Burn-out syndrome in Spanish internists during the COVID-19 outbreak and associated factors: a cross-sectional survey

Cristina Macía-Rodríguez; Álvaro Alejandre de Oña; Daniel Martín-Iglesias; Lucía Barrera-López; María Teresa Pérez-Sanz; Javier Moreno-Diaz; Adriana González-Munera

doi:10.1136/bmjopen-2020-042966

Burn-out syndrome in Spanish internists during the COVID-19 outbreak and associated factors: a cross-sectional survey

BMJ Open. 2021 Feb 11;11(2):e042966. doi: 10.1136/bmjopen-2020-042966.

Authors

Cristina Macía-Rodríguez^{1

2}, Álvaro Alejandre de Oña^{2

3}, Daniel Martín-Iglesias^{2

4}, Lucía Barrera-López^{2

5}, María Teresa Pérez-Sanz^{2

3}, Javier Moreno-Diaz^{2

6}, Adriana González-Munera^{2

3}

Affiliations

¹ Department of Internal Medicine, POVISA Hospital-Ribera Salud Group, Vigo, Spain cristina.macia.rodriguez@gmail.com.
² Formation Work Group of the Spanish Society of Internal Medicine, Madrid, Spain.
³ Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
⁴ Autoimmune Diseases Research Unit, Department of Internal Medicine, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Barakaldo, Spain.
⁵ Department of Internal Medicine, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
⁶ Chief Medical Officer, Hospital Real Nuestra Señora de Gracia, Zaragoza, Spain.

Abstract

Objectives: The objective of this study is to evaluate the impact of the COVID-19 outbreak on mental health and burn-out syndrome in Spanish internists and the factors that could be related to its appearance.

Design: We performed an observational, cross-sectional, descriptive study for which we designed a survey that was distributed in May 2020.

Setting: We included internists who worked in Spain during the COVID-19 outbreak.

Participants: A total of 1015 internists responded to the survey. Of those 62.9% were women.

Results: Of 1015 people, 58.3% presented with high emotional exhaustion, 61.5% had a high level of depersonalisation and 67.6% reported low personal fulfilment. 40.1% presented with the 3 criteria described, and therefore burn-out syndrome.Burn-out syndrome was independently related to the management of patients with SARS-CoV-2 (HR: 2.26; 95% CI 1.15 to 4.45), the lack of availability of personal protective equipment (HR: 1.41; 95% CI 1.05 to 1.91), increased responsibility (HR: 2.13; 95% CI 1.51 to 3.01), not having received financial compensation for overtime work (HR: 0.43; 95% CI 0.31 to 0.62), not having rested after 24-hour shifts (HR: 1.61; 95% CI 1.09 to 2.38), not having had holidays in the previous 6 months (HR: 1.36; 95% CI 1.01 to 1.84), consumption of sleeping pills (HR: 1.83; 95% CI 1.28 to 2.63) and higher alcohol intake (HR: 1.95; 95% CI 1.39 to 2.73).

Conclusions: During the COVID-19 outbreak, 40.1% of Internal Medicine physicians in Spain presented with burn-out syndrome, which was independently related to the assistance of patients with SARS-CoV-2, overworking without any compensation and the fear of being contagious to their relatives. Therefore, it is imperative to initiate programmes to prevent and treat burn-out in front-line physicians during the COVID-19 outbreak.

Keywords: COVID-19; anxiety disorders; internal medicine; occupational & industrial medicine.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Burnout, Professional / epidemiology*
COVID-19 / psychology*
Cross-Sectional Studies
Female
Humans
Internal Medicine
Male
Pandemics
Physicians / psychology*
Spain / epidemiology
Surveys and Questionnaires