Civantos AM., et al.
Mental health among head and neck surgeons in Brazil during the COVID-19 pandemic: A national study.
American Journal of Otolaryngology, 2020 Brazil |
Use validated studies into burnout, anxiety, depression, and distress to assess mental health outcomes among Brazilian head and neck surgeons as they approach the peak of the pandemic. |
Cross-sectional, survey-based, national study conducted during the Covid-19 pandemic in Brazil from May 14, 2020 to May 31, 2020. Four self-applied instruments validated in Brazil were used. Demographics were self-reported. Respondents were also asked about a history of any psychiatric condition. Finally, they categorized their current mental health as better, worse, or the same compared to their pre-pandemic baseline. Level IV |
163 physicians |
774.2% of the participants were male. Symptoms of anxiety, distress, burnout, and depression were reported in 74 (45.5%), 43 (26.3%), 24 (14.7%), and 26 (16%) physicians, respectively. In the multivariable analysis, female physicians were more likely to report a positive screening for burnout compared to men (OR 2.88, CI [1.07-7.74]). Physicians aged 45 or older were less likely to experience anxiety symptoms than those younger than 45 (OR 0.40, CI [0.20-0.81]). Physicians without self-reported prior psychiatric conditions were less likely to have symptoms of distress compared to those with such a history (OR 0.11, CI [0.33-0.38]). |
Jha SS., et al.
The Effect of COVID-19 on Interventional Pain Management Practices: A Physician Burnout Survey.
Pain Physician, 2020 United States of America |
Assess the presence of Covid-19 pandemic-specific Burnout among interventional pain physicians. |
Cross-sectional study, in which participants were recruited through registered e-mail addresses. They introduced the study by e-mail and provided a link to the survey (www.constantcontact.com) The instrument used consisted of 32 questions. Level IV |
100 physicians |
The survey data showed that 98% of medical practices were affected by Covid-19. 91% of physicians felt a significant financial impact. Roughly 67% of physicians responded that internal billing was responsible for the increased level of burnout, while 73% responded that Electronic Medical Records (EMRs) were a cause. Overall, 78% were very concerned. Almost all respondents were affected with a reduction in interventional procedures. 60% had a negative opinion about the future of their practice, while 66% were negative about the entire healthcare industry. |
Hu D., 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.
Research Paper, 2020 China |
To examine mental health (burnout, anxiety, depression and fear) and its associated factors in front line nurses caring for Covid-19 patients in Wuhan, China. |
Descriptive study, developed with front line nurses from two hospitals in Wuhan, China. A sociodemographic questionnaire and a set of valid and reliable instruments were used to measure burnout, anxiety, depression, fear, skin injury, self-efficacy, resilience, and social support scores via the online survey in February 2020. Level IV |
2,014 nurses |
The participants had a moderate level of burnout and a high level of fear. About half of the nurses reported moderate and high burnout at work, evidenced in emotional exhaustion (n = 1,218, 60.5%), depersonalization (n = 853, 42.3%) and personal accomplishment (n = 1,219, 60.6%). The results showed that 288 (14.3%), 217 (10.7%) and 1,837 (91.2%) nurses reported moderate and high levels of anxiety, depression and fear, respectively. Most nurses (n = 1,910, 94.8%) had one or more skin lesions, and 1,950 (96.8%) nurses expressed their willingness to work on the front line. Mental health outcomes were statistically positively correlated with skin lesion and negatively correlated with self-efficacy, resilience, social support,and willingness to work on the front line. |
Kannampallil TG., et al.
Exposure to COVID-19 patients increases physician trainee stress and burnout.
Plos One, 2020 United States of America |
Investigate the effect of exposure of trainee physicians to Covid-19 patients in their clinical roles on their mental health and well-being outcomes. |
Cross-sectional study, developed online, in which the instruments were sent by e-mail to the trainee physicians. The study was conducted during the period April 10 to 25, 2020. The instrument used consisted of questions related to sociodemographic data, clinical responsibilities, residency program, and daily stressors. Level IV |
393 physicians |
Compared to the unexposed group, the exposed group had a higher prevalence of stress (29.4% vs. 18.9%) and burnout (46.3% vs. 33.7%). The exposed group also had moderate to extremely high perceived stress regarding childcare and had a lower work-family balance. Multivariable models indicated that physicians who were exposed to Covid-19 patients reported significantly higher stress (10.96 [95% CI, 9.65 to 12.46] vs 8.44 [95% CI, 7.3 to 9.76]; P = 0.043) and were more likely to be exhausted (1.31 [95% CI, 1.21-1.41] vs 1.07 [95% CI, 0.96-1.19]; P = 0.002]. Female medical interns were more likely to be stressed (P = 0.043); unmarried interns were more likely to be depressed (P = 0.009) and marginally more likely to have anxiety (P = 0.051). |
Barello S., et al.
Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic.
