STRESS CAUSED BY COVID-19 AS A PREDICTOR OF BURNOUT TO MEDICAL STAFF

Abstract

Objective: The aim of the study is to highlight a statistically significant relationship between burnout and stress caused by COVID 19 in medical staff. Methods: The study included 160 participants from Cluj-Napoca County Emergency Clinical Hospital using the Maslach Burnout Inventory and The Covid-19 Stress scales. The research period was from January 2021 to April 2021. Results: The result showed that there is a positive correlation between burnout and stress caused by Covid-19. At the same time, there is a positive correlation between burnout and, traumatic stress, contamination) and checking. And there is a statistically significant positive correlation between stress Covid-19 and emotional exhaustion, Depersonalization, personal achievement. In the Pearson statistical method, we obtained a significant correlation p<0.01.

Headnote

Abstract:

Objective: The aim of the study is to highlight a statistically significant relationship between burnout and stress caused by COVID 19 in medical staff.

Methods: The study included 160 participants from Cluj-Napoca County Emergency Clinical Hospital using the Maslach Burnout Inventory and The Covid-19 Stress scales. The research period was from January 2021 to April 2021.

Results: The result showed that there is a positive correlation between burnout and stress caused by Covid-19. At the same time, there is a positive correlation between burnout and, traumatic stress, contamination) and checking. And there is a statistically significant positive correlation between stress Covid-19 and emotional exhaustion, Depersonalization, personal achievement. In the Pearson statistical method, we obtained a significant correlation p<0.01.

Keywords: COVID-19, burnout, stress, SARS-CoV-2, professional emotional exhaustion.

The spread of virus causing severe acute respiratory syndrome (SARS-Cov2) generated a global health crisis with consequences in all population categories. In March 2020, the World Health Organisation (WHO, 2020) declared the state of pandemic due to the speed of infection and number of deaths caused by the virus.

Health and wellbeing were factors contributing to the negative impact on population's mental state, quality of life affected both physically and mentally. With the extension and deepening of the epidemic situation, people's worries facing this vital threat increased exponentially, leading to a significant psychological distress. There is a multitude of critical and level of anxiety associated with COVID-19.1

Major efforts, in the medical and psychological areas, were made in order to explore the implications of the pandemic in the psycho-social domain and permitting later intervention strategies. Many recent studies aim to describe the mental state of people facing the Coronavirus pandemic and the factors that might influence the mental health.2

Depression, anxiety, sleeping problems, fear of becoming infected from other people leading to xenophobia, traumatic stress symptoms like intrusive thoughts and nightmares have been reported worldwide. The medical and psychological literature is rich and oriented towards general or specific population categories i.e. students, children and adolescents, pregnant women, medical workers. Researches constantly reveal direct and indirect neuropsychiatric consequences of the pandemic3 The high prevalence of anxiety, stress and depression within front-line workers caring for COVID-19 patients has been repeatedly confirmed.4

Burnout syndrome is the result of poorly managed workplace stress and is characterized by emotional exhaustion describes the feeling of being exhausted and drained by ones work, chronic fatigue, sleeping and psychical troubles, depersonalization describing emotional coldness and impersonal reactions to the beneficiaries of works, cynicism and negative attitudes, feelings of guilt and personal achievement describing feelings of competence and accomplishment in one's work with other people.5

METHODOLOGY OF RESEARCH

Objectives

The aim of the study is to highlight a statistically significant relationship between burnout and stress caused by COVID 19 in medical staff.

Research assumptions are:

Hl - It is presumed that there is a statistically significant correlation between burnout and stress caused by COVID 19 in medical staff.

H2 - It is presumed that burnout - manifests differently in the medical staff, by academic training.

H3 - It is presumed that Stress caused by COVID 19 - manifests differently in the medical staff, by academic training.

Participants

The study involved a total of 160 participants, of which 2 biologist, 131 nurses, 11 medical registrars, 16 doctor (Tabel 1). By study, 66 post high school education, 48 License degree or equivalent, 40 master's degree or equivalent, 6 PhD graduate (Tabel 2). By gender, 135 of participants were women and 25 are men (Tabel 3).

RESEARCH INSTRUMENTS

1. Masłach Burnout Inventory - MBI 6. The questionnaire contains 25 items and is structured in 3 dimensions: (a) emotional exhaustion (9 items) describes the feeling of being exhausted and drained by one's work, chronic fatigue, sleeping and psychical troubles. Item example for this scale: I feel emotionally drained (item 1). For this scale obtained a Cronbach Alpha coefficient a = .92; (b) depersonalization (6 items) describing emotional coldness and impersonal reactions to the beneficiaries of works, cynicism and negative attitudes, feelings of guilt. Item example for this scale: I communicate with some colleagues how I would communicate with objects (item 5). For this scale obtained a Cronbach Alpha coefficient a = .80; (c) personal achievement (10 items). Item example for this scale: I have periods when I feel overwhelmed (item 4). For this scale obtained a Cronbach Alpha coefficient a = .85. In present research Masłach Burnout Inventory proved to be of very good psychometric value (for MBI total, Cronbach Alpha = .94)

