A Model of Burnout Among Healthcare Professionals

BackgroundBurnout is common and can lead to worse outcomes for both healthcare workers and patients. Our study purpose was to assess the structural relationship among factors that protect against or worsen burnout.Data Sources and Study SettingWe surveyed healthcare professionals in 15 different Japanese intensive care units during the 3rd wave of the COVID-19 pandemic (March 2021). Surveys assessed burnout (Mini Z 2.0), resilience (Brief Resilience Scale), depressive (PHQ-9) and anxiety (GAD-7) symptoms, job and work environment characteristics, and personal experience with COVID. We explored survey domains with principal component factor analysis and modeled our results using structural equation modeling.Principal FindingsAmong 936 ICU professionals, 24.3% met criteria for burnout. Our model suggested that resilience (beta = - 0.26, 95% CI - 0.32 to - 0.20), teamwork (beta = - 0.23, 95% CI - 0.30 to - 0.16), and feeling safe (beta = - 0.11, 95% CI - 0.18 to - 0.04) reduced burnout. Depression (beta = - 0.32, 95% CI - 0.41 to - 0.23) and anxiety (beta = - 0.20, 95% CI - 0.29 to - 0.10) both decreased resilience as did COVID fear (beta = 0.08, 95% CI - 0.14 to - 0.02). In addition to directly reducing resilience, anxiety also indirectly reduced resilience by increasing COVID fear (0.23, 95% CI 0.17 to 0.23), which decreased resilience (beta - 0.08, 95% CI - 0.14 to - 0.02).ConclusionsBurnout is common among Japanese ICU professionals. Resilience, teamwork, and safety are all correlated with reduced burnout. Those who had depression or anxiety or COVID fear had higher degrees of burnout, an effect that appears to be mediated by reduced resilience. These are potential targets for interventions to reduce burnout.