From Resilience to Burnout: Psychological Features of Italian General Practitioners During COVID-19 Emergency

Abstract

During the COronaVIrus Disease 2019 (COVID-19) pandemic in Italy, general practitioners (GPs) are ensuring continued access to primary care for citizens while also absorbing more of the impact of the crisis than most professional groups. The aim of this study is to explore the relationships between dimensions of burnout and various psychological features among Italian GPs during the COVID-19 emergency. A group of 102 GPs completed self-administered questionnaires available online through Google Forms, including Maslach Burnout Inventory (MBI), Resilience Scale, Intolerance of Uncertainty Scale Short Form (IU), and Coping Inventory for Stressful Situations (CISS). Cluster analysis highlighted four distinct burnout risk profiles: Low Burnout, Medium Risk, High Risk, and High Burnout. The High Burnout group showed both lower Resilience and lower CISS Task-oriented coping strategy than the Medium Risk group and higher IU Prospective than the Low Burnout group. Results of a linear regression analysis confirmed that CISS Emotion-oriented style positively predicted MBI Emotional Exhaustion, CISS Task-oriented and Emotion-oriented emerged as significant predictors (negatively and positively, respectively) of MBI Depersonalization, and Resilience positively predicted MBI Personal Accomplishment. In conclusion, the results showed that the COVID-19 emergency had a significant impact on GPs’ work management. Implementing task-oriented problem management, rather than emotional strategies, appears to protect against burnout in these circumstances. It is possible that the emotions related to the pandemic are too intense to be regulated and used productively to manage the professional issues that the COVID-19 pandemic presents.

Experiences and management of physician psychological symptoms during infectious disease outbreaks: a rapid review

“…Eleven studies [ 32 , 54 , 74 , 81 , 82 , 84 , 85 , 94 , 136 , 143 , 201 ] focused on the experiences of family physicians during infectious disease outbreaks. Family physicians practicing in Singapore during the H5N1 outbreak feared there would be inadequate staff to manage patient demand [ 85 ].…”

“…Physicians reported the importance of having social support from friends, family, colleagues, and professionals (e.g., counsellors) in 29 studies [ 28 , 30 , 39 , 43 , 44 , 48 , 56 , 58 , 67 , 72 , 78 , 83 , 91 , 99 , 102 , 106 , 115 , 119 , 131 , 150 , 155 , 163 , 172 , 192 , 202 – 205 ]. Several studies ( n = 29) described positive personal coping strategies such as maintaining a positive attitude and resilience [ 37 , 46 , 83 , 100 , 106 , 108 , 136 , 202 , 205 , 206 ], practicing self-care (e.g., physical activity, eating well, resting, engaging in activities they enjoy) [ 30 , 35 , 56 , 65 , 70 , 91 , 102 , 103 , 117 , 119 , 129 , 131 , 150 , 151 , 207 ], and engaging with religious practices [ 39 , 46 , 131 , 205 ] as a way to mitigate negative psychological outcomes. In contrast, two studies reported that physicians engaged in avoidance coping strategies (e.g., screaming, crying, denial, self-blame, disengaging, substance abuse, etc.)…”

Psychological resilience, coping behaviours, and social support among healthcare workers during the COVID-19 pandemic: A systematic review of quantitative studies

“…Nine studies described the interaction between coping skills and mental health in HCWs during the COVID-19 pandemic (Baboe et al ., 2020; Chew et al ., 2020; Di Monte et al ., 2020; Hou et al ., 2020; Maiorano et al ., 2020; Mi et al ., 2020; Nie et al ., 2020; Vagni et al ., 2020; Zhu et al ., 2020;). The use of positive coping mechanisms such as seeking social support, positive thinking, and problem solving were associated with lower levels of traumatic stress, stigma (Chew et al ., 2020), psychological distress (Baboe et al ., 2020), stress symptoms (Nie et al ., 2020), anxiety, and depression (Zhu et al ., 2020; Mi et al ., 2020).…”

The Impact of Coping Strategies and Perceived Family Support on Depressive and Anxious Symptomatology During the Coronavirus Pandemic (COVID-19) Lockdown

“…Burnout is one additional social factor that may become increasingly relevant to the development of pandemic-related psychopathology as pressures on families-especially parents-continue to mount; it may resonate deeply with those engaged in intense, concurrent domestic and professional labor during this crisis, and may produce some of the same psychopathology (18)(19)(20). Burnout in individuals in the health profession in particular should be taken into consideration as a social implication of the pandemic (21).…”