Sense of Coherence and Burnout in Healthcare Professionals in the COVID-19 Era

Abstract

Emotional exhaustion in the context of vulnerability to burnout is a part of the universal narrative of high stress and systematically reported in healthcare professionals. The sense of coherence (SOC) is a salutogenic construct, operationalized by A. Antonovsky as a generalized resistance resource (GRR) to stress in three dimensions: meaningfulness (Me), the desire of a person to be motivated to cope; comprehensibility (C), the belief that the challenge is understood; and manageability (Ma), the belief that coping resources are available. The relation between SOC and the dimensions of burnout-Emotional Exhaustion (EE), Depersonalization (D), and Personal Accomplishment (PA)-is a part of salutogenic functioning, which reveals the inner motivation and self-organization of the psycho-emotional energetic resource. This study traces the salutogenic functioning of Bulgarian healthcare professionals during the pandemic. A general psychological background of coherence and exhaustion has been identified. All components of the SOC were positively correlated to Personal Accomplishment. Emotional Exhaustion and Depersonalization correlated negatively with coherence. SOC was validated as a possible determinant to predict the reduction of exhaustion and depersonalization as well as high levels of professional performance. The dimension of Meaningfulness in the coherence phenomenon was demonstrated to have the highest predictive value for professional burnout.

Keywords: Bulgaria; COVID-19; burnout; health care professionals; mentalization; salutogenic functioning; sense of coherence.