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AIMS Public Health

2023, Volume 10, Issue 4: 755-774. doi: 10.3934/publichealth.2023051
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Research article Special Issues

Stress and burnout among Greek critical care nurses during the COVID-19 pandemic

  • 1.
    Hellenic Open University, Athens, Greece
  • 2.
    Faculty of Nursing, University of West Attica, Athens, Greece
  • 3.
    Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
  • 4.
    Faculty of Nursing, University of Thessaly, Greece
  • 5.
    Medical School, National and Kapodistrian University of Athens, Athens, Greece
  • Received: 08 May 2023 Revised: 04 August 2023 Accepted: 22 August 2023 Published: 07 September 2023

  • Occupational stress and burnout of health personnel during the COVID-19 pandemic, especially of the nursing population in intensive care units (ICUs), were quite frequent along with negative effects and a direct correlation with the manifestation of many physical, behavioral and psychological symptoms. For the purposes of this research, a quantitative survey was carried out, in which 153 ICU nurses of secondary and tertiary public hospitals in Greece participated. Nurses completed anonymously and voluntarily a special electronic questionnaire about stress, burnout, personal concerns about the pandemic, the consequences of the outbreak and their resilience toward COVID-19 patients' care. Specific validated scales were used in this study. Female nurses felt, to a greater extent than males, work-related burnout, especially patient-related burnout and total burnout. There was a statistically significant negative relationship between the existence of a psychological support group within a hospital and personal burnout. Participants who had experience in caring for SARS-CoV-2 patients had higher mental resilience than those without experience. As the consequences experienced by the health professionals of the reference COVID-19 hospitals were increased, so did mental resilience and stress coping strategies during the pandemic. The COVID-19 outbreak and the conditions configurated in the health system had negative effects on the psycho-emotional state of ICU nurses. The manifestation of anxiety, stress and burnout had a direct correlation with both the work and personal functionality of the nurses and the whole of the healthcare services provided. The early recognition of symptoms and their individualized management are imperative for the protection of the psycho-emotional well-being of nurses.

    Citation: Thiresia Sikioti, Afroditi Zartaloudi, Despoina Pappa, Polyxeni Mangoulia, Evangelos C. Fradelos, Freideriki Eleni Kourti, Ioannis Koutelekos, Evangelos Dousis, Nikoletta Margari, Areti Stavropoulou, Eleni Evangelou, Chrysoula Dafogianni. Stress and burnout among Greek critical care nurses during the COVID-19 pandemic[J]. AIMS Public Health, 2023, 10(4): 755-774. doi: 10.3934/publichealth.2023051

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  • Occupational stress and burnout of health personnel during the COVID-19 pandemic, especially of the nursing population in intensive care units (ICUs), were quite frequent along with negative effects and a direct correlation with the manifestation of many physical, behavioral and psychological symptoms. For the purposes of this research, a quantitative survey was carried out, in which 153 ICU nurses of secondary and tertiary public hospitals in Greece participated. Nurses completed anonymously and voluntarily a special electronic questionnaire about stress, burnout, personal concerns about the pandemic, the consequences of the outbreak and their resilience toward COVID-19 patients' care. Specific validated scales were used in this study. Female nurses felt, to a greater extent than males, work-related burnout, especially patient-related burnout and total burnout. There was a statistically significant negative relationship between the existence of a psychological support group within a hospital and personal burnout. Participants who had experience in caring for SARS-CoV-2 patients had higher mental resilience than those without experience. As the consequences experienced by the health professionals of the reference COVID-19 hospitals were increased, so did mental resilience and stress coping strategies during the pandemic. The COVID-19 outbreak and the conditions configurated in the health system had negative effects on the psycho-emotional state of ICU nurses. The manifestation of anxiety, stress and burnout had a direct correlation with both the work and personal functionality of the nurses and the whole of the healthcare services provided. The early recognition of symptoms and their individualized management are imperative for the protection of the psycho-emotional well-being of nurses.


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    Acknowledgments


    This study is not funded by any agency and is being conducted by the authors independently.

    Conflict of Interest


    Evangelos C. Fradelos is an editorial board member for AIMS Public Health, Evangelos C. Fradelos and Polyxeni Mangoulia are guest editors of AIMS Public Health Special Issue, and they were not involved in the editorial review or the decision to publish this article. All authors declare that there are no competing interests.

