Burnout among workers in emergency Departments in Palestinian hospitals: prevalence and associated factors

Abstract

BackgroundWorking in Emergency Departments (EDs) entails high work pressure and stress due to witnessing human suffering and the unpredictable nature of the work. This environment puts personnel at risk of burnout. This analysis aims to assess burnout levels and associated risk factors among health workers in EDs in Palestinian hospitals. Also, it examines the association between burnout and workplace violence, as well as with job turnover.MethodsCross-sectional design utilising a self-administered questionnaire was used to collect data from all workers at 14 EDs; 8 from the West Bank and 6 from the Gaza Strip. Burnout was measured using Maslach Burnout Inventory-Human Services Survey.ResultsA total of 444 workers (response rate 74.5%) participated: 161(36.3%) nurses, 142(32.0%) physicians and 141(31.7%) administrative personnel. Results showed high levels of burnout among EDs workers; 64.0% suffered from high emotional exhaustion, 38.1% from high depersonalization and 34.6% from low personal accomplishment. In addition, high levels of emotional exhaustion (72.3%) was significantly prevalent among physicians compared to nurses (69.8%) and administrative workers (51.4%) (p < 0.05). In comparison, high levels of depersonalization was significantly prevalent among nurses (48.8%) compared to physicians (32.1%) and administrative workers (31.9%) (p < 0.05). However, there were no significant differences in the levels of personal accomplishment burnout among the three groups (p > 0.05). Moreover, high degree of burnout was more prevalent among EDs workers in the West Bank than among those working in the Gaza Strip (OR 2.02, 95% CI = 1.11–3.69, p = 0.019), and higher among younger workers (aged ≤30 years old) than their older counterparts (OR 2.4, 95% CI = 1.302–4.458, p = 0.005). Exposure to physical violence was significantly associated with having a high degree of burnout (OR 2.017 95% CI = 1.121–3.631, p = 0.019), but no association was observed with regards to exposure to verbal violence (p > 0.05). Finally, burnout was significantly associated with workers’ intention to leave work at EDs (p < 0.05).ConclusionsBurnout is considerably prevalent among EDs’ workers, especially nurses and physicians. Burnout is positively associated with job turnover intention and also with exposure to workplace violence. Therefore, there is a need for prevention and management strategies to address occupational burnout and reduce negative consequences on workers, patients and organisations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2356-3) contains supplementary material, which is available to authorized users.

Work-related exposure to violence or threats and risk of mental disorders and symptoms: a systematic review and meta-analysis

“…Burnout, including emotional exhaustion and fatigue, was examined in six studies (supplementary data, appen- dix C, table S5) (41,43,44,(52)(53)(54): three cohort studies and three cross-sectional studies. The summary estimate across all six studies was 1.60 (95% CI 1.25-2.05, I 2 =57%), figure 3.…”

Associations between psychosocial work factors and provider mental well-being in emergency departments: A systematic review

“…Four studies used a single-centre approach [ 35 , 37 , 41 , 59 ]. Multi-centre designs varied in eight studies with 2 to 10 EDs [ 28 , 31 , 34 , 36 , 39 , 51 , 57 , 58 ], nine studies with 11 to 20 EDs [ 21 , 29 , 30 , 38 , 43 , 50 , 53 , 55 , 56 ], and three studies with 112 to 168 EDs [ 27 , 49 , 52 ]. Fifteen studies did not provide information on the number of surveyed EDs [ 22 – 26 , 32 , 33 , 40 , 42 , 44 – 48 , 54 ].…”

“…Concerning sampled ED professions, 18 studies explicitly focused on nurses [ 21 , 27 – 31 , 34 – 36 , 38 , 40 , 41 , 43 , 45 , 47 , 50 , 58 , 59 ], 12 on physicians [ 22 – 26 , 42 , 44 , 46 , 48 , 51 , 53 , 54 ], while three interrogated multi-professional samples [ 32 , 33 , 57 ]. Four studies further involved non-clinical ED professions including administrative and support staff [ 37 , 39 , 55 , 56 ]. Two studies used EDs as units of analyses [ 49 , 52 ].…”

“…Two studies used EDs as units of analyses [ 49 , 52 ]. Ten studies likely used similar samples for different study questions [ 21 , 29 , 30 , 32 , 33 , 38 , 49 , 52 , 55 , 56 ]…”

Psycho‐cognitive predictors of burnout in healthcare professionals working in emergency departments

“…Maslach and Jackson () defined “burnout” as a prolonged response to chronic interpersonal stressors on the job and is a critical issue for healthcare professionals (Maslach & Jackson, ; Maslach & Leiter, ). High work pressure and stress due to witnessing human suffering and the unpredictable nature of the work make burnout a common phenomenon among healthcare professionals working in emergency departments (ED) (Essex & Scott, ; Hamdam, ; Kuhn, Goldberg, & Compton, ; Gilardi, Guglielmetti, & Pravettoni, ). Healthcare professionals working in ED had a higher level of burnout compared to other medical specialties (e.g., Howlett et al., ).…”