Since the breakout of COVID-19 in early 2021, countries across the globe have suffered various degrees of workforce shortages. As a result, current medical workforces have been pushed to work longer than usual hours, under a much more intense workload compared to the pre-pandemic period.
Despite seeing this frequently on the news, how bad is the situation? How common is burnout in medical workers?
One of the most thorough studies1 focusing on the prevalence of anxiety, depression, and job burnout among frontline healthcare workers (HCW) across six Southeast Asian countries (Indonesia, Malaysia, Philippines, Singapore, Thailand, and Vietnam) during the COVID-19 pandemic in 2021 was published in mid-2022 on International Journal of Environmental Research and Public Health. It sampled 1381 frontline HCWs including doctors, nurses and other allied health professionals, and asked them to complete self-reported surveys on anxiety, depression and job burnout.
The average proportion of HCWs reporting a moderate degree of anxiety, moderately severe depression, and job burnout across all countries were 10%, 4%, and 20%, respectively, detailed in Table 1. For job burnout, countries with the highest score (most-burnt out) to lowest score are Singapore, Philippines, Thailand, Malaysia, Indonesia, and Vietnam; for anxiety: Singapore, Philippines, Malaysia, Indonesia, Thailand, Vietnam; for depression: Singapore, Malaysia, Philippines, Thailand, Indonesia, Vietnam. Overall, Singaporean healthcare professionals score the highest and Vietnamese scored the lowest.
Interestingly, the prevalence of all three indications reported in this survey are consistently lower than a meta-analysis study2 focusing on worldwide HCWs, and a separate meta-analysis study3 conducted in China, both published in mid-2021. Both meta-analysis studies identified 31.1% of HCWs have a certain degree of depression while working in the frontline in 2021. However, this difference in the Southeast Asia study could be attributed to different survey questions being used and different standards applied in those studies.
Table 1 Healthcare Worker Psychological Outcomes and Perceptions (N = 1381).
In the Southeast Asia study1, high job risk, working longer hours than usual, and perceived inadequacy of personal protective equipment (PPE) were associated with higher odds of anxiety and job burnout. Working night shifts was also associated with higher odds of depression. On the other hand, perceiving good teamwork in the workplace was associated with lower odds of anxiety, depression, and job burnout. Nurses, in general, have a lower burnout rate than doctors, while having a long career in the workforce also seems to be a protective factor.
Interestingly, another study4 on Malaysian HCWs published in late 2022 showed that more than half of the country’s HCWs had moderate to high degrees of burnout in occupational exhaustion and depersonalization with a low degree of personal accomplishment. What’s worse, all four domains of quality of life (physical health, psychological, social, and environmental) assessed in that study fell below the international standard.
Despite the fact that the COVID-19 pandemic is mostly in the rear mirror now, countries and healthcare systems should actively prepare the medical workforce for potential future pandemics and analyse how the system should cope with such public health emergencies better. The data has shown alarmingly high rates of mental health issues and burnout rates among HCWs during such high-intensity periods. More studies could focus on what kind of policy interventions can best help HCWs cope with burnout and promote their quality of life.
References
- Teo I, Nadarajan GD, Ng S, Bhaskar A, Sung SC, Cheung YB, et al. The Psychological Well-Being of Southeast Asian Frontline Healthcare Workers during COVID-19: A Multi-Country Study. International Journal of Environmental Research and Public Health. 2022 May 24;19(11):6380.
- Marvaldi M, Mallet J, Dubertret C, Moro MR, Guessoum SB. Anxiety, depression, trauma-related, and sleep disorders among healthcare workers duirng the COVID-19 pandemic: a systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews. 2021 Mar;126.
- Dong F, Liu H, Yang M, Lu C, Dai N, Zhang Y, et al. Immediate Psychosocial Impact on Healthcare Workers During COVID-19 Pandemic in China: A Systematic Review and Meta-Analysis. Frontiers in Psychology. 2021 May 28;12.
- Marzo RR, Khaled Y, ElSherif M, Abdullah MSAMB, Zhu Thew H, Chong C, et al. Burnout, resilience and the quality of life among Malaysian healthcare workers during the COVID-19 pandemic. Frontiers in Public Health. 2022 Nov 30;10.
