BİR ÜNİVERSİTE HASTANESİNDE TIPTA UZMANLIK ÖĞRENCİLERİNDE TÜKENMİŞLİK DURUMU VE COVID-19 KORKUSU

Yıl 2023, Cilt: 8 Sayı: 3, 230 - 240, 29.10.2023

Halit Emin Alıcılar , Meltem Çöl

https://doi.org/10.35232/estudamhsd.1285896

Öz

Sağlık çalışanlarının tükenmişlik sorunu, pandemide zorlaşan çalışma koşulları ve COVID-19 korkusu ile daha da artmıştır. COVID-19 sürecinde en önde görev alan tıpta uzmanlık öğrencileri, en çok etkilenen gruplardan biridir. Bu çalışmada, bir üniversite hastanesindeki uzmanlık öğrencilerinin tükenmişlik ve COVID-19 korkusu değerlendirilerek ilişkili etmenleri saptamak amaçlanmıştır. Araştırma kesitsel tipte olup Eylül-Kasım 2021’de Ankara Üniversitesi Tıp Fakültesi’nde çalışan tıpta uzmanlık öğrencilerinde yürütülmüştür. Örnekleme seçilen 400 kişiden 324’ü araştırmaya katılmış, veriler tanımlayıcı bilgilerin yanısıra Türkçe uyarlaması yapılmış olan Maslach Tükenmişlik Ölçeği (MTÖ) ve Koronavirüs Korkusu Ölçeği (KKÖ) kullanılarak çevrim içi toplanmıştır. MTÖ’de duygusal tükenme (DT) ve duyarsızlaşma (D) puanlarının yüksek, kişisel başarı (KB) puanının düşük olması yüksek tükenmişlikle ilişkilidir. KKÖ’de puan arttıkça COVID-19 korkusu artışını göstermektedir. Verilerin analizinde SPSS 26 programı kullanılmış, tekli analizlerde anlamlı saptanan değişkenler için çoklu lineer regresyon analizi uygulanmıştır. Araştırmaya katılanların yaş ortalaması 28,03±2,48 yıl olup %59’u kadındı. DT puanı 19,20±7,88, D puanı 8,00±4,11, KB puanı 18,48±4,78; KKÖ puanı 15,72±5,06 idi. Yoğun çalışma koşulları, şiddet, baskı, psikolojik destek ihtiyacı, yetersiz maaş gibi faktörlerin yanı sıra yüksek COVID-19 korkusu da tükenmişliğin çeşitli alt boyutlarını anlamlı ölçüde etkilemiştir. COVID-19 korkusu ise ileri yaşta, kadınlarda, evde 65 yaş üstü bireyle yaşayanlarda, uyku düzeni bozulanlarda, ailesinden ayrılanlarda ve pandemide görev almayanlarda daha yüksek bulunmuştur. İlişkili faktörlere dayanarak iş yükünün ve stresin azaltılması, çalışma sürelerinin kısıtlanması, olanakların iyileştirilmesi ve sağlıkta şiddetin çözümlenmesi önerilmiştir.

Anahtar Kelimeler

Tükenmişlik, COVID-19 korkusu, tıpta uzmanlık öğrencileri, iş sağlığı

BURNOUT AND COVID-19 FEAR OF RESIDENTS WORKING AT A UNIVERSITY HOSPITAL

Öz

Burnout problem of healthcare workers was exacerbated by difficult working conditions and fear of COVID -19 during the pandemic. Medical students, who are at the forefront of the COVID -19 process, are one of the most affected groups. In this study it was aimed to determine the associated factors by evaluating the burnout and fear of COVID -19 in medical students at a university hospital. The study was a cross-sectional study and was conducted in September-November 2021 among medical residents at Ankara University Faculty of Medicine. 324 of the 400 selected people participated in the study. Data were collected online using the Maslach Burnout Scale (MBI) and the Fear of Coronavirus Scale (FCS), which were adapted into Turkish, as well as descriptive information. High scores for emotional exhaustion (EE) and depersonalization (D) and low scores for personal accomplishment (PA) in the MBI scale are associated with high burnout. The higher the score in FCS, the greater the fear of COVID -19. The SPSS 26 program was used to analyze the data, and multiple linear regression analysis was applied for the variables that were found to be significant in the individual analyzes. The mean age of the participants was 28.03±2.48 years, and 59% were women. EE was 19.20±7.88, D was 8.00±4.11, PA was 18.48±4.78; FCS was 15.72±5.06. In addition to factors such as intense working conditions, violence, pressure, need for psychological support, and insufficient salary, high fear of COVID -19 also significantly affected various subdimensions of burnout. Fear of COVID -19 was found to be higher in older age, women, those living at home with individuals over 65 years of age, those with disturbed sleep patterns, those separated from their families, and those who had not worked in the pandemic response. Based on related factors, it has been suggested to reduce workload and stress, limit working hours, improve opportunities and resolve violence in health care.

