International Journal of Biomedicine. 2022;12(2):256-264.
Originally published June 5, 2022
Background: Healthcare workers (HCWs) faced numerous job-related hazards during the COVID-19 pandemic outbreak, such as job-related stress and burnout, which are considered to be the paramount burdens. The aim of the present study was to assess the extent of burnout and stress among HCWs during COVID-19 in primary healthcare centers.
Methods and Results: This cross-sectional study was conducted at five primary healthcare centers in Port Said governorate (Egypt). The study sample consisted of 250 HCWs (physicians, nurses, pharmacists, paramedical personnel, and administrative staff). Measurement tools included Maslach Burnout Inventory (MDI) and Perceived Stress Scale (PSS). Regarding degree of burnout, the current study results concluded that, two-thirds of HCWs had high occupational exhaustion, around three-quarters had high depersonalization, and the majority of them had low PA assessment. Regarding stress levels, almost half of HCWs had high stress, and more than one-third had moderate stress. There was a statistically significant, positive correlation between degrees of occupational exhaustion, depersonalization, and stress level.
Conclusion: This research can inform healthcare leaders and enable them to improve HCWs’ experience by addressing levels of stress and burnout; managers must support staff who provide care and service to decrease the harmful effects of the COVID-19 pandemic.
- Sahin T, Aslaner H, Eker OO, Gokcek MB, Dogan M. Effect of COVID-19 pandemic on anxiety and burnout levels in emergency healthcare workers. Res. Square. 2020. doi: 10.21203/rs.3.rs-32073/v1
- Worldometer [Internet]. COVID-19 Coronavirus Pandemic. Available from: https://www.worldometers.info/coronavirus/.
- Li X, Jiang T, Sun J, Shi L, Liu J. The relationship between occupational stress, job burnout and quality of life among surgical nurses in Xinjiang, China. BMC Nurs. 2021 Sep 27;20(1):181. doi: 10.1186/s12912-021-00703-2.
- de Girolamo G, Cerveri G, Clerici M, Monzani E, Spinogatti F, Starace F, Tura G, Vita A. Mental Health in the Coronavirus Disease 2019 Emergency-The Italian Response. JAMA Psychiatry. 2020 Sep 1;77(9):974-976. doi: 10.1001/jamapsychiatry.2020.1276.
- Marôco J, Marôco AL, Leite E, Bastos C, Vazão MJ, Campos J. Burnout em Profissionais da Saúde Portugueses: Uma Análise a Nível Nacional [Burnout in Portuguese Healthcare Professionals: An Analysis at the National Level]. Acta Med Port. 2016 Jan;29(1):24-30. doi: 10.20344/amp.6460. Epub 2016 Jan 29. Erratum in: Acta Med Port. 2016 Aug;29(7-8):494.[Article in. Portuguese].
- Dugani S, Afari H, Hirschhorn LR, Ratcliffe H, Veillard J, Martin G, Lagomarsino G, Basu L, Bitton A. Prevalence and factors associated with burnout among frontline primary health care providers in low- and middle-income countries: A systematic review. Gates Open Res. 2018 Jun 11;2:4. doi: 10.12688/gatesopenres.12779.3.
- World Health Organization. Burn-out an "occupational phenomenon": International Classification of Diseases. Available from: https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenom...
- Guixia L, Hui ZA. Study on burnout of nurses in the period of COVID-19. Psychol Behav Sci. 2020;9:31–36. doi: 10.11648/j.pbs.20200903.12.
- Hofmeyer A, Taylor R, Kennedy K. Fostering compassion and reducing burnout: How can health system leaders respond in the Covid-19 pandemic and beyond? Nurse Educ Today. 2020 Nov;94:104502. doi: 10.1016/j.nedt.2020.104502.
- Thomas LR, Ripp JA, West CP. Charter on Physician Well-being. JAMA. 2018 Apr 17;319(15):1541-1542. doi: 10.1001/jama.2018.1331.
- Salazar de Pablo G, Vaquerizo-Serrano J, Catalan A, Arango C, Moreno C, Ferre F, Shin JI, Sullivan S, Brondino N, Solmi M, Fusar-Poli P. Impact of coronavirus syndromes on physical and mental health of health care workers: Systematic review and meta-analysis. J Affect Disord. 2020 Oct 1;275:48-57. doi: 10.1016/j.jad.2020.06.022.
- Vizheh M, Qorbani M, Arzaghi SM, Muhidin S, Javanmard Z, Esmaeili M. The mental health of healthcare workers in the COVID-19 pandemic: A systematic review. J Diabetes Metab Disord. 2020 Oct 26;19(2):1-12. doi: 10.1007/s40200-020-00643-9.
