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Keywords = prevalence of healthcare worker burnout

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13 pages, 1632 KB  
Article
Association Between Morning Serum Cortisol and Burnout Syndrome in Healthcare Workers in Boyacá, Colombia: A Cross-Sectional Study
by Juan Pablo Carvajal and Fred Gustavo Manrique-Abril
Int. J. Environ. Res. Public Health 2026, 23(8), 995; https://doi.org/10.3390/ijerph23080995 - 29 Jul 2026
Viewed by 1100
Abstract
The present study evaluated the association between morning serum cortisol levels and burnout syndrome among healthcare workers in the department of Boyacá, Colombia. An observational, analytical, cross-sectional, and quantitative study was conducted on 69 employees. Total serum cortisol was measured via chemiluminescence in [...] Read more.
The present study evaluated the association between morning serum cortisol levels and burnout syndrome among healthcare workers in the department of Boyacá, Colombia. An observational, analytical, cross-sectional, and quantitative study was conducted on 69 employees. Total serum cortisol was measured via chemiluminescence in fasting morning samples (reference: 110–692 nmol/L). Burnout was assessed using the Maslach Burnout Inventory–General Survey (MBI-GS). A total of 96.6% of participants fell within the normal range for serum cortisol. MBI-GS dimensions reported mean scores of: exhaustion 1.54 ± 1.17, cynicism 0.93 ± 0.89, and professional efficacy 5.60 ± 0.60. High exhaustion prevalence was 16.9%, high cynicism 6.8%, and low efficacy 3.4%. Profile classification showed 67.8% “engaged,” 13.6% “overextended/worn-out,” and 5.1% with “burnout.” No significant association was found between cortisol and burnout dimensions: exhaustion (r = 0.069, p = 0.605), cynicism (r = −0.135, p = 0.309), and professional efficacy (r = 0.044, p = 0.742). Mean cortisol comparisons between high and low dimension groups showed no statistically significant differences (p > 0.05). The study documented a low prevalence of established burnout and an absence of significant association between morning serum cortisol and MBI-GS dimensions, suggesting a relatively healthy work environment; however, the prevalence of high emotional exhaustion warrants preventive interventions. Multilevel organizational strategies like workload management, job stability, role clarity, and psychosocial support are recommended for worker mental health protection. Full article
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16 pages, 3619 KB  
Article
Beyond the Immediate Impact: Burnout, Psychological Distress, and Workforce Retention Among Healthcare Workers One Year After the Türkiye Earthquakes
by Neslihan Cansel, Osman Kurt, Ayça Elçim Sahar Gürbüz, Merve Bulut, Şahide Nur İpek Melez and Burcu Kayhan Tetik
Healthcare 2026, 14(12), 1599; https://doi.org/10.3390/healthcare14121599 - 6 Jun 2026
Viewed by 489
Abstract
Background/Objectives: This study aimed to evaluate burnout, psychological distress, and intention to quit among healthcare workers one year after the 6 February 2023 earthquakes, and to examine the relative contributions of disaster-related exposures and organizational factors using a hierarchical analytical approach. Methods: This [...] Read more.
Background/Objectives: This study aimed to evaluate burnout, psychological distress, and intention to quit among healthcare workers one year after the 6 February 2023 earthquakes, and to examine the relative contributions of disaster-related exposures and organizational factors using a hierarchical analytical approach. Methods: This cross-sectional study included 640 healthcare workers from a tertiary referral hospital in one of the provinces most severely affected by the earthquakes. Data were collected using validated instruments, including the Maslach Burnout Inventory, Hospital Anxiety and Depression Scale, Impact of Event Scale–Revised, and Intention to Quit Scale. Hierarchical multiple linear regression analyses were performed to evaluate factors associated with burnout dimensions, psychiatric symptoms, and intention to quit. Results: Clinically significant anxiety symptoms were observed in 32.5% of participants, depressive symptoms in 55.8%, and PTSD risk in 54.1%. Low personal accomplishment was the most prevalent burnout dimension (69.1%), while high emotional exhaustion and depersonalization were observed in 43.0% and 18.9% of participants, respectively. Workplace climate variables accounted for the largest increment in explained variance across all seven models. Low job satisfaction was the strongest and most consistent factor associated with adverse outcomes, with standardized coefficients ranging from β = +0.27 to +0.61. Non-close colleague relations were independently associated with higher burnout, anxiety, depression, and intention to quit scores, as well as lower personal accomplishment. Despite the high prevalence of psychological symptoms, post-earthquake psychiatric help-seeking was reported by only 6.2% of participants. Conclusions: One year after the earthquakes, healthcare workers continued to experience a substantial psychological burden. Although disaster-related exposures were associated with several adverse outcomes, organizational factors appeared to demonstrate more consistent associations with mental health indicators. These findings highlight the potential importance of improving modifiable workplace conditions to support psychological well-being and workforce sustainability in post-disaster healthcare systems. Full article
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16 pages, 805 KB  
Review
Burnout and Biological Biomarkers in Emergency and Acute-Care Healthcare Workers: A Systematic Scoping Review with Evidence Mapping
by Mihai Alexandru Butoi, Vlad Ionut Belghiru, Monica Iuliana Puticiu, Raluca Tat, Adela Golea and Luciana Teodora Rotaru
Medicina 2026, 62(3), 526; https://doi.org/10.3390/medicina62030526 - 12 Mar 2026
Cited by 2 | Viewed by 1762
Abstract
Background and Objectives: Burnout is highly prevalent among emergency and acute care healthcare workers (HCWs), yet biological correlates remain debated because candidate biomarkers are strongly shaped by circadian timing, shift work, sleep loss, and overlapping affective symptoms. We mapped post-2018 evidence of [...] Read more.
