Burnout and the Psychological Impact among Physiatrists in Saudi Arabia during COVID-19
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Study Procedure
2.3. Variables and Instruments
2.4. Statistical Analysis
3. Results
3.1. Sociodemographic and Educational Characteristics
3.2. Prevalence of Burnout and Depression among the Study Population
3.3. Relationship between Burnout and Mental Health Outcomes among the Study Population
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Huang, C.; Wang, Y.; Li, X.; Ren, L.; Zhao, J.; Hu, Y.; Zhanget, L.; Fan, G.; Xu, J.; Gu, X.; et al. Clinical Features of Patients Infected with 2019 Novel Coronavirus in Wuhan, China. Lancet 2020, 395, 497–506. [Google Scholar] [CrossRef] [Green Version]
- Bateman, E.A.; Viana, R. Burnout among Specialists and Trainees in Physical Medicine and Rehabilitation: A Systematic Review. J. Rehabil. Med. 2019, 51, 869–874. [Google Scholar] [CrossRef]
- Patel, R.S.; Bachu, R.; Adikey, A.; Malik, M.; Shah, M. Factors Related to Physician Burnout and Its Consequences: A Review. Behav. Sci. 2018, 8, 98. [Google Scholar] [CrossRef] [Green Version]
- Shah, K.; Kamrai, D.; Mekala, H.; Mann, B.; Desai, K.; Patel, R.S. Focus on Mental Health during the Coronavirus (COVID-19) Pandemic: Applying Learnings from the Past Outbreaks. Cureus 2020, 12, e7405. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Shanafelt, T.D.; Balch, C.M.; Bechamps, G.J.; Russell, T.; Dyrbye, L.; Satele, D.; Collicott, P.; Novotny, P.; Sloan, J.; Freischlag, J. Burnout and Career Satisfaction among American Surgeons. Ann. Surg. 2009, 250, 463–470. [Google Scholar] [CrossRef]
- Alotaibi, A.K.; Alsalim, A.; Alruwaili, F.; Almubarak, A.; Alhamzah, A.; Albahlal, A.; Alrobaianade, M. Burnout during Ophthalmology Residency Training: A National Survey in Saudi Arabia. Saudi J. Ophthalmol. 2019, 33, 130–134. [Google Scholar] [CrossRef]
- Gloster, A.T.; Rhoades, H.M.; Novy, D.; Klotsche, J.; Senior, A.; Kunik, M.; Wilson, N.; Stanley, M.A. Psychometric Properties of the Depression Anxiety and Stress Scale-21 in Older Primary Care Patients. J. Affect. Disord. 2008, 110, 248–259. [Google Scholar] [CrossRef] [Green Version]
- Kannampallil, T.G.; Goss, C.W.; Evanoff, B.A.; Strickland, J.R.; McAlister, R.P.; Duncan, J. Exposure to COVID-19 Patients Increases Physician Trainee Stress and Burnout. PLoS ONE 2020, 15, e0237301. [Google Scholar] [CrossRef] [PubMed]
- Kulkarni, A.; Khasne, R.W.; Dhakulkar, B.S.; Mahajan, H.C. Burnout among Healthcare Workers during COVID-19 Pandemic in India: Results of a Questionnaire-Based Survey. Indian J. Crit. Care Med. 2020, 24, 664–671. [Google Scholar]
- Shanafelt, T.; Trockel, M.; Ripp, J.; Murphy, M.L.; Sandborg, C.; Bohman, B. Building a Program on Well-Being: Key Design Considerations to Meet the Unique Needs of Each Organization. Acad. Med. 2019, 94, 156–161. [Google Scholar] [CrossRef]
