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      Prevalence and predictors of burnout among nurses during COVID-19: a cross-sectional study in hospitals in central Uganda

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      Author(s): ,
      Publication date (Electronic):
      Journal: BMJ Open
      Publisher: BMJ Publishing Group
      Keywords: public health, COVID-19, suicide & self-harm

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          Abstract

          Objective

          To determine the prevalence of burnout and associated factors among nurses during COVID-19 in central Uganda.

          Design

          A cross-sectional design.

          Setting

          Nurse from one referral and four general hospitals. These were reception centres and cared for patients with COVID-19 in central Uganda.

          Participants

          395 nurses.

          Main outcome measures

          Burnout scores.

          Results

          Of the total 395 participants, 65.1% (n=257) were female; 40% (n=158) had a diploma; 47.1% (n=186) were single; and 39.2% (n=155) had worked for 11–15 years. The results show that 40% (n=158), 41.77% (n=165) and 18.23% (n=77) reported high, average and low levels of burnout, respectively. The results show that the predictors of nurses’ burnout were personal protective equipment (PPE) (OR: 7.1, 95% CI 4.08 to 12.31) and increased workload (OR 4.3, 95% CI 2.43 to 7.93).

          Conclusion

          This study of nurses working in hospitals dealing with patients with COVID-19 in central Uganda reported high rates of burnout, and it was associated with PPE and workload. Interventions like contracting new nurses to reduce workload, the WHO guidelines on PPE, adjusting working hours and ensuring hours of effective rest should be adapted.

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          Most cited references51

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          Mental health problems faced by healthcare workers due to the COVID-19 pandemic- a review

          Mamidipalli Sai Spoorthy (2020)
          Highlights • The current review was done to conduct systematic appraisal of studies conducted on Mental health problems faced by healthcare workers due to the COVID-19 pandemic. • Out of 23 articles selected by initial screening 6 original articles were included in the final review. • Review of all the 6 articles showed that several socio-demographic variables like gender, profession, age, place of work, department of work and certain psychological variables like poor social support, self-efficacy were found to be associated with increased reporting of stress, anxiety, depressive symptoms, insomnia in HCW. • There is increasing evidence which suggests that COVID-19 can be an independent risk factor for stress in HCW.
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            Frontline nurses’ burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: A large-scale cross-sectional study

            Deying Hu, Yue Kong, Wengang Li … (2020)
            Background During the Coronavirus Disease 2019 (COVID-19) pandemic, frontline nurses face enormous mental health challenges. Epidemiological data on the mental health statuses of frontline nurses are still limited. The aim of this study was to examine mental health (burnout, anxiety, depression, and fear) and their associated factors among frontline nurses who were caring for COVID-19 patients in Wuhan, China. Methods A large-scale cross-sectional, descriptive, correlational study design was used. A total of 2,014 eligible frontline nurses from two hospitals in Wuhan, China, participated in the study. Besides sociodemographic and background data, a set of valid and reliable instruments were used to measure outcomes of burnout, anxiety, depression, fear, skin lesion, self-efficacy, resilience, and social support via the online survey in February 2020. Findings On average, the participants had a moderate level of burnout and a high level of fear. About half of the nurses reported moderate and high work burnout, as shown in emotional exhaustion (n = 1,218, 60.5%), depersonalization (n = 853, 42.3%), and personal accomplishment (n = 1,219, 60.6%). The findings showed that 288 (14.3%), 217 (10.7%), and 1,837 (91.2%) nurses reported moderate and high levels of anxiety, depression, and fear, respectively. The majority of the nurses (n = 1,910, 94.8%) had one or more skin lesions, and 1,950 (96.8%) nurses expressed their frontline work willingness. Mental health outcomes were statistically positively correlated with skin lesion and negatively correlated with self-efficacy, resilience, social support, and frontline work willingness. Interpretation The frontline nurses experienced a variety of mental health challenges, especially burnout and fear, which warrant attention and support from policymakers. Future interventions at the national and organisational levels are needed to improve mental health during this pandemic by preventing and managing skin lesions, building self-efficacy and resilience, providing sufficient social support, and ensuring frontline work willingness.
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              A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being

              Johannes H. De Kock, Helen Ann Latham, Stephen J. Leslie … (2021)
              Background Health and social care workers (HSCWs) have carried a heavy burden during the COVID-19 crisis and, in the challenge to control the virus, have directly faced its consequences. Supporting their psychological wellbeing continues, therefore, to be a priority. This rapid review was carried out to establish whether there are any identifiable risk factors for adverse mental health outcomes amongst HSCWs during the COVID-19 crisis. Methods We undertook a rapid review of the literature following guidelines by the WHO and the Cochrane Collaboration’s recommendations. We searched across 14 databases, executing the search at two different time points. We included published, observational and experimental studies that reported the psychological effects on HSCWs during the COVID-19 pandemic. Results The 24 studies included in this review reported data predominantly from China (18 out of 24 included studies) and most sampled urban hospital staff. Our study indicates that COVID-19 has a considerable impact on the psychological wellbeing of front-line hospital staff. Results suggest that nurses may be at higher risk of adverse mental health outcomes during this pandemic, but no studies compare this group with the primary care workforce. Furthermore, no studies investigated the psychological impact of the COVID-19 pandemic on social care staff. Other risk factors identified were underlying organic illness, gender (female), concern about family, fear of infection, lack of personal protective equipment (PPE) and close contact with COVID-19. Systemic support, adequate knowledge and resilience were identified as factors protecting against adverse mental health outcomes. Conclusions The evidence to date suggests that female nurses with close contact with COVID-19 patients may have the most to gain from efforts aimed at supporting psychological well-being. However, inconsistencies in findings and a lack of data collected outside of hospital settings, suggest that we should not exclude any groups when addressing psychological well-being in health and social care workers. Whilst psychological interventions aimed at enhancing resilience in the individual may be of benefit, it is evident that to build a resilient workforce, occupational and environmental factors must be addressed. Further research including social care workers and analysis of wider societal structural factors is recommended. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-10070-3.
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMJ Open
                Journal ID (iso-abbrev): BMJ Open
                Journal ID (hwp): bmjopen
                Journal ID (publisher-id): bmjopen
                Title: BMJ Open
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Electronic): 2044-6055
                Publication date Collection: 2021
                Publication date (Electronic): 30 September 2021
                Publication date PMC-release: 30 September 2021
                Volume: 11
                Issue: 9
                Electronic Location Identifier: e054284
                Affiliations
                [1]departmentDepartment of Psychiatry , Lira University , Lira, Uganda
                Author notes
                [Correspondence to ] Dr Amir Kabunga; amirkabs2017@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-0481-2220
                Article
                Publisher ID: bmjopen-2021-054284
                DOI: 10.1136/bmjopen-2021-054284
                PMC ID: 8487018
                PubMed ID: 34593507
                SO-VID: 4c88f8da-f673-4a23-af55-385c4fb0f1f7
                Copyright © © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
                License:

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                Date received : 09 June 2021
                Date accepted : 10 September 2021
                Categories
                Subject: Mental Health
                Subject: 1506
                Subject: 2474
                Subject: 1712
                Series title: Original research
                Custom metadata
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                ScienceOpen disciplines: Medicine
                Keywords: public health,covid-19,suicide & self-harm
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: public health, covid-19, suicide & self-harm

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