Factors Associated With Burnout, Post-traumatic Stress and Anxio-Depressive Symptoms in Healthcare Workers 3 Months Into the COVID-19 Pandemic: An Observational Study

Samuel Cyr; Marie-Joelle Marcil; Marie-France Marin; Jean-Claude Tardif; Stéphane Guay; Marie-Claude Guertin; Camille Rosa; Christine Genest; Jacques Forest; Patrick Lavoie; Mélanie Labrosse; Alain Vadeboncoeur; Shaun Selcer; Simon Ducharme; Judith Brouillette

doi:10.3389/fpsyt.2021.668278

Factors Associated With Burnout, Post-traumatic Stress and Anxio-Depressive Symptoms in Healthcare Workers 3 Months Into the COVID-19 Pandemic: An Observational Study

Front Psychiatry. 2021 Jul 8:12:668278. doi: 10.3389/fpsyt.2021.668278. eCollection 2021.

Authors

Samuel Cyr^{1

2}, Marie-Joelle Marcil^{1

3}, Marie-France Marin^{3

4

5}, Jean-Claude Tardif^{1

6}, Stéphane Guay^{3

7}, Marie-Claude Guertin⁸, Camille Rosa⁸, Christine Genest⁹, Jacques Forest¹⁰, Patrick Lavoie^{1

9}, Mélanie Labrosse^{6

11}, Alain Vadeboncoeur^{1

6}, Shaun Selcer^{1

6}, Simon Ducharme^{12

13}, Judith Brouillette^{1

3}

Affiliations

¹ Research Center, Montreal Heart Institute, Montreal, QC, Canada.
² Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada.
³ Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada.
⁴ Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada.
⁵ Research Center, Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada.
⁶ Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
⁷ Centre D'étude sur le Trauma, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.
⁸ Montreal Health Innovations Coordinating Center, Montreal, QC, Canada.
⁹ Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.
¹⁰ Department of Organization and Human Resources, ESG UQAM, Montreal, QC, Canada.
¹¹ Division of Emergency Medicine, Department of Pediatrics, Centre hospitalier universitaire Sainte-Justine, Montreal, QC, Canada.
¹² Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
¹³ McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.

Abstract

Objective: This study examined how best to identify modifiable protective and risk factors for burnout in healthcare workers in the face of the COVID-19 pandemic. Individual, occupational, organizational and social factors were investigated. The study also assessed the impact of these factors on post-traumatic stress disorder (PTSD), anxiety, and depression. Methods: Healthcare workers in the Quebec (Canada) healthcare system were recruited between May 21 to June 5, 2020. Participants answered an electronic survey 3 months after the COVID-19 epidemic outbreak began in Canada. Using the Maslach Burnout Inventory, PTSD Checklist for DSM-5, and Hospital Anxiety and Depression Scale, we studied the prevalence of burnout, PTSD, anxiety and depression in this cohort. Multivariable logistic or linear regression models including resilience, social and organizational support, workload and access to mental health help, simulation techniques and protective personal equipment (PPE) as well as perception of PPE security were conducted for each outcome. Results: In mid-June 2020, 467 participants completed the survey. We found that half (51.8%) of the respondents experienced burnout characterized by emotional exhaustion and/or depersonalization at least once a week. In total, 158 healthcare workers (35.6%) displayed severe symptoms of at least one of the mental health disorders (24.3% PTSD, 23.3% anxiety, 10.6% depression). Resilience (OR = 0.69, 95% CI: [0.55-0.87]; p = 0.002) and perceived organizational support (OR = 0.75, 95% CI: [0.61-0.93]; p = 0.009) were significantly associated with burnout and other outcomes. Social support satisfaction, perception of PPE security, work type and environment, mental health antecedents and reassignment were associated with PTSD and/or anxiety and/or depression, but not burnout. Conclusion: Future studies should address primarily resilience and perceived organizational support to promote mental health and prevent burnout, PTSD, anxiety and depression.

Keywords: COVID-19; anxiety; burnout; depression; health personnel; post-traumatic stress disorders; psychological stress.