Background and Objectives: Burnout is highly prevalent among emergency and acute care healthcare workers (HCWs), yet biological correlates remain debated because candidate biomarkers are strongly shaped by circadian timing, shift work, sleep loss, and overlapping affective symptoms. We mapped post-2018 evidence of biological biomarkers assessed alongside validated burnout measures in emergency department (ED), emergency medical services (EMS), and related acute care settings. Specifically, we asked whether reproducible biological correlates of burnout can be identified in emergency and acute-care healthcare workers when biomarker endpoint class and sampling context are systematically considered. Materials and Methods: We conducted a systematic scoping review with evidence mapping (PRISMA-ScR). PubMed/MEDLINE and the MDPI platform were searched for English-language studies published from 2018 onward (through January 2026). Eligible quantitative studies enrolled ED/EMS or acute care HCWs, assessed burnout using validated instruments, and reported at least one biological biomarker. Evidence was charted by biomarker domain and endpoint class (basal measures, stress reactivity paradigms, and chronic indices such as hair-based markers). Results: Overall, 19 studies were included in mapping/synthesis. Biomarker selection clustered around the hypothalamic–pituitary–adrenal axis (cortisol; n = 10/19), with fewer studies focused on autonomic function (heart rate variability; n = 2/19) and immune–inflammatory markers (n = 2/19), and single-study coverage for oxidative stress (n = 1/19), cardiometabolic candidates (n = 1/19), cellular aging (n = 1/19), neuroglial/multi-system candidates (n = 1/19), and feasibility-oriented multi-marker designs (n = 1/19). Reported associations with burnout were heterogeneous in direction and magnitude, but were more interpretable when endpoint class, timing anchors, and shift/sleep-related covariates were explicitly reported. Rates of confounder adjustment were low across studies (e.g., only 3/19 reported multivariable adjustment, and none systematically measured sleep or circadian factors), substantially limiting interpretability. Conclusions: The 2018+ literature does not support a single reproducible biomarker for burnout in emergency and acute care workforces. Evidence instead suggests multi-system dysregulation that is highly sensitive to endpoint class, sampling timing, and contextual confounding. Future studies should prioritize timing-anchored repeated-measures protocols across shift and recovery windows, jointly model sleep/circadian factors and depressive symptoms, and evaluate multi-marker panels and intervention responsiveness. Full article
(This article belongs to the Section Epidemiology & Public Health)
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37 pages, 574 KB  
Review
Burnout, PTSD, and Medical Error: The Medico-Legal Implications of the Mental Health Crisis Among Frontline Healthcare Professionals During COVID-19
by Sorin Hostiuc and Florentina Gherghiceanu
Medicina 2026, 62(2), 305; https://doi.org/10.3390/medicina62020305 - 2 Feb 2026
Cited by 3 | Viewed by 3546
Abstract
Background and Objectives: The COVID-19 pandemic has led to an unprecedented mental health crisis among workers in the healthcare field, with average burnout rates increasing from about 32% before the pandemic to 46–52% during peak times and post-traumatic stress disorder (PTSD) affecting [...] Read more.