Anahtar Kelimeler

Burnout, COVID-19 fear, residents, occupational health

Kaynakça

• 1. Salvagioni DAJ, Melanda FN, Mesas AE, González AD, Gabani FL, Andrade SM de. Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLoS One. 2017;12(10):e0185781.
• 2. Morgantini LA, Naha U, Wang H, Francavilla S, Acar Ö, Flores JM, et al. Factors contributing to healthcare professional burnout during the COVID-19 pandemic: A rapid turnaround global survey. PLoS One. 2020;15(9):e0238217. Available from: https://pubmed.ncbi.nlm.nih.gov/32881887
• 3. Rothenberger DA. Physician Burnout and Well-Being: A Systematic Review and Framework for Action. Dis Colon Rectum. 2017;60(6). Available from: https://journals.lww.com/dcrjournal/Fulltext/2017/06000/Physician_Burnout_and_Well_Being__A_Systematic.5.aspx
• 4. Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J, 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):1600–13. Available from: https://www.sciencedirect.com/science/article/pii/S0025619615007168
• 5. Ishak W, Nikravesh R, Lederer S, Perry R, Ogunyemi D, Bernstein C. Burnout in medical students: a systematic review. Clin Teach. Ağustos 2013;10(4):242–5.
• 6. Coskun O, Ocalan AO, Ocbe CB, Semiz HO, Budakoglu I. Depression and hopelessness in pre-clinical medical students. Clin Teach. Ağustos 2019;16(4):345–51.
• 7. Macaron MM, Segun-Omosehin OA, Matar RH, Beran A, Nakanishi H, Than CA, et al. A systematic review and meta analysis on burnout in physicians during the COVID-19 pandemic: A hidden healthcare crisis. C. 13, Frontiers in Psychiatry. Switzerland; 2022. pp. 1071397.
• 8. Melnikow J, Padovani A, Miller M. Frontline physician burnout during the COVID-19 pandemic: national survey findings. BMC Health Serv Res. 2022;22(1):365.
• 9. Kannampallil TG, Goss CW, Evanoff BA, Strickland JR, McAlister RP, Duncan J. Exposure to COVID-19 patients increases physician trainee stress and burnout. PLoS One. 06 Ağustos 2 0 2 0 ; 1 5 ( 8 ) : e 0 2 3 7 3 0 1 – e 0 2 3 7 3 0 1 . Available from: https://pubmed.ncbi.nlm.nih.gov/32760131
• 10. Gencer N. Pandemi Sürecinde Bireylerin Koronavirüs (Kovid-19) Korkusu: Çorum Örneği. Uluslararası Sos Bilim Akad Derg. 2020;4:1153–73.
• 11. Abdelghani M, El-Gohary HM, Fouad E, Hassan MS. Addressing the relationship between perceived fear of COVID-19 virus infection and emergence of burnout symptoms in a sample of Egyptian physicians during COVID-19 pandemic: a cross-sectional study. Middle East Curr Psychiatry. 2020;27(1):70. doi:10.1186/s43045- 020-00079-0.
• 12. Maslach C, Jackson SE. The measurement of experienced burnout. J Organ Behav. 01 Nisan 1981;2(2):99-113. doi:10.1002/job.4030020205.
• 13. Ergin C. Doktor ve Hemşirelerde Tükenmişlik ve Maslach Tükenmişlik Ölçeğinin Uyarlanması. VII. Ulusal Psikoloji Kongresi, 22 Eylül 1992, Ankara.
• 14. Ahorsu DK, Lin C-Y, Imani V, Saffari M, Griffiths MD, Pakpour AH. The Fear of COVID-19 Scale: Development and Initial Validation. Int J Ment Health Addict. 27 Mart 2020;1–9. Available from: https://pubmed.ncbi.nlm.nih. gov/32226353
• 15. Bakioğlu F, Korkmaz O, Ercan H. Fear of COVID-19 and Positivity: Mediating Role of Intolerance of Uncertainty, Depression, Anxiety, and Stress. Int J Ment Health Addict. 28 Mayıs 2020;1–14. Available from: https://pubmed.ncbi.nlm.nih.gov/32837421
