A cross‐sectional analysis of factors associated with stress, burnout and turnover intention among healthcare workers during the COVID‐19 pandemic in the United States

Mercado, Micaela; Wachter, Karin; Schuster, Roseanne C.; Mathis, Cherra; Johnson, Emma; Davis, Olga Idriss; Johnson‐Agbakwu, Crista

doi:10.1111/hsc.13712

Cited by 35 publications

(35 citation statements)

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“…Mirzaei et al [ 51 ] also noted that male nurses experienced turnover intention at a higher rate. While two American studies found that seniority in nurses was associated with greater turnover intention [ 34 , 50 ], this was in contrast to findings in a study from Peru [ 67 ], which reported that younger HCWs were more prone to experiencing turnover intention. Social affiliation was also identified by some studies to impact turnover intention, as nurses with strong ties to friends and family perceived greater social support.…”

Section: Resultscontrasting

confidence: 79%

“…Increases in workload were widely found to be positively correlated with turnover intention among HCWs [ 38 , 45 , 55 , 56 ]. In addition, HCWs who worked long hours, or faced an increase in working hours due to the pandemic, were more prone to experiencing turnover intention [ 40 , 50 , 55 , 59 ]. Mirzaei et al [ 51 ] found that job stressors were positively correlated with turnover intention.…”

Section: Resultsmentioning

confidence: 99%

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A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: a systematic review with future directions

et al. 2022

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Background Globally, the health workforce has long suffered from labour shortages. This has been exacerbated by the workload increase caused by the COVID-19 pandemic. Major collapses in healthcare systems across the world during the peak of the pandemic led to calls for strategies to alleviate the increasing job attrition problem within the healthcare sector. This turnover may worsen given the overwhelming pressures experienced by the health workforce during the pandemic, and proactive measures should be taken to retain healthcare workers. This review aims to examine the factors affecting turnover intention among healthcare workers during the COVID-19 pandemic. Methods A mixed studies systematic review was conducted. The PubMed, Embase, Scopus, CINAHL, Web of Science and PsycINFO databases were searched from January 2020 to March 2022. The Joanna Briggs Institute’s Critical Appraisal Tools and the Mixed Methods Appraisal Tool version 2018 were applied by two independent researchers to critically appraise the methodological quality. Findings were synthesised using a convergent integrated approach and categorised thematically. Results Forty-three studies, including 39 quantitative, two qualitative and two mixed methods studies were included in this review. Eighteen were conducted in the Middle East, ten in the Americas, nine in the Asia–Pacific region and six in Europe. Nurses (n = 35) were included in the majority of the studies, while physicians (n = 13), allied health workers (n = 11) and healthcare administrative or management staff (n = 7) were included in a smaller proportion. Five themes emerged from the data synthesis: (1) fear of COVID-19 exposure, (2) psychological responses to stress, (3) socio-demographic characteristics, (4) adverse working conditions, and (5) organisational support. Conclusions A wide range of factors influence healthcare workers’ turnover intention in times of pandemic. Future research should be more focused on specific factors, such as working conditions or burnout, and specific vulnerable groups, including migrant healthcare workers and healthcare profession minorities, to aid policymakers in adopting strategies to support and incentivise them to retain them in their healthcare jobs.

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Section: Resultscontrasting

confidence: 79%

Section: Resultsmentioning

confidence: 99%

A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: a systematic review with future directions

et al. 2022

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“…When controlling negative affect at work, organisational constraints and interpersonal conflicts at work are not directly related to intention to leave the job or profession. Previous studies have demonstrated direct relationships between job burnout [ 63 ], general job stress [ 64 ], specific interpersonal and organisational stressors, and intention to leave the workplace [ 10 ]. Our findings add to the existing body of knowledge insofar as they suggest that the relationship between stressors and intention to leave the workplace or profession is more complex.…”

Section: Discussionmentioning

confidence: 99%

Work Stressors and Intention to Leave the Current Workplace and Profession: The Mediating Role of Negative Affect at Work

Jasiński

Derbis

2022

IJERPH

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The first aim of this study was to determine whether organisational constraints, interpersonal conflicts at work, workload and negative affect at work have a positive relationship with intention to leave a current job or profession. The second aim was to investigate whether negative affect at work mediates the relationship between work stressors and intention to leave a current job or profession. The study was a quantitative cross-sectional design in nature. Data were collected between March and April 2022. The sample consisted of 306 midwives working in the Polish public health service. The theoretical model was tested using structural equation modelling. The results confirmed positive direct relationships between workload and negative affect with intention to leave the current workplace and intention to leave the midwifery profession in general. The relationships between organisational constraints and interpersonal conflicts at work and intention to leave a job or profession were found to be completely mediated by negative affect at work. Our study revealed that workload is the strongest direct predictor of intention to leave the current job or profession. Organisational constraints and interpersonal conflicts at work lead to an intention to leave a job or profession by inducing negative affect at work. Interpersonal conflicts at work are the strongest predictor of negative affect at work.

