Öz
Amaç: COVID-19 pandemisinde artan iş yükü ve çalışma koşulları, sağlık çalışanlarının yaşamlarını, fiziksel iyiliklerini ve mental sağlıklarını (tükenmişlik gibi) tehdit etmektedir. Bu çalışmada, COVID-19 pandemisinin ilk dalgasında sağlık çalışanlarının tükenmişlik oranını inceleyen çalışma bulgularının meta-analiz yöntemi kullanılarak analizi amaçlanmıştır.
Gereç ve Yöntem: PubMed, PsycINFO ve WOS kullanılarak COVID-19 pandemisinin sağlık çalışanları arasındaki tükenmişliğini (Maslach Tükenmişlik Ölçeği ile) 25 Şubat 2021'e kadar inceleyen çalışmalar tarandı ve 145 çalışmadan 10'u meta-analize dahil edildi.
Bulgular: Sağlık çalışanlarında duygusal tükenme oranı %31 (%95 GA: %24-%40), duyarsızlaşma oranı %28 (%95 GA: %23-%38) ve kişisel başarısızlık oranı %22 (%95 GA: %13-%34) olarak elde edilmiştir. Vaka sayısının yüksek, yatak ve doktor sayısının düşük olduğu ülkelerde, duygusal tükenme düzeyinin daha düşük, kişisel başarısızlığın daha yüksek olduğu saptanmıştır. Alt grup analizlerinde ise anlamlı bir farklılık bulunmamıştır.
Sonuç: Erken dönem çalışmalarından elde edilen kanıtlar, COVID-19 pandemisi sırasında sağlık çalışanlarının önemli bir bölümünde tükenmişliğin olduğunu göstermiştir. Sağlık çalışanlarının mental sağlığına dikkat etmenin, olası riskleri azaltmanın yollarını belirlemenin ve salgın sırası ile sonrasında sağlık çalışanları için rehabilitasyon programı hazırlamanın gerekli olduğu sonucuna ulaşılmıştır.
Anahtar Kelimeler
Koronavirüs COVID-19 sağlık çalışanları tükenmişlik sistematik derleme ve meta-analiz
Kaynakça
- 1. Maslach C; Goldberg, J. Prevention of burnout: New perspectives. Applied and Preventive Psychology 1998; 7(1), 63–74. https://doi.org/10.1016/S0962-1849(98)80022-X
- 2. Bianchi, R. Do burnout and depressive symptoms form a single syndrome ? Con fi rmatory factor analysis and exploratory structural equation modeling bifactor analysis. Journal of Psychosomatic Research 2020; 131, 109954. https://doi.org/10.1016/j.jpsychores.2020.109954
- 3. Engebretsen, K. M., & Bjorbækmo, W. S. Burned out or “just” depressed ? An existential phenomenological exploration of burnout. Journal of Evaluation in Clinical Practice 2020; 26(2), 439–446. https://doi.org/10.1111/jep.13288
- 4. Koutsimani, P., Montgomery, A., & Georganta, K. he relationship between burnout, depression, and anxiety: A systematic review and meta-analysis. Frontiers in Psychology 2019; 10(284), 1–19. https://doi.org/10.3389/fpsyg.2019.00284
- 5. Fischer, R., Mattos, P., Teixeira, C., Ganzerla, D. S., Rosa, R. G., & Bozza, F. A. Association of Burnout With Depression and Anxiety in Critical Care Clinicians in Brazil. JAMA Network Open 2021; 3(12), 1–12. https://doi.org/10.1001/jamanetworkopen.2020.30898
- 6. Massaro, G., Monteiro, C., Lucia, F., Baeza, C., & Hauck, S. Work Environment Evaluation Instrument (WEEI): development, validation, and association with burnout. Trends in Psychiatry and Psychotherapy 2020; 42(2), 185–189.
- 7. West, C. P., Dyrbye, L. N., Erwin, P. J., & Shanafelt, T. D. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. The Lancet 2016; 388(10057), 2272–2281. https://doi.org/10.1016/S0140-6736(16)31279-X
- 8. Joanna Briggs Institute 2017; https://jbi.global/critical-appraisal-tools
- 9. Maslach, C., & Leiter, M. P. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry: Official Journal of the World Psychiatric Association (WPA) 2016; June, 103–111.
