Professional Burnout of Medical Workers Before, During and After the Pandemic

The problem of professional burnout attracted the attention of researchers and health care organizers even before the pandemic, it was expected that occupational risks during the pandemic would increase the severity of the indicators of professional burnout of physicians, and a decrease in the number of patients and the end of the pandemic would reduce the indicators. Studies have shown the presence of fluctuations in the severity of professional burnout during periods of various waves of morbidity. It is noted that during the pandemic, the most effective coping methods were coping related to obtaining family support and social approval. But after the end of the pandemic, there was a decrease in the effectiveness of these methods in the situation of combating professional burnout, and the search for the meaning of their work turned out to be more productive. It was noted that after the pandemic, compassion fatigue and the “second victim syndrome” played an important role in professional burnout. As a conceptualization of the data obtained on the professional burnout of medical workers before, during and after the pandemic, there was a model of psychological experience of a natural disaster. Studies have shown that certain groups of medical workers are more susceptible to professional burnout. Among them, a special place is occupied by students and residents who are at risk both before and during the pandemic and after it. Despite the increase in psychological stress, psychological exhaustion, the willingness of doctors to seek psychological help remains low at different stages of the pandemic and is associated with fear of discrimination in the professional environment.

1. Gaucher N., Trottier E.D., Côté A.-J., Ali H., Lavoie B., Bourque C.-J., Ali S. A Survey of Canadian Emergency Physicians’ Experiences and Perspectives during the COVID-19 Pandemic. Canadian Journal of Emergency Medicine, 2021. Vol. 23, pp. 466—474. DOI:10.1007/s43678-021-00129-4
2. Aloweni F., Ayre T.C., Teo I., Tan H.K., Lim S.H. A year after COVID-19.: Its impact on nurses' psychological well-being. Journal of Nursing Management, 2022. Vol. 30, no. 7, pp. 2585—2596. DOI:10.1111/jonm.13814
3. Office of the Surgeon General. Addressing Health Worker Burnout: The U.S. Surgeon General’s Advisory on Building a Thriving Health Workforce [Elektronnyi resurs]. 2022. 76 p. U.S. Department of Health and Human Services. URL: https://www.hhs.gov/sites/default/files/health-worker-wellbeing-advisory.pdf (Accessed 26.06.2023).
4. Ahmadi S., Maleki A. The Relationship between Burnout and Intention to Leave Work among Midwives: The Long-Lasting Impacts of COVID-19. Journal of Healthcare Engineering, 2022, article ID 8608732, 7 p. DOI:10.1155/2022/8608732
5. Aitkenhead D. Panic, chronic anxiety and burnout: Doctors at breaking point [Elektronnyi resurs]. The Guardian. URL: https://www.theguardian.com/society/2018/mar/10/panic-chronic-anxiety-burnout-doctors-breaking-point (Accessed 26.06.2023).
6. Favre S., Bajwa N.M., Dao M.D., Audétat Voirol M.-C., Nendaz M., Junod Perron N., Perneger T., Richard-Lepouriel H. Association between burnout and stigma in physicians. PLoS One, 2023. Vol. 18(4), article ID e0283556. 13 p. DOI:10.1371/journal.pone.0283556
7. Hodkinson A., Zhou A., Johnson J., Geraghty K., Riley R., Zhou A., Panagopoulou E., Chew-Graham C.A., Peters D., Esmail A., Panagioti M. Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis. BMJ, 2022. Vol. 378, article ID e070442. 15 p. DOI:10.1136/bmj-2022-070442
8. Aubusson K. The doctors sleeping under desks because they’re too tired to drive [Elektronnyi resurs]. The Sydney Morning Herald, 26 September 2022. URL: https://www.smh.com.au/national/nsw/the-doctors-sleeping-under-desks-because-they-re-too-tired-to-drive-20220922-p5bk5i.html (Accessed 26.06.2023).