    [1] World Health Organization DirectorGeneral's remarks at the media briefing on 2019-nCoV on 11 February (2020). Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020.
    [2] World Health Organization DirectorGeneral's opening remarks at the media briefing on COVID19-11 March (2020). Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-Covid-19---11-march-2020.
    [3] Liu Q, Luo D, Haase JE, et al. (2020) The experiences of health-care providers during the COVID-19 crisis in China: A qualitative study. Lancet Glob Health 8: e790-e798. https://doi.org/10.1016/S2214-109X(20)30204-7
    [4] Donchin Y, Seagull FJ (2002) The hostile environment of the intensive care unit. Curr Opin Crit Care 8: 316-320. https://doi.org/10.1097/00075198-200208000-00008
    [5] Embriaco N, Azoulay E, Barrau K, et al. (2007) High level of burnout in intensivists: prevalence and associated factors. Am J Respir Crit Care Med 175: 686-692. https://doi.org/10.1164/rccm.200608-1184OC
    [6] Mangoulia P, Fildissis G, Koukia E, et al. (2010) Secondary traumatic stress among ICU nurses in Greece. Intensive Care Med 36: 340.
    [7] Mangoulia P, Fildissis G, Koukia, et al. (2011) Factors associated with compassion fatigue among ICU nurses in Greece. Critical Care 15: 172. https://doi.org/10.1186/cc9909
    [8] Mangoulia P (2011) The influence of secondary traumatic stress on the productivity of health professionals focus on ICU and psychiatric nurses. Doctoral Dissertation. Greece: Faculty of Nursing, National and Kapodistrian University of Athens.
    [9] Gautam R, Sharma M (2020) COVID-19 pandemic: A disruptive and stressful atmosphere for Indian academic fraternity. Brain, Behav Immun 88: 948-949. https://doi.org/10.1016/j.bbi.(2020).04.025
    [10] Dafogianni C, Pappa D, Koutelekos I, et al. (2021) Stress, anxiety and depression in nurses during COVID-19 pandemic: Evaluation of coping strategies. Int J Nurs 8: 1-10. https://doi.org/10.15640/ijn.v8n1a1
    [11] van Doremalen N, Bushmaker T, Morris DH, et al. (2020) Aerosol and Surface Stability of SARS-COV2-CoV-2 as Compared with SARS-COV2-CoV-1. N Engl J Med 382: 1564-1567. https://doi.org/10.1056/NEJMc2004973
    [12] Joob B, Wiwanitkit V (2020) Traumatization in medical staff helping with COVID-19 control. Brain Behav Immun 87: 10. https://doi.org/10.1016/j.bbi.(2020).03.020
    [13] Montemurro N (2020) The emotional impact of COVID-19: From medical staff to common people. Brain Behav Immun 87: 23-24. https://psycnet.apa.org/doi/10.1016/j.bbi.(2020).03.032
    [14] Moore DJ, Dawkins D, Hampton MD, et al. (2022) Experiences of critical care nurses during the early months of the COVID-19 pandemic. Nurs Ethics 29: 540-551. https://doi.org/10.1177/09697330211043273
    [15] Levi P, Moss J (2022) Intensive care unit nurses' lived experiences of psychological stress and trauma caring for COVID-19 Patients. Workplace Health Saf 70: 358-367. https://doi.org/10.1177/21650799211064262
    [16] Azoulay E, Cariou A, Bruneel F, et al. (2020) Symptoms of anxiety, depression, and peritraumatic dissociation in critical care clinicians managing patients with COVID-19. A cross-sectional study. Am Journal Resp Crit Care Med 202: 1388-1398. https://doi.org/10.1164/rccm.202006-2568OC
    [17] Despres C, Brunin Y, Berthier F, et al. (2020) Prone positioning combined with high-flow nasal or conventional oxygen therapy in severe Covid-19 patients. Crit Care 24: 256. https://doi.org/10.1186/s13054-020-03001-6
    [18] Lee H, Choi S (2022) Factors affecting fatigue among nurses during the COVID-19 Pandemic. Int J Environ Res Public Health 19: 11380. https://doi.org/10.3390/ijerph191811380
