Burnout among Healthcare Workers during COVID-19 Pandemic in India: Results of a Questionnaire-based Survey
Ruchira W Khasne, Bhagyashree S Dhakulkar, Hitendra C Mahajan, Atul P Kulkarni
Citation Information :
Khasne RW, Dhakulkar BS, Mahajan HC, Kulkarni A P. Burnout among Healthcare Workers during COVID-19 Pandemic in India: Results of a Questionnaire-based Survey. Indian J Crit Care Med 2020; 24 (8):664-671.
Background: Burnout, a state of physical and emotional exhaustion, in healthcare workers (HCWs) is a major concern. The prevalence of burnout, due to COVID-19 pandemic in India, is unknown. We therefore conducted this survey. Materials and methods: A questionnaire-based survey using Copenhagen Burnout Inventory was carried out among HCWs looking after COVID-19 patients. Questionnaire was sent to the HCWs, using WhatsApp Messenger, and voluntary participation was sought. We received responses from 2026 HCWs. Burnout was assessed in personal, work, and client-related (COVID-19 pandemic-related) domains. Burnout was defined at a cut-off score of 50 for each domain. Results: The prevalence of personal burnout was 44.6% (903), work-related burn-out was only 26.9% (544), while greater than half of the respondents (1,069, 52.8%) had pandemic-related burnout. Younger respondents (21–30 years) had higher personal and work-related burnout. The prevalence of personal and work-related burnout was significantly (p < 0.01) higher among females. The doctors were 1.64 times, and the support staff were 5 times more likely to experience pandemic-related burnout. Conclusion: There is a significant prevalence of burnout during the COVID-19 pandemic among HCWs, in particular, doctors and support staff. Female respondents had higher prevalence. We suggest that the management should be proactive and supportive in improving working conditions and providing assurance to the HCWs. The long-term effects of the current pandemic need to be assessed later.
Maslach C, Jackson SE. The measurement of experienced burnout. J Occup Behav 1981;2(2):99–113. DOI: 10.1002/job.4030020205.
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;369:m1642. DOI: 10.1136/bmj.m1642.
Shanafelt TD, Gorringe G, Menaker R, Storz KA, Reeves D, Buskirk SJ, et al. Impact of organizational leadership on physician burnout and satisfaction. Mayo Clin Proc 2015;90(4):432–440. DOI: 10.7326/0003-4819-136-5-200203050-00008.
World Health Organization, Mental health and psychosocial considerations during the COVID-19 outbreak, 2020. World Health Organization. https://apps.who.int/iris/handle/10665/331490.
Kristensen TS, Borritz M, Villadsen E, Christensen KB. The Copenhagen burnout inventory: a new tool for the assessment of burnout. Work Stress 2005;19(3):192–207. DOI: 10.1080/02678370500297720.
Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020;3(3):e203976. DOI: 10.1001/jamanetworkopen.2020.3976.
Xiao H, Zhang Y, Kong D, Li S, Yang N. 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 2020;26:e923549. Available from: 10.12659/MSM. 923549.
Bianchi R. What is “severe burnout” and can its prevalence be assessed? Intensive Care Med 2015;41(1):166. DOI: 10.1007/s00134-014-3534-y.
Prins JT, Gazendam-Donofrio SM, Tubben BJ, van der Heijden FM, van de Wiel HB, Hoekstra-Weebers JE. Burnout in medical residents: a review. Med Educ 2007;41(8):788–800. DOI: 10.1111/j.1365-2923.2007.02797.x.
Kesarwani V, Husaain ZG, George J. Prevalence and factors associated with burnout among healthcare professionals in India: a systematic review and meta-analysis. Indian J Psychol Med 2020;42(2):108–115. DOI: 10.4103/IJPSYM.IJPSYM_387.
Dubale BW, Friedman LE, Chemali Z, Denninger JW, Mehta DH, Alem A, et al. Systematic review of burnout among healthcare providers in sub-Saharan Africa. BMC Public Health 2019;19(1):1247. DOI: 10.1186/s12889-019-7566-7.
Peter W, Anthony W. Comparing two measures of burnout among dentists in Australia. Int J Stress Manag 2004;11(3):282. DOI: 10.1037/1072-5245.11.3.282.
Shanafelt TD, Balch CM, Bechamps G, Russell T, Dyrbye L, Satele D, et al. Burnout and medical errors among American surgeons. Ann Surg 2010;251(6):995–1000. DOI: 10.1097/SLA.0b013e3181bfdab3.
Fahrenkopf AM, Sectish TC, Barger LK, Sharek PJ, Lewin D, Chiang VW, et al. Rates of medication errors among depressed and burnt out residents: prospective cohort study. BMJ 2008;336(7642):488–491. DOI: 10.1136/bmj.39469.763218.BE.
