Published online Aug 28, 2022. doi: 10.13105/wjma.v10.i4.206
Peer-review started: March 27, 2022
First decision: June 11, 2022
Revised: July 27, 2022
Article in press: July 27, 2022
Published online: August 28, 2022
Processing time: 143 Days and 5.5 Hours
For decades and before the coronavirus disease 2019 (COVID-19) pandemic, for health care workers, (HCWs) burnout can be experienced as an upsetting confrontation with their self and the result of a complex a multifactorial process interacting with environmental and personal features.
During these century previous outbreak, some HCWs isolated themselves out of fear of infecting their friends and families, and lack of training, protection and hospital support was associated with higher burnout.
The objective of this literature review and meta-analysis was to obtain a comprehensive understanding of burnout and work-related stress in health care workers around the world during the first outbreak of the COVID-19 pandemic.
We analysed burnout risk factors and protective factors in included studies published from June 1, 2020 to October 10, 2020, studying an HCW population during the first COVID-19 wave. The typical profile of an HCW with high levels of burnout was a young, single, female nurse or resident physician in an institution perceived as poorly prepared for the COVID-19 pandemic. This HCW experienced anxiety related to infection with COVID-19 or infecting her friends and family and possibly had a history of prior psychiatric conditions and low levels of resilience. Nevertheless, COVID-19 exposure was not a leading factor in burnout, as burnout levels were not notably higher than those before the COVID-19 pandemic. We included original studies published in peer-reviewed journals as of January 2020, studying an HCW population during the first COVID-19 wave without any geographic restrictions
Through screening, 39 cross-sectional, one longitudinal and one prospective cohort study were retained. Of the 41 studies, all from 2020, 12 were included in the meta-analysis. Table 2 details the main features of the studies. Of the 27907 health care professionals who participated in the reviewed studies, 70.4% were women, and two-thirds were either married or living together. The most represented age category was 31-45 years, at 41.5%. Approximately half of the sample comprised nurses (47.6%), and 44.4% were working in COVID-19 wards (intensive care unit, emergency room and dedicated internal medicine wards). The meta-analytic estimate of burnout prevalence in HCWs was 30.05% (95%CI: 23.91%–36.5%), with a sample size of 6784.
During the COVID-19 pandemic, HCWs have been under high levels of stress and have suffered considerable burnout, putting quality of care at risk. We reviewed 41 studies and highlighted personal and sociodemographic features strongly associated with higher perceived stress and burnout. Female sex, younger age, low resilience, nurse occupational role and lack of preparedness were associated with higher burnout, but actual COVID-19 exposure was not a leading factor. Prevalence pre-COVID-19 was either lower or in the same ballpark as during COVID-19; our meta-analytic estimate based on 12 studies and approximately 6800 respondents returned a burnout prevalence of 30%, with important geographical variation
In a pandemic context such as COVID-19, specific interventions could probably yield immediate results, benefiting HCWs and patients in very direct ways. We have highlighted how institutional preparedness has a clear correlation with stress and burnout. PPE, up-to-date protocols and regular communication from hospital management are low hanging fruit, as they would both reduce actual infection rates amongst staff and alleviate fear of infection and transmission. Workload and stress about childcare are recurring subjects, and if the former is a challenge during a pandemic, it should be feasible for ins