Exhaustion in Healthcare Workers after the First Three Waves of the COVID-19 Pandemic
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Collection
2.2. Outcomes
2.3. Explanatory Variables
2.4. Statistical Methods
3. Results
3.1. Description of the Study Population
3.2. Univariate Analysis
3.3. Multivariate Analysis
3.4. Comparison of the Perceived Job Stressors and Exhaustion Score between flHCW and slHCW
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic N (%) | All 1872 | flHCW 1311 (70.03) | slHCW 561 (29.97) | p-Value |
---|---|---|---|---|
Demographic characteristics Gender | 0.367 | |||
Men | 340 (18.16) | 245 (18.69) | 95 (16.93) | |
Women | 1532 (81.84) | 1066 (81.31) | 466 (83.07) | |
Age (average ± SD) | 48.6 ± 10.9 | 48.6 ± 11.1 | 48.8 ± 10.6 | 0.776 * |
Age, years | 0.519 | |||
20–29 | 128 (6.84) | 89 (6.79) | 39 (6.95) | |
30–39 | 240 (12.82) | 177 (13.50) | 63 (11.23) | |
40–49 | 586 (31.30) | 413 (31.50) | 173 (30.84) | |
>50 | 918 (49.04) | 632 (48.21) | 286 (50.98) | |
Marital status | 0.001 | |||
Married/couple | 1390 (74.25) | 1002 (76.43) | 388 (69.16) | |
Single | 482 (25.75) | 309 (23.57) | 173 (30.84) | |
Education level | <0.001 | |||
Undergraduate | 179 (9.56) | 93 (7.09) | 86 (15.33) | |
University degree | 1693 (90.44) | 1218 (92.91) | 475 (84.67) | |
Job characteristics | ||||
Occupation | <0.001 | |||
Doctors | 1328 (70.94) | 1084 (82.68) | 244 (43.49) | |
Nurses | 248 (13.27) | 152 (11.59) | 96 (17.11) | |
Other health professionals | 168 (8.99) | 64 (4.88) | 104 (18.54) | |
Health management and support | 128 (6.85) | 11 (0.84) | 117 (20.86) | |
Workplace | <0.001 | |||
Hospital | 368 (19.66) | 328 (25.02) | 40 (7.14) | |
Other | 1504 (80.34) | 983 (74.98) | 520 (92.86) | |
Tenure (years) | 0.135 | |||
<1 | 37(1.98) | 22 (1.68) | 15 (2.67) | |
1–5 | 229 (12.23) | 160 (12.20) | 69 (12.30) | |
6–10 | 163 (8.71) | 125 (9.53) | 38 (6.77) | |
>10 | 1443 (77.08) | 1004 (76.58) | 439 (78.25) | |
Number of daily working hours (hours) | <0.025 | |||
≤8 | 1556 (83.12) | 1073 (81.85) | 483 (86.10) | |
>8 | 316 (16.88) | 238 (18.15) | 78 (13.9) | |
Working in shifts | 0.0009 | |||
No | 1524 (81.415) | 1047 (79.86) | 477 (85.03) | |
Yes | 348 (18.59) | 264 (20.14) | 84 (14.97) | |
Number of patients/day | ||||
<5 | 138 (10.53) | |||
Between 5–15 | 366 (27.92) | |||
Over 15 | 807(61.56) | |||
Management of risk of COVID-19 infection | 0.0002 | |||
Very well | 647 (34.56) | 480 (36.61) | 167 (29.78) | |
Well | 682 (36.43) | 492 (37.53) | 190 (33.87) | |
Acceptable | 429 (22.92) | 269 (20.52) | 160 (22.92) | |
Not so well | 88 (4.7) | 55 (4.2) | 33 (5.88) | |
Very badly | 26 (1.39) | 15 (1.14) | 11 (1.96) | |
Perceived job stressors | ||||
Reward score (average ± SD) | 5.44 ± 1.54 | 5.21 ± 1.522 | 5.99 ± 1.44 | <0.001 ** |
Effort score (average ± SD) | 9.19 ± 2.04 | 9.51 ± 1.89 | 8.45 ± 2.16 | <0.001 ** |
Personal factors | ||||