- Emener, W.G. Professional Burnout: Rehabilitation’s Hidden Handicap. J. Rehabil. 1979, 45, 55. [Google Scholar]
- Johnson, E. “Burnout” (A Metaphoric Myth). Am. J. Phys. Med. Rehabil. 1988, 67, 237. [Google Scholar]
- Silver, J. Physician Burnout in Physical Medicine and Rehabilitation (PM&R): Should We Focus More on Physiatrists’ Mission? Am. J. Phys. Med. 2017, 96, 159–161. [Google Scholar]
- Houkes, I.; Winants, Y.; Twellaar, M.; Verdonk, P. Development of Burnout Over Time and the Causal Order of the Three Dimensions of Burnout among Male and Female GPS. A Three-Wave Panel Study. BMC Public Health 2011, 11, 1–13. [Google Scholar] [CrossRef] [Green Version]
- Langballe, E.M.; Innstrand, S.T.; Aasland, O.G.; Falkum, E. The Predictive Value of Individual Factors, Work-Related Factors, and Work-Home Interaction on Burnout in Female and Male Physicians: A Longitudinal Study. Stress Health 2011, 27, 73–87. [Google Scholar] [CrossRef]
- Al Ateeq, D.A.; Aljhani, S.; Althiyabi, I.; Majzoub, S. Mental Health among Healthcare Providers during Coronavirus Disease (COVID-19) Outbreak in Saudi Arabia. J. Infect. Public Health 2020, 13, 1432–1437. [Google Scholar] [CrossRef]
- Panagioti, M. A Systematic Review and Meta-Analysis of Controlled Interventions to Reduce Burnout 1 in Physicians. JAMA Intern. Med. 2017, 177, 195–205. [Google Scholar] [CrossRef] [PubMed]
- Freudenberger, H.J. Staff Burn-Out. J. Soc. Issues 1974, 30, 159–165. [Google Scholar] [CrossRef]
- Busireddy, K.R.; Miller, J.A.; Ellison, K.; Ren, V.; Qayyum, R.; Panda, M. Efficacy of Interventions to Reduce Resident Physician Burnout: A Systematic Review. J. Grad. Med. Educ. 2017, 9, 294–301. [Google Scholar] [CrossRef] [Green Version]
- Hategan, A.; Riddell, T. Bridging the Gap: Responding to Resident Burnout and Restoring Well-Being. Perspect. Med. Educ. 2020, 9, 117–122. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Dreison, K.C.; Luther, L.; Bonfils, K.A.; Sliter, M.T.; McGrew, J.H.; Salyers, M.P. Job Burnout in Mental Health Providers: A Meta-Analysis of 35 Years of Intervention Research. J. Occup. Health Psychol. 2018, 23, 18–30. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Howlett, M.; Doody, K.; Murray, J.; LeBlanc-Duchin, D.; Fraser, J.; Atkinson, P.R. Burnout in Emergency Department Healthcare Professionals Is Associated with Coping Style: A Cross-Sectional Survey. Emerg. Med. J. 2015, 32, 722–727. [Google Scholar] [CrossRef] [PubMed]
Variables | Frequency | Percent |
---|---|---|
Age | ||
24–34 years | 74 | 73.3 |
35–45 years | 12 | 11.9 |
46–56 years | 7 | 6.9 |
56–65 years | 8 | 7.9 |
Gender | ||
Male | 56 | 55.4 |
Female | 45 | 44.6 |
Marital status | ||
Single | 30 | 29.7 |
Married | 65 | 64.4 |
