Burnout among Healthcare Providers of COVID-19; a Systematic Review of Epidemiology and Recommendations Burnout in healthcare providers
Archives of Academic Emergency Medicine,
Vol. 9 No. 1 (2021),
1 January 2021
Introduction: In the current systematic review, we intended to systematically review the epidemiology of burnout and the strategies and recommendations to prevent or reduce it among healthcare providers (HCPs) of COVID-19 wards, so that policymakers can make more appropriate decisions.
Methods: MEDLINE (accessed from PubMed), Science Direct, and Scopus electronic databases were systematically searched in English from December 01, 2019 to August 15, 2020, using MESH terms and related keywords. After reading the title and the abstract, unrelated studies were excluded. The full texts of the studies were evaluated by authors, independently, and the quality of the studies was determined. Then, the data were extracted and reported.
Results: 12 studies were included. Five studies investigated the risks factors associated with burnout; none could establish a causal relationship because of their methodology. No study examined any intervention to prevent or reduce burnout, and the provided recommendations were based on the authors' experiences and opinions. None of the studies followed up the participants, and all assessments were done according to the participants’ self-reporting and declaration. Assessing burnout in the HCPs working in the frontline wards was performed in four studies; others evaluated burnout among all HCPs working in the regular and frontline wards.
Conclusion: Paying attention to the mental health issues, reducing the workload of HCPs through adjusting their work shifts, reducing job-related stressors, and creating a healthy work environment may prevent or reduce the burnout.
- Burnout, Professional; COVID-19; Coronavirus; Health policy; Workforce
How to Cite
Imo UO. Burnout and psychiatric morbidity among doctors in the UK: a systematic literature review of prevalence and associated factors. BJPsych bulletin. 2017;41(4):197-204. doi: 10.1192/pb.bp.116.054247. PubMed PMID: 28811913.
Woo T, Ho R, Tang A, Tam W. Global prevalence of burnout symptoms among nurses: A systematic review and meta-analysis. J Psychiatr Res. 2020;123:9-20. doi: 10.1016/j.jpsychires.2019.12.015. PubMed PMID: 32007680.
Organization WH. Burn-out an "occupational phenomenon": International Classification of Diseases 2019. Available from: https://www.who.int/mental_health/evidence/burn-out/en/.
Maunz S, Steyrer J. [Burnout syndrome in nursing: etiology, complications, prevention]. Wien Klin Wochenschr. 2001;113(7-8):296-300. PubMed PMID: 11383392.
Schluter J, Winch S, Holzhauser K, Henderson A. Nurses' moral sensitivity and hospital ethical climate: a literature review. Nurs Ethics. 2008;15(3):304-21. Epub 2008/04/05. doi: 10.1177/0969733007088357. PubMed PMID: 18388166.
Hartzband P, Groopman J. Physician Burnout, Interrupted. N Engl J Med. 2020;382(26):2485-7. Epub 2020/05/02. doi: 10.1056/NEJMp2003149. PubMed PMID: 32356624.
Panagioti M, Geraghty K, Johnson J, Zhou A, Panagopoulou E, Chew-Graham C, et al. Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction: A Systematic Review and Meta-analysis. JAMA Intern Med. 2018;178(10):1317-31. doi: 10.1001/jamainternmed.2018.3713. PubMed PMID: 30193239.
Organization WH. Coronavirus disease (COVID-19) pandemic World Health Organization2020. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019.
Dimitriu MCT, Pantea-Stoian A, Smaranda AC, Nica AA, Carap AC, Constantin VD, et al. Burnout syndrome in Romanian medical residents in time of the COVID-19 pandemic. Med Hypotheses. 2020;144:109972. Epub 2020/06/13. doi: 10.1016/j.mehy.2020.109972. PubMed PMID: 32531540; PubMed Central PMCID: PMCPMC7276114.
Upadhyay P. Healthcare Workers and Burnout During COVID-19 Pandemic. J Lumbini Med Coll. 2020;8(1):178-80. doi: https://doi.org/10.22502/jlmc.v8i1.380.
