Burnout, resilience and psychological flexibility in frontline nurses during the acute phase of the COVID‐19 pandemic (2020) in Madrid, Spain

Abstract

Background In April 2020, Spain was the country with the highest number of patients infected by COVID‐19 in Europe. The pressure on health care providers has had a direct impact on nurses and their mental health. Aim The aim of this study is to demonstrate the causal relationship between resilience, acceptance, experiential avoidance, psychological inflexibility and burnout syndrome, all of which are measured with validated questionnaires. Methods This was designed as a transversal correlational study with nurses who worked during the acute phase of the pandemic in public hospitals in the Community of Madrid with patients diagnosed with COVID‐19 in COVID‐19 medical hospitalization units, emergency services and intensive care units. Google Forms was used to obtain an informed consent sheet, socio‐demographic variables and the following questionnaires: 10 CD‐Risk, Connor‐Davidson Risk Resilience Scale, Acceptance and Action Questionnaire‐II and the Maslach Burnout Inventory. Results The final sample included 375 nurses with a high number of consecutive days of direct exposure to an infected patient and a very high number of consecutive days without rest; almost 18% suffered from COVID‐19. The nurses presented medium levels of resilience, medium levels of experiential avoidance and medium levels as measured for emotional exhaustion, personal accomplishment and depersonalization. We also found a predictive correlation between all the dimensions of the burnout questionnaire in relation to the data obtained from the resilience questionnaire. Conclusions There is a direct and predictive relationship between the resilience that nurses had during the acute phase of the pandemic and their capacity for acceptance, experiential avoidance, psychological inflexibility and burnout syndrome. Implications for Nursing Management The scores show the necessity to implement preventive measures to avoid fatal psychological consequences for nurses.

Exploring the relationships between resilience, burnout, work engagement, and intention to leave among nurses in the context of the COVID-19 pandemic: a cross-sectional study

“…The results of the current study indicated that higher levels of resilience were associated with lower levels of emotional exhaustion, depersonalization, and diminished personal accomplishment among nurses working in Thailand during the pandemic period. The findings largely confirm previous studies where higher resilience has been linked to lower emotional exhaustion, depersonalization, and reduced personal accomplishment among nurses working in public hospitals in Madrid, Spain [ 20 ], nurse managers in tertiary public hospitals in China [ 25 ], nurses and nursing students from a college and a state nursing association in Pennsylvania, USA [ 18 ], nurses in Brazil [ 42 ], and hospital staff in Australia [ 4 ].…”

“…An individual demonstrating resilience actively endeavors to progress constructively, drawing upon the insights and knowledge gained from confronting adverse experiences. Indeed, several studies among healthcare workers and nurses during the pandemic have found associations between resilience and lower levels of burnout [ 4 , 20 , 25 , 42 ], intention to leave [ 29 , 40 ] and a higher level of work engagement [ 9 , 26 ]. However, these studies have been limited to the United States, Australia, China, Brazil, and Spain.…”

Burnout study during the COVID-19 pandemic in Thailand: psychometric evaluation of the Maslach Burnout Inventory–Human Services Survey for Medical Personnel

“…One study demonstrated that the number of days spent directly providing care to patients with COVID-19 infections was significantly correlated with feelings of DP among nurses (Jiménez-Fernández et al, 2022 ). While the frontline nurses in our study tended to express symptoms of DP more than the nonfrontline workers, there were no significant differences in the 3 burnout scores of physicians who worked on the front line and those who did not.…”

Sleep Quality and Its Relationship to Anxiety and Hardiness in a Cohort of Frontline Italian Nurses during the First Wave of the COVID-19 Pandemic

“…The Insomnia Severity Index (ISI) is a 7-item self-report questionnaire assessing the nature, severity, and impact of insomnia via a 5-point Likert scale during the "last month", yielding a total score ranging from 0 to 28 [47]. The total score was interpreted as follows: absence of insomnia (0-7); sub-threshold insomnia (8)(9)(10)(11)(12)(13)(14); moderate insomnia (15)(16)(17)(18)(19)(20)(21); and severe insomnia (22)(23)(24)(25)(26)(27)(28). The dimensions evaluated were severity of sleep onset, sleep maintenance, early morning awakening problems, sleep dissatisfaction, interference of sleep difficulties with daytime functioning, noticeability of sleep problems by others, and distress caused by sleep difficulties.…”