Determinants of development, prediction and prevention of professional burnout in nurses during the COVID-19 pandemic

Background. In the context of the COVID-19 pandemic, nurses turned out to be the most vulnerable category of medical workers in terms of the level of professional stress, professional burnout, level of anxiety, coping strategies implemented and the quality of life of nurses specialized in the “red zone” of multidisciplinary hospitals (MDHs), as well as outpatient clinics (OCs) during the new coronavirus infection COVID-19 pandemic.

Methods. The study was carried out at the Department of Occupational Diseases and Clinical Pharmacology named after the Honored Scientist of the Russian Federation, Professor V.V. Kosarev, Samara State Medical University, and the regional center of occupational pathology of the Samara City Hospital № 5. The following groups of nurses were examined: the first group consisted of nurses working in the “red zone” (n=29); the second group consisted of nurses working in MDHs (n=29), the third group consisted of nurses working in outpatient clinics (n=31), the fourth, control group (CG), included workers in engineering, technical and economic specialties not related to activity profile with work in medical organizations (n=190). The assessment of professional burnout syndrome was carried out using the “Maslach Burnout Inventory” for assessing professional burnout, developed by American psychologists S. Maslach, S.E. Jackson adapted by N.E. Vodopyanova, E.S. Starchenkova, as well as the V.V. Boyko questionnaire. The study used the Integrative Anxiety Test (IAT) to study the development of psycho-emotional disorders among general practitioners during the new coronavirus pandemic. The assessment of coping strategies among therapists during the pandemic of the new coronavirus infection COVID-19 was carried out according to the method developed by R. Lazarus and S. Folkman in 1988, adapted by E.V. Kuftyak. Quality of life was determined using the SF-36 questionnaire. Processing of the obtained data was carried out using the Statistica statistical package, StatSoft (USA).

Results. It has been established that the work of medical workers during the COVID-19 pandemic was associated with the impact of a number of specific risk factors associated with the provision of medical care to infected patients, as well as with significant changes in work regarding aspects related to organization and safety, which contributed to an increase in level of professional stress, professional burnout, decreased quality of life.

Conclusion. The work of nurses in a COVID hospital, when compared with nurses working in the MDHs and nurses working in outpatient clinics, was associated with an increase in the level of professional stress, the level of professional burnout, the level of anxiety, an increase in the level of use of coping strategies, and a decrease in the quality of life. It is necessary to continue research into the emotional state of nurses in order to carry out timely preventive treatment to preserve the health of this category of medical workers.

Limitations of the study. The study has regional (Samara region) and professional (in terms of detailing working conditions in the comparison groups studied) limitations.