Prevalence and risk factors associated with burnout syndrome among healthcare workers in Afghanistan

Year 2021, Volume: 19 Issue: 3, 223 - 234, 02.12.2021

Khwaja Mir Islam Saeed

https://doi.org/10.20518/tjph.845089

Abstract

Objective: This study aims to identify the prevalence of burnout syndrome (BS) with its subscales of emotional exhausting (EE), depersonalization (DP), and personal accomplishment (PA) among frontline healthcare workers in Afghanistan.Methods: A total of 623 health workers contracted by NGOs participated in a cross-sectional study in ten provinces. A self-administered questionnaire including Maslach Burnout Inventory were used for data collection. Proportions and factors associated with BS were calculated. Epi info v.7 and SPSS v.20 were used for data management.Results:Totally, 264 were females (41.8%); 83% were married and two-third had ≥14 years of education. Half (58%) had monthly income of 130$-260$. The mean age was 32.5 years, by differentiation of 29.4 years in females and 34.9 years in males. Ten (1.6%)declared currently smoking and 5% dissatisfied with their job. Just 13% were doing private business besides current job. Average number of children was 3.4 and average years of experiences was 8.7. Proportion of high EE, DP and PA was 6.3%, 8.3% and 26.6% respectively. At multivariate analysis age, job satisfaction and work pressure were associated with EE; high level of DP was related to age and job satisfaction; and PA was associated with age, work load, work pressure, security and annual vacation. Conclusion: Frontline health workers are affected by various level of burnout syndrome. They should be supported by management with better work environment to prevent problem and provide quality health services. 

Keywords

Afghanistan, burnout, depersonalization, health worker, prevalence

Afganistan’da sağlık çalışanlarında tükenmişlik sendromu sıklığı ve ilişkili risk faktörleri

Abstract

Amaç: Bu çalışma, Afganistan’da ön saflarda çalışan sağlık çalışanları arasında tükenmişlik sendromu (BS) ve alt boyutları olan duygusal tükenme (EE), duyarsızlaşma (DP) ve kişisel başarı (PA) yaygınlığını belirlemeyi amaçlamaktadır. Yöntem: Kesitsel çalışmaya on ilde sivil toplum kuruluşlarında sözleşmeli olarak çalışan toplam 623 sağlık çalışanı katılmıştır. Veri toplamada Maslach Tükenmişlik Envanterini de içeren, kendi kendine uygulanan bir anket kullanıldı. Çalışmada BS sıklığı ve ilişkili faktörler hesaplanmıştır. Veri analizi için Epi info v.7 ve SPSS v.20 kullanıldı. Bulgular: Katılımcıların 264’ü kadındı (% 41.8); % 83’ü evli ve üçte ikisi ≥14 yıl eğitim almıştı. Yarısının (% 58) aylık geliri 130−260 $ idi. Yaş ortalaması kadınlarda 29.4, erkeklerde 34.9’ olmak üzere toplamda 32.5 idi. On kişi (% 1.6) halen sigara içtiğini ve % 5 çalışan işinden memnun olmadığını belirtti. Katılımcıların %13’ü mevcut işle birlikte özel iş yapıyordu. Katılımcıların ortalama olarak 3.4 çocuğu vardı ve ortalama deneyim yılı 8.7 yıldı. Yüksek EE, DP ve PA oranı sırasıyla %6.3, % 8.3 ve % 26.6 idi. Çok değişkenli analizlerde yaş, iş doyumu ve iş baskısı EE ile ilişkilendirildi; yüksek DP seviyesi yaş ve iş doyumu ile ilişkiliydi ve PA yaş, iş yükü, iş baskısı, güvenlik ve yıllık tatillerle ilişkiliydi. Sonuç: Sağlık hizmetlerinin sunumunda ön saflarda yer alan sağlık çalışanları, çeşitli düzeylerde tükenmişlik sendromundan etkilenmektedir. Kaliteli sağlık hizmetlerinin sağlanması için çalışanlar yönetim tarafından desteklenmelidirler.

