and anxiety symptoms) and positive outcomes (wellbeing). Emotion-focused coping was moderately correlated (Tb = 0.348, p<0.017) with higher levels of wellbeing at T2. Thematic analyses revealed MHCWs felt supported by the responsiveness of the institution, emotional and informational support, and the availability from direct leaders, presence of team and hospital leaders on the ground, helped build trust and confidence in the leadership.ConclusionsMHCWs experienced significantly higher levels of stress and sleep disturbance during COVID-19. The ways that organizations can offset the psychological burden of pandemics on MHCWs are discussed.

Project description:ObjectivesThe aim of this scoping review was to identify pre-existing interventions to support the well-being of healthcare workers during a pandemic or other crisis and to assess the quality of these interventions.DesignArksey and O'Malley's five-stage scoping review framework was used to identify the types of evidence available in the field of well-being interventions for healthcare workers during a pandemic. PubMed, PsycINFO, Embase, Scopus, Web of Science, CINAHL and ERIC databases were searched to find interventions for the well-being of doctors during pandemics. Owing to a lack of results, this search was expanded to all healthcare workers and to include any crisis. Databases were searched in June 2020 and again in October 2020.Inclusion/exclusion criteriaArticles were included that studied healthcare workers, reported an intervention design and were specifically designed for use during a pandemic or other crisis. Well-being was defined broadly and could include psychological, physical, social or educational interventions.ResultsSearching produced 10 529 total academic references of which 2062 were duplicates. This left 8467 references. Of these, 16 met our inclusion criteria and were included in data extraction. During data extraction, three more papers were excluded. This left 13 papers to summarise and report. Of these 13 papers, 6 were prospective studies and 7 were purely descriptive. None of the interventions were theoretically informed in their development and the quality of the evidence was generally deemed poor.ConclusionsThere are no high-quality, theory-based interventions for the well-being of healthcare workers during a pandemic or other crisis. Given that previous pandemics have been shown to have a negative effect on healthcare workers well-being, it is imperative this shortcoming is addressed. This scoping review highlights the need for high-quality, theory-based and evidence-based interventions for the well-being of healthcare workers during a pandemic.

Project description:Burnout, depression, and anxiety are prevalent among healthcare workers (HCWs) during the COVID-19 pandemic and have been previously shown to contribute to poor health outcomes and reduced quality of care. Positive psychological constructs such as positive affect and meaning and purpose are related to resilience in the face of significant stress. No studies have examined these associations among a cohort of HCWs during this pandemic. The purpose of this study was to examine the association of depression, anxiety, positive affect, and meaning and purpose with burnout among HCWs during the COVID-19 pandemic. We utilized data from a cross-sectional survey conducted between September 29-December 8, 2021, among a cohort of 2,411 HCWs from a large, tertiary academic health care system in the Chicago area. We employed the Patient-Reported Outcomes Measurement Information System (PROMIS) measures for depression, anxiety, positive affect, and meaning and purpose and burnout was measured by the Oldenburg Burnout Inventory (OLBI). The majority (80.88%) of HCWs in this study identified as White, Non-Hispanic race/ethnicity, female sex (82.37%), and roughly one third were between ages 30-39 years old (30.98%). Registered nurses (26.96%) accounted for the largest single occupation group. The mean burnout score was 36.87 (SD = 7.65), with 53.38% of participants classified as having burnout, and registered nurses demonstrating the highest proportions of burnout (63.54%). Higher depression (coef = 0.15, SE = 0.03, p < 0.001) and anxiety (coef = 0.25, SE = 0.02, p < 0.001) scores were associated with higher burnout in multivariable linear regression models. Increased positive affect (coef= -0.19, SE= 0.02, p < 0.001) and meaning and purpose (coef= -0.12, SE= 0.01, p < 0.001) scores were significantly associated with reduced burnout. Positive affect and meaning and purpose were inversely associated with burnout among a cohort of HCWs during the COVID-19 pandemic. Previous studies of positive affect and meaning and purpose suggest the potential buffering effect that these indices may have on burnout. Future research is needed to examine the effect of positive affect and meaning and purpose on mitigating the negative impacts of burnout, depression, and anxiety among HCWs as they cope with the stress of the COVID-19 pandemic and beyond.

Project description:Conflicting perspectives on whether mixed emotions are adaptive states which promote integrative processes or uncomfortable states which are agonizing make divergent predictions on whether mixed emotions in daily life are conducive towards psychological well-being. We examined this across three studies. Study 1 (N = 335, 135 males; M age = 41.31) examined associations between state mixed emotions and psychological well-being. Study 2 (N = 389; 160 males; M age = 40.86) examined associations between workplace-specific mixed emotions and workplace ill-being assessed based on burnout. Both direct measures and indirect measures were examined in Study 1 and 2, allowing some comparison of methodological issues related to their predictive validity. Study 3 (N = 3444; 1587 males; M age = 55.34) examined bidirectional relationships between an index of emotional ambivalence and psychological well-being about ten years later, controlling for baselines. Demographic covariates, positive emotions, and negative emotions were controlled for in all studies. Analyses were performed using latent variable structural equation modelling. After adjusting for all covariates, the direct measures of mixed emotions predicted poorer psychological well-being (Study 1) and greater burnout (Study 2). However, indirect measures were found to suffer from relatively greater multicollinearity and poorer predictive validity upon controlling for positive and negative emotions. In Study 3, emotional ambivalence predicted poorer long-term psychological well-being, while psychological well-being also predicted lower emotional ambivalence, supporting bidrectionality. The findings provide preliminary evidence that naturalistically experienced mixed emotions may be conflicting and unpleasant, with potentially negative implications for psychological well-being over and above positive and negative emotions.Supplementary informationThe online version contains supplementary material available at 10.1007/s10902-021-00493-z.

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Determinants of burnout and other aspects of psychological well-being in healthcare workers during the Covid-19 pandemic: A multinational cross-sectional study.

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