Background and Objectives: The COVID-19 pandemic has led to an unprecedented mental health crisis among workers in the healthcare field, with average burnout rates increasing from about 32% before the pandemic to 46–52% during peak times and post-traumatic stress disorder (PTSD) affecting 24–34% of frontline staff. The primary objective of this article is to synthesize evidence on the prevalence of burnout and PTSD among healthcare workers before and during the COVID-19 pandemic. The secondary objectives are: (a) to examine the mechanisms and empirical evidence linking clinician mental health to medical errors and patient safety outcomes and (b) to analyze the medico-legal implications of this relationship, including malpractice liability, institutional responsibility, and opportunities for policy reform. Materials and Methods: We conducted a narrative review searching PubMed (November 2025–January 2026) using predefined keyword combinations. Inclusion criteria comprised original research, systematic reviews, and meta-analyses examining mental health outcomes or patient safety among clinical staff. Data were synthesized narratively across five thematic domains. Results: Burnout prevalence increased from approximately 32% pre-pandemic to 46–52% during peak periods, with emotional exhaustion reaching 67.5% in some settings. PTSD rates rose to 24–34% among frontline staff, exceeding pre-pandemic levels of 15–20%, with ICU staff particularly affected (27–40%). Substantial overlap exists between conditions (86–98% comorbidity). Physician burnout is associated with 2.72 times higher odds of self-reported errors (95% CI: 2.19–3.37), with each point increase in emotional exhaustion raising the error risk by 5–11%. Mechanisms include cognitive impairment (reduced executive function, g = −0.39; impaired working memory, g = −0.36) and sleep disturbance. Malpractice litigation compounds psychological harm, increasing depression and suicidal ideation. Conclusions: This review, synthesizing data from over 500,000 healthcare workers, demonstrates bidirectional relationships among burnout, PTSD, and medical errors with significant medico-legal ramifications. Addressing this crisis requires systemic interventions including workload management, psychological support, blame-free reporting cultures, and policy reforms balancing accountability with recognition of system-level contributors to error. Full article
(This article belongs to the Special Issue The Burden of COVID-19 Pandemic on Mental Health, 2nd Edition)
15 pages, 282 KB  
Article
Suicidality and/or Death-Related Thoughts in Health Workers After Pandemics: The Role of DYMERS
by Antonio Urban, Elisa Cantone, Viviana Forte, Michela Atzeni, Stefano Lorrai, Mauro Carzedda, Gabriele Finco, Cesar Ivan Aviles Gonzalez, Sergio Machado, Roberta Montisci, Enzo Tramontano, Orsola Marra, Francesco Muscas, Fabrizio Bert, Giulia Cossu and Mauro Giovanni Carta
J. Clin. Med. 2025, 14(23), 8343; https://doi.org/10.3390/jcm14238343 - 24 Nov 2025
Viewed by 1224
Abstract
Background/Objectives: Healthcare workers (HCWs) experienced marked psychological distress during and after the COVID-19 pandemic, including high levels of burnout, depression, and suicidal ideation. Italy, one of the first Western countries to be severely affected, recorded high mortality, even among healthcare staff. Emerging [...] Read more.
Background/Objectives: Healthcare workers (HCWs) experienced marked psychological distress during and after the COVID-19 pandemic, including high levels of burnout, depression, and suicidal ideation. Italy, one of the first Western countries to be severely affected, recorded high mortality, even among healthcare staff. Emerging evidence suggests that suicidal ideation may also occur in the absence of major depressive episodes, possibly linked to subthreshold mood dysregulation and circadian rhythm disturbances, described within the construct of Dysregulation of rhythms and hyper-energy Syndrome (DYMERS). This study examined the prevalence of suicidal ideation and/or death-related thoughts among Italian HCWs, with particular attention to clinically relevant signs emerging in the absence of a full depressive episode. Methods: A cross-sectional analysis was conducted on 97 HCWs at the University Hospital of Cagliari, Italy, compared with a pre-pandemic community sample from the same region. Depressive symptoms and suicidal ideation or death-related thoughts were assessed with the Patient Health Questionnaire-9 (PHQ-9), considering their presence both in individuals with and without a depressive episode. Daily activation and energy were measured using item 10 of the 12-Item Short Form Health Survey (SF-12), while circadian rhythm dysregulation was evaluated with the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN). Results: HCWs showed a significantly higher prevalence of suicidal or death-related thoughts than the community sample (14.4% vs. 5.7%, p = 0.001; OR = 2.81, 95% CI 1.4–4.4). Notably, 8.2% of HCWs without probable depression reported such thoughts; given the very small number of events (n = 4), this estimate is exploratory, and inferential statistics should be interpreted with caution. Based on descriptive data, these individuals appeared to show higher perceived activation (SF-12, item 10) and rhythm dysregulation (BRIAN). This observation is exploratory and consistent with the DYMERS heuristic framework. Conclusions: Subthreshold symptoms and DYMERS may represent critical risk factors in suicide prevention strategies for HCWs. Full article
(This article belongs to the Section Mental Health)
13 pages, 610 KB  
Article
Burnout and Moral Injury in Healthcare Workers: An Observational Study in a Romanian Chronic Care Hospital
by Enășoni Sorina, Szekely Diana, Raluca Mioara Cosoroabă, Flavia Zara, Dorin Novacescu, Cristina Stefania Dumitru, Raul Patrascu and Alexandra Enache
Healthcare 2025, 13(18), 2278; https://doi.org/10.3390/healthcare13182278 - 12 Sep 2025
Cited by 7 | Viewed by 2400
Abstract
Background/Objectives: Healthcare workers in chronic care hospitals are vulnerable to psychosocial risks such as burnout and moral injury due to prolonged patient exposure and limited institutional support. This study assessed the prevalence of burnout and moral injury among staff at the Chronic Diseases [...] Read more.