- 10. Hedges, L. V, & Pigott, T. D. The power of statistical tests in meta-analysis. Psychol Methods 2001; 6(3), 203–217. https://doi.org/10.1037//1082-989X.6.3.203
- 11. Sayilan, A. A. Burnout levels and sleep quality of COVID‐19 heroes. Perspectives in Psychiatric Care 2020; 57(3), 1231–1236. https://doi.org/10.1111/ppc.12678
- 12. Lasalvia, A., Amaddeo, F., Porru, S., Carta, A., Tardivo, S., Bovo, C., Ruggeri, M., & Bonetto, C. Levels of burn-out among healthcare workers during the COVID-19 pandemic and their associated factors: a cross-sectional study in a tertiary hospital of a highly burdened area of north-east Italy. BMJ Open. 2021; 11(1), 1–12. https://doi.org/10.1136/bmjopen-2020-045127
- 13. Barello, S., Palamenghi, L., & Graffigna, G. Stressors and Resources for Healthcare Professionals During the Covid-19 Pandemic: Lesson Learned From Italy. Frontiers in Psychology 2020b; 11(October), 1–5. https://doi.org/10.3389/fpsyg.2020.02179
- 14. Barello, S., Palamenghi, L., & Graffigna, G. Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic. Psychiatry Research 2020a; January.
- 15. Lange, M., Joo, D., Couette, P. A., Jaegher, S., Joly, F., & Humbert, X. Impact on mental health of the COVID-19 outbreak among community pharmacists during the sanitary lockdown period. In Annales Pharmaceutiques Francaises 2020; 78(6), 459–463.
- 16. Luceño-moreno, L., Talavera-velasco, B., & Garc, Y. Symptoms of Posttraumatic Stress, Anxiety, Depression, Levels of Resilience and Burnout in Spanish Health Personnel during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health 2020; 15, 5514.
- 17. Martínez-López, J., Lázaro-Pérez, C., Gómez-Galán, J., & Fernández-Martínez, M. Psychological Impact of COVID-19 Emergency on Health Professionals: Burnout Incidence at the Most Critical Period in Spain. Journal of Clinical Medicine 2020; January 2020, 1–18.
- 18. Monte, C. Di, Monaco, S., Mariani, R., & Trani, M. Di. From Resilience to Burnout : Psychological Features of Italian General Practitioners During COVID-19 Emergency. Frontiers in Psychology 2020; 11, 2476. https://doi.org/10.3389/fpsyg.2020.567201
- 19. Naldi, A., Vallelonga, F., Liberto, A. Di, Cavallo, R., Agnesone, M., Gonella, M., Sauta, M. D., Lochner, P., Tondo, G., Bragazzi, N. L., Botto, R., & Leombruni, P. COVID-19 pandemic-related anxiety, distress and burnout: prevalence and associated factors in healthcare workers of North-West Italy. BJPsych Open 2021; 7(1). https://doi.org/10.1192/bjo.2020.161
- 20. Treluyer, L., & Tourneux, P. Burnout among paediatric residents during the COVID-19 outbreak in France. European Journal of Pediatrics 2021; 180(2), 627–633.