Overcommitment score (average ± SD) | 16.01 ± 2.89 | 16.34 ± 2.80 | 15.24 ± 2.94 | <0.001 ** |
COVID-19 diagnosis | 0.002 | |||
Yes | 476 (25.43) | 360 (27.46) | 116 (20.68) | |
No | 1396 (74.57) | 951 (72.54) | 445 (79.32) | |
Persistent symptoms of COVID-19 | 0.023 | |||
Yes | 201 (46.10) | 161 (49.24) | 40 (36.70) | |
No | 235 (53.90) | 166 (50.76) | 69 (63.30) | |
Duration of symptoms | 0.138 | |||
<1 month | 23 (11.44) | 19 (11.80) | 4 (10.00) | |
1–3 months | 75 (37.31) | 65 (40.37) | 10 (25.00) | |
>3 months | 103 (51.24) | 77 (47.83) | 26 (65.00) |
Total | flHCW | slHCW | ||||
---|---|---|---|---|---|---|
Variables | Coefficient (CI 95%) | p-Value | Coefficient (CI 95%) | p-Value | Coefficient (CI 95%) | p-Value |
Demographics | ||||||
Age | −0.05 (−0.07–−0.03) | <0.0001 | −0.06 (−0.08–−0.04) | <0.0001 | −0.04 (−0.07–−0.001) | 0.04 |
Gender | ||||||
Men | reference | |||||
Women | 0.73 (0.18–1.29) | 0.010 | 0.61 (−0.03–1.23) | 0.06 | 12.14 (0.14–2.21) | 0.03 |
Level of education | ||||||
Undergraduate | reference | |||||
University degree | 1.45 (0.73–2.18) | 0.00009 | 1.09 (0.12–2.08) | 0.03 | 1.14 (0.07–2.22) | 0.04 |
Marital status | ||||||
Married/couple | reference | |||||
Single | 0.005 (−0.48–0.5) | 0.98 | −0.52 (−1.11–0.08) | 0.09 | −0.58 (−1.43–0.26) | 0.17 |
Objective job characteristics | ||||||
Occupation | ||||||
Health management and support | reference | |||||
Doctors | 2.77 (1.85–3.68) | <0.001 | 0.20 (−2.55–2.96) | 0.884 | 1.95 (0.85–3.04) | 0.001 |
Nurses | 1.89 (0.84–2.95) | <0.001 | −0.53 (−3.38–2.31) | 0.712 | 1.60 (0.29–2.91) | 0.017 |
Other health professionals | 1.42 (0.31–2.53) | 0.012 | −0.94 (−3.91–2.03) | 0.534 | 1.51 (0.27–2.75) | 0.017 |
Workplace | ||||||
Other | reference | |||||
Hospital | 1.55 (1.10–2.003) | <0.0001 | 0.64 (−0.15–1.45) | 0.11 | 0.57 (−0.71–1.87) | 0.38 |
Tenure | −0.12 (−0.39–0.15) | 0.4 | −0.21 (−0.54–0.12) | 0.21 | 0.32 (−0.37–1.02) | 0.36 |
Working h/day | ||||||
≤8 h | reference | |||||
>8 h | 2.20 (1.76–3.08) | <0.0001 | 1.64 (0.99–2.29) | <0.0001 | 3.43 (2.34–4.52) | <0.0001 |
Night shifts | ||||||
No | reference | |||||
Yes | 1.02 (0.48–1.57) | 0.0003 | 0.45 (−0.17–1.08) | 0.16 | 2.22 (0.55–1.15) | 0.00006 |
Perceived job stressors | ||||||
Effort score | 1.28 (1.2–1.37) | <0.0001 | 1.27 (1.16–1.38) | <0.0001 | 1.24 (1.1–1.39) | <0.0001 |
Reward score | −1.20 (−1.33–1.075) | <0.0001 | −1.17 (−1.33–−1.02) | <0.0001 | −1.06 (−1.32–−0.80) | <0.0001 |
Effort/reward score | 3.17 (2.91–3.44) | <0.0001 | 2.81 (2.51–3.11) | <0.0001 | 4.39 (3.73–5.03) | <0.0001 |
Distress (Effort/reward score > 1) | 0.25 (0.21–0.28) | <0.0001 | 4.01 (3.53–4.48) | <0.0001 | 4.87 (4.07–5.05) | <0.0001 |
Management of the infection risk in the workplace | ||||||
Very well | reference | |||||
Well | 0.72 (0.22–1.22) | 0.005 | 0.86 (0.29–1.44) | 0.003 | 0.49 (−0.46–1.44) | 0.309 |