Background/Objectives: Healthcare workers in chronic care hospitals are vulnerable to psychosocial risks such as burnout and moral injury due to prolonged patient exposure and limited institutional support. This study assessed the prevalence of burnout and moral injury among staff at the Chronic Diseases Hospital of Sebiș, Romania, and examined their associations with perceived stress and managerial support. Methods: A cross-sectional study was conducted between October 2022 and October 2024, including 62 healthcare workers (physicians, nurses, and auxiliary staff). Participants completed a sociodemographic survey, the Maslach Burnout Inventory (MBI), the Moral Injury Symptom Scale-Health Professional (MISS-HP), and additional items on perceived stress and institutional support. Statistical analysis included descriptive statistics, group comparisons, correlation matrices, and logistic regression. Results: High emotional exhaustion (MBI-EE ≥ 27) was reported by 45.2% of participants, with the highest rates among nurses (50%) and auxiliary staff (45.5%). Mean moral injury scores were moderate (mean = 5.3), with elevated levels observed in nurses and auxiliary staff. Pearson correlation analysis revealed no strong linear associations between burnout dimensions and moral injury. Logistic regression did not identify emotional exhaustion, perceived stress, or support as significant predictors of high moral injury. Conclusions: Burnout and moral injury are prevalent but appear to be partially dissociated in this Romanian chronic care setting. Moral injury may arise from contextual ethical pressures beyond general occupational strain. Interventions should focus on ethical climate, institutional responsiveness, and peer-based moral support to enhance staff resilience. Full article
(This article belongs to the Special Issue Occupational Stress and Burnout in Healthcare Workers)
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26 pages, 438 KB  
Review
Contributing Factors to Burnout in Healthcare Professionals—Does Emotional Intelligence Play a Protective Role? A Narrative Review
by Ioana Ruxandra Stoian-Bălăşoiu, Liliana Veronica Diaconescu, Alexandra Ioana Mihăilescu, Sabina Stan, Adela Magdalena Ciobanu and Ovidiu Popa-Velea
Healthcare 2025, 13(17), 2156; https://doi.org/10.3390/healthcare13172156 - 29 Aug 2025
Cited by 4 | Viewed by 5864
Abstract
Background: In light of the concerning increase in burnout among healthcare professionals, it is essential to identify the specific factors that contribute to this phenomenon and can be addressed. This narrative review synthesizes evidence on the relationship between burnout and emotional intelligence [...] Read more.
Background: In light of the concerning increase in burnout among healthcare professionals, it is essential to identify the specific factors that contribute to this phenomenon and can be addressed. This narrative review synthesizes evidence on the relationship between burnout and emotional intelligence (EI) among healthcare professionals, alongside additional factors that may influence both concepts. Methods: A structured search in OVID, PubMed, Medline, Scopus, and Web of Science (2000–2024) was conducted. The inclusion criteria were English language and peer-reviewed studies assessing both burnout and EI in healthcare professionals. The exclusion criteria were non-English papers, studies without EI–burnout correlation, or involving non-healthcare populations. Thirty-one eligible studies were included in this analysis. Results: The findings suggest a consistent inverse correlation between EI and burnout across various healthcare professionals, including doctors, nurses, and residents. Higher EI was associated with reduced levels of emotional exhaustion and depersonalization and a greater sense of personal accomplishment. Burnout was found to be prevalent among younger healthcare workers, particularly residents, with contributing factors including exposure to workplace violence, high workload, and diminished psychological ownership. In contrast, associations that suggest protective influences on emotional intelligence included spiritual intelligence, self-control, income, and healthy habits, such as sufficient sleep and physical activity. Conclusions: This narrative review highlights a consistent inverse association between EI and burnout in healthcare professionals. Given that both burnout and EI are affected by adjustable individual and organizational elements, specific interventions aimed at enhancing EI and improving workplace conditions may provide effective techniques to boost clinician occupational well-being and performance. Full article
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17 pages, 734 KB  
Article
Occupational Stress, Burnout, and Fatigue Among Healthcare Workers in Shanghai, China: A Questionnaire-Based Cross-Sectional Survey
by Qiaochu Wang, Jiayun Ding, Yiming Dai, Sijia Yang and Zhijun Zhou
Healthcare 2025, 13(13), 1600; https://doi.org/10.3390/healthcare13131600 - 3 Jul 2025
Cited by 4 | Viewed by 5585
Abstract
Background: Occupational burnout and fatigue are critical issues affecting the health and performance of healthcare workers (HCWs) globally. These outcomes are often driven by complex and overlapping work-related stressors, which remain insufficiently understood in combination. Objective: To investigate the associations of [...] Read more.