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“…Members of minoritized groups and individuals from communities excluded from economic opportunities may also be at increased risk for adverse mental health impacts from the pandemic. 14,[19][20][21][22][23][24] However, gaps remain in understanding how multiple pandemic-associated hardships, health behavior changes, and coping strategies may co-occur by levels of socioeconomic advantage and/or racial and ethnic group and how these factors are associated with traumatic stress symptoms. The Environmental influences on Child Health Outcomes (ECHO) Program 25,26 follows a diverse multicohort sample and provides an opportunity to understand associations between the COVID-19 pandemic and mothers' psychological health.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Pandemic Experiences and Symptoms of Pandemic-Associated Traumatic Stress Among Mothers in the US

et al. 2022

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ImportanceThe primary outcomes of the COVID-19 pandemic on the mental health of women with children remain largely unknown.ObjectivesTo identify and describe clusters of mothers of children participating in the Environmental influences on Child Health Outcomes (ECHO) Program that characterize pandemic-associated hardships, coping mechanisms, and behaviors, and to evaluate associations between pandemic-associated hardships, coping strategies, and behavior changes with pandemic-associated traumatic stress symptoms.Design, Setting, and ParticipantsThis multicenter cohort study investigated experiences during the COVID-19 pandemic between April 2020 and August 2021 among maternal caregivers of children participating in the ECHO Program. Data from self-identified mothers of ECHO-enrolled children from 62 US cohorts were included in analyses. Data were analyzed from November 2021 to July 2022.ExposuresThe primary exposures were pandemic-associated changes in mothers’ health, health care utilization, work and finances, coping strategies, and health-associated behaviors. Exposures were assessed via a self-reported questionnaire designed by ECHO investigators.Main Outcomes and MeasuresThe primary outcome was the total symptoms score of pandemic-associated traumatic stress (PTS), defined as the number of items endorsed at least sometimes or more frequently, from a 10-item self-report measure.ResultsThe study surveyed 11 473 mothers (mean [SD] age, 37.8 [7.4] years; 342 American Indian [2.98%], 378 Asian [3.29%], 1701 Black [14.83%], and 7195 White [62.71%]; 2184 with Hispanic/Latina ethnicity [19.04%]) and identified 2 clusters that best characterized their COVID-19 pandemic experiences—one characterized by higher life disruptions (eg, to work and health care), higher social isolation, more coping behaviors to mitigate the outcomes of the pandemic, and more changes to their health behavior routines (high change [1031 mothers]) and the other characterized by lower changes (low change [3061 mothers]). The high change cluster was more socioeconomically advantaged and reported higher PTS (mean [SD] number of symptoms, 3.72 [2.44] vs 2.51 [2.47]). Across both clusters, higher pandemic-associated hardships, coping mechanisms, and behavior changes were associated with higher PTS, and these associations were greater in the low change cluster.Conclusions and RelevanceIn this study of more than 11 000 US mothers, associations between socioeconomic factors, stressful life events, and mental health sequelae were complex. Accordingly, programs, policies, and practices targeting mental health during public health crises such as the COVID-19 pandemic should consider the range and configuration of hardships in designing the most effective interventions to mitigate long-term outcomes.

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A cross‐sectional analysis of factors associated with stress, burnout and turnover intention among healthcare workers during the COVID‐19 pandemic in the United States

Abstract: the health, economic and social consequences of the COVID-19 pandemic were ubiquitous across the United States Hospitalisation and infections rates quadrupled between November and December, overwhelming healthcare systems (CDC, 2021).

Cited by 35 publications

References 74 publications

A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: a systematic review with future directions

A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: a systematic review with future directions

Work Stressors and Intention to Leave the Current Workplace and Profession: The Mediating Role of Negative Affect at Work

COVID-19 Pandemic Experiences and Symptoms of Pandemic-Associated Traumatic Stress Among Mothers in the US

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