- 21. Varani, S., Ostan, R., Franchini, L., Ercolani, G., Pannuti, R., Biasco, G., & Bruera, E. Caring Advanced Cancer Patients at Home During COVID-19 Outbreak : Burnout and Psychological Morbidity Among Palliative Care Professionals in Italy. Journal of Pain and Symptom Management 2021; 61(2), e4–e12. https://doi.org/10.1016/j.jpainsymman.2020.11.026
- 22. Lu, W., Wang, H., Lin, Y., & Li, L. Psychological status of medical workforce during the COVID-19 pandemic: A cross-sectional study. Psychiatry Research 2020; 288, 112936. https://doi.org/10.1016/j.psychres.2020.112936
- 23. Wurm, W., Vogel, K., Holl, A., Ebner, C., & Bayer, D. Depression-Burnout Overlap in Physicians. PloS One 2016; 11(3), e0149913. https://doi.org/10.1371/journal.pone.0149913
- 24. Connor, K. O., Pitman, S., Muller, D., & Pitman, S. Burnout in mental helath professionals : A systematic review and meta- anaysis of prevalence and determinants Burnout in mental health professionals : A systematic review and meta-analysis of prevalence and determinants. European Psychiatry 2018; 53(June), 74–99. https://doi.org/10.1016/j.eurpsy.2018.06.003
- 25. Kesarwani, V., Husaain, Z. G., & George, J. Prevalence and factors associated with burnout among healthcare professionals in India: a systematic review and meta-analysis. Indian Journal of Psychological Medicine 2020; 42(2), 108–115. https://doi.org/10.4103/IJPSYM.IJPSYM
- 26. la Fuente-Solana, D., Inmaculada, E., Pradas-Hernández, L., Ramiro-Salmerón, A., Suleiman-Martos, N., Gómez-Urquiza, J., & Albendín-García, L. Burnout Syndrome in Paediatric Oncology Nurses: A Systematic Review and Meta-Analysis. Multidisciplinary Digital Publishing Institute 2020; 8(3), 309.
- 27. Rodrigues, H., Id, R. C., Gonc, A. K., Medeiros, L., & Gurgel, K. Burnout syndrome among medical residents : A systematic review and meta-analysis. PLoS One 2018; 1–17.
- 28. Trufelli, D. C., Students, M., Foundation, A. B. C., Andre, S., Bensi, C. G., Andre, S., Diniz, R. W., Students, M., & Foundation, A. B. C. Burnout in cancer professionals: a systematic review and meta-analysis. European Journal of Cancer Care 2008; 17(6), 524–531. https://doi.org/10.1111/j.1365-2354.2008.
- 29. Kansoun, Z., Boyer, L., Hodgkinson, M., Villes, V., Lançon, C., & Fond, G. Burnout in French physicians : A systematic review and meta-analysis. Journal of Affective Disorders 2019; 246(December 2018), 132–147. https://doi.org/10.1016/j.jad.2018.12.056
- 30. Eden, A. R., Jabbarpour, Y., Morgan, Z. J., Dai, M., Coffman, M., & Bazemore, A. Gender Differences in Personal and Organizational Mechanisms to Address Burnout Among Family Physicians. The Journal of the American Board of Family Medicine 2020; 33(3), 14–17. https://doi.org/10.3122/jabfm.2020.03.190344
Öz
conditions during the COVID-19 pandemic, threaten the lives and physical well-being of healthcare workers (HCWs), and also their mental health, such as burnout, etc. which is often neglected. The aim of this review is to analyze published studies on the proportion of burnout among HCWs during the first wave of the COVID-19.
Materials and Methods: We conducted a systematic review of studies that reported burnout (measured by Maslach Burnout Inventory) among HCWs during the COVID-19 pandemic and searched PubMed, PsycINFO, and WOS of relevant articles up to Feb 25th, 2021. Out of 145 non-duplicate studies, 10 were included in the meta-analysis.
Results: The overall estimated pooled proportion for emotional exhaustion (EE) was 31% (95% CI: 24%-40%), for depersonalization (DP) was 28% (95% CI: 23%-38%) and 22% (95% CI: 13%-34%) for personal accomplishment (PA). The results show that in countries where the number of cases is high and the number of beds and doctors is low, the level of EE appears to be slightly lower and PA is slightly higher. However, there were no significant differences according to subgroup analyses.
Conclusion: Evidence from early studies highlight the fact that a significant proportion of HCWs suffers from burnout during this pandemic. It will be necessary to pay close attention to HCWs' mental health and identify ways to reduce risks and prepare a rehabilitation program for the HCWs during and after the pandemic.
Anahtar Kelimeler
Coronavirus COVID-19 Healthcare workers Burnout Systematic Review-Meta Analysis.