• 16. Total Coronavirus Cases in Turkey. [cited 2022 Apr 28]. Available from: https://www.worldometers.info/coronavirus/country/turkey/
• 17. Koh D. Occupational risks for COVID-19 infection. Occup Med (Lond). 12 Mart 2020;70(1):3–5. Available from: https://pubmed.ncbi.nlm.nih.gov/32107548
• 18. Çöl M. İtalya’da Sağlık Sistemi ve COVID-19 Pandemisi Yanıtı. Toplum ve Hekim. 2021;36(5):388–400.
• 19. Müller SA, Wood RR, Hanefeld J, El-Bcheraoui C. Seroprevalence and risk factors of COVID-19 in healthcare workers from 11 African countries: a scoping review and appraisal of existing evidence. Health Policy Plan. Nisan 2022;37(4):505–13.
• 20. Yılmaz TD. Ankara Üniversitesi Tıp Fakültesi Hastaneleri’nde Tıpta Uzmanlık Öğrencilerinin Tükenmişlik Düzeyi ve İlişkili Etmenler. Tıpta Uzm Tezi, Ankara Üniversitesi Tıp Fakültesi Halk Sağlığı Anabilim Dalı. 2009;Ankara.
• 21. Gündoğdu G. Sivas Cumhuriyet Üniversitesi Tıp Fakültesi Hastanesinde Çalışan Araştırma Görevlilerinde Tükenmişlik Düzeyi ve İlişkili Etmenler. Tıpta Uzm Tezi, Sivas Üniversitesi Tıp Fakültesi Halk Sağlığı Anabilim Dalı. 2021;Sivas.
• 22. Aslan D, Şengelen M, Erişgen G. Hekimler Arasında Tükenmişlik Durumu ve İlişkili Faktörler. Ankara: Türk Tabipleri Birliği Yayınları; 2021.
• 23. Ashkar K, Romani M, Musharrafieh U, Chaaya M. Prevalence of burnout syndrome among medical residents: experience of a developing country. Postgrad Med J. Mayıs 2010;86(1015):266–71.
• 24. Jalili M, Niroomand M, Hadavand F, Zeinali K, Fotouhi A. Burnout among healthcare professionals during COVID-19 pandemic: a cross-sectional study. Int Arch Occup Environ Health. 2021; doi:10.1007/s00420-021-01695-x.
• 25. Sung CW, Chen CH, Fan CY, Su F, Chang JH, Hung CC, et al. Burnout in Medical Staffs During a Coronavirus Disease (COVID-19) Pandemic. SSRN Electron J. 01 Ocak 2020;
• 26. Teixeira C, Ribeiro O, Fonseca AM, Carvalho AS. Burnout in intensive care units - a consideration of the possible prevalence and frequency of new risk factors: a descriptive correlational multicentre study. BMC Anesthesiol. 31 Ekim 2013;13(1):38. Available from: https://pubmed.ncbi.nlm.nih.gov/24172172
• 27. Yıldız A, Çiçek İ, Şanlı ME. Sağlık Çalışanlarında Tükenmişliğin Belirleyicileri: Sigara ve Alkol Kullanımına Etkisinin İncelenmesi. Celal Bayar Üniversitesi Sağlık Bilim Enstitüsü Derg. 2018;5(3):126–32.
• 28. Siu C, Yuen S, Cheung A. Burnout among public doctors in Hong Kong: cross-sectional survey. Hong Kong Med J. 2012;18(3):186–92.
• 29. Sahin T, Aslaner H, Olguner Eker Ö, Gökçek MB, Doğan M. A Questionnaire Study Effect of COVID-19 Pandemic on Anxiety and Burnout Levels in Emergency Healthcare Workers. Int J Med Sci Clin Invent. 16 Eylül 2020;7(09SE-Research Article):4991–5001. Available from: https://valleyinternational.net/index.php/ijmsci/article/view/2801
• 30. Çelik H. Sağlık Çalışanlarının Tükenmişlik Düzeylerinin ve Problem Çözme Becerilerinin İncelenmesi: Kadirli Devlet Hastanesi Örneği. Yüksek Lisans Tezi, Çağ Üniversitesi Sos Bilim Enstitüsü. 2020; Mersin.
• 31. Liu W, Zhao S, Shi L, Zhang Z, Liu X, Li L, et al. Workplace violence, job satisfaction, burnout, perceived organisational support and their effects on turnover intention among Chinese nurses in tertiary hospitals: a cross-sectional study. BMJ Open. Haziran 2018;8(6):e019525.