- Zakeri MA, Dehghan M, Ghaedi-Heidari F, Pakdaman H, Mehdizadeh M, Ganjeh H, et al. Mental health outcomes among health-care workers during the COVID-19 outbreak in Iran. Mental Health Rev J. 2021;26:152–160. doi: 10.1108/MHRJ-10-0075.
- Naldi A, Vallelonga F, Di Liberto A, Cavallo R, Agnesone M, Gonella M, Sauta MD, Lochner P, Tondo G, Bragazzi NL, Botto R, Leombruni P. COVID-19 pandemic-related anxiety, distress and burnout: prevalence and associated factors in healthcare workers of North-West Italy. BJPsych Open. 2021 Jan 7;7(1):e27. doi: 10.1192/bjo.2020.161.
- Badahdah AM, Khamis F, Mahyijari NA. The psychological well-being of physicians during COVID-19 outbreak in Oman. Psychiatry Res. 2020 Jul;289:113053. doi: 10.1016/j.psychres.2020.113053.
- Shanafelt T, Ripp J, Trockel M. Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic. JAMA. 2020 Jun 2;323(21):2133-2134. doi: 10.1001/jama.2020.5893.
- Centers for Diseases Control and Prevention. Employees: How to Cope with Job Stress and Build Resilience during the COVID-19 Pandemic. Available from: https://www.baycounty-mi.gov/Docs/COVID19/Coping%20with%20Stress%20and%2...
- Daniel WW. Biostatistics: A Foundationfor Analysis in the Health Sciences. 7th edition. New York: John Wiley & Sons; 1999.
- Maslach C, Jackson SE. The measurement of experienced burnout. J Occupational Behavior.1981;2:99-113.
- Al-Dubai SA, Rampal KG. Prevalence and associated factors of burnout among doctors in Yemen. J Occup Health. 2010;52(1):58-65. doi: 10.1539/joh.o8030.
- Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983 Dec;24(4):385-96.
- Almadi T, Cathers I, Hamdan Mansour AM, Chow CM. An Arabic version of the perceived stress scale: translation and validation study. Int J Nurs Stud. 2012 Jan;49(1):84-9. doi: 10.1016/j.ijnurstu.2011.07.012.
- Abdo SA, El-Sallamy RM, El-Sherbiny AA, Kabbash IA. Burnout among physicians and nursing staff working in the emergency hospital of Tanta University, Egypt. East Mediterr Health J. 2016 Mar 15;21(12):906-15. doi: 10.26719/2015.21.12.906.
- Allan SM, Bealey R, Birch J, Cushing T, Parke S, Sergi G, Bloomfield M, Meiser-Stedman R. The prevalence of common and stress-related mental health disorders in healthcare workers based in pandemic-affected hospitals: a rapid systematic review and meta-analysis. Eur J Psychotraumatol. 2020 Oct 16;11(1):1810903. doi: 10.1080/20008198.2020.1810903.
- Jihn CH, Kim B, Kim KS. Predictors of Burnout in Hospital Health Workers during the COVID-19 Outbreak in South Korea. Int J Environ Res Public Health. 2021 Nov 8;18(21):11720. doi: 10.3390/ijerph182111720.
- 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 Aug;290:113129. doi: 10.1016/j.psychres.2020.113129.
- Afulani PA, Gyamerah AO, Nutor JJ, Laar A, Aborigo RA, Malechi H, Sterling M, Awoonor-Williams JK. Inadequate preparedness for response to COVID-19 is associated with stress and burnout among healthcare workers in Ghana. PLoS One. 2021 Apr 16;16(4):e0250294. doi: 10.1371/journal.pone.0250294.
- Scott SB, Sliwinski MJ, Blanchard-Fields F. Age differences in emotional responses to daily stress: the role of timing, severity, and global perceived stress. Psychol Aging. 2013 Dec;28(4):1076-87. doi: 10.1037/a0034000.
- Dechasa DB, Worku T, Baraki N, Merga BT, Asfaw H. Burnout and associated factors among nurses working in public hospitals of Harari region and Dire Dawa administration, eastern Ethiopia. A cross sectional study. PLoS One. 2021 Oct 29;16(10):e0258224. doi: 10.1371/journal.pone.0258224.
- Hu D, Kong Y, Li W, Han Q, Zhang X, Zhu LX, Wan SW, Liu Z, Shen Q, Yang J, He HG, Zhu J. 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 Jun 27;24:100424. doi: 10.1016/j.eclinm.2020.100424.
- Hawari FI, Obeidat NA, Dodin YI, Albtoosh AS, Manasrah RM, Alaqeel IO, Mansour AH. The inevitability of Covid-19 related distress among healthcare workers: Findings from a low caseload country under lockdown. PLoS One. 2021 Apr 1;16(4):e0248741. doi: 10.1371/journal.pone.0248741.