Acceptable | 2.10 (1.54–2.67) | <0.001 | 2.21 (1.53–2.89) | <0.001 | 2.52 (1.53–3.51) | <0.001 |
Not so well | 2.71 (1.68–3.75) | <0.001 | 3.11 (1.84–4.38) | <0.001 | 2.65 (0.95–4.36) | 0.002 |
Very badly | 3.34 (1.52–5.16) | <0.001 | 3.81 (1.46–6.15) | 0.001 | 3.44 (0.65–6.23) | 0.016 |
Personal factors | ||||||
Overcommitment | 1.04 (0.99–1.1) | <0.0001 | 1.03 (0.96–1.10) | <0.0001 | 1.01 (0.91–1.12) | <0.0001 |
HCW diagnosed with COVID-19 | ||||||
No | reference | |||||
Yes | 0.95 (0.47–1.45) | 0.0001 | 0.76 | 0.009 | 1.03 (0.07–1.99) | 0.003 |
Persistence of symptoms | reference | |||||
No | 1.79 (0.9–2.68) | |||||
Yes | 0.00008 | 1.52 (0.49–2.56) | 0.004 | 2.15 (0.42–3.88) | 0.02 |
Variables | Model 1 | Model 2 | Model 3 | Model 4 | Model 5 | |||||
---|---|---|---|---|---|---|---|---|---|---|
Beta Coef. | p | Beta Coef. | p | Beta Coef. | p | Beta Coef. | p | Beta Coef. | p | |
Demographics | ||||||||||
Age | −0.144 | <0.0001 | −0.178 | <0.001 | −0.169 | <0.001 | −0.190 | <0.001 | −0.189 | <0.001 |
Level of education | 0.074 | 0.007 | 0.048 | 0.198 | 0.040 | 0.234 | 0.041 | 0.146 | 0.059 | 0.006 |
Objective job characteristics | ||||||||||
Occupation | −0.085 | 0.003 | −0.04 | 0.12 | −0.026 | 0.23 | 0.009 | 0.84 | ||
Working h/day | 0.160 | <0.001 | 0.098 | <0.001 | 0.043 | 0.048 | 0.043 | 0.046 | ||
Number of patients/day | ||||||||||
<5 | reference | |||||||||
5–15 | 0.007 | 0.874 | −0.0009 | 0.982 | 0.003 | 0.933 | 0.003 | 0.919 | ||
>15 | 0.117 | 0.008 | 0.046 | 0.245 | −0.005 | 0.888 | −0.005 | 0.891 | ||
Perceived job stressors | ||||||||||
Effort/reward score | 0.422 | <0.001 | 0.207 | <0.001 | 0.207 | <0.001 | ||||
Management of the risk of infection in the workplace | 0.113 | <0.001 | 0.092 | <0.001 | 0.091 | <0.001 | ||||
Personal factors | ||||||||||
Overcommitment score | 0.532 | <0.001 | 0.531 | <0.001 | ||||||
Personal history of COVID-19 | 0.013 | 0.519 |
Variable | Unstandardized Coefficients | Standard Error | Beta | t | p * |
---|---|---|---|---|---|
Age | −0.00566 | 0.00089 | −0.15207 | −6.39373 | <0.0001 |
Score of overcommitment | 0.05210 | 0.00388 | 0.35508 | 13.42087 | <0.0001 |
Effort/reward score | 0.12807 | 0.01439 | 0.23497 | 8.90018 | <0.0001 |
Intercept | −0.54038 |
Variables | Model 1 | Model 2 | Model 3 | Model 4 | Model 5 | |||||
---|---|---|---|---|---|---|---|---|---|---|
Beta Coef. | p | Beta Coef. | p | Beta Coef. | p | Beta Coef. | p | Beta Coef. | p | |
Demographics | ||||||||||
Age | −0.086 | 0.04 | −0.008 | 0.048 | -0.077 | 0.038 | −0.122 | <0.001 | −0.1123 | <0.001 |
Gender | 0.100 | 0.02 | 0.082 | 0.042 | 0.075 | 0.039 | 0.009 | 0.777 | 0.009 | 0.771 |
Level of education | 0.082 | 0.05 | 0.072 | 0.068 | 0.042 | 0.251 | 0.001 | 0.733 | 0.010 | 0.745 |
Objective job characteristics | ||||||||||
Occupation | −0.124 | 0.004 | −088 | 0.023 | −0.100 | 0.002 | −0.101 | 0.002 | ||
Working h/day | 0.246 | <0.001 | 0.158 | <0.001 | 0.064 | 0.057 | 0.065 | 0.053 | ||