Kaynakça
- 1. Maslach C; Goldberg, J. Prevention of burnout: New perspectives. Applied and Preventive Psychology 1998; 7(1), 63–74. https://doi.org/10.1016/S0962-1849(98)80022-X
- 2. Bianchi, R. Do burnout and depressive symptoms form a single syndrome ? Con fi rmatory factor analysis and exploratory structural equation modeling bifactor analysis. Journal of Psychosomatic Research 2020; 131, 109954. https://doi.org/10.1016/j.jpsychores.2020.109954
- 3. Engebretsen, K. M., & Bjorbækmo, W. S. Burned out or “just” depressed ? An existential phenomenological exploration of burnout. Journal of Evaluation in Clinical Practice 2020; 26(2), 439–446. https://doi.org/10.1111/jep.13288
- 4. Koutsimani, P., Montgomery, A., & Georganta, K. he relationship between burnout, depression, and anxiety: A systematic review and meta-analysis. Frontiers in Psychology 2019; 10(284), 1–19. https://doi.org/10.3389/fpsyg.2019.00284
- 5. Fischer, R., Mattos, P., Teixeira, C., Ganzerla, D. S., Rosa, R. G., & Bozza, F. A. Association of Burnout With Depression and Anxiety in Critical Care Clinicians in Brazil. JAMA Network Open 2021; 3(12), 1–12. https://doi.org/10.1001/jamanetworkopen.2020.30898
- 6. Massaro, G., Monteiro, C., Lucia, F., Baeza, C., & Hauck, S. Work Environment Evaluation Instrument (WEEI): development, validation, and association with burnout. Trends in Psychiatry and Psychotherapy 2020; 42(2), 185–189.
- 7. West, C. P., Dyrbye, L. N., Erwin, P. J., & Shanafelt, T. D. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. The Lancet 2016; 388(10057), 2272–2281. https://doi.org/10.1016/S0140-6736(16)31279-X
- 8. Joanna Briggs Institute 2017; https://jbi.global/critical-appraisal-tools
- 9. Maslach, C., & Leiter, M. P. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry: Official Journal of the World Psychiatric Association (WPA) 2016; June, 103–111.
- 10. Hedges, L. V, & Pigott, T. D. The power of statistical tests in meta-analysis. Psychol Methods 2001; 6(3), 203–217. https://doi.org/10.1037//1082-989X.6.3.203
- 11. Sayilan, A. A. Burnout levels and sleep quality of COVID‐19 heroes. Perspectives in Psychiatric Care 2020; 57(3), 1231–1236. https://doi.org/10.1111/ppc.12678
- 12. Lasalvia, A., Amaddeo, F., Porru, S., Carta, A., Tardivo, S., Bovo, C., Ruggeri, M., & Bonetto, C. Levels of burn-out among healthcare workers during the COVID-19 pandemic and their associated factors: a cross-sectional study in a tertiary hospital of a highly burdened area of north-east Italy. BMJ Open. 2021; 11(1), 1–12. https://doi.org/10.1136/bmjopen-2020-045127
- 13. Barello, S., Palamenghi, L., & Graffigna, G. Stressors and Resources for Healthcare Professionals During the Covid-19 Pandemic: Lesson Learned From Italy. Frontiers in Psychology 2020b; 11(October), 1–5. https://doi.org/10.3389/fpsyg.2020.02179
- 14. Barello, S., Palamenghi, L., & Graffigna, G. Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic. Psychiatry Research 2020a; January.
- 15. Lange, M., Joo, D., Couette, P. A., Jaegher, S., Joly, F., & Humbert, X. Impact on mental health of the COVID-19 outbreak among community pharmacists during the sanitary lockdown period. In Annales Pharmaceutiques Francaises 2020; 78(6), 459–463.
- 16. Luceño-moreno, L., Talavera-velasco, B., & Garc, Y. Symptoms of Posttraumatic Stress, Anxiety, Depression, Levels of Resilience and Burnout in Spanish Health Personnel during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health 2020; 15, 5514.
- 17. Martínez-López, J., Lázaro-Pérez, C., Gómez-Galán, J., & Fernández-Martínez, M. Psychological Impact of COVID-19 Emergency on Health Professionals: Burnout Incidence at the Most Critical Period in Spain. Journal of Clinical Medicine 2020; January 2020, 1–18.
