Determinants of Burnout and Other Aspects of Psychological Well-Being in Healthcare Workers During the COVID-19 Pandemic: A Multinational Cross-Sectional Study

  1. Alasdair Scott
  2. Benjamin YQ Tan
  3. Chan Yiong Huak
  4. Ching-Hui Sia
  5. Chua Ying Xian
  6. Ee Teng Goh
  7. Gabriela Zbikowska
  8. Grazyna Dykowska
  9. Guy Martin
  10. James Kinross
  11. Jan Przybylowicz
  12. Jaroslaw Fedorowski
  13. Jasmine Winter Beatty
  14. Jonathan Clarke
  15. Kang Sim
  16. Kanneganti Abhiram
  17. Kelsey Flott
  18. Lucas JH Lim
  19. Mary Wells
  20. Max Denning
  21. Melanie T Almonte
  22. Melanie Tan
  23. Sam Mason
  24. Sanjay Purkayastha
  25. Seema Yalamanchili
  26. Sheraz Markar
  27. Shirley BS Ooi
  28. Swathikan Chidambaran
  29. Tan Lifeng
  30. Vijay K Sharma
  31. Viknesh Sounderajah
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Abstract

Background

The Covid-19 pandemic has placed unprecedented pressure on healthcare systems and workers around the world. Such pressures may impact on working conditions, psychological wellbeing and perception of safety. In spite of this, no study has assessed the relationship between safety attitudes and psychological outcomes. Moreover, only limited studies have examined the relationship between personal characteristics and psychological outcomes during Covid-19.

Methods

From 22nd March 2020 to 18th June 2020, healthcare workers from the United Kingdom, Poland, and Singapore were invited to participate using a self-administered questionnaire comprising the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory (OLBI) and Hospital Anxiety and Depression Scale (HADS) to evaluate safety culture, burnout and anxiety/depression. Multivariate logistic regression was used to determine predictors of burnout, anxiety and depression.

Results

Of 3,537 healthcare workers who participated in the study, 2,364 (67%) screened positive for burnout, 701 (20%) for anxiety, and 389 (11%) for depression. Significant predictors of burnout included patient-facing roles: doctor (OR 2.10; 95% CI 1.49-2.95), nurse (OR 1.38; 95% CI 1.04-1.84), and ‘other clinical’ (OR 2.02; 95% CI 1.45-2.82); being redeployed (OR 1.27; 95% CI 1.02-1.58), bottom quartile SAQ score (OR 2.43; 95% CI 1.98-2.99), anxiety (OR 4.87; 95% CI 3.92-6.06) and depression (OR 4.06; 95% CI 3.04-5.42). Factors significantly protective for burnout included being tested for SARS-CoV-2 (OR 0.64; 95% CI 0.51-0.82) and top quartile SAQ score (OR 0.30; 95% CI 0.22-0.40). Significant factors associated with anxiety and depression, included burnout, gender, safety attitudes and job role.

Conclusion

Our findings demonstrate a significant burden of burnout, anxiety, and depression amongst healthcare workers. A strong association was seen between SARS-CoV-2 testing, safety attitudes, gender, job role, redeployment and psychological state. These findings highlight the importance of targeted support services for at risk groups and proactive SARS-CoV-2 testing of healthcare workers.

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