Sung C-W, Chen C-H, Fan C-Y, Su F-Y, Chang J-H, Hung C-C, et al. Burnout in Medical Staffs During a Coronavirus Disease (COVID-19) Pandemic. Available at SSRN 3594567. 2020.
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. Epub 2020/06/03. doi: 10.1016/j.psychres.2020.113129. PubMed PMID: 32485487; PubMed Central PMCID: PMCPMC7255285 competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Fessell D, Cherniss C. Coronavirus Disease 2019 (COVID-19) and Beyond: Micropractices for Burnout Prevention and Emotional Wellness. J Am Coll Radiol. 2020;17(6):746-8. Epub 2020/03/26. doi: 10.1016/j.jacr.2020.03.013. PubMed PMID: 32208139; PubMed Central PMCID: PMCPMC7146659.
Wu Y, Wang J, Luo C, Hu S, Lin X, Anderson AE, et al. A Comparison of Burnout Frequency Among Oncology Physicians and Nurses Working on the Frontline and Usual Wards During the COVID-19 Epidemic in Wuhan, China. J Pain Symptom Manage. 2020;60(1):e60-e5. Epub 2020/04/14. doi: 10.1016/j.jpainsymman.2020.04.008. PubMed PMID: 32283221; PubMed Central PMCID: PMCPMC7151285.
Sahin T, Aslaner H, Eker OO, Gokcek MB, Dogan M. Effect of COVID-19 pandemic on anxiety and burnout levels in emergency healthcare workers: a questionnaire study. 2020.
Gronseth GS, Woodroffe LM, Getchius TS. Clinical practice guideline process manual. St Paul, MN: American Academy of Neurology. 2011.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8(5):336-41.
Kannampallil TG, Goss CW, Evanoff BA, Strickland JR, McAlister RP, Duncan J. Exposure to COVID-19 patients increases physician trainee stress and burnout. PLoS One. 2020;15(8):e0237301. Epub 2020/08/08. doi: 10.1371/journal.pone.0237301. PubMed PMID: 32760131; PubMed Central PMCID: PMCPMC7410237.
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. Epub 2020/08/09. doi: 10.1016/j.eclinm.2020.100424. PubMed PMID: 32766539; PubMed Central PMCID: PMCPMC7320259.
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. 2020;17(7):921-6. Epub 2020/06/02. doi: 10.1016/j.jacr.2020.05.021. PubMed PMID: 32479798; PubMed Central PMCID: PMCPMC7250786.
Luceno-Moreno L, Talavera-Velasco B, Garcia-Albuerne Y, Martin-Garcia J. 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. 2020;17(15). Epub 2020/08/06. doi: 10.3390/ijerph17155514. PubMed PMID: 32751624; PubMed Central PMCID: PMCPMC7432016.
Zerbini G, Ebigbo A, Reicherts P, Kunz M, Messman H. Psychosocial burden of healthcare professionals in times of COVID-19–a survey conducted at the University Hospital Augsburg. GMS German Medical Science. 2020;18.
Morgantini LA, Naha U, Wang H, Francavilla S, Acar O, Flores JM, et al. Factors Contributing to Healthcare Professional Burnout During the COVID-19 Pandemic: A Rapid Turnaround Global Survey. medRxiv. 2020. Epub 2020/06/09. doi: 10.1101/2020.05.17.20101915. PubMed PMID: 32511501; PubMed Central PMCID: PMCPMC7273269.
Wan Z, Lian M, Ma H, Cai Z, Xianyu Y. Factors Associated with Burnout among Chinese Nurses during COVID-19 Epidemic: a cross-sectional study. 2020.
Houtrow AJ. Addressing Burnout: Symptom Management Versus Treating the Cause. J Pediatr. 2020;224:18-9. Epub 2020/05/07. doi: 10.1016/j.jpeds.2020.04.068. PubMed PMID: 32370952; PubMed Central PMCID: PMCPMC7194062.
Shah K, Chaudhari G, Kamrai D, Lail A, Patel RS. How Essential Is to Focus on Physician's Health and Burnout in Coronavirus (COVID-19) Pandemic? Cureus. 2020;12(4):e7538. Epub 2020/05/08. doi: 10.7759/cureus.7538. PubMed PMID: 32377486; PubMed Central PMCID: PMCPMC7198080.