Divorced | 6 | 5.9 |
Raising children | ||
Yes | 55 | 54.5 |
No | 46 | 45.5 |
Hospital type | ||
Primary care | 2 | 2.0 |
Secondary care | 10 | 9.9 |
Tertiary care | 89 | 88.1 |
Working hours | ||
≤40 h/week | 28 | 27.7 |
41–60 h/week | 70 | 69.3 |
61–80 h/week | 3 | 3.0 |
Current role | ||
Junior resident | 35 | 34.7 |
Senior resident | 23 | 22.8 |
Specialist | 27 | 26.7 |
Consultant | 16 | 15.8 |
Handling COVID-19 patients | ||
Yes | 26 | 25.7 |
No | 75 | 74.3 |
Received mental health help in the past year | ||
Yes | 6 | 5.9 |
No | 95 | 94.1 |
Statements | Strongly Disagree | Disagree | Neutral | Agree | Strongly Agree |
---|---|---|---|---|---|
Worried about becoming infected | 2 (2.0%) | − | 20 (19.8%) | 28 (27.7%) | 51 (50.5%) |
Feel more burnout now than before COVID-19 | 9 (8.9%) | 12 (11.9%) | 14 (13.9%) | 26 (25.7%) | 40 (39.6%) |
Worried about family becoming infected | 3 (3.0%) | 1 (1.0%) | 1 (1.0%) | 23 (22.8%) | 73 (72.3%) |
Worried about the crisis going on for too long | − | − | 8 (7.9%) | 30 (29.7%) | 63 (62.4%) |
Variables | Frequency | Percent (%) |
---|---|---|
Burnout syndrome * | ||
Yes | 81 | 80.2 |
No | 20 | 19.8 |
Burnout subscales | ||
High emotional exhaustion | 52 | 51.5 |
High depersonalization | 72 | 71.3 |
Low personal accomplishment | 92 | 91.1 |
Stress ** | ||
Yes | 11 | 10.9 |
No | 90 | 89.1 |
Anxiety ** | ||
Yes | 23 | 22.8 |
No | 78 | 77.2 |
Depression ** | ||
Yes | 7 | 6.9 |
No | 94 | 93.1 |
Stress * | Anxiety * | Depression * | |
---|---|---|---|
Score, Mean ± SD | 10.5 ± 6.2 | 5.0 ± 5.4 | 6.0 ± 5.8 |
Categories, N (%) | |||
Normal | 74 (73.3%) | 67 (66.3%) | 74 (73.3%) |
Mild | 16 (15.8%) | 11 (10.9%) | 20 (19.8%) |
Moderate | 10 (9.9%) | 16 (15.8%) | 5 (5.0%) |
Severe | 1 (1.0%) | 5 (5.0%) | 1 (1.0%) |
Extremely severe | − | 2 (2.0%) | 1 (1.0%) |
Variables | Burnout | Stress | Anxiety | Depression | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Yes | No | p | Yes | No | p | Yes | No | p | Yes | No | p | |
Age | ||||||||||||
24–34 years | 61 (82.4%) | 13 (17.6%) | 0.351 | 10 (13.5%) | 64 (86.5%) | 0.280 | 19 (25.7%) | 55 (74.3%) | 0.296 | 7 (9.5%) | 67 (90.5%) | 0.098 |
35–65 years | 20 (74.1%) | 7 (25.9%) | 1 (3.7%) | 26 (96.3%) | 4 (14.8%) | 23 (85.2%) | 0 (0.0%) | 27 (100.0%) | ||||
Gender | ||||||||||||
Male | 40 (71.4%) | 16 (28.6%) | 0.014 | 5 (8.9%) | 51 (91.1%) | 0.480 | 12 (21.4%) | 44 (78.6%) | 0.719 | 3 (5.4%) | 53 (94.6%) | 0.697 |
Female | 41 (91.1%) | 4 (8.9%) | 6 (13.3%) | 39 (86.7%) | 11 (24.4%) | 34 (75.6%) | 4 (8.9%) | 41 (91.1%) | ||||
Marital status | ||||||||||||
Single/divorced | 31 (86.1%) | 5 (13.9%) | 0.267 | 5 (13.9%) | 31 (86.1%) | 0.472 | 8 (22.2%) | 28 (77.8%) | 0.922 | 4 (11.1%) | 32 (88.9%) | 0.244 |
Married | 50 (76.9%) | 15 (23.1%) | 6 (9.2%) | 59 (90.8%) | 15 (23.1%) | 50 (76.9%) | 3 (4.6%) | 62 (95.4%) | ||||
