Abstract
In the current period of global public health crisis due to the COVID-19, healthcare workers are more exposed to physical and mental exhaustion – burnout – for the torment of difficult decisions, the pain of losing patients and colleagues, and the risk of infection, for themselves and their families. The very high number of cases and deaths, and the probable future “waves” raise awareness of these challenging working conditions and the need to address burnout by identifying possible solutions. Measures have been suggested to prevent or reduce burnout at individual level (physical activity, balanced diet, good sleep hygiene, family support, meaningful relationships, reflective practices and small group discussions), organizational level (blame-free environments for sharing experiences and advices, broad involvement in management decisions, multi-disciplinary psychosocial support teams, safe areas to withdraw quickly from stressful situations, adequate time planning, social support), and cultural level (involvement of healthcare workers in the development, implementation, testing, and evaluation of measures against burnout). Although some progress has been made in removing the barrier to psychological support to cope with work-related stress, a cultural change is still needed for the stigma associated with mental illness. The key recommendation is to address the challenges that the emergency poses and to aggregate health, well-being and behavioral science expertise through long term researches with rigorous planning and reporting to drive the necessary cultural change and the improvement of public health systems.
Highlights
Burnout is a psychological syndrome described as a self-reported state of care- or work- related physical and mental stress [1] that induces emotional exhaustion (EE), depersonalization (DP), and a sense of reduced personal accomplishment (PA) [2]
healthcare workers (HCWs) Burnout During COVID-19 exactly constitutes burnout and on how to measure it [5], there is a great heterogeneity in the prevalence of this phenomenon: Rodrigues and colleagues, in their meta-analysis on different medical resident specialties [2], reported that the overall prevalence of burnout for all specialties was 35.1%; Rotenstein and colleagues, in their meta-analysis on practicing physicians [5], estimate an overall burnout ranging from 0 to 80.5% with pooled prevalence of 21.3% on overall burnout; they calculate a pooled prevalence of 34.4% on EE, 25.8% on DP, and of 23.5% on PA
We limited our search to works published in English or Italian and used the following search terms: “healthcare workers,” “physicians,” “residents,” “nurses,” “burnout,” “chronic pain,” “pain syndrome,” “painful disorders,” “stress,” “workloads,” “suicide,” “Covid19,” “coronavirus disease,” “pandemic”
Summary
Burnout is a psychological syndrome described as a self-reported state of care- or work- related physical and mental stress [1] that induces emotional exhaustion (EE), depersonalization (DP), and a sense of reduced personal accomplishment (PA) [2]. As referred in recent publications, medical staff report physical and mental exhaustion – due to the ethical dilemmas and moral injuries for the torment of life-or-death decisions required to be made fast and without the support of optimal care protocols, the pain of losing patients and colleagues, and the risk of infection for themselves and their families [12, 13] All these issues are especially true for residents and young HCWs who, as discussed in Zoorob et al [14], received ever-changing information on protective measures, and are asked to work in services other than their specialty, in frontline situations [15]
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