| Abstract |
Background: The unexpected nature of the novel pandemic of COVID-19 has
already widely impacted on the psychological wellbeing and overall health of the
healthcare professionals. Especially those who work in the primary health care
(P.H.C) and are at the “frontline”, are most vulnerable to a range of stressors.
According to the literature, the P.H.C professionals are expected to present higher risk
of the burnout syndrome during such periods of crisis. Assessment of this
phenomenon is considered crucial.
Aim: The aim of this study was to explore the prevalence of the burnout syndrome
and its dimensions among the P.H.C professionals. Additionally, other secondary
objectives were; to assess the factors that have a negative impact and may lead to the
increase of the burnout syndrome and to monitor the thoughts and feelings of the
healthcare professionals, map their preferences, views and suggestions on how to
improve and manage this phenomenon.
Methods: The current cross-sectional mixed-methods study took place in the county
of Heraklion in the regional P.H.C units (Local Health Units of Heraklion and Units
of Home care). It was a three-month study during the winter period (2020-2021) of
the second wave of the pandemic (quarantine). The mixed methodological approach
included a quantitative and a qualitative part. In the quantitative part, a sample of 73
P.H.C professionals participated and filled in the 7-point Likert Maslach burnout
syndrome scale. The analysis was performed in the IBM SPSS 26.00, with two-sided
test at a level of significance of a=0.05. In the qualitative part, 7 participants joined
two focus groups that used semi-structured questions to motivate dialogue. A thematic
content analysis was performed afterwards.
Results: The majority of the participants (61.4%) reported that they were affected
psychologically during the pandemic, due to the quarantine and the relative measures.
The overall burnout syndrome score was found to be at medium levels (3.55), with
two of each dimensions to be at lower-medium levels (emotional exhaustion (3.83)
and depersonalization (2.08)). Contrary to that, the dimension of low feeling of
personal achievements had very high score of 4.76. Additionally, the high number of
family members (OR=1.561, 95%CI= 1.322-1.901) and children (1.584, 1.301-1.985),
as well as the years of smoking (1.2, 1.074-1.421) presented higher probability of
burnout syndrome. Contrary to that, frequent exercise (0.672, 0.521-0.793) and
frequent social activity (0.128, 0.093-0.282) had a protective impact. Similar
correlation trends were found for the three dimensions. Furthermore, through the
focus groups, the participants stressed the importance of this subject and the criticality
of the phenomenon we are all experiencing, as well as how they think it has an impact
on the increase of the burnout syndrome. It seems that the overall impact on the
relations between collaborators was positive. However, the effects on other parts were
only negative. Some of the most frequent problems and barriers they faced and think
Public Health-Primary Health Care-Health Services
School of Medicine – University of Crete
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that contributed to the increase of burnout were; the increase of fear, stress, physical
and mental burden, crisis and confusion of roles, lack of support by their directors
(centrally) and from the bodies of policy and decision making and absence of
guidelines and comprehensive continuous training.
Conclusions: The pandemic and the quarantine period seem to have a great impact on
the burnout syndrome prevalence among the P.H.C professionals working in the
frontline. Still, an even greater impact is expected to be observed after the quarantine
where the strict measures of the pandemic will come to an end. Based on our findings
and the monitored needs and preferences of the participants, a range of measures
should be undertaken, starting from P.H.C governance, integration with tertiary
healthcare, resources for safety and diagnostic procedures, recognition of roles within
the P.H.C and among other types of care, formulation of specific responsibilities,
coordination of educational/training activities, continuous exchange of best practices
and the coordinated psychological support in group conversations taking place in the
units.
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