Background: Occupational burnout and fatigue are critical issues affecting the health and performance of healthcare workers (HCWs) globally. These outcomes are often driven by complex and overlapping work-related stressors, which remain insufficiently understood in combination. Objective: To investigate the associations of multiple work-related stressors with occupational burnout and fatigue, and to identify distinct stress patterns and critical stressors among HCWs. Method: A cross-sectional survey was conducted using a self-administered electronic questionnaire among 2695 HCWs in Shanghai, China. Validated questionnaire scales were used to assess work-related stress (self-developed occupational stress scale for medical staff, CSSM), occupational burnout (Maslach Burnout Inventory–General Survey, MBI-GS), and fatigue (Fatigue Scale-14, FS-14). Latent profile analysis (LPA) was employed to identify distinct work-related stress patterns. Generalized linear models (GLMs) were used to explore the associations between individual stressors, stress patterns, and occupational burnout and fatigue. Additionally, weighted quantile sum (WQS) models were utilized to evaluate the combined effects of multiple stressors and identify the main contributors. Results: In this study, 77.0% and 71.2% of participants were classified as experiencing occupational burnout and fatigue, respectively. A strained doctor–patient relationship was the highest-rated work-related stressor. All work-related stressors, including career development, interpersonal relationships, work–life imbalance, physical environment, doctor–patient relationship, social environment, and workload, were significantly associated with burnout (β: 0.444~0.956, p < 0.001) and fatigue (β: 1.384~3.404, p < 0.001). WQS assigned higher weights to career development and workload for burnout, and to workload and work–life imbalance for fatigue. LPA identified two distinct occupational stress patterns. HCWs characterized by higher stress levels in physical environment, career development, workload, and interpersonal relationships exhibited significantly higher burnout scores (β = 0.325, 95% CI: 0.122, 0.528), particularly in the reduced personal accomplishment (PA) dimension (β = 1.003, 95% CI: 0.746, 1.259). Conclusions: This study highlighted the high prevalence of occupational burnout and fatigue among HCWs in Shanghai, China. Occupational stressors were associated with both burnout and fatigue, with higher workload, work–life imbalance, and poorer career development showing particularly significant contributions. These findings emphasized the urgent need for targeted interventions, including workload management, career development programs, and mental health support, to reduce occupational stress and mitigate its adverse effects on HCWs. Full article
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18 pages, 1091 KB  
Article
Assessment of Anger and Burnout Levels Among Addiction Service Operators in Calabria and Sicily: An Open Trial Study
by Francesco Principato and Vincenzo Maria Romeo
Healthcare 2025, 13(13), 1586; https://doi.org/10.3390/healthcare13131586 - 2 Jul 2025
Viewed by 1983
Abstract
Background/Objectives: Burnout and anger are prevalent among healthcare professionals in high-stress environments, particularly in addiction services. This study explores the relationship between burnout and anger among 124 operators working in public addiction services (SERD) in Calabria and Sicily. The objective is to assess [...] Read more.
Background/Objectives: Burnout and anger are prevalent among healthcare professionals in high-stress environments, particularly in addiction services. This study explores the relationship between burnout and anger among 124 operators working in public addiction services (SERD) in Calabria and Sicily. The objective is to assess how different anger dimensions contribute to burnout and identify protective factors that could inform targeted interventions. Methods: The sample consisted of 58 men and 66 women, with a mean age of 39.2 years (SD = 9.8), ranging from 25 to 59 years old. Burnout was measured using the Maslach Burnout Inventory (MBI), assessing emotional exhaustion, depersonalization, and personal accomplishment. Anger was evaluated through the State-Trait Anger Expression Inventory-2 (STAXI-2), examining trait anger, state anger, anger expression (anger-in, anger-out), and anger control. A cross-sectional design was used, with correlation and regression analyses controlling for gender and years of service. Results: High levels of burnout, particularly emotional exhaustion and depersonalization, were found. Emotional exhaustion correlated strongly with trait anger, indicating that individuals with a chronic predisposition to anger are more vulnerable to burnout. Suppression of anger (anger-in) significantly predicted depersonalization, exacerbating emotional disengagement from patients. Conversely, anger control acted as a protective factor, helping maintain a sense of personal accomplishment. Conclusions: These findings underscore the importance of emotional regulation in mitigating burnout among addiction service workers. Interventions such as emotional regulation training and anger management programs could help reduce psychological distress and promote resilience. Workplace strategies that support emotional well-being may improve both staff retention and patient care quality. Further research should explore longitudinal trends and intervention effectiveness. Full article
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11 pages, 576 KB  
Article
The Relevance of Insomnia Among Healthcare Workers: A Post-Pandemic COVID-19 Analysis
by Carlos Roncero, José Bravo-Grande, Diego Remón-Gallo, Pilar Andrés-Olivera, Candela Payo-Rodríguez, Alicia Fernández-Parra, Lourdes Aguilar, Marta Peña and Armando González-Sánchez
J. Clin. Med. 2025, 14(5), 1663; https://doi.org/10.3390/jcm14051663 - 28 Feb 2025
Cited by 6 | Viewed by 4038
Abstract
Background: Insomnia significantly impairs healthcare worker (HCW) well-being, particularly amid COVID-19 sequelae and shift work demands. We aimed to assess the prevalence of insomnia among HCWs, identify those needing clinical intervention, analyze shift work as a potential risk factor, and explore associations with [...] Read more.