Nadler MB, Barry A, Murphy T, Prince R, Elliott M. Strategies to support health care providers during the COVID-19 pandemic. CMAJ. 2020;192(19):E522. Epub 2020/06/24. doi: 10.1503/cmaj.75499. PubMed PMID: 32575044; PubMed Central PMCID: PMCPMC7234263.
Janeway D. The Role of Psychiatry in Treating Burnout Among Nurses During the Covid-19 Pandemic. J Radiol Nurs. 2020;39(3):176-8. Epub 2020/08/25. doi: 10.1016/j.jradnu.2020.06.004. PubMed PMID: 32837392; PubMed Central PMCID: PMCPMC7377731.
Ong AM. Impact of COVID-19 on medical education and resident burnout in a postgraduate programme. Singapore Med J. 2020. Epub 2020/06/27. doi: 10.11622/smedj.2020100. PubMed PMID: 32588582.
Ong AM-L. Outrunning Burnout in a GI Fellowship Program During the COVID-19 Pandemic. Digestive Diseases and Sciences. 2020:1.
Sasangohar F, Jones SL, Masud FN, Vahidy FS, Kash BA. Provider Burnout and Fatigue During the COVID-19 Pandemic: Lessons Learned From a High-Volume Intensive Care Unit. Anesth Analg. 2020;131(1):106-11. Epub 2020/04/14. doi: 10.1213/ANE.0000000000004866. PubMed PMID: 32282389; PubMed Central PMCID: PMCPMC7173087.
Sultana A, Sharma R, Hossain MM, Bhattacharya S, Purohit N. Burnout among healthcare providers during COVID-19 pandemic: Challenges and evidence-based interventions. 2020.
Freudenberger HJ. Staff burn‐out. Journal of social issues. 1974;30(1):159-65.
Maslach C, Jackson SE. The measurement of experienced burnout. Journal of organizational behavior. 1981;2(2):99-113.
De Simone S, Vargas M, Servillo G. Organizational strategies to reduce physician burnout: a systematic review and meta-analysis. Aging clinical and experimental research. 2019:1-12.
Pfefferbaum B, North CS. Mental health and the Covid-19 pandemic. New England Journal of Medicine. 2020.
Deldar K, Froutan R, Dalvand S, Gheshlagh RG, Mazloum SR. The relationship between resiliency and burnout in Iranian nurses: A systematic review and meta-analysis. Open access Macedonian journal of medical sciences. 2018;6(11):2250.
Gavidia M. Sleep, Physician Burnout Linked Amid COVID-19 Pandemic AJMC News2020. Available from: Sleep, Physician Burnout Linked Amid COVID-19 Pandemic.
Shrestha R. Post-traumatic stress disorder among medical personnel after Nepal earthquake, 2015. Journal of Nepal Health Research Council. 2015.
Karampelias V, Karonis D, Psaroudi V. The psycho-emotional impact of COVID-19 on surgical staff working in emergency departments. Eur J Trauma Emerg Surg. 2020;46(4):747-9. Epub 2020/06/05. doi: 10.1007/s00068-020-01411-3. PubMed PMID: 32494836; PubMed Central PMCID: PMCPMC7269422.
Albott CS, Wozniak JR, McGlinch BP, Wall MH, Gold BS, Vinogradov S. Battle Buddies: Rapid Deployment of a Psychological Resilience Intervention for Health Care Workers During the COVID-19 Pandemic. Anesth Analg. 2020;131(1):43-54. Epub 2020/04/30. doi: 10.1213/ANE.0000000000004912. PubMed PMID: 32345861; PubMed Central PMCID: PMCPMC7199769.
Kamal AH, Bull JH, Wolf SP, Swetz KM, Shanafelt TD, Ast K, et al. Prevalence and predictors of burnout among hospice and palliative care clinicians in the US. Journal of pain and symptom management. 2020;59(5):e6-e13.
Burton J. Healthy workplace framework and model: background and supporting literature and practice World Health Organization2010.
Maslach C. Burnout: The cost of caring: Ishk; 2003.
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