Abstract
Amaç: Tükenmişlik sendromu, iş yaşantısında bireylerin, kronik kişilerarası stres faktörlerine verdiği sürekli bir yanıttan kaynaklanan zihinsel ve fiziksel bitkinlik durumunu tanımlayan psikolojik sendromdur. COVID-19 salgını ile doktorlar kritik hastalardaki artışla karşı karşıya kalmış, belirli uzmanlık dallarındaki uzman ve asistanların daha yüksek iş yüküne maruz kalması nedeniyle, fiziksel bitkinlik ve tükenmişlik sendromu daha da belirgin hale gelmiştir. 5 Mayıs 2023’de WHO COVID-19’un artık ‘’küresel bir acil durumu’’ teşkil etmediğini açıklamıştır. Ancak pandemide asistanlarda gösterilmiş olan tükenmişlik durumları pandemi sonrasında ne duruma gelmiştir, bu konuda yeterli veri yoktur.
Çalışmada COVID-19 pandemisi sonrasında, yoğun bakımlarda ve/veya COVID-19 servislerinde hasta takip ve tedavi etmiş farklı branşlardan asistanlar arasında tükenmişlik prevalansını değerlendirmek ve tükenmişlik ilişkili risk faktörlerini belirlemek amaçlanmıştır.
Gereç ve Yöntem: Hastane Etik Kurulu onayı( 31.10.2022/299sayı), bilgilendirilmiş onam sonrası çalışmaya 251 asistan dahil edildi. Çalışmada standartlaştırılmış Maslach Tükenmişlik Envanteri (MBI)kullanıldı.
Bulgular: Çalışmaya 251 asistan doktor katılmıştır. Asistanların %52.2’si uyku bozukluğu bildirmiştir. %42.6’sının 8-6 saat arasında uyuduğu gözlenmiştir. %64.5’i (n=162)24 saatlik çalışma sonrasında yapmak istediği ''ilk'' şeyin uyumak olduğunu belirtirken, %14.3’ü(n=36) tek başına gezmek veya alışveriş yapmak olduğunu, %21.1’i(n=53)arkadaşlarla veya aile ile buluşmak olduğunu belirtmiştir. 24 saatlik çalışma sonrasında ilk yapmak istediği şeye göre katılımcıların MBI “Duygusal Tükenme-DT”, “Duyarsızlaşma-D”ve“Kişisel Başarısızlık-KB” alt boyutlarından aldıkları puanlar farklılık göstermemektedir(p>0,05). MBI “DT” alt boyutundan aldıkları puanlar ortalama 2.42±0.70 olarak “D” alt boyutundan aldıkları puanlar ortalama 2.02±0.74 “KB” alt boyutundan aldıkları puanlar ortalama 1.64±0.63 ve ölçek toplamından aldıkları puanlar ortalama 2.04±0.49 olarak saptanmıştır. Ölçeğin iç tutarlılıkları değerlendirildiğinde; DT alt boyutu için α=0.788, D alt boyutu için α=0.581,KB alt boyutu için α=0.681 olarak, ölçek toplamı için α=0.778 saptanmıştır.
Sonuç: Pandemide, doktorları potansiyel tükenmişlik konusunda bilinçlendirmek, dijital teknolojileri kullanmak, örgütsel yaklaşımlarla kolaylaştırıcı ortam yaratmak gibi çok yönlü kanıta dayalı yaklaşımlar önerilmesine rağmen, yüksek iş gücü süregelmiştir. Bu nedenle asistanları ciddi travma sonrası stres bozukluğu beklemektedir. Sağlık hizmetlerinin yeniden düzenlenmesi, doğru tanımlama ve farkındalık bu sendromu önlemenin ilk önemli adımıdır.
References
- Appiani FJ, Rodríguez Cairoli F, Sarotto L, Yaryour C, Basile ME, Duarte JM. Prevalence of stress, burnout syndrome, anxiety and depression among physicians of a teaching hospital during the COVID-19 pandemic. Arch Argent Pediatr. 2021 ;119(5):317-324. English, Spanish. doi: 10.5546/ aap.2021.eng.317. PMID: 34569739.
- Amaral MLC, da Silva IM, Bello AF, da Silva FC, Romão GS, Trapani A. Prevalence and factors associated with anxiety, depression and burnout in gynecology and obstetrics residents during the COVID-19 pandemic. Rev Bras Ginecol Obstet. 2024 Mar 15;46:e-rbgo17. doi: 10.61622/ rbgo/2024AO17. PMID: 38765522; PMCID: PMC11075398.
- Armon G, Shirom A, Shapira I, et al. On the nature of burnout-insomnia relationships: a prospective study of employed adults. J Psychosom Res 2008; 65: 5–12. DOI: 10.1016/j.jpsychores.2008.01.012.
