CC BY
20
https://doi.org/10.29013/EJEAP-21-1.2-19-23
Valbona Uka, University College, Faculty of Nursing, Prishtine, Kosovo Arjeta Arifi,
Family Medicine Center, Lipjan, Kosovo E-mail: vuka5@live.com
THE LINK BETWEEN COVID-19 VIRUS AND BURNOUT IN HEALTH PROFESSIONALS
Abstract. During the pandemic, health care professionals for 11 months now are on the front line against COVID-19 and have faced work overload, high stress, pressure, fear, fatigue, insecurity; they have realized the risk for becoming infected and pressure to provide quality health services during the pandemic.
The purpose of this study is to uncover the link between the COVID-19 virus and burnout risk in health professionals.
The study was conducted in the period November-December 2020, involving 150 health workers, to understand the effects of the pandemic and the risk ofburnout. The measuring instruments of the research were: demographic questionnaire and burnout inventory. Data were analyzed through quantitative and qualitative methods.
Based on the results, there is a statistically significant difference in the level of chronic stress in health workers during the pandemic (p: 0.000, r: 0.593). Based on Spearman correlation analysis, the result shows that there is a positive and quite significant relationship between MBI and health workers during the pandemic (p: 0.000, r: 0.673). This means that with increasing workload and chronic stress appears the high level of burnout in health workers during the pandemic period.
Our findings reinforce that the spread of COVID-19 can create stress in health care workers, including the risk of burnout syndrome over a period of time. Identifying and preventing burns through psychological services would be helpful for health care workers during the pandemic period.
Keywords: stress, Covid-19, health professionals, burnout.
I. Introduction to adhering to the measures and recommendations.
Coronavirus disease (COVID-19) is an infec- Health workers during the pandemic had to change tious disease caused by severe acute coronavirus the way they think, feel and act, a complete change of 2(SARS-CoV-2) respiratory syndromes. The spread approach, as opposed to working under normal con-of COVID-19 in Kosovo has brought many challenges ditions. Like most countries in the world, Kosovo has and fears to health care workers for their lives and due faced citizens' suspicion ofthe existence of the virus, as to unsafe working conditions. Like most countries in well as their lack of conviction to adhering to the mea-the world, Kosovo has faced citizens' suspicion of the sures and recommendations. Health workers during existence of the virus, as well as their lack of conviction the pandemic had to change the way they think, feel
and act, a complete change of approach, as opposed has had a negative impact on our healthcare system,
to working under normal conditions. In addition, an- which are not used to coping with this workload on a
other factor in the pandemic is the high number of daily basis, adapting to this situation was challenging
patients arriving at hospitals all at the same time, this and difficult for health workers.
STAGE 1 Honeymoon phase
STAGE 4 Burnout
4
STAGE 5 Habitual burnout
STAGE 2 Onset of stress
STAGE 3 Chronic stress
Job satisfaction Accepting responsibility Sustained energy levels Commitment to the job Free-flowing creativity High productivity levels
CV symptoms Inability to focus Irritability
Reduced sleep quality Lack of social interaction Lower productivity
-Anxiety
-Change in appetite -Headache
• Persistent tiredness -Apathy
• Resentfiilness -Cynical attitude
• Social withdrawal -Denial of problems
• Aggressive behavior -Feeling threatened
• Chronic exhaustion -Felling pressures
• Alcohol/drugs consumption
• Obsession with problems -Chronic headaches
• Pessimistic outlook - Self-doubt
• Neglect of personal needs -Escapist activities
• Physical symptoms -Behavioral changes
• Social isolation
Chronic sadness Chronic mental fatigue Chronic physical fatigue Depression
Figure.1 Symptoms in the different stages of burnout
During the 11-month period, the total number of infected health workers exceeded 55% of the total number of health workers and several cases of deaths of health workers who lost the battle against Covid-19 were recorded. Since the onset of the 2019 coronavirus pandemic (covid-19), health care workers have shown tremendous resilience and professional dedication despite fears of becoming infected and being able to infect others.