- 18. Monte, C. Di, Monaco, S., Mariani, R., & Trani, M. Di. From Resilience to Burnout : Psychological Features of Italian General Practitioners During COVID-19 Emergency. Frontiers in Psychology 2020; 11, 2476. https://doi.org/10.3389/fpsyg.2020.567201
- 19. Naldi, A., Vallelonga, F., Liberto, A. Di, Cavallo, R., Agnesone, M., Gonella, M., Sauta, M. D., Lochner, P., Tondo, G., Bragazzi, N. L., Botto, R., & Leombruni, P. COVID-19 pandemic-related anxiety, distress and burnout: prevalence and associated factors in healthcare workers of North-West Italy. BJPsych Open 2021; 7(1). https://doi.org/10.1192/bjo.2020.161
- 20. Treluyer, L., & Tourneux, P. Burnout among paediatric residents during the COVID-19 outbreak in France. European Journal of Pediatrics 2021; 180(2), 627–633.
- 21. Varani, S., Ostan, R., Franchini, L., Ercolani, G., Pannuti, R., Biasco, G., & Bruera, E. Caring Advanced Cancer Patients at Home During COVID-19 Outbreak : Burnout and Psychological Morbidity Among Palliative Care Professionals in Italy. Journal of Pain and Symptom Management 2021; 61(2), e4–e12. https://doi.org/10.1016/j.jpainsymman.2020.11.026
- 22. Lu, W., Wang, H., Lin, Y., & Li, L. Psychological status of medical workforce during the COVID-19 pandemic: A cross-sectional study. Psychiatry Research 2020; 288, 112936. https://doi.org/10.1016/j.psychres.2020.112936
- 23. Wurm, W., Vogel, K., Holl, A., Ebner, C., & Bayer, D. Depression-Burnout Overlap in Physicians. PloS One 2016; 11(3), e0149913. https://doi.org/10.1371/journal.pone.0149913
- 24. Connor, K. O., Pitman, S., Muller, D., & Pitman, S. Burnout in mental helath professionals : A systematic review and meta- anaysis of prevalence and determinants Burnout in mental health professionals : A systematic review and meta-analysis of prevalence and determinants. European Psychiatry 2018; 53(June), 74–99. https://doi.org/10.1016/j.eurpsy.2018.06.003
- 25. Kesarwani, V., Husaain, Z. G., & George, J. Prevalence and factors associated with burnout among healthcare professionals in India: a systematic review and meta-analysis. Indian Journal of Psychological Medicine 2020; 42(2), 108–115. https://doi.org/10.4103/IJPSYM.IJPSYM
- 26. la Fuente-Solana, D., Inmaculada, E., Pradas-Hernández, L., Ramiro-Salmerón, A., Suleiman-Martos, N., Gómez-Urquiza, J., & Albendín-García, L. Burnout Syndrome in Paediatric Oncology Nurses: A Systematic Review and Meta-Analysis. Multidisciplinary Digital Publishing Institute 2020; 8(3), 309.
- 27. Rodrigues, H., Id, R. C., Gonc, A. K., Medeiros, L., & Gurgel, K. Burnout syndrome among medical residents : A systematic review and meta-analysis. PLoS One 2018; 1–17.
- 28. Trufelli, D. C., Students, M., Foundation, A. B. C., Andre, S., Bensi, C. G., Andre, S., Diniz, R. W., Students, M., & Foundation, A. B. C. Burnout in cancer professionals: a systematic review and meta-analysis. European Journal of Cancer Care 2008; 17(6), 524–531. https://doi.org/10.1111/j.1365-2354.2008.
- 29. Kansoun, Z., Boyer, L., Hodgkinson, M., Villes, V., Lançon, C., & Fond, G. Burnout in French physicians : A systematic review and meta-analysis. Journal of Affective Disorders 2019; 246(December 2018), 132–147. https://doi.org/10.1016/j.jad.2018.12.056
- 30. Eden, A. R., Jabbarpour, Y., Morgan, Z. J., Dai, M., Coffman, M., & Bazemore, A. Gender Differences in Personal and Organizational Mechanisms to Address Burnout Among Family Physicians. The Journal of the American Board of Family Medicine 2020; 33(3), 14–17. https://doi.org/10.3122/jabfm.2020.03.190344
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Eylül 2022 |
| Kabul Tarihi | 8 Ağustos 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 47 Sayı: 3 |