Night shifts | 0.054 | 0.22 | −0.0006 | 0.880 | −0.0004 | 0.988 | 0.00006 | 0.999 | ||
Perceived job stressors | ||||||||||
Effort/reward score | 0.411 | <0.001 | 0.199 | <0.001 | 0.199 | <0.001 | ||||
Management of the risk of infection in the workplace | −0.067 | 0.08 | −0.067 | 0.04 | −0.067 | 0.04 | ||||
Personal factors | ||||||||||
Overcommitment score | 0.521 | <0.001 | 0.523 | <0.001 | ||||||
Personal history of COVID-19 | 0.012 | 0.701 |
Variable | Unstandardized Coefficients | Standard Error | Beta | t | p * |
---|---|---|---|---|---|
Average working hours/day | 0.04226 | 0.01500 | 0.10789 | 2.81773 | 0.00501 |
Score of overcommitment | 0.04084 | 0.00488 | 0.34874 | 8.35956 | <0.0001 |
Effort/reward score | 0.12349 | 0.02719 | 0.18794 | 4.54216 | <0.0001 |
Intercept | −0.72794 |
flHCW | slHCW | p * | |||
---|---|---|---|---|---|
Average + SD | Median | Average + SD | Median | ||
Doctors | 15.023 ± 4.64 | 15 | 13.63 ± 4.72 | 13 | 0.00002 |
Nurses | 14.28 ± 4.82 | 14 | 13.28 ± 5.23 | 13 | 0.06 |
Other health professionals | 13.88 ± 3.75 | 14 | 13.19 ± 4.37 | 13 | 0.20 |
Health management and support | 14.82 ± 6.54 | 15 | 11.68 ± 4.16 | 11 | 0.11 |
OR (CI 95%) | p * | |
---|---|---|
flHCW group | ||
COVID-19—exhaustion score > 75% of the maximum score | 1.36 (1.027–1.82) | 0.03 |
Persistence of symptoms—exhaustion score > 75% of the maximum score | 1.41 (0.87–2.31) | 0.16 |
Duration of symptoms—exhaustion score > 75% of the maximum score | 1.13 (0.69–1.85) | 0.62 |
slHCW group | ||
COVID-19—exhaustion score > 75% of the maximum score | 1.41 (0.81–2.47) | 0.21 |
Persistence of symptoms—exhaustion score > 75% of the maximum score | 2.52 (0.94–6.77) | 0.06 |
Duration of symptoms—exhaustion score > 75% of the maximum score | 1.88 (0.54–6.47) | 0.31 |
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Oțelea, M.R.; Rașcu, A.; Staicu, C.; Călugăreanu, L.; Ipate, M.; Teodorescu, S.; Persecă, O.; Voinoiu, A.; Neamțu, A.; Calotă, V.; et al. Exhaustion in Healthcare Workers after the First Three Waves of the COVID-19 Pandemic. Int. J. Environ. Res. Public Health 2022, 19, 8871. https://doi.org/10.3390/ijerph19148871
Oțelea MR, Rașcu A, Staicu C, Călugăreanu L, Ipate M, Teodorescu S, Persecă O, Voinoiu A, Neamțu A, Calotă V, et al. Exhaustion in Healthcare Workers after the First Three Waves of the COVID-19 Pandemic. International Journal of Environmental Research and Public Health. 2022; 19(14):8871. https://doi.org/10.3390/ijerph19148871
Chicago/Turabian StyleOțelea, Marina Ruxandra, Agripina Rașcu, Cătălin Staicu, Lavinia Călugăreanu, Mădălina Ipate, Silvia Teodorescu, Ovidiu Persecă, Angelica Voinoiu, Andra Neamțu, Violeta Calotă, and et al. 2022. "Exhaustion in Healthcare Workers after the First Three Waves of the COVID-19 Pandemic" International Journal of Environmental Research and Public Health 19, no. 14: 8871. https://doi.org/10.3390/ijerph19148871