    [19] Nilsson U, Odom-Forren J, Ring M, et al. (2022) Stress of conscience of COVID-19 among perianaesthesia nurses having worked in a COVID-ICU during the coronavirus pandemic: An international perspective. BMC Nurs 21: 82. https://doi.org/10.1186/s12912-022-00862-w
    [20] Da Silva FCT, Barbosa CP (2021) The impact of the COVID-19 pandemic in an intensive care unit (ICU): Psychiatric symptoms in healthcare professionals. Prog Neuropsychopharmacol Biol Psychiatry 110: 110299. https://doi.org/10.1016/j.pnpbp.(2021).110299
    [21] Şanlıtürk D (2021) Perceived and sources of occupational stress in intensive care nurses during the COVID-19 pandemic. Intensive Crit Care Nurs 67: 103107. https://doi.org/10.1016/j.iccn.103107
    [22] Kristensen TS, Borritz M, Villadsen E, et al. (2005) The Copenhagen burnout inventory: A new tool for the assessment of burnout. Work Stress 19: 192-207. https://doi.org/10.1080/02678370500297720
    [23] Chaudhary FA, Ahmad B, Ahmad P, et al. (2020) Concerns, perceived impact, and preparedness of oral healthcare workers in their working environment during COVID-19 pandemic. J Occup Health 62: e12168. https://doi.org/10.1002/1348-9585.12168
    [24] Kuo FL, Yang PH, Hsu HT, et al. (2020) Survey on perceived work stress and its influencing factors among hospital staff during the COVID-19 pandemic in Taiwan. Kaohsiung J Med Sci 36: 944-952. https://doi.org/10.1002/kjm2.12294
    [25] Smith B W, Dalen J, Wiggins K, et al. (2008) The brief resilience scale: Assessing the ability to bounce back. Int J Behav Med 15: 194-200. https://doi.org/10.1080/10705500802222972
    [26] Carver CS (1997) You want to measure coping but your protocol is too long: Consider the brief cope. Int J Behav Med 4: 92-100. https://doi.org/10.1207/s15327558ijbm0401_6
    [27] Kapsou M, Panayiotou G, Kokkinos CM, et al. (2010) Dimensionality of coping: an empirical contribution to the construct validation of the brief-COPE with a Greek-speaking sample. J Health Psychol 15: 215-229. https://doi.org/10.1177/1359105309346516
    [28] Alsulimani LK, Farhat AM, Borah RA, et al. (2021) Health care worker burnout during the COVID-19 pandemic: a cross-sectional survey study in Saudi Arabia. Saudi Med J 42: 306. https://doi.org/10.15537/smj.2021.42.3.20200812
    [29] Su TP, Lien TC, Yang CY, et al. (2007) Prevalence of psychiatric morbidity and psychological adaptation of the nurses in a structured SARS-COV2 caring unit during outbreak: A prospective and periodic assessment study in Taiwan. J Psychiat Res 41: 119-130. https://doi.org/10.1016/j.jpsychires.2005.12.006
    [30] Carayon P, Gürses AP (2005) A human factors engineering conceptual framework of nursing workload and patient safety in intensive care units. Intens Crit Care Nurs 21: 284-301. https://doi.org/10.1016/j.iccn.2004.12.003
    [31] Edwards D, Burnard P, Coyle D, et al. (2000) Stress and burnout in community mental health nursing: A review of the literature. J Psychiatr Ment Health Nurs 7: 7-14. https://doi.org/10.1046/j.1365-2850.2000.00258.x
    [32] Duarte I, Teixeira A, Castro L, et al. (2020) Burnout among Portuguese healthcare workers during the COVID-19 pandemic. BMC Public Health 20: 1885. https://doi.org/10.1186/s12889-020-09980-z
    [33] Ratnakaran B, Prabhakaran A, Karunakaran V (2016) Prevalence of burnout and its correlates among residents in a tertiary medical center in Kerala, India: A cross-sectional study. J Postgrad Med 62: 157. https://doi.org/10.4103%2F0022-3859.184274
    [34] Zhang H, Ye Z, Tang L, et al. (2020) Anxiety symptoms and burnout among Chinese medical staff of intensive care unit: the moderating effect of social support. BMC Psychiatry 20: 1-7. https://doi.org/10.1186/s12888-020-02603-2