Psychiatry Research, 2020 Italy |
To describe the levels of occupational burnout and physical symptoms of Italian front line health care workers directly involved in the care of Covid-19 patients at the height of the pandemic in the country, comparing them across genders and occupational roles. It also investigated the relationship between work-related burnout and negative health symptoms. |
Cross-sectional study, which used the Maslach Burnout Inventory (MBI), developed online. Participants were selected considering their risk of contracting Covid-19. Level IV |
1.153 profissionais de saúde |
A large percentage of health care professionals reported high scores in at least one of the MBI domains: in particular, more than a third reported high Emotional Exhaustion scores and more than a quarter reported high levels of depersonalization, while only about 15% reported lowlevels of personal accomplishment. |
Morgantini LA., et al.
Factors contributing to healthcare professional burnout during the COVID-19 pandemic: A rapid turnaround global survey.
Plos One, 2020. United States of America |
To understand the impact of Covid-19 on healthcare professionals around the world working during the pandemic. |
Cross-sectional study, developed with health professionals, during the period from April 6 to 16, 2020. The platforms Facebook, WhatsApp and Twitter, and e-mailwere used for recruitment. Socio-demographic data were collected, as well as data on exposure, perception, workloads, and emotional exhaustion. Level IV |
2,707 health professionals |
51% of professionals reported burnout, and it was associated with work impacting household activities (RR = 1 - 57, 95% CI = 1 - 39-1 - 78, P <0-001), developing work beyond technical ability (RR = 1 - 32, 95% CI = 1 - 20-1 - 47, P <0 - 001), exposure to Covid-19 patients (RR = 1.18, 95% CI = 1 - 05-1 - 32, P = 0 - 005), and prioritizing personal decisions (RR = 1 - 16, 95% CI = 1 - 02-1 - 31, P = 0 - 03). Appropriate Personal Protective Equipment (PPE) was seen as a protective factor against burnout (RR = 0 - 88, 95% CI = 0 - 79-0 - 97, P = 0 - 01). Burnout was higher in high-income countries compared to low- and middle-income countries (RR = 1.18; 95% CI = 1.2-1.36, P = 0.018). |
Franza F., et al.
The Role of Fatigue of Compassion, Burnout and Hopelessness in Healthcare: Experience in the Time of COVID-19 Outbreak.
Psychiatr Danub, 2020. Italy |
Investigate stress, burnout and fatigue among healthcare professionals. |
Cross-sectional study developed in two phases, in March and April 2020 in different rehabilitation departments (psychiatric and multidisciplinary). Level IV |
102 health professionals |
The results show a high percentage of burnout and fatigue among the professionals. Higher educational level was seen as a protective factor against work-related stress. |
Matsuo T., et al.
Prevalence of Health CareWorker Burnout During the Coronavirus Disease 2019 (COVID-19) Pandemic in Japan.
JAMA Netw Open. 2020 Japan |
To assess the prevalence of burnout among front line healthcare workers during the Covid-19 pandemic in Japan based on job categories and other factors. |
A cross-sectional study, developed online with healthcare professionals at St. Luke’s International Hospital, Tokyo, Japan, during the period April 6-19, 2020. Sociodemographic characteristics, work history, work environment, perceived anxiety compared to before the pandemic were analyzed. The primary outcome was the prevalence of burnout syndrome. Level IV |
312 health professionals |
The majority of the participants were between 26 and 40 years old, 71.5% were women. The overall prevalence of burnout was 31.4% (98 of 312). Of 126 nurses, 59 (46.8%) were suffering from burnout; of 22 radiology technicians, 8 (36.4%) were suffering from burnout; and of 19 pharmacists, 7 (36.8%) were suffering from burnout. The syndrome was more present in women (80.6%). Using physicians as a comparison group, the prevalence of burnout was significantly higher among nurses (OR, 4.9; 95% CI, 2.2-11.2; P = 0.001), laboratory technicians (OR, 6.1; 95% CI, 2.0-18.5; P = 0.002), radiologic technicians (OR, 16.4; 95% CI, 4.3-61.6; P = 0.001), and pharmacists (OR, 4.9; 95% CI, 1.3-19.2; P = 0.02). Furthermore, burnout was more prevalent in participants with fewer years of experience (OR, 0.93; 95% CI, 0.89-0.97; P = 0.001), with high anxiety due to unfamiliarity with personal protective equipment (OR, 2.8; 95% CI, 1.4-5.5; P = 0.002), with reduced hours of sleep compared to the pre-pandemic period (OR, 2.0; 95% CI, 1.1-3.6; P = 0.03), with a desire for reduced workloads (OR, 3.6; 95% CI, 1.6-8.0; P = 0.002), and with a desire to expect appreciation or respect (OR, 2.2; 95% CI, 1.1-4.6; P = 0.03). |
Luceño-Moreno L., et al.