9. Vayr F., Herin F., Jullian B., Soulat J.M., Franchitto N. Barriers to seeking help for physicians with substance use disorder: A review. Drug alcohol depend, 2019. Vol. 199, pp. 116—21. DOI:10.1016/j.drugalcdep.2019.04.004
10. Gee P.M., Weston M.J., Harshman T., Kelly L.A. Beyond Burnout and Resilience: The Disillusionment Phase of COVID-19. AACN Advanced Critical Care, 2022. Vol. 33, no. 2, pp. 134—142. DOI:10.4037/aacnacc2022248
11. Cunningham A.T., Felter J., Smith K.R., Sifri R., Arenson C., Patel A., Kelly E.L. Burnout and Commitment After 18 Months of the COVID-19 Pandemic: A Follow-Up Qualitative Study with Primary Care Teams. The Journal of the American Board of Family Medicine, 2023. Vol. 36, no. 3, article ID 220226R1. 13 p. DOI:10.3122/jabfm.2022.220226R1
12. Antao H.S., Sacadura-Leite E., Correia A.I., Figueira M.L. Burnout in hospital healthcare workers after the second COVID-19 wave: Job tenure as a potential protective factor. Frontiers in Psychology, 2022. Vol. 13, article ID 942727, 10 p. DOI:10.3389/fpsyg.2022.942727
13. Rodrigues H., Cobucci R., Oliveira A., Cabral J.V., Medeiros L., Gurgel K., Souza T., Gonçalves A.K. Burnout syndrome among medical residents: a systematic review and meta-analysis. PLoS One, 2018. Vol. 13(11), article ID e0206840. 17 p. DOI:10.1371/journal.pone.0206840
14. Shanafelt T.D., West C.P., Sinsky C., Trockel M., Tutty M., Wang H., Carlasare L.E., Dyrbye L.N. Changes in burnout and satisfaction with work-life integration in physicians and the general US working population between 2011 and 2020. Mayo Clinic Proceedings, 2022. Vol. 97, no. 3, pp. 491—506. DOI:10.1016/j.mayocp.2021.11.021
15. Lange M., Licaj I., Stroiazzo R., Rabiaza A., Le Bas J., Le Bas F., Humbert X. COVID-19 psychological impact in general practitioners: A longitudinal study. Encephale, 2023. 6 p. Article in press. DOI:10.1016/j.encep.2023.03.001
16. DeWolfe D.J., Department of Health & Human Services. Training manual for mental health and human service workers in major disasters. Washington: National Mental Health Services Knowledge Exchange Network, 2000. 156 p.
17. Adams G.C., Reboe-Benjamin M., Alaverdashvili M., Le T., Adams S. Doctors' Professional and Personal Reflections: A Qualitative Exploration of Physicians' Views and Coping during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 2023. Vol. 20(7), article ID 5259, 16 p. DOI:10.3390/ijerph20075259
18. Baumann B.M., Cooper R.J., Medak A.J., Lim S., Chinnock B., Frazier R., Roberts B.W., Epel E.S., Rodriguez R.M. Emergency physician stressors, concerns, and behavioral changes during COVID-19: A longitudinal study. Academic Emergency Medicine, 2021. Vol. 28, no. 3, pp. 314—324. DOI:10.1111/acem.14219
19. Cyr S., Marcil M.J., Houchi C., Marin M.F., Rosa C., Tardif J.C., Guay S., Guertin M.C., Genest C., Forest J., Lavoie P., Labrosse M., Vadeboncoeur A., Selcer S., Ducharme S., Brouillette J. Evolution of burnout and psychological distress in healthcare workers during the COVID-19 pandemic: a 1-year observational study. BMC Psychiatry, 2022. Vol. 22, no. 1, article ID 809, 13 p. DOI:10.1186/s12888-022-04457-2
20. Zhou A.Y., Hann M., Panagioti M., Patel M., Agius R., Van Tongeren M., Esmail A., Bower P. Exploring Associations between Stressors and Burnout in Trainee Doctors During the COVID-19 Pandemic in the UK. Academic Psychiatry, 2022. Vol. 46, pp. 723—728. DOI:10.1007/s40596-022-01660-x
21. Ferreira R.J., Buttell F., Cannon C. COVID-19: Immediate Predictors of Individual Resilience. Sustainability, 2020. Vol. 12, no. 16, article ID 6495, 11 p. DOI:10.3390/su12166495
22. Holland J.C., Bultz B.D. The NCCN guideline for distress management: A case for making distress the sixth vital sign. Journal of the National Comprehensive Cancer Network, 2007. Vol. 5, no. 1, pp. 3—7. DOI:10.6004/jnccn.2007.0003
23. Tran A., Wallner C., de Wit K., Gérin-Lajoie C., Ritchie K., Mercuri M., Clayton N., Boulos M., Archambault P., Schwartz L., Gray S., Man-Yee T. Chan Humans Not Heroes: Canadian Emergency Physician Experiences during the Early COVID-19 Pandemic. Emergency Medicine Journal, 2022. Vol. 40, pp. 86—91. DOI:10.1136/emermed-2022-212466
24. Kane L. Death by 1000 Cuts [Elektronnyi resurs]. Medscape National Physician Burnout & Suicide Report, 2021. URL: https://www.medscape.com/sites/public/lifestyle/2021 (Accessed 26.06.2023).