Background: Insomnia significantly impairs healthcare worker (HCW) well-being, particularly amid COVID-19 sequelae and shift work demands. We aimed to assess the prevalence of insomnia among HCWs, identify those needing clinical intervention, analyze shift work as a potential risk factor, and explore associations with COVID-19 sequelae and psychiatric comorbidities. Methods: A cross-sectional online survey was administered at the University of Salamanca University Care Complex (CAUSA) from March 2023 to January 2024. Validated scales (Insomnia Severity Index, Patient Health Questionnaire-4, Generalized Anxiety Disorder Scale-2) were used to measure insomnia, depression, and anxiety. Participants scoring ISI ≥ 7 were invited for Occupational Medicine follow-up. Descriptive and inferential analyses were performed. Results: Overall, 1121 HCWs participated (mean age 44.59 ± 11.78, 78.3% women). The mean ISI score was 10.5 ± 5.8 (subclinical insomnia), with 22.7% reporting moderate and 3% reporting severe insomnia. Depression and anxiety affected 28.4% and 33% of respondents, respectively. Shift workers had poorer sleep (mean ISI 11.3 ± 0.9 vs. 8.8 ± 0.3, p < 0.001). Individuals reporting COVID-19 sequelae were 3.1 times more likely to have insomnia than those who did not (mean ISI 13.89 ± 5.9 vs. 10.33 ± 5.7, p < 0.001). Over one-quarter reported at least the monthly use of sleep or psychiatric medications. Conclusions: Insomnia remains prevalent among HCWs, influenced by shift work, COVID-19 sequelae, and mental health factors. Targeted, multidisciplinary interventions, e.g., workplace policy changes, mental health programs, and shift schedule adjustments) are urgently needed to safeguard well-being, reduce burnout, and maintain quality patient care. Ensuring adequate sleep is central to minimizing errors and preserving professional performance. Future studies should investigate the impact of coordinated workplace strategies to effectively address insomnia. Full article
(This article belongs to the Special Issue Effect of Long-Term Insomnia on Mental Health)
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17 pages, 895 KB  
Article
Headaches in Healthcare Workers: A Prospective Study of Precipitating and Maintenance Variables and Their Relationship with Burnout as a Post-COVID Syndrome
by Fernanda Gil-Almagro, Francisco Javier Carmona-Monge, Fernando José García-Hedrera and Cecilia Peñacoba-Puente
Neurol. Int. 2024, 16(6), 1464-1480; https://doi.org/10.3390/neurolint16060109 - 14 Nov 2024
Viewed by 2816
Abstract
Background: Headaches are a common symptom in healthcare workers (HCWs), mainly associated with high levels of stress. Different research has studied their incidence during the COVID-19 pandemic, most of them with correlational designs, and at the beginning of the pandemic and focused on [...] Read more.
Background: Headaches are a common symptom in healthcare workers (HCWs), mainly associated with high levels of stress. Different research has studied their incidence during the COVID-19 pandemic, most of them with correlational designs, and at the beginning of the pandemic and focused on the associated occupational variables. Aims: (1) To analyze the incidence of headaches in HCWs at the beginning of the COVID-19 pandemic and their maintenance six months later. (2) To explore the risk factors associated with their onset and maintenance, including sociodemographic, occupational, emotional symptomatology, and personality variables. (3) To propose a model to explain the chronification of stress in burnout, including the moderating role of chronic headaches. Methods: A prospective study (n = 259 HCWs) at three points in time during the COVID-19 pandemic, from the alarm state phase (T1: May–June 2020) to the post-pandemic stage (T3: April–July 2022), including an intermediate measure six months after T1 (T2). Descriptive analyses, Pearson’s chi-square, Student’s t, logistic regressions, and moderated mediation models were conducted using the Process package for SPSS. In addition to headaches, socio-demographic, occupational, emotional symptomatology, and personality variables were included. Results: At T1 the prevalence of headaches was 69.9%. At T2 the prevalence was 73.7%. Of these, 59.5% are T1–T2 sustained headaches. Headaches at T1 were associated with age (p = 0.010) (younger HCWs), professional category (p = 0.049) (nurses), service (p = 0.023) (ICU, COVID hospitalization), non-availability of PPE (p = 0.010), additional COVID-19 symptomatology (p < 0.001), and concern for contagion of family members (p < 0.001) (higher scores). In addition, HCWs with headaches had higher levels of stress (p = 0.001), anxiety (p = 0.001), depression (p = 0.041), and sleep disorders (p < 0.001). A subsequent logistic regression analysis showed that of the above variables, the presence of additional COVID-19 symptoms (p < 0.001) and depression (p = 0.010) were the predictor variables. With regard to the maintenance of headaches (T1–T2), anxiety (p = 0.035), stress (p = 0.001), and cognitive fusion (p = 0.013) were found to be the significant variables. The tested model proposes anxiety (T1) as antecedent, cognitive fusion (T2) as mediator, burnout (T3) as consequent, and chronic headaches (yes/no) as the moderating variable between anxiety and burnout (model 5). The model is significant (F = 19.84, p < 0.001) and contributes to the explanation of 36% of the variance of burnout. The relationships in the model are all statistically significant, and specifically chronic headaches contribute to a 6-fold increase in the likelihood of burnout. Conclusions: The present research differentiates between precipitating and maintenance factors of headaches in HCWs. The former, more studied in previous research, are usually related to sociodemographic and occupational variables and levels of anxiety and stress. Maintenance factors, scarcely explored, are related to the maintenance of emotional symptomatology and the inability to manage intrusive thoughts (i.e., cognitive fusion). Of particular interest is that the presence of chronic headaches itself is capable of producing burnout as a post-COVID syndrome. Full article
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16 pages, 1181 KB  
Review
A Narrative Review of Burnout Syndrome in Medical Personnel
by Andreea-Petra Ungur, Maria Bârsan, Andreea-Iulia Socaciu, Armand Gabriel Râjnoveanu, Răzvan Ionuț, Letiția Goia and Lucia Maria Procopciuc
Diagnostics 2024, 14(17), 1971; https://doi.org/10.3390/diagnostics14171971 - 6 Sep 2024
Cited by 30 | Viewed by 9653
Abstract
Burnout among healthcare workers has been extensively studied since its initial recognition in 1960, with its defining characteristics established by Maslach in 1982. The syndrome, characterized by emotional exhaustion, depersonalization, and low personal accomplishment, is exacerbated by work-related stress and has profound implications [...] Read more.