- Baro Vila RC, Burgos LM, Sigal A, Costabel JP, Alves de Lima A. Burnout Syndrome in Cardiology Residents. Impact of the COVID-19 Pandemic on Burnout Syndrome in Cardiology Residents. Curr Probl Cardiol. 2022 ;47(1):100873. doi: 10.1016/j.cpcardiol.2021.100873. Epub 2021 May 10. PMID: 34108084
- Dimitriu MCT, Pantea-Stoian A, Smaranda AC, Nica AA, Carap AC, Constantin VD, Davitoiu AM, Cirstoveanu C, Bacalbasa N, Bratu OG, Jacota-Alexe F, Badiu CD, Smarandache CG, Socea B. Burnout syndrome in Romanian medical residents in time of the COVID-19 pandemic. Med Hypotheses. 2020 ;144:109972. doi: 10.1016/j.mehy.2020.109972. Epub 2020 Jun 7. PMID: 32531540
- Edú-Valsania S, Laguía A, Moriano JA. Burnout: A Review of Theory and Measurement. Int J Environ Res Public Health. 2022 Feb 4;19(3):1780. doi: 10.3390/ijerph19031780. PMID: 35162802; PMCID: PMC8834764.
- Ergin C, Bayraktar R, Dağ İ, editors. Doktor ve hemşirelerde tükenmişlik ve Maslach Tükenmişlik Ölçeğinin uyarlanması. VII. Ulusal Psikoloji Kongresi Bilimsel Çalışmaları; Ankara. VII. Ulusal Psikoloji Kongresi Düzenleme Kurulu ve Türk Psikologlar Derneği Yayını; 1993
- Fadle AA, Khalifa AA, Mahran DG, Khidr SS, Said HG, Farouk O. Burnout syndrome (BOS) among resident doctors in an Egyptian tertiary care university hospital: Prevalence and determinants during the COVID-19 pandemic. Int J Soc Psychiatry. 2023 ;69(2):396-405. doi: 10.1177/00207640221104698. Epub 2022 Jun 13. PMID: 35695719
- Freudenberger HJ. Staff Burn-Out. J Soc Issues. 1974;90(1):159–65. 10.1111/ j.1540-4560.1974.tb00706.x
- Friganović A, Selič P, Ilić B, Sedić B. Stress and burnout syndrome and their associations with coping and job satisfaction in critical care nurses: a literature review. Psychiatr Danub. 2019 ;31(Suppl 1):21-31. PMID: 30946714.
- Gualano, M.R.; Sinigaglia, T.; Lo Moro, G.; Rousset, S.; Cremona, A.; Bert, F.; Siliquini, R. The Burden of Burnout among Healthcare Professionals of Intensive Care Units and Emergency Departments during the COVID-19 Pandemic: A Systematic Review. Int. J. Environ. Res. Public Health 2021, 18, 8172. https://doi.org/10.3390/ijerph18158172
- Grossi G, Perski A, Osika W, et al. Stress-related exhaustion disorder– clinical manifestation of burnout? A review of assessment methods, sleep impairments, cognitive disturbances, and neuro-biological and physiological changes in clinical burnout. Scand J Psychol 2015; 56: 626– 636. DOI: 10.1111/sjop.12251
- Jéssica Loubak Paes, Martina Mesquita Tonon, Zuleide Maria Ignácio, Paula Teresinha Tonin
- Prevalence of burnout syndrome among nursing professionals in an emergency room and in an intensive care unit. J Bras Psiquiatr. 2022;71(4):296-302 DOI: 10.1590/0047-2085000000386
- Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry. 2016 Jun;15(2):103- 11. doi: 10.1002/wps.20311. PMID: 27265691; PMCID: PMC4911781.
- Rocio C. Baro Vila, Lucrecia M. Burgos, Alan Sigal, Juan Pablo Costabel, Alberto Alves de Lima. Burnout Syndrome in Cardiology Residents. Impact of the COVID-19 Pandemic on Burnout Syndrome in Cardiology Residents. Curr Probl Cardiol 2022;47:100873 https://doi. org/10.1016/j.cpcardiol.2021.100873
- Rodrigues H, Cobucci R, Oliveira A, Cabral JV, Medeiros L, Gurgel K, Souza T, Gonçalves AK. Burnout syndrome among medical residents: A systematic review and meta-analysis. PLoS One. 2018 12;13(11):e0206840. doi: 10.1371/journal.pone.0206840. PMID: 30418984;.
- Sonnentag S. The recovery paradox: Portraying the complex interplay between job stressors, lack of recovery, and poor well-being. Research in Organizational Behavior. Volume 38, 2018, Pages 169-185 https://doi. org/10.1016/j.riob.2018.11.002
- Sultana A, Sharma R, Hossain MM, Bhattacharya S, Purohit N. Burnout among healthcare providers during COVID-19: Challenges and evidence-based interventions. Indian J Med Ethics. 2020 ;V(4):1-6. doi: 10.20529/ IJME.2020.73. PMID: 34018959.