25. Aguayo-Estremera R., Cañadas G.R., Ortega-Campos E., Pradas-Hernández L., Martos-Cabrera B., Velando-Soriano A., de la Fuente-Solana E.I. Levels of Burnout and Engagement after COVID-19 among Psychology and Nursing Students in Spain: A Cohort Study. International Journal of Environmental Research and Public Health, 2022. Vol. 20, no. 1, article ID 377, 12 p. DOI:10.3390/ijerph20010377
26. Maslach C., Leiter M.P. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry, 2016. Vol. 15, no. 2, pp. 103—111. DOI:10.1002/wps.20311
27. Civantos A.M., Byrnes Y., Chang C., Prasad A., Chorath K., Poonia S.K., Jenks C.M., Bur A.M., Thakkar P., Graboyes E.M., Seth R., Trosman S., Wong A., Laitman B.M., Harris B.N., Shah J., Stubbs V., Choby G., Long Q., Rassekh C.H., Thaler E., Rajasekaran K. Mental Health among Otolaryngology Resident and Attending Physicians during The COVID-19 Pandemic: National Study. Head Neck, 2020. Vol. 42, no. 7, pp. 1597—1609. DOI:10.1002/hed.26292
28. General Medical Council. National training surveys reports [Elektronnyi resurs]. [London]: General Medical Council, 2021. 18 p. URL: https://www.gmc-uk.org/about/what-we-do-and-why/data-and-research/national-training-surveys-reports (Accessed 26.06.2023).
29. Petrino R., Riesgo L.G., Yilmaz B. Burnout in emergency medicine professionals after 2 years of the COVID-19 pandemic: a threat to the healthcare system? European Journal of Emergency Medicine, 2022. Vol. 29, no. 4, pp. 279—284. DOI:10.1097/MEJ.0000000000000952
30. Andhavarapu S., Yardi I., Bzhilyanskaya V., Lurie T., Bhinder M., Patel P., Pourmand A., Tran Q.K. Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Research, 2022. Vol. 317, article ID 114890, 23 p. DOI:10.1016/j.psychres.2022.114890
31. Grigorescu S., Cazan A.M., Rogozea L., Grigorescu D. Predictive Factors of the Burnout Syndrome Occurrence in the Healthcare Workers During the COVID-19 Pandemic. Frontiers in Medicine, 2022. Vol. 9, article ID 842457, 13 p. DOI:10.3389/fmed.2022.842457
32. Prasad K., McLoughlin C., Stillman M., Poplau S., Goelz E., Taylor S., Nankivil N., Brown R., Linzer M., Cappelucci K., Barbouche M., Sinsky C.A. Prevalence and correlates of stress and burnout among U.S. healthcare workers during the COVID-19 pandemic: A national cross-sectional survey study. EClinicalMedicine, 2021. Vol. 35, article ID 100879, 9 p. DOI:10.1016/j.eclinm.2021.100879
33. Restauri N., Sheridan A.D. Burnout and Posttraumatic Stress Disorder in the Coronavirus Disease 2019 (COVID-19) Pandemic: Intersection, Impact, and Interventions. Journal of the American College of Radiology, 2020. Vol. 17, no. 7, pp. 921—926. DOI:10.1016/j.jacr.2020.05.021
34. Chandrabhatla T., Asgedom H., Gaudiano Z.P., de Avila L., Roach K.L., Venkatesan C., Weinstein A.A., Younossi Z.M. Second victim experiences and moral injury as predictors of hospitalist burnout before and during the COVID-19 pandemic. PLoS One, 2022. Vol. 17(10), article ID e0275494. 12 p. DOI:10.1371/journal.pone.0275494
35. Shaukat N., Ali D.M., Razzak J. Physical and Mental Health Impacts of COVID-19 on Healthcare Workers: A Scoping Review. International Journal of Emergency Medicine, 2020. Vol. 13, article ID 40, 8 p. DOI:10.1186/s12245-020-00299-5
36. Sasaki N., Asaoka H., Kuroda R., Tsuno K., Imamura K., Kawakami N. Sustained Poor Mental Health among Healthcare Workers in COVID-19 Pandemic: A Longitudinal Analysis of the Four-Wave Panel Survey over 8 Months in Japan. Journal of Occupational Health, 2021. Vol. 63, no. 1, article ID e12227. 5 p. DOI:10.1002/1348-9585.12227
37. The Correlation of Stress in Residency with Future Stress and Burnout: A 10-Year Prospective Cohort Study. Journal of Graduate Medical Education, 2018. Vol. 10(5), pp. 524—531. DOI:10.4300/JGME-D-18-00273.1
38. Dyrbye L.N., Eacker A., Durning S.J., Brazeau C., Moutier C., Massie F.S., Satele D., Sloan J.A., Shanafelt T.D. The Impact of Stigma and Personal Experiences on the Help-Seeking Behaviors of Medical Students with Burnout. Academic Medicine, 2015. Vol. 90, no. 7, pp. 961—969. 9 p. DOI:10.1097/ACM.0000000000000655
39. West C.P. COVID-19 impact on healthcare worker burnout: Insights from the areas of worklife model for job burnout. In Leiter M.P., Cooper C.L. (eds.), Burnout While Working: Lessons from Pandemic and Beyond. 1st ed. London: Routledge, 2022. Chapter 8. pp. 139—149. DOI:10.4324/978100325053
40. Whang O. Physician Burnout Has Reached Distressing Levels, New Research Finds [Elektronnyi resurs]. The New York Times, 30 september 2022. URL: https://www.nytimes.com/2022/09/29/health/doctor-burnout-pandemic.html?smid=url-share (Accessed 26.06.2023).