Raising children | ||||||||||||
Yes | 41 (74.5%) | 14 (25.5%) | 0.119 | 5 (9.1%) | 50 (90.9%) | 0.525 | 14 (25.5%) | 41 (74.5%) | 0.482 | 3 (5.5%) | 52 (94.5%) | 0.699 |
No | 40 (87.0%) | 6 (13.0%) | 6 (13.0%) | 40 (87.0%) | 9 (19.6%) | 37 (80.4%) | 4 (8.7%) | 42 (91.3%) | ||||
Hospital type | ||||||||||||
Primary/Secondary care | 7 (58.3%) | 5 (41.7%) | 0.043 | 2 (16.7%) | 10 (83.3%) | 0.616 | 5 (41.7%) | 7 (58.3%) | 0.096 | 2 (16.7%) | 10 (83.3%) | 0.194 |
Tertiary care | 74 (83.1%) | 15 (16.9%) | 9 (10.1%) | 80 (89.9%) | 18 (20.2%) | 71 (79.8%) | 5 (5.6%) | 84 (94.4%) | ||||
Working hours | ||||||||||||
≤40 h/week | 19 (67.9%) | 9 (32.1%) | 0.054 | 3 (10.7%) | 25 (89.3%) | 0.972 | 5 (17.9%) | 23 (82.1%) | 0.466 | 3 (10.7%) | 25 (89.3%) | 0.393 |
41–80 h/week | 62 (84.9%) | 11 (15.1%) | 8 (11.0%) | 65 (89.0%) | 18 (24.7%) | 55 (75.3%) | 4 (5.5%) | 69 (94.5%) | ||||
Current role | ||||||||||||
Junior/senior resident | 52 (89.7%) | 6 (10.3%) | 0.006 | 10 (17.2%) | 48 (82.8%) | 0.022 | 15 (25.9%) | 43 (74.1%) | 0.390 | 6 (10.3%) | 52 (89.7%) | 0.234 |
Specialist/consultant | 29 (67.4%) | 14 (32.6%) | 1 (2.3%) | 42 (97.7%) | 8 (18.6%) | 35 (81.4%) | 1 (2.3%) | 42 (97.7%) | ||||
Handling COVID-19 patients | ||||||||||||
Yes | 23 (88.5%) | 3 (11.5%) | 0.220 | 6 (23.1%) | 20 (76.9%) | 0.021 | 10 (38.5%) | 16 (61.5%) | 0.027 | 3 (11.5%) | 23 (88.5%) | 0.369 |
No | 58 (77.3%) | 17 (22.7%) | 5 (6.7%) | 70 (93.3%) | 13 (17.3%) | 62 (82.7%) | 4 (5.3%) | 71 (94.7%) | ||||
Received mental health help | ||||||||||||
Yes | 6 (100.0%) | 0 (0.0%) | 0.209 | 1 (16.7%) | 5 (83.3%) | 0.509 | 1 (16.7%) | 5 (83.3%) | 0.713 | 1 (16.7%) | 5 (83.3%) | 0.358 |
No | 75 (78.9%) | 20 (21.1%) | 10 (10.5%) | 85 (89.5%) | 22 (23.2%) | 73 (76.8%) | 6 (6.3%) | 89 (93.7%) | ||||
Burnout | ||||||||||||
Yes | − | − | NA | 10 (12.3%) | 71 (87.7%) | 0.688 | 19 (23.5%) | 62 (76.5%) | 0.741 | 5 (6.2%) | 76 (93.8%) | 0.623 |
No | − | − | 1 (5.0%) | 19 (95.0%) | 4 (20.0%) | 16 (80.0%) | 2 (10.0%) | 18 (90.0%) |
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Alwashmi, A.H.; Alkhamees, A.A. Burnout and the Psychological Impact among Physiatrists in Saudi Arabia during COVID-19. Int. J. Environ. Res. Public Health 2021, 18, 9621. https://doi.org/10.3390/ijerph18189621
Alwashmi AH, Alkhamees AA. Burnout and the Psychological Impact among Physiatrists in Saudi Arabia during COVID-19. International Journal of Environmental Research and Public Health. 2021; 18(18):9621. https://doi.org/10.3390/ijerph18189621
Chicago/Turabian StyleAlwashmi, Ahmad H., and Abdulmajeed A. Alkhamees. 2021. "Burnout and the Psychological Impact among Physiatrists in Saudi Arabia during COVID-19" International Journal of Environmental Research and Public Health 18, no. 18: 9621. https://doi.org/10.3390/ijerph18189621