• 32. Dikmetaş E, Top M, Ergin G. An examination of mobbing and burnout of residents. Turk Psikiyatri Derg. 2011;22(3):137–49.
• 33. Yakut E, Kuru Ö, Güngör Y. Sağlık Personelinin Covid-19 Korkusu İle Tükenmişliği Arasındaki İlişkide Aşırı İş Yükü Ve Algılanan Sosyal Desteğin Etkisinin Yapısal Eşitlik Modeliyle Belirlenmesi. Ekev Akad Derg. 2020;(83):241–62.
• 34. Ali SM, Nausheen S. Psychosocial Impact of COVID-19 on Healthcare Workers: A cross-sectional survey from Pakistan. Sultan Qaboos Univ Med J. 2022/02/28. Şubat 2022;22(1):82–90. Available from: https://pubmed.ncbi.nlm.nih.gov/35299803
• 35. Karagöl A, Törenli Kaya Z. Healthcare workers’ burn-out, hopelessness, fear of COVID-19 and perceived social support levels. Eur J Psychiatry. 2022; Available from: https://www.sciencedirect.com/science/article/pii/S0213616322000015
• 36. Hu D, Kong Y, Li W, Han Q, Zhang X, Zhu LX, et al. 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. EClinicalMedicine. 27 Haziran 2020;24:100424. Available from: https://pubmed.ncbi.nlm.nih.gov/32766539
• 37. Arpacıoğlu MS, Baltacı Z, Ünübol B. COVID-19 pandemisinde sağlık çalışanlarında tükenmişlik, Covid korkusu, depresyon, mesleki doyum düzeyleri ve ilişkili faktörler. Cukurova Med J. 2021;46(1):88–100.
• 38. Bulca Karadem F. Sağlık Çalışanlarında COVID Korkusunu Belirleyen Psikiyatrik Değişkenlerin İncelenmesi. Tıpta Uzm Tezi, Süleyman Demirel Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hast Anabilim Dalı. 2020;Isparta.
• 39. Quadros S, Garg S, Ranjan R, Vijayasarathi G, Mamun MA. Fear of COVID 19 Infection Across Different Cohorts: A Scoping Review. Front psychiatry. 07 Eylül 2021;12:708430. Available from: https://pubmed.ncbi.nlm.nih.gov/34557117
• 40. Metin A, Erbiçer ES, Şen S, Çetinkaya A. Gender and COVID-19 related fear and anxiety: A meta-analysis. J Affect Disord. 2022;310:384–95. Available from: https://www.sciencedirect.com/science/article/pii/S0165032722005377
• 41. Hosen I, Pakpour AH, Sakib N, Hussain N, Al Mamun F, Mamun MA. Knowledge and preventive behaviors regarding COVID-19 in Bangladesh: A nationwide distribution. PLoS One. 03 Mayıs 2 0 2 1 ; 1 6 ( 5 ) : e 0 2 5 11 5 1 – e 0 2 5 11 5 1 . Available from: https://pubmed.ncbi.nlm.nih.gov/33939763
• 42. Centers for Disease Control and Prevention. People with Certain Medical Conditions. 2021 [cited 2022 Jun 2]. Available from:https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html
• 43. Özbiler Ş, Demirel H. An Investigation of COVID-19 Anxiety And Subjective Well-being of Emerging Adults in Terms of Different Variables. İnsan ve Sos Bilim Derg. 2022; 5(1):1-18.
• 44. Xu L, Lu W, Smith AW, Wu Q, Chan V, Hou A. Gender, ethnicity differences in mental health status and COVID-19 vaccine intention among U.S. College students during COVID-19 pandemic. J Am Coll Heal. 12 Mayıs 2022;1–10. doi:10.1080/07448481.2022.2070024.
• 45. Güven E, Altay B. The Level of Fear Experienced by the Individuals and their Applications to Health Institutions during the Covid-19 Pandemic. OMEGA - J Death Dying. 19 Mayıs 2022;00302228221103105. doi:10.1177/00302228221103105.
• 46. Duong CD. The impact of fear and anxiety of Covid-19 on life satisfaction: Psychological distress and sleep disturbance as mediators. Pers Individ Dif. 2021;178:110869. Available from: https://www.sciencedirect.com/science/article/pii/S0191886921002440