- Maraqa B, Nazzal Z, Zink T. Palestinian Health Care Workers' Stress and Stressors During COVID-19 Pandemic: A Cross-Sectional Study. J Prim Care Community Health. 2020 Jan-Dec;11:2150132720955026. doi: 10.1177/2150132720955026.
- Arafa A, Mohammed Z, Mahmoud O, Elshazley M, Ewis A. Depressed, anxious, and stressed: What have healthcare workers on the frontlines in Egypt and Saudi Arabia experienced during the COVID-19 pandemic? J Affect Disord. 2021 Jan 1;278:365-371. doi: 10.1016/j.jad.2020.09.080.
- Zhu Z, Xu S, Wang H, Liu Z, Wu J, Li G, Miao J, Zhang C, Yang Y, Sun W, Zhu S, Fan Y, Chen Y, Hu J, Liu J, Wang W. COVID-19 in Wuhan: Sociodemographic characteristics and hospital support measures associated with the immediate psychological impact on healthcare workers. EClinicalMedicine. 2020 Jun 24;24:100443. doi: 10.1016/j.eclinm.2020.100443.
- Al-Mansour K, Alfuzan A, Alsarheed D, Alenezi M, Abogazalah F. Work-Related Challenges among Primary Health Centers Workers during COVID-19 in Saudi Arabia. Int J Environ Res Public Health. 2021 Feb 16;18(4):1898. doi: 10.3390/ijerph18041898.
- Comfort AB, Krezanoski PJ, Rao L, El Ayadi A, Tsai AC, Goodman S, Harper CC. Mental health among outpatient reproductive health care providers during the US COVID-19 epidemic. Reprod Health. 2021 Feb 24;18(1):49. doi: 10.1186/s12978-021-01102-1.
- Di Giuseppe M, Nepa G, Prout TA, Albertini F, Marcelli S, Orrù G, Conversano C. Stress, Burnout, and Resilience among Healthcare Workers during the COVID-19 Emergency: The Role of Defense Mechanisms. Int J Environ Res Public Health. 2021 May 14;18(10):5258. doi: 10.3390/ijerph18105258.
- Teo I, Chay J, Cheung YB, Sung SC, Tewani KG, Yeo LF, Yang GM, Pan FT, Ng JY, Abu Bakar Aloweni F, Ang HG, Ayre TC, Chai-Lim C, Chen RC, Heng AL, Nadarajan GD, Ong MEH, See B, Soh CR, Tan BKK, Tan BS, Tay KXK, Wijaya L, Tan HK. Healthcare worker stress, anxiety and burnout during the COVID-19 pandemic in Singapore: A 6-month multi-centre prospective study. PLoS One. 2021 Oct 22;16(10):e0258866. doi: 10.1371/journal.pone.0258866.
- Lasalvia A, Amaddeo F, Porru S, Carta A, Tardivo S, Bovo C, Ruggeri M, Bonetto C. 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 Jan 17;11(1):e045127. doi: 10.1136/bmjopen-2020-045127.
- Kisely S, Warren N, McMahon L, Dalais C, Henry I, Siskind D. Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis. BMJ. 2020 May 5;369:m1642. doi: 10.1136/bmj.m1642.
- Alanazi KH, bin Saleh GM, AlEidi SM, AlHarbi MA, Hathout HM. Prevalence and risk factors of burnout among healthcare professionals during COVID-19 Pandemic-Saudi Arabia. Am Journal Public Health. 2021;9:18–27.
- Giusti EM, Pedroli E, D'Aniello GE, Stramba Badiale C, Pietrabissa G, Manna C, Stramba Badiale M, Riva G, Castelnuovo G, Molinari E. The Psychological Impact of the COVID-19 Outbreak on Health Professionals: A Cross-Sectional Study. Front Psychol. 2020 Jul 10;11:1684. doi: 10.3389/fpsyg.2020.01684.
- Norful AA, Rosenfeld A, Schroeder K, Travers JL, Aliyu S. Primary drivers and psychological manifestations of stress in frontline healthcare workforce during the initial COVID-19 outbreak in the United States. Gen Hosp Psychiatry. 2021 Mar-Apr;69:20-26. doi: 10.1016/j.genhosppsych.2021.01.001.
- Dutheil F, Aubert C, Pereira B, Dambrun M, Moustafa F, Mermillod M, Baker JS, Trousselard M, Lesage FX, Navel V. Suicide among physicians and health-care workers: A systematic review and meta-analysis. PLoS One. 2019 Dec 12;14(12):e0226361. doi: 10.1371/journal.pone.0226361.
- Çelmeçe N, Menekay M. The Effect of Stress, Anxiety and Burnout Levels of Healthcare Professionals Caring for COVID-19 Patients on Their Quality of Life. Front Psychol. 2020;11:597624. doi: 10.3389/fpsyg.2020.597624.
Received April 22, 2022.
Accepted May 30, 2022.
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