    [35] Azoulay E, Kentish-Barnes N (2020) A. 5-point strategy for improved connection with relatives of critically ill patients with COVID-19. Lancet Respir Med 8: e52. https://doi.org/10.1016%2FS2213-2600(20)30223-X
    [36] Sun N, Wei L, Shi S, et al. (2020) A qualitative study on the psychological experience of caregivers of COVID-19 patients. Am J Infect Control 48: 592-598. https://doi.org/10.1016/j.ajic.03.018
    [37] Barello S, Palamenghi L, Graffigna G (2020) Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic. Psychiatry Res 290: 113129. https://doi.org/10.1016/j.psychres.(2020).113129
    [38] Peters L, Cant R, Payne S, et al. (2013) How death anxiety impacts nurses' caring for patients at the end of life: A review of literature. Open Nurs J 7: 14-21. https://doi.org/10.2174%2F1874434601307010014
    [39] Faraji A, Karimi M, Azizi SM, et al. (2019) Occupational stress and its related demographic factors among Iranian CCU nurses: a cross sectional study. BMC Res. Notes 12: 1-5. https://doi.org/10.1186/s13104-019-4674-5
    [40] Mokhtari R, Moayedi S, Golitaleb M (2020) COVID-19 pandemic and health anxiety among nurses of intensive care units. Int J Ment Health Nurs 29: 1275-1277. https://doi.org/10.1111%2Finm.12800
    [41] Çelmeçe N, Menekay M (2020) The effect of stress, anxiety and burnout levels of healthcare professionals caring for COVID-19 patients on their quality of life. Front Psychol 11: 3329. https://doi.org/10.3389%2Ffpsyg.(2020).597624
    [42] Chou LP, Li CY, Hu SC (2014) Job stress and burnout in hospital employees: Comparisons of different medical professions in a Regional Hospital in Taiwan. BMJ Open 4: 4185. https://doi.org/10.1136/bmjopen-2013-004185
    [43] Vandevala T, Pavey L, Chelidoni O, et al. (2017) Psychological rumination and recovery from work in intensive care professionals: associations with stress, burnout, depression and health. J Intensive Care 5: 16. https://doi.org/10.1186/s40560-017-0209-0
    [44] Olanrewaju AS, Chineye OJ (2013) Gender differences in burnout among health workers in the Ekiti State University Teaching Hospital Ado-Ekiti. Int J Soc Behav Sci 1: 112-121.
    [45] Adam S, Mohos A, Kalabay L, et al. (2018) Potential correlates of burnout among general practitioners and residents in Hungary: The significant role of gender, age, dependant care and experience. BMC Fam Pract 19: 193. https://doi.org/10.1186/s12875-018-0886-3
    [46] Cañadas-De la Fuente GA, Vargas C, San Luis C, et al. (2015) Risk factors and prevalence of burnout syndrome in the nursing profession. Int J Nurs Stud 52: 240-249. https://doi.org/10.1186/s12875-018-0886-3
    [47] Azoulay E, De Waele J, Ferrer R, et al. (2020) Symptoms of burnout in intensive care unit specialists facing the COVID19 outbreak. Ann Intensive Care 10: 110. https://doi.org/10.1186/s13613-020-00722-3
    [48] Lai J, Ma S, Wang Y, et al. (2020) Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 3: e203976. https://doi.org/10.1001/jamanetworkopen.(2020).3976
    [49] Borritz M, Rugulies R, Bjorner JB, et al. (2006) Burnout among employees in human service work: design and baseline findings of the PUMA study. Scand J Public Health 34: 49-58. https://doi.org/10.1080/14034940510032275
    [50] Pines AM, Neal MB, Hammer LB, et al. (2011) Job burnout and couple burnout in dual-earner couples in the sandwiched generation. Soc Psychol Q 74: 361-386. https://doi.org/10.1177/0190272511422452
    [51] Maben J, Bridges J (2020) Covid-19: supporting nurses' psychological and mental health. J Clin Nurs 29: 2742-50. https://doi.org/10.1111%2Fjocn.15307