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. Spain |
To assess symptoms of post-traumatic stress, anxiety, depression, levels of burnout and resilience in Spanish healthcare workers during the Covid-19 pandemic. Also aims to assess the relationship between each of the variables (demographics, job, Covid-19, burnout and resilience) and symptoms of post-traumatic stress, depression and anxiety. It is also intended to identify which variables carry the most weight in each of the three categories (post-traumatic stress, anxiety, and depression). |
Cross-sectional study, which used as instruments: a sociodemographic questionnaire, post-traumatic stress scale, anxiety and depression scale, Maslach Burnout Inventory and resilience scale. The data were collected via online survey from April 1 to April 30, 2020. Level IV |
1,422 health professionals |
A total of 56.6% of the health care workers showed symptoms of post-traumatic stress disorder, 58.6% of anxiety disorder, 46% of depressive disorder, and 41.1% feel emotionally exhausted. The profile of a healthcare worker with greater symptoms of post-traumatic stress would be: a person who works in the Autonomous Community of Madrid, in a hospital, a woman, worries that a person with whom she lives might be infected, and thinks that she/he is very likely to be infected. The risk variables for anxiety and depression would be a person who is female, working 12- or 24-hour shifts, and worried that a family member might be infected. High scores on emotional exhaustion and depersonalization (which are dimensions of burnout) are risk factors for mental health, with resilience and personal accomplishment being protective variables. |
Wu Y., 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. China |
Compare the frequency of burnout between doctors and nurses on frontline wards (FLs) and those working on regular wards (UWs). |
Cross-sectional study, developed from March 13 to 27, 2020, performing a comparison in a 1:1 ratio. The survey included 15 demographic questions and questions about the participants’ status in the two previous months, and the Maslach Burnout Inventory. Burnout was defined as a high level of emotional exhaustion greater than 27 and / or a high level of depersonalization greater than 10. We separately considered the frequency of participants with a low sense of personal accomplishment (PA) of less than 31. Level IV |
220 doctors and nurses |
The group working on the front line had a lower frequency of burnout (13% vs. 39%; P <0.0001) and were less worried about being infected compared to the group not working on the front line. |
Zerbini G., et al.
Psychosocial burden of health care professionals in times of COVID-19- a survey conducted at the University Hospital Augsburg.
Ger Med Sci. 2020. Germany |
To explore whether individuals working on Covid-19 special wards are experiencing higher psychosocial strain compared to their colleagues working on regular wards, and whether different healthcare professionals (nurses vs. doctors) are affected differently by the pandemic. In addition, we used open-ended questions to explore individual reasons and perceptions of psychosocial burden and possible solutions for improving working conditions. |
Cross-sectional study, with data collected between March and April 2020 at Augsburg University Hospital. The participants worked on both Covid-19 special wards and regular wards. Participants completed two standardized questionnaires (the Patient Health Questionnaire, PHQ; and the Maslach Burnout Inventory, MBI) and reported their fear of a Covid-19 infection and job stress on a 10-point Likert scale. Finally, they answered three open-ended questions about the causes of the burden, support resources, and needs during the crisis. Level IV |
75 nurses 35 physicians |
Nurses working on Covid-19 wards reported higher levels of stress, burnout, and depressed mood, as well as lower levels of work-related accomplishment compared to their colleagues on regular wards. Physicians reported similar scores regardless of their contact with Covid-19 patients. The most common causes of overload were work-related stress and uncertainty about the future. Psychosocial support as well as leisure time were listed as important resources and a better infrastructure setup for Covid-19 in the hospital (e.g., sufficient staffing, keeping work teams and timetables stable) as a suggestion for improvement. |
Azoulay E., et al.
Symptoms of burnout in intensive care unit specialists facing the COVID‑19 outbreak.
Ann Intensive Care, 2020. Belgium |
Document the prevalence of mental health outcomes in ICU specialists facing the Covid-19 outbreak. |
Cross-sectional study, data collected online from April 30 to May 25, 2020. Sociodemographic data, symptoms of severe burnout, anxiety, and depression were collected. Level IV |
1,001 ICU specialists |
The majority of the participants were between 39 and 53 years old and 34% were women. The prevalence of symptoms of anxiety and depression or severe burnout was 46.5%, 30.2%, and 51%, respectively, and varied significantly between regions. Factors independently associated with anxiety were female gender (HR 1.85 [1.33-2.55]), working in a university-affiliated hospital (HR 0.58 [0.42-0.80]), living in a city of > 1 million inhabitants (HR 1.40 [1.01-1.94]), and clinician’s rating of the ethical climate (HR 0.83 [0.77-0.90]). Independent determinants of depression included female gender (HR 1.63 [1.15-2.31]) and clinician’s rating of the ethical climate (HR 0.84 [0.78-0.92]). Factors independently associated with severe burnout symptoms included age (HR 0.98 / year [0.97-0.99]) and clinician’s rating of the ethical climate (HR 0.76 [0.69-0.82]). |
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Source: developed by the authors.
Source: developed by the authors.