Burnout among healthcare workers has been extensively studied since its initial recognition in 1960, with its defining characteristics established by Maslach in 1982. The syndrome, characterized by emotional exhaustion, depersonalization, and low personal accomplishment, is exacerbated by work-related stress and has profound implications for individual and societal well-being. Methods: A review of the literature, including PubMed searches and analyses of risk factors and protective measures, was conducted to assess the prevalence, impacts, and biomarkers associated with burnout among healthcare workers. Various instruments for evaluating burnout were examined, including the widely used Maslach Burnout Inventory, alongside specific tools tailored to different occupational populations. Results: Healthcare workers, particularly physicians, exhibit significantly higher rates of burnout compared to the general population. Factors such as night shifts, workload, and exposure to biohazards contribute to elevated burnout risk. Biomarkers like cortisol, melatonin, and thyroid hormones have been linked to burnout, highlighting physiological implications. Conclusions: Burnout poses significant challenges to healthcare systems globally, impacting patient care, worker retention, and overall well-being. Identifying and addressing risk factors while promoting protective factors such as resilience and social support are crucial in mitigating burnout. Further research into prevention strategies and biomarker monitoring is warranted to support the mental and physical health of healthcare workers. Full article
(This article belongs to the Special Issue Advances in Mental Health Diagnosis and Screening)
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13 pages, 651 KB  
Article
Compassion Fatigue in a Cohort of South Italian Nurses and Hospital-Based Clinical Social Workers Following COVID-19: A Cross-Sectional Survey
by Rosaria De Luca, Mirjam Bonanno, Maria Grazia Maggio, Antonino Todaro, Carmela Rifici, Carmela Mento, Maria Rosaria Anna Muscatello, Milva Veronica Castorina, Paolo Tonin, Angelo Quartarone, Maria Elena Pugliese and Rocco Salvatore Calabrò
J. Clin. Med. 2024, 13(14), 4200; https://doi.org/10.3390/jcm13144200 - 18 Jul 2024
Cited by 7 | Viewed by 2959
Abstract
Background/Objective: The COVID-19 pandemic has led to a significant increase in the workloads of healthcare workers (HCWs). The fear of contracting the new virus with the frequent medical consequences has affected their mental health. As a result, they are at high risk [...] Read more.
Background/Objective: The COVID-19 pandemic has led to a significant increase in the workloads of healthcare workers (HCWs). The fear of contracting the new virus with the frequent medical consequences has affected their mental health. As a result, they are at high risk of compassion fatigue (CF). In this multicentric study, as a primary objective, we evaluate the incidence and/or prevalence of CF in a cohort of Italian nurses and HCWs (hospital-based clinical social workers of neurological patients) who have contracted SARS-CoV-2 infection. Our secondary aim is to evaluate the difference in experiencing CF between subjects with and without long-term COVID. Methods: In this study, 101 HCWs attending three different neurorehabilitation settings (the Neurorehabilitation Unit of the “Bonino Pulejo” Neurolesi Center of Messina, the Neurorehabilitation Department of Crotone, and the Psychiatric Unit of the University Hospital of Messina) were enrolled from May 2021 to May 2023. Data were collected through self-administered semi-structured interviews. Results: We observed high percentages of CF difficulties in both nurses and HCWs, related to mood alteration in 57.7%, headaches in 44.4%, and fatigue in 62%. Higher percentages were found in individuals with long-term COVID-19, including mood alteration in 93.9%, headache in 88.6%, and memory-related problems in 98.5%. Conclusions: The complexity of a patient’s care pathway, especially in chronic disease situations, requires an enormous commitment that can lead to burnout and CF, which should be considered to initiate preventive interventions aimed at helping “those who help”, for the well-being of patients, healthcare teams, and healthcare organizations. Full article
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9 pages, 633 KB  
Communication
Associations between Sleep Hygiene and Mental Complaints in a French Healthcare Worker Population during the COVID-19 Crisis: A Cross-Sectional Analysis to Personalize Sleep Health Interventions
by Julien Coelho, Jean-Arthur Micoulaud-Franchi and Pierre Philip
Clocks & Sleep 2024, 6(2), 246-254; https://doi.org/10.3390/clockssleep6020017 - 22 Apr 2024
Cited by 3 | Viewed by 4590
Abstract
Healthcare workers often have irregular work schedules and experience significant stress, which can lead to poor sleep quality and frequent mental health issues, especially in the context of the COVID-19 pandemic. In this cross-sectional study, we aimed to assess the prevalence of poor [...] Read more.