    [52] Sriharan A, Ratnapalan S, Tricco AC, et al. (2021) Women in healthcare experiencing occupational stress and burnout during COVID-19: a rapid review. BMJ Open 11: e048861. https://doi.org/10.1136/bmjopen-(2021)-048861
    [53] Arafa A, Mohammed Z, Mahmoud O, et al. (2020) Depressed, anxious, and stressed: What have healthcare workers on the frontlines in Egypt and Saudi Arabia experienced during the COVID-19 pandemic?. J Affect Disord 278: 365-371. https://doi.org/10.1016/j.jad.(2020).09.080
    [54] Coşkun Şimşek D, Günay U (2021) Experiences of nurses who have children when caring for COVID-19 patients. Int Nurs Rev 68: 219-227. https://doi.org/10.1111/inr.12651
    [55] Hu D, Kong Y, Li W, et al. (2021) Frontline nurses' burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: a large-scale cross-sectional study. E Clinical Med 24: 100424. https://doi.org/10.1016/j.eclinm.(2020).100424
    [56] Rose S, Hartnett J, Pillai S (2021) Healthcare worker's emotions, perceived stressors and coping mechanisms during the COVID-19 pandemic. PLoS ONE 16: e0254252. https://doi.org/10.1371/journal.pone.0254252
    [57] Moradi Y, Baghaei R, Hosseingholipour K, et al. (2021) Challenges experienced by ICU nurses throughout the provision of care for COVID-19 patients: A qualitative study. J Nurs Manag 29: 1159-1168. https://doi.org/10.1111/jonm.13254
    [58] Siam B G A H, Alrasheedi L N (2022) Burnout among emergency nurses during COVID-19 pandemic at hail governmental hospitals in the Kingdom of Saudi Arabia. Ethiopian J Health Sci 32: 1245-1253. https://doi.org/10.4314/ejhs.v32i6.23
    [59] Sampaio F, Sequeira C, Teixeira L (2020) Nurses' mental health during the Covid-19 outbreak: A cross-sectional study. J Occup Environ Med 62: 783-787. https://doi.org/10.1097/JOM.0000000000001987
    [60] Murat M, Köse S, Savas er S (2021) Determination of stress, depression and burnout levels of front-line nurses during the COVID-19 pandemic. Int J Ment Health Nurs 30: e533-e543. https://doi.org/10.1111/inm.12818
    [61] Nobr DFR, Rabiais ICM, Ribeiro PCPSV, et al. (2019) Burnout assessment in nurses from a general emergency service. Rev Bras Enferm 72: 1457-1463. https://doi.org/10.1111/inm.12818
    [62] Portela NLC, Pedrosa AO, Cunha JDS, et al. (2015) Burnout syndrome in nursing professionals from urgency and emergency services. Rev Pesqui: Cuid Fundam 7: 2749-2760. https://doi.org/10.9789/2175-5361.2015.v7i3.2749-2760
    [63] Lima-Setta F, De Moraes CL, Silami PHNC, et al. (2023) Mental health and emotional disorders during the COVID-19 pandemics: Prevalence and extent in PICU staff. Pediatr Crit Care Med 24: 277-288. https://doi.org/10.1097/PCC.0000000000003119
    [64] Roberts LW, Warner TD, Moutier C, et al. (2011) Are doctors who have been ill more compassionate? Attitudes of resident physicians regarding personal health issues and the expression of compassion in clinical care. Psychosomatics 52: 367-374. https://doi.org/10.1016/j.psym.2011.01.042
    [65] Konstantinou D, Minasidou E, Grizioti M, et al. (2018) Exploring the job demands and support resources of Intensive Care Unit nurses in Cyprus' public hospitals. Hellenic J Nurs Sci 11: 47-60.
    [66] Xing J, Sun N, Xu J, et al. (2020) Study of the mental health status of medical personnel dealing with new coronavirus pneumonia. PLoS ONE 15: e0233145. https://doi.org/10.1371/journal.pone.0233145
    [67] Mahmoudi S, Barkhordari-Sharifabad M, Pishgooie A H, et al. (2018) Burnout among Iranian nurses: A national survey. BMC Nurs 19: 1-9. https://doi.org/10.1186/s12912-020-00461-7
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