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      Burnout syndrome and its determinants among healthcare workers during the first wave of the Covid-19 outbreak in Italy: a cross-sectional study to identify sex-related differences

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          Abstract

          Introduction:

          Several studies described burnout levels of healthcare workers (HCWs) during the COVID-19 pandemic; however, sex-related differences remain poorly investigated. Objective: To describe sex-related differences in burnout and its determinants among HCWs during the first pandemic wave of the COVID-19 in Italy.

          Methods:

          A cross-sectional study was performed between April and May 2020. The framework given by the Job Demands Resources (JD-R) model was used to assess burnout determinants (risk and protective factors).

          Results:

          Male HCWs (n=133) had higher levels of depersonalization than female HCWs (P=0,017) and female HCWs (n=399) reported greater emotional exhaustion rates (P=0,005). Female nurses were the most exposed to burnout (OR=2,47; 95%CI=1,33-4,60; P=0,004), emotional exhaustion (OR=1,89; 95% CI=1,03-3,48; P=0,041), and depersonalization (OR=1,91; 95% CI=1,03-3,53; P=0,039). Determinants of burnout differed between sexes, and some paradoxical associations were detected: the score of job demands was a protective factor in females for burnout, emotional exhaustion, and depersonalization, resilience was a risk factor for males.

          Conclusions:

          This study reveals that the stressors in male and female HCWs tended to be associated with burnout differently. Both sexes showed alarming burnout levels, even if the weights of emotional exhaustion and depersonalization acted in different ways between the sexes. The revealed paradoxical effects in this study could reflect the study’s cross-sectional nature, highlighting that more resilient and empathic individuals were more consciously overwhelmed by the challenges related to the COVID-19 pandemic, thus reporting higher scores of emotional exhaustion and burnout. Future in-depth and longitudinal analyses are recommended to further explore sex-related differences in burnout among HCWs.

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          Most cited references41

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          COVID-19 and mental health: A review of the existing literature

          Highlights • Subsyndromal mental health concerns are a common response to the COVID-19 outbreak. • These responses affect both the general public and healthcare workers. • Depressive and anxiety symptoms have been reported in 16–28% of subjects screened. • Novel methods of consultation, such as online services, can be helpful for these patients. • There is a need for further long-term research in this area, especially from other countries
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            The brief resilience scale: assessing the ability to bounce back.

            While resilience has been defined as resistance to illness, adaptation, and thriving, the ability to bounce back or recover from stress is closest to its original meaning. Previous resilience measures assess resources that may promote resilience rather than recovery, resistance, adaptation, or thriving. To test a new brief resilience scale. The brief resilience scale (BRS) was created to assess the ability to bounce back or recover from stress. Its psychometric characteristics were examined in four samples, including two student samples and samples with cardiac and chronic pain patients. The BRS was reliable and measured as a unitary construct. It was predictably related to personal characteristics, social relations, coping, and health in all samples. It was negatively related to anxiety, depression, negative affect, and physical symptoms when other resilience measures and optimism, social support, and Type D personality (high negative affect and high social inhibition) were controlled. There were large differences in BRS scores between cardiac patients with and without Type D and women with and without fibromyalgia. The BRS is a reliable means of assessing resilience as the ability to bounce back or recover from stress and may provide unique and important information about people coping with health-related stressors.
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              Job demands–resources theory: Taking stock and looking forward.

              The job demands-resources (JD-R) model was introduced in the international literature 15 years ago (Demerouti, Bakker, Nachreiner, & Schaufeli, 2001). The model has been applied in thousands of organizations and has inspired hundreds of empirical articles, including 1 of the most downloaded articles of the Journal of Occupational Health Psychology (Bakker, Demerouti, & Euwema, 2005). This article provides evidence for the buffering role of various job resources on the impact of various job demands on burnout. In the present article, we look back on the first 10 years of the JD-R model (2001-2010), and discuss how the model matured into JD-R theory (2011-2016). Moreover, we look at the future of the theory and outline which new issues in JD-R theory are worthwhile of investigation. We also discuss practical applications. It is our hope that JD-R theory will continue to inspire researchers and practitioners who want to promote employee well-being and effective organizational functioning. (PsycINFO Database Record
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                Author and article information

                Journal
                Med Lav
                Med Lav
                La Medicina del Lavoro
                Mattioli 1885 srl (Italy )
                0025-7818
                2532-1080
                2021
                26 August 2021
                : 112
                : 4
                : 306-319
                Affiliations
                [1 ] Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
                [2 ] Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
                [3 ] Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
                [4 ] Department of Psychology, EngageMinds HUB – Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
                Author notes
                Corresponding author: Federica Dellafiore, PhD, RN, Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Edmondo Malan Square 2, 20097 San Donato Milanese, Milan, ItalyPhone:+39 0252774940; Email: federica.dellafiore@ 123456grupposandonato.it .
                Article
                MDL-112-306
                10.23749/mdl.v112i4.11316
                8436819
                34446687
                d4db1a46-5371-4b08-b9c9-5a60941a67b4
                Copyright: © 2021 ACTA BIO MEDICA SOCIETY OF MEDICINE AND NATURAL SCIENCES OF PARMA

                This work is licensed under a Creative Commons Attribution 4.0 International License

                History
                : 06 February 2021
                : 08 June 2021
                Categories
                Original Article

                burnout,covid-19,depersonalization,emotional exhaustion,healthcare workers

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