Healthcare workers often have irregular work schedules and experience significant stress, which can lead to poor sleep quality and frequent mental health issues, especially in the context of the COVID-19 pandemic. In this cross-sectional study, we aimed to assess the prevalence of poor sleep hygiene and mental health complaints among healthcare workers and examine their associations. We investigated participants’ typical sleep–wake patterns on workdays and free days as indicators of sleep hygiene. Sleep efficiency and social jetlag were calculated as the ratio of mean sleep duration to time spent in bed, while sleep rebound was defined as the difference in mean sleep duration between workdays and free days. Social jetlag was determined as the difference in mid-sleep timing between workdays and free days, with mid-sleep defined as the midpoint between bedtime and wake-up time. Insomnia severity was assessed using the Insomnia Severity Index (ISI), daytime sleepiness using the Epworth Sleepiness Scale (ESS), and symptoms of anxiety and depression using the Patient Health Questionnaire 4 (PHQ-4). Fatigue was measured using a single item inspired by the Maslach Burnout Inventory (MBI). A total of 1562 participants (80.5% women, mean age 40.0 years) were included in the study. The results revealed that 25.9% of participants slept less than 6 h, 24.3% had a sleep efficiency of less than 85%, 27.3% experienced a sleep rebound of more than 2 h, and 11.5% reported a social jetlag exceeding 2 h. Additionally, 33.9% of participants reported insomnia, 45.1% reported excessive daytime sleepiness, 13.1% reported fatigue, 16.5% reported symptoms of depression, and 35.7% reported symptoms of anxiety. After adjustment, mean sleep duration and sleep efficiency were associated with most mental health complaints. Sleep rebound and social jetlag were associated with significant insomnia but not with anxiety or depression symptoms. Our findings underscore the high prevalence of poor sleep hygiene and mental health complaints among healthcare workers, exacerbated by the COVID-19 crisis. We advocate for the promotion of sleep health through behavioral sleep strategies to safeguard the well-being of healthcare professionals. Full article
(This article belongs to the Special Issue Role of Sleep and Circadian Rhythms in Health III)
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15 pages, 318 KB  
Article
Downside of Helping Professions: A Comparative Study of Health Indicators and Health Behaviour among Nurses and Early Childhood Educators
by Melinda Csima, Judit Podráczky, Szabolcs Cseh, Dávid Sipos, Sára Garai and Judit Fináncz
Healthcare 2024, 12(8), 863; https://doi.org/10.3390/healthcare12080863 - 20 Apr 2024
Cited by 2 | Viewed by 2433
Abstract
The activities of health care workers and early childhood educators have received increased attention both in lay public discourse and in scientific discourse. These professional groups play a significant role in shaping the health behaviours of those they interact with; thus, understanding the [...] Read more.
The activities of health care workers and early childhood educators have received increased attention both in lay public discourse and in scientific discourse. These professional groups play a significant role in shaping the health behaviours of those they interact with; thus, understanding the patterns they convey is of paramount importance. The aim of our study is a comparative analysis of health conditions and health behaviours of professionals working in Hungarian early childhood education and nurses working in the healthcare system (n = 1591). We carried out our quantitative, cross-sectional research using convenience sampling among healthcare professionals working in nursing job positions (n = 581) and as early childhood educators (n = 1010), in south-west Hungary. Diagnosed chronic illnesses affect early childhood educators at a significantly higher rate (p < 0.05): the prevalence of musculoskeletal disorders is particularly high among them, as a result of which they reported a significant degree of physical limitation in relation to work. In the context of mental health, comparing the professional groups, nurses’ indicators were significantly (p < 0.001) more unfavourable in all examined dimensions. Moreover, the comparison in terms of educational attainment directed attention to the worse indicators of non-graduates. In this context, early childhood educators are less affected by all three dimensions of burnout (p < 0.001). As for health behaviour, the smoking habits of nurses are more unfavourable (p < 0.05). Regarding screening tests, participation in cytological testing was significantly higher among nurses, whereas early childhood educators showed increased participation in mammography (p < 0.001). Our findings draw attention to the fact that early childhood educators are primarily affected by chronic musculoskeletal disorders, while healthcare workers are more affected by problems related to mental health. Mental well-being can be further endangered by the fact that both professional groups perceive low social appreciation for the work they carry out. Full article
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