2. The Covid-19 Stress scales7The questionnaire contains 36 items and is structured in 6 dimensions: (a) danger (6 items) Item example for this scale: I am worried about catching the virus (item 1). For this scale obtained a Cronbach Alpha coefficient a = .88; (b) the socio-economic consequences (6 items) Item example for this scale: I am worried about grocery stores running out of food (item 7). For this scale obtained a Cronbach Alpha coefficient a = .94; (c) xenophobia (6 items) Item example for this scale: I am worried that foreigners are spreading the virus in my country (item 13). For this scale obtained a Cronbach Alpha coefficient a = .91; (d) contamination (6 items) Item example for this scale: I am worried that people around me will infect me with the virus (item 19). For this scale obtained a Cronbach Alpha coefficient a = .94; (e) traumatic stress (6 items) Item example for this scale: I had trouble sleeping because I worried about the virus (item 25). For this scale obtained a Cronbach Alpha coefficient a = .92; (f) checking (6 items) Item example for this scale: Checked social media posts concerning COVID-19 (item 31). For this scale obtained a Cronbach Alpha coefficient a = .87. In present research The Covid-19 Stress scales proved to be of very good psychometric value (for The Covid-19 Stress scales, Cronbach Alpha = .95).

DATA ANALYSIS

The preliminary data analysis checked the score normal distribution. The values of Skewness and Kurtosis indices were within normal ranges (less than 3 for Skewness and less than 8 for kurtosis). The mean and standard deviation scores of measured variables are shown in Table 4.

DISCUSSION AND CONCLUSION

The result of our research showed that is a positive correlation between burnout and stress caused by Covid-19 (r=.43, p < .001). At the same time, there is a positive correlation between burnout and danger (r=.46, p< .001), traumatic stress (r=.52, p < .001), contamination (r=.39, p< .001) and checking (r=.3O, p < .001). And there is a statistically significant positive correlation between stress Covid-19 and emotional exhaustion (r = .40, p< .001), Depersonalization (r = .36, p< .001), personal achievement (r = .40, p< .001).

Data analysis shows that burnout and stress caused by Covid-19 is pronounced to all medical staff that are directly exposed to Covid-19 (intermediate medical staff - nurses and senior medical staff - doctor). This finding is supported by numerous previous studies that have shown that the medical staff has a high level of burnout and stress1, which is pronounced in depression and anxiety2, emotional distress 3 and medical problems.

LIMITATIONS OF THE STUDY

The limitations of this study that caution against the generalization of the results are of theoretical and methodological nature. A first limitation is represented by the tools used: the self-assessment scales depend on the respondents' honesty and reflexive ability. Moreover, some of these scales underwent special adaptation to the Romanian population. Another limitation ensues form the convenience of study population selection, namely the number of subjects from only one geographical area.

FUTURE DIRECTIONS OF INVESTIGATION:

We emphasize the necessity to undertake additional research that should include a larger number of participants from several geographical areas of the country in order to investigate burnout and stress caused by Covid-19. At the same time, we consider necessary to perform repeated assessments of the studied variables in order to be able to draw a conclusion on how long the results would stand the test of time.

Footnote

1 Guan at all.. Prevalence and factors for anxiety during the COVID-19 pandemic among college students in China. International Journal of Environmental Research and Public Health, 18(9), 4974, 2021.

2 Shah et all. Prevalence, psychological responses and associated correlates of depression, anxiety and stress in a global population, during the coronavirus disease (COVID-19) pandemic. Community Mental Health Journal, 57(1), 2021, p. 101-110.

3 N. Vmdegaard & M. Benros, ECOVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain, Behavior, and Immunity, 89, 2020, p. 531-542.

4 Salari et all The prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients: a systematic review and metaregression. Human Resources for Health, 18(1), 2020, p. 1-14.

5 C. Masłach & S.E. Jackson, Burnout in organizational settings. Applied Social Psychology Annual, 1984.

6 C. Masłach, S.E. Jackson, M.P. Leiter, Masłach burnout inventory. Scarecrow Education., 1997

7 Taylor and all. Development and initial validation of the COVID Stress Scales. Journal of Anxiety Disorders, 2020, 72,102232.

1 Di mi Iriu et all.. Burnout syndrome in Romanian medical residents in time of the COVID-19 pandemic. Medical Hypotheses, 2020,144,109972

2 F. Vancea & M. Apostol, Changes in mental health during the COVID-19 crisis in Romania: A repeated cross-section study based on the measurement of subjective perceptions and experiences. Science Progress, 2021, 104(2), 00368504211025873.

3 C. Delcea & C.V Siserman, The Emotional Impact of Covid-19 On Forensic Staff. Rom J Leg Med [29], 2021, p. 142-146.

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