- The World Health Organization Burn-out an "occupational phenomenon": International Classification of Diseases 28 2019 https://www.who.int
- Y.Karagöz; “SPSS 21.1 application, Biyoistatistik; Nobel Akademik Yayıncılık; 1st edition; 2014; p:698)
Abstract
Objective:Burnout syndrome is a psychological condition that describes mental and physical exhaustion resulting from a prolonged response to chronic interpersonal stress factors in the workplace. With the COVID-19 pandemic, doctors faced an increase in critical illnesses, and due to the higher workload among specialists and residents in certain fields, physical exhaustion and burnout syndrome became even more pronounced. On May 5, 2023, the World Health Organization (WHO) announced that COVID-19 no longer constituted a "global emergency." However, there is insufficient data regarding the post-pandemic status of burnout, which was previously observed among residents during the pandemic.
This study aims to evaluate the prevalence of burnout among residents from different specialties who managed and treated patients in intensive care units and/or COVID-19 wards after the pandemic and to determine the risk factors associated with burnout.
Materials and Methods: Following the approval of the Hospital Ethics Committee (Approval No: 31.10.2022/299) and informed consent, 251 residents were included in the study. The standardized Maslach Burnout Inventory (MBI) was used in the study.
Results: A total of 251 resident doctors participated in the study. 52.2% of the residents reported sleep disorders. It was observed that 42.6% slept between 6-8 hours per day.
When asked what they wanted to do first after a 24-hour shift, 64.5% (n=162) stated they wanted to sleep, 14.3% (n=36) preferred going out alone or shopping, 21.1% (n=53) wanted to meet with friends or family. The scores obtained in the MBI subdimensions—"Emotional Exhaustion (EE)," "Depersonalization (D)," and "Personal Accomplishment (PA)"—did not show a statistically significant difference based on the activity they preferred after a 24-hour shift (p > 0.05). The mean scores for each subdimension were as follows: EE: 2.42 ± 0.70, D: 2.02 ± 0.74, PA: 1.64 ± 0.63, Total MBI score: 2.04 ± 0.49. Regarding the internal consistency of the scale: EE subdimension: α = 0.788, D subdimension: α = 0.581, PA subdimension: α = 0.681, Total scale: α = 0.778
Conclusion: Although various evidence-based approaches were recommended during the pandemic to mitigate burnout—such as raising awareness among doctors, utilizing digital technologies, and creating a supportive environment through organizational strategies—the high workload has persisted. As a result, residents are at significant risk for post-traumatic stress disorder (PTSD). Reorganizing healthcare services, accurate diagnosis, and increased awareness are the first essential steps in preventing this syndrome.
References
- Appiani FJ, Rodríguez Cairoli F, Sarotto L, Yaryour C, Basile ME, Duarte JM. Prevalence of stress, burnout syndrome, anxiety and depression among physicians of a teaching hospital during the COVID-19 pandemic. Arch Argent Pediatr. 2021 ;119(5):317-324. English, Spanish. doi: 10.5546/ aap.2021.eng.317. PMID: 34569739.
- Amaral MLC, da Silva IM, Bello AF, da Silva FC, Romão GS, Trapani A. Prevalence and factors associated with anxiety, depression and burnout in gynecology and obstetrics residents during the COVID-19 pandemic. Rev Bras Ginecol Obstet. 2024 Mar 15;46:e-rbgo17. doi: 10.61622/ rbgo/2024AO17. PMID: 38765522; PMCID: PMC11075398.
- Armon G, Shirom A, Shapira I, et al. On the nature of burnout-insomnia relationships: a prospective study of employed adults. J Psychosom Res 2008; 65: 5–12. DOI: 10.1016/j.jpsychores.2008.01.012.
- Baro Vila RC, Burgos LM, Sigal A, Costabel JP, Alves de Lima A. Burnout Syndrome in Cardiology Residents. Impact of the COVID-19 Pandemic on Burnout Syndrome in Cardiology Residents. Curr Probl Cardiol. 2022 ;47(1):100873. doi: 10.1016/j.cpcardiol.2021.100873. Epub 2021 May 10. PMID: 34108084
- Dimitriu MCT, Pantea-Stoian A, Smaranda AC, Nica AA, Carap AC, Constantin VD, Davitoiu AM, Cirstoveanu C, Bacalbasa N, Bratu OG, Jacota-Alexe F, Badiu CD, Smarandache CG, Socea B. Burnout syndrome in Romanian medical residents in time of the COVID-19 pandemic. Med Hypotheses. 2020 ;144:109972. doi: 10.1016/j.mehy.2020.109972. Epub 2020 Jun 7. PMID: 32531540
- Edú-Valsania S, Laguía A, Moriano JA. Burnout: A Review of Theory and Measurement. Int J Environ Res Public Health. 2022 Feb 4;19(3):1780. doi: 10.3390/ijerph19031780. PMID: 35162802; PMCID: PMC8834764.