I.1 COVID -19, Health Professionals and Burnout
Burnout is a work-related stress syndrome that results from chronic exposure to work stress. The term was introduced in the early 1970s by the psychoanalyst Freudenberg and was later defined by Maslach et al, consisting of three qualitative dimensions which are: the feeling of exhaustion; feeling of negativity associated with work, and reduced professional efficiency. Studies conducted in similar circumstances so far have shown that due to the heavy workload, health professionals are very predisposed to emotional states like anxiety or depression. Health professionals are at risk of "occupational burnout" that results from chronic stress in the workplace. Clinical features: The symptomatology of burning is quite complex as the syndrome appears to develop in several successive stages. Initially, Freudenberg described his development in a 12-stage model. Later, this model was simplified, and currently, a 5-phase model is used.
The list of symptoms is long and most of them are not very specific (Figure 1). Symptoms are related to the different stages of the syndrome and have been divided into different clusters.
II. Literature Review
When we talk about Covid-19, so far there is little scientific knowledge, and detailed material about this deadly virus is missing. According to recent data, research on Covid-19 has gained momentum around the world; this trend has included our country. This research deals with the connection between Covid-19 and burnout in health workers during the
pandemic in our country and is one of the first researches in our country.
III. Methodology
3.1 Subject of research
The aim of this study is to discover the association between the COVID-19 virus and burnout risk in health professionals. The main tasks of the research are 1) To identify that health workers are exposed to chronic stress at work. 2) To prove that health workers during the pandemic have experienced feelings of exhaustion and feelings of negativity.3. Identify the link between the COVID -19 virus and burnout risk.
3.2 Research Hypotheses
H1: There is a statistically significant difference in the level of chronic stress in health workers during the pandemic.
H2: There is a positive correlation between Co-vid-19 and burnout risk in health workers.
3.3 Research methods and techniques
Research measurement instruments for data collection by subjects were based on two questionnaires, the Demographic Questionnaire, and the Burnout Inventory ON (Maslach, 1981). Demographic questionnaires include gender, age, social status, level of education, profession, Institution where you work. The Burnout Inventory (Maslach, 1981) is a psychological assessment tool that measures three dimensions: emotional exhaustion, depersonalization, and reduced professional achievement. The inventory includes 22 items which are divided into three subitems. Emotional fatigue includes nine items that evaluate feelings ofbeing emotionally tired and exhausted from work. Depersonalization includes five items that measure an unconscious and impersonal response to recipients of service, care, treatment, or guidance. Personal achievements include eight items that nurture feelings of competence and reduced performance at work. Inventory takes 5-10 minutes to complete. The reliability coefficients for the subscales are emotional exhaustion 0.90, depersonalization 0.79, and personal achievement 0.71; this indicates that the burnout Inventory has reliability for application.
3.4 Population and sample
The research application was conducted in the period November-December 2020 and lasted 8-10 weeks involving 150 health workers working in Family Medicine Centers in the Municipality of Lipjan and Prishtina, and private hospitals. The analysis of the research results was done by evaluating and analyzing the answers of the respondents tested by means of qualitative questionnaires. Statistical results were made with the SPSS program version 23.
IV. Results
Out of 150 participants in the research are included: 64 (43%) health technicians, 17 (11%), laboratory technicians, 22 (15%) doctors, 47 (31%) specialties. Among the participants, 132 (88%) provided services in public institutions, while 18 (12%) provided services in private health institutions. Of all participants, 137 (91%) worked part-time, while 13 (9%) of them did not work part-time due to health problems. Among the participants 140 (93%), they worked directly with patients with Covid-19, while only 10 (7%) of them did not work directly with patients with Covid-19. Among the participants, 97 (65%) provided palliative services to patients with Covid-19, while 53 (35%) of them did not provide palliative services.
Based on the results, there is a statistically significant difference in the level of chronic stress in health
workers during the pandemic (p: 0.000, r: 0.593). Based on Spearman correlation analysis, the result shows that there is a positive and quite significant relationship between MBI and health workers during the pandemic (p: 0.000, r: 0.673). This means that with increasing workload and chronic stress appears the high level of burnout in health workers during the pandemic period.
4.1The limitations of the study are the small number of participants in the research, the possibility that the subjects may not be honest in their answers. In terms of strengths, this study is one of the first studies in our country.
V. Conclusion
The COVID-19 pandemic causes stress and tension to all people in the world, increases the fear and uncertainty associated with their future. Our findings show that the spread of COVID -19 in health workers has shown an intense workload, the need to continue living, providing health services to patients with the virus creates chronic stress in health care workers, including the risk of burn syndrome after a period of time. Identifying and preventing burns through psychological services would be a necessary help for health care workers during the pandemic period.
Conflict of interest: The authors state that there is no conflict of interest.
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