Burnout, Resilience, and Mindfulness in Healthcare Workers in a Medically Underserved Region during the COVID-19 Pandemic

South Med J. 2023 Nov;116(11):888-896. doi: 10.14423/SMJ.0000000000001623.

Abstract

Objectives: To evaluate employee burnout, work conditions, resilience, and mindfulness at an academic medical center in a US medically underserved region during the coronavirus disease 2019 pandemic.

Methods: We surveyed employees from August 7, 2020 to January 17, 2021. Respondents completed the Maslach Burnout Inventory (MBI), the Areas of Worklife Survey, the Connor-Davidson Resilience Scale, and the Philadelphia Mindfulness Scale (PHLMS) and answered a question about intention to stay in the present job until retirement. We performed exploratory stepwise logistic regression to evaluate associations between variables and intention to stay. We evaluated associations between variables with a structural equation model (SEM).

Results: The 655 respondents mostly were White women providers, aged 50 years and younger, who worked in inpatient wards, emergency departments, or intensive care units. Respondents had high mean MBI emotional exhaustion (35 ± 12) and moderate MBI depersonalization (12 ± 6), despite high MBI personal accomplishment (43 ± 8), middle-range Areas of Worklife Survey results, and middle to high Connor-Davidson Resilience Scale scores (29 ± 5), PHLMS awareness scores (37 ± 6), and PHLMS acceptance scores (30 ± 8). There were 408 respondents (62%) with MBI latent profiles consistent with being burned out, but 447 respondents (68%) were willing to stay in their present job. Older age was associated with intention to stay (coefficient 1.1 ± 0.1; P < 0.001). The latent variable burnout structural equation model (burnout-SEM) constructed from the MBI subscales inversely predicted intention to stay (coefficient - 0.33; P < 0.001), and this relationship was mediated by age.

Conclusions: Burnout was prevalent despite substantial personal accomplishment, resilience, and mindfulness.

MeSH terms

  • Burnout, Professional* / epidemiology
  • COVID-19* / epidemiology
  • Female
  • Health Personnel
  • Humans
  • Medically Underserved Area
  • Mindfulness*
  • Pandemics
  • Surveys and Questionnaires