- Ergin C, Bayraktar R, Dağ İ, editors. Doktor ve hemşirelerde tükenmişlik ve Maslach Tükenmişlik Ölçeğinin uyarlanması. VII. Ulusal Psikoloji Kongresi Bilimsel Çalışmaları; Ankara. VII. Ulusal Psikoloji Kongresi Düzenleme Kurulu ve Türk Psikologlar Derneği Yayını; 1993
- Fadle AA, Khalifa AA, Mahran DG, Khidr SS, Said HG, Farouk O. Burnout syndrome (BOS) among resident doctors in an Egyptian tertiary care university hospital: Prevalence and determinants during the COVID-19 pandemic. Int J Soc Psychiatry. 2023 ;69(2):396-405. doi: 10.1177/00207640221104698. Epub 2022 Jun 13. PMID: 35695719
- Freudenberger HJ. Staff Burn-Out. J Soc Issues. 1974;90(1):159–65. 10.1111/ j.1540-4560.1974.tb00706.x
- Friganović A, Selič P, Ilić B, Sedić B. Stress and burnout syndrome and their associations with coping and job satisfaction in critical care nurses: a literature review. Psychiatr Danub. 2019 ;31(Suppl 1):21-31. PMID: 30946714.
- Gualano, M.R.; Sinigaglia, T.; Lo Moro, G.; Rousset, S.; Cremona, A.; Bert, F.; Siliquini, R. The Burden of Burnout among Healthcare Professionals of Intensive Care Units and Emergency Departments during the COVID-19 Pandemic: A Systematic Review. Int. J. Environ. Res. Public Health 2021, 18, 8172. https://doi.org/10.3390/ijerph18158172
- Grossi G, Perski A, Osika W, et al. Stress-related exhaustion disorder– clinical manifestation of burnout? A review of assessment methods, sleep impairments, cognitive disturbances, and neuro-biological and physiological changes in clinical burnout. Scand J Psychol 2015; 56: 626– 636. DOI: 10.1111/sjop.12251
- Jéssica Loubak Paes, Martina Mesquita Tonon, Zuleide Maria Ignácio, Paula Teresinha Tonin
- Prevalence of burnout syndrome among nursing professionals in an emergency room and in an intensive care unit. J Bras Psiquiatr. 2022;71(4):296-302 DOI: 10.1590/0047-2085000000386
- Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry. 2016 Jun;15(2):103- 11. doi: 10.1002/wps.20311. PMID: 27265691; PMCID: PMC4911781.
- Rocio C. Baro Vila, Lucrecia M. Burgos, Alan Sigal, Juan Pablo Costabel, Alberto Alves de Lima. Burnout Syndrome in Cardiology Residents. Impact of the COVID-19 Pandemic on Burnout Syndrome in Cardiology Residents. Curr Probl Cardiol 2022;47:100873 https://doi. org/10.1016/j.cpcardiol.2021.100873
- Rodrigues H, Cobucci R, Oliveira A, Cabral JV, Medeiros L, Gurgel K, Souza T, Gonçalves AK. Burnout syndrome among medical residents: A systematic review and meta-analysis. PLoS One. 2018 12;13(11):e0206840. doi: 10.1371/journal.pone.0206840. PMID: 30418984;.
- Sonnentag S. The recovery paradox: Portraying the complex interplay between job stressors, lack of recovery, and poor well-being. Research in Organizational Behavior. Volume 38, 2018, Pages 169-185 https://doi. org/10.1016/j.riob.2018.11.002
- Sultana A, Sharma R, Hossain MM, Bhattacharya S, Purohit N. Burnout among healthcare providers during COVID-19: Challenges and evidence-based interventions. Indian J Med Ethics. 2020 ;V(4):1-6. doi: 10.20529/ IJME.2020.73. PMID: 34018959.
- The World Health Organization Burn-out an "occupational phenomenon": International Classification of Diseases 28 2019 https://www.who.int
- Y.Karagöz; “SPSS 21.1 application, Biyoistatistik; Nobel Akademik Yayıncılık; 1st edition; 2014; p:698)
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health and Community Services |
| Journal Section | Articles |
| Authors | |
| Publication Date | June 27, 2025 |
| Submission Date | March 11, 2025 |
| Acceptance Date | May 10, 2025 |
| Published in Issue | Year 2025 Volume: 11 Issue: 2 |
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