Keywords

Afganistan, tükenmişlik, duyarsızlaşma, sağlık çalışanı, prevalans

References

• Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol 2001;52:397–422.
• Schaufeli WB, Green glass ER. Introduction to special issue on burnout and health. Psychol Health 2001;16(5):501–510.
• Shirey MR. Stress and burnout in nursing faculty. Nurse Educator 2006;31(3):95-97.
• Johns G, Sakes M. Organizational behaviour: understanding life at work. 5th ed. Indianapolis: Prentice Hall; 2000.
• Cordes CL, Dougherty TW. A review and an integration of research on job burnout.Acad Manag 1993;18(4):621.
• Gundersen L. Physician burnout. Ann Intern Med 2001;135(2):145–148.
• Parker PA, Kulik JA. Burnout, self- and supervisor-rated job performance, and absenteeism among nurses. J Behav Med 1995;18(6):581–99.
• Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med 2002;136(5):358–367.
• Abdulla L, Al-Qahtani DM, Al-Kuwari MG. Prevalence and determinants of burnout syndrome among primary healthcare physicians in Qatar. S Afr Fam Pract 2011;53(4):380-383
• Silva SCPS, Nunes MAP, Santana VR, Reis FP, Neto JM, Lima SO. Burnout syndrome in professionals of the primary healthcare network in Aracaju, Brazil. Cien Saude Colet 2015;20(10):3011-3020.
• Burns N. Understanding nursing research. 4th ed. Missouri: Saunders Publishing Company;2007.
• Kalemoglu M, Keskin O. Burnout syndrome at the emergency services.Scand J trauma Resusc Emerge Med 2006; 14:37-40.
• Langade D, Modi PD, Sidhwa YF, Hishikar NA, Gharpure AS, Wankhade K, Langade J, Joshi K. Burnout Syndrome Among Medical Practitioners Across India: A Questionnaire-Based Survey. Cureus. 2016 Sep 8;8(9):e771. PMID: 27833826;PMCID: PMC5101402.
• Latief A, Mahfouz EM, Ewis AA, Seedhom AE. Burnout syndrome among healthcare Providers in different hospitals in Mina city. Egypt J Occup Med 2018; 42 (1): 21-32.
• Ogresta J, Rusac S, Zorec L. Relation between burnout syndrome and job satisfaction among mental health workers. Croat Med J 2008; 49:364-74.
• Al-Sareai NS, Al-Khaldi YM, Mostafa OA, Abdel-Fattah MM. Magnitude and risk factors for burnout among primary health care physicians in Asir province,Saudi Arabia. East Mediterr Health J 2013;19 (5): 426 – 434.
• ThorsenVC, Tharp ALT, Meguid T. High rates of burnout among maternal health staff at a referral hospital in Malawi: a cross-sectional study. BMC Nurs 2011;23:1-7.
• Naz S, Hashmi AM, Asif A. Burnout and quality of life in nurses of a tertiary care hospital in Pakistan. J Pak Med Assoc 2016;66(5):532-536.
• Cagan O, Gunay O. The job satisfaction and burnout levels of primary care health workers in the province of Malatya in Turkey. Pak J Med Sci 2015;31(3):543-547.
• Piko BF. Burnout, role conflict, job satisfaction and psychosocial health among Hungarian health care staff: a questionnaire survey. Int J Nurs Stud 2006;43(3):311-318.
• Violante S, Benso PG, Gerbaudo L, Violante B. Correlation between job satisfaction and stress factors, and burnout and psychosocial well-being among nurses working in different health care settings. G Ital Med Lav Ergon 2009;31(1 Suppl A): A36-44.
• Kovacs M. Kovacs E, Hegedu K. Emotional work and burnout: cross sectional study of nurses and physicians in Hungray. Croat Med J 2010;51(5):432-42.
• Ministry of Public Health (MoPH), Revised Basic Package of Health Services(BPHS). 2nd ed. Kabul: MSH Publication;2010.
• Ministry of Public Health (MoPH), the Essential Package of Health Services(EPHS). MoPH Publication; 2005/1384.
• Hall, E. (2005). Nurse burnout in a high stress health care environment: prognosis better than expected (Working Paper No. 05/01). University of Otago. Retrieved from http://hdl.handle.net/10523/1581.
• Keshvari M, Mohammadi E, Zargham BA, Farajzadegan Z. Burnout: Interpreting the Perception of Iranian Primary Rural Health Care Providers from Working and Organizational Conditions. Int J Prev Med 2012; 3(Suppl 1): S79-88
• Bijari B, Ali Abassi. Prevalence of Burnout Syndrome and Associated Factors Among Rural HealthWorkers (Behvarzes) in South Khorasan. Iran Red Crescent Med J 2016; 18(10):1-7.
• Haq Z, Iqbal Z, Rahman A. Job stress among community health workers; a multi-method study from Pakistan. Int J Ment Health Syst 2008;2(1):1-6.
• Maslach C, Jackson SE. The measurement of experienced burnout. J Occup Behav 1981; 2:99–113.
• Ministry of Public Health. Annual Report 2018: Health Management Information System (HMIS). Kabul Afghanistan.
• Waheed K et al. Burnout among gynecological residents in Lahore, Pakistan: A cross-sectional survey. J Pak Med Assoc, 2017;67(9):1318-1322.
• Truzzi A, Sauza W, Bucasio E, et al. Burnout in a sample of Alzheimer’s disease caregivers in Brazil. Eur J Psychiatry 2008; 22:151–160.
• Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in Burnout and Satisfaction with Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. Mayo Clin Proc 2015;90(12):1600-1613.
• Chemali Z, Ezzeddine FL, Gelaye B, et al. Burnout among healthcare providers in the complex environment of the Middle East: a systematic review. BMC Public Health 2019; 1319:1337.
• Asghar A A, Faiq A, Shafique S, et al. Prevalence and Predictors of the Burnout Syndrome in Medical Students of Karachi, Pakistan. Cureus 2019;11(6): e4879.
• Doulougeri K, Georganta K, Montgomery A. Diagnosing burnout among healthcare professionals: Can we find consensus? Cogent Medicine 2016; 3:1.
• Jalili M, Roodsari S, Anahita, Nia B. Burnout and Associated Factors among Iranian Emergency Medicine Practitioners. Iranian J Publ Health,2013;42(9):1034-1042.
• Feyza Nazik F, Yilmaz E, Tatli H. Burnout in health sector: Sample of public hospital.Medicine Science 2018;7(4):821-5.
• Sabbah II, Sabbah H, Sabbah S, Akoum H, Droubi N. Burnout among Lebanese nurses: Psychometric properties of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Health 2012;4:644-652.
• Muzafar Y, Khan H H, Ashraf H, et al.Burnout and its Associated Factors in Medical Students of Lahore, Pakistan. Cureus 2015;7(11): e390.