Gergen Barnett KA. In pursuit of the fourth aim in health care: The joy of practice. Med Clin North Am 2017;101(5):1031–1040. DOI: 10.1016/j.mcna.2017.04.014.
Wong TW, Yau JKY, Chan CLW, Kwong RSY, Ho SMY, Lau CC, et al. The psychological impact of severe acute respiratory syndrome outbreak on healthcare workers in emergency departments and how they cope. Eur J Emerg Med 2005;12(1):13–18. DOI: 10.1097/00063110-2005.
Maunder R, Lancee W, Balderson K, Bennett J, Borgundvaag B, Evans S, et al. Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerg Infect Dis 2006;12(12):1924–1932. DOI: 10.3201/eid1212.060584.
Martini S, Arfken CL, Churchill A, Balon R. Burnout comparison among residents in different medical specialties. Acad Psychiatry 2004;28(3):240–242. DOI: 10.1176/appi.ap.28.3.240.
Grover S, Sahoo S, Bhalla A, Avasthi A. Psychological problems and burnout among medical professionals of a tertiary care hospital of North India: a cross-sectional study. Indian J Psychiatry 2018;60(2):175–188. DOI: 10.4103/psychiatry.IndianJPsychiatry_2.
Klein J, Grosse Frie K, Blum K, von dem Knesebeck O. Burnout and perceived quality of care among German clinicians in surgery. Int J Qual Health Care 2010;22(6):525–530. DOI: 10.1093/intqhc/mzq056.
Wright JG, Khetani N, Stephens D. Burnout among faculty physicians in an academic health science centre. Paediatr Child Health 2011;16(7):409–413. DOI: 10.1093/pch/16.7.409.
Žutautienė R, Radišauskas R, Kaliniene G, Ustinaviciene R. The prevalence of burnout and its associations with psychosocial work environment among Kaunas region (Lithuania) hospitals’ physicians. Int J Env Res Public Heal 2020;17(10):3739. DOI: 103390/ijerph17103739.
Ratnakaran B, Prabhakaran A, Karunakaran V. Prevalence of burnout and its correlates among residents in a tertiary medical center in Kerala, India: a cross-sectional study. J Postgrad Med 2016;62(3):157–161. DOI: 10.4103/0022-3859.184274.
Dhusia AH, Dhaimade PA, Jain AA, Shemna SS, Dubey PN. Prevalence of occupational burnout among resident doctors working in public sector hospitals in Mumbai. Indian J Community Med 2019;44(4):352–356. DOI: 10.4103/ijcm.IJCM_78_19.
Biksegn A, Kenfe T, Matiwos S, Eshetu G. Burnout status at work among health care professionals in a tertiary hospital. Ethiop J Health Sci 2016;26(2):101–108. DOI: 10.4314/ejhs.v26i2.3.
Reardon M, Abrahams R, Thyer L, Simpson P. Review article: prevalence of burnout in paramedics: a systematic review of prevalence studies. Emerg Med Australas 2020;32(2):182–189. DOI: 10.1111/1742-6723.13478.
Society of critical care medicine COVID-19 rapid cycle survey work group: SCCM COVID-19 rapid-cycle survey 2 report globally. Soc Crit Care Med 2020. 1–8.
Xiao X, Zhu X, Fu S, Hu Y, Li X, Xiao J. Psychological impact of healthcare workers in China during COVID-19 pneumonia epidemic: a multi-center cross-sectional survey investigation. J Affect Disord 2020;274:405–410. DOI: 10.1016/j.jad.2020.05.081.
Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun 2020;88:901–907. DOI:10.1016/j.bbi.2020.05.026.
Albert PR. Why is depression more prevalent in women? J Psychiatry Neurosci 2015;40(4):219–221. DOI: 10.1503/jpn.150205.
Tan BYQ, Chew NWS, Lee GKH, Jing M, Goh Y, Yeo LLL, et al. Psychological impact of the COVID-19 pandemic on health care workers in Singapore. Ann Intern Med 2020(4):M20–1083. DOI: 10.7326/M20-1083.
Zhang WR, Wang K, Yin L, Zhao WF, Xue Q, Peng M, et al. Mental health and psychosocial problems of medical health workers during the COVID-19 epidemic in China. Psychother Psychosom 2020(4):1–9. DOI: 10.1159/000507639.
Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med 2002;136(5):358–367. DOI: 10.7326/0003-4819-136-5-200203050-00008.
Blake H, Bermingham F, Johnson G, Tabner A. Mitigating the psychological impact of COVID-19 on healthcare workers: a digital learning package. Int J Environ Res Public Health 2020;17(9):2997. DOI: 10.3390/ijerph17092997.
Aziz S, Arabi YM, Alhazzani W, Evans L, Citerio G, et al. Managing ICU surge during the COVID-19 crisis: Rapid guidelines. Intensive Care Med 2020(7):1–23. DOI: 10.1007/s00134-020-06092-5.