DOI QR코드

DOI QR Code

Post-traumatic Stress Disorder and Burnout of Healthcare Providers who cared for Patients with Coronavirus Disease-19 (COVID-19) in a Tertiary General Hospital

코로나바이러스감염증 환자를 돌본 일개 상급종합병원 의료인의 외상 후 스트레스 장애와 소진

  • Kim, Kyung Deok (Samsung Medical Center) ;
  • Yi, Young Hee (Department of Clinical Nursing Science, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2022.09.14
  • Accepted : 2022.10.21
  • Published : 2022.10.31

Abstract

Purpose : This study aimed to identify post-traumatic stress disorder (PTSD) and burnout experienced by healthcare providers who cared for patients with Coronavirus Disease 2019 (COVID-19) and their influencing factors. Methods : Data were collected from 135 healthcare providers who cared for patients with COVID-19 in a tertiary general hospital from June 8 to September 2, 2021, using a questionnaire. Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, t-test, ANOVA and Scheffe's test, Pearson's correlation coefficients, and multiple regression were used for analysis using SPSS/WIN 27.0. Results : Participants' average PTSD score was 9.31 ± 11.80, and 8.9% were in the high-risk group. Participants' average burnout score was 51.77±21.28, and 62.2% were at high risk. PTSD scores differed significantly according to participants' age, education, job, position, and current workplace. Burnout scores differed significantly according to their age, gender, marital status, parental status, and education. There was positive correlation between participants' PTSD and burnout. The factors influencing participants' PTSD were term of self-isolation and age (R2=.09). There were no significant influencing factors on participants' burnout. Conclusion : This study reconfirmed that healthcare providers who cared for patients with COVID-19 experienced both PTSD and burnout, suggesting that interventions are needed such as regular pre-training or simulation training and establishing a support system.

Keywords

Acknowledgement

이 논문은 서울시간호사회 한마음장학금의 지원을 받았음

References

  1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J. A novel coronavirus from patients with pneumonia in China, 2019. New England Journal of Medicine. 2020;382:727-33. https://doi.org/10.1056/NEJMoa2001017
  2. Petersen E, Koopmans M, Go U, Hamer DH, Petrosillo N, Castelli F, et al. Comparing SARSCoV-2 with SARS-CoV and influenza pandemics. The Lancet Infectious Diseases. 2020;20:e238-44. https://doi.org/10.1016/S1473-3099(20)30484-9
  3. Lee SH, Kim SJ, Sim MY, Yoo SY, Won SD, Lee BC. Mental health of disaster workers. Journal of Korean Neuropsychiatric Association, 2015;54(2): 135-41. https://doi.org/10.4306/jknpa.2015.54.2.135
  4. Ministry of Health and Welfare. COVID-19 regular briefing of the Central Disaster Management Headquaters. [Internet]. Seoul: Ministry of Health and Welfare; 2020 [cited 2021 September 7]. Available from: http://ncov.mohw.go.kr/tcmBoardView.do?brdId=&brdGubun=&dataGubun=&ncvContSeq=354535&contSeq=354535&board_id=140&gubun=BDJ
  5. Lim E, Seet R, Lee KH, Wilder-Smith E, Chuah B, Ong B. Headaches and the N95 face-mask amongst healthcare providers. Acta Neurologica Scandinavica. 2006;113(3):199-202. https://doi.org/10.1111/j.1600-0404.2005.00560.x
  6. Azoulay E, De Waele J, Ferrer R, Staudinger T, Borkowska M, Povoa P, et al. Symptoms of burnout in intensive care unit specialists facing the COVID-19 outbreak. Annals of Intensive Care. 2020;10(1):1-8. https://doi.org/10.1186/s13613-020-00722-3
  7. Pfefferbaum B, North CS. Mental health and the COVID-19 pandemic. New England Journal of Medicine. 2020;383:508-10. https://doi.org/10.1056/NEJMp2008017
  8. Yang MH, Lee EI, Choi JW, Kim HJ. PTSD and related factors among dispatched firefighters to rescue sites after the great Japanese earthquake. Korean Journal of Occupational Environmental Medicine. 2012;24(2):167-79. http://www.riss.kr/link?id=A60184560 https://doi.org/10.35371/kjoem.2012.24.2.167
  9. Berger W, Coutinho ESF, Figueira I, Marques-Portella C, Luz MP, Neylan TC. Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers. Social Psychiatry and Psychiatric Epidemiology. 2012;47(6):1001-11. https://doi.org/10.1007/s00127-011-0408-2
  10. Chan AO, Huak CY. Psychological impact of the 2003 severe acute respiratory syndrome outbreak on health care workers in a medium size regional general hospital in Singapore. Occupational Medicine. 2004; 54(3):190-6. https://doi.org/10.1093/occmed/kqh027
  11. Sim K, Chong PN, Chan YH, Soon WSW. Severe acute respiratory syndrome-related psychiatric and posttraumatic morbidities and coping responses in medical staff within a primary health care setting in Singapore. The Journal of Clinical Psychiatry. 2004;65(8):1120-7. https://doi.org/10.4088/jcp.v65n0815.
  12. Jung HJ, Kim JY, Jeong SY. Factors affected with post-traumatic stress in nurses involved in direct care for Middle East Respiratory Syndrome patients. Health and Social Welfare Review. 2016;36(4):488-507. https://doi.org/10.15709/hswr.2016.36.4.488
  13. Kim Y, Seo E, Seo Y, Dee V, Hong E. Effects of Middle East Respiratory Syndrome Coronavirus on post-traumatic stress disorder and burnout among registered nurses in South Korea. International Journal of Healthcare. 2018;4(2):27-33. https://doi.org/10.5430/ijh.v4n2p27
  14. Jo SH, Koo BH, Seo WS, Yun SH, Kim HG. The psychological impact of the coronavirus disease pandemic on hospital workers in Daegu, South Korea. Comprehensive Psychiatry. 2020;103:152213. https://doi.org/10.1016/j.comppsych.2020.152213
  15. Gomez-Urquiza JL, la Fuente-Solana EI, AlbendinGarcia L, Vargas-Pecino C, Ortega-Campos EM. Prevalence of burnout syndrome in emergency nurses: A meta-analysis. Critical Care Nurse, 2017;37(5):e1-e9. https://doi.org/10.4037/ccn2017508
  16. Kumar S. Burnout and doctors: prevalence, prevention and intervention. Healthcare. 2016;4(3):37. https://doi.org/10.3390/healthcare4030037
  17. Maunder RG, Lancee WJ, Balderson KE, Bennett JP, Borgundvaag B, Evans S, et al. Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerging Infectious Diseases. 2006;12(12):1924-32. https://doi.org/10.3201/eid1212.060584
  18. Kim JS, Choi JS. Factors influencing emergency nurses' burnout during an outbreak of Middle East Respiratory Syndrome Coronavirus in Korea. Asian Nursing Research. 2016;10(4):295-9. http://dx.doi.org/10.1016/j.anr.2016.10.002
  19. Morgantini LA, Naha U, Wang H, Francavilla S, Acar O, Flores JM, et al. Factors contributing to healthcare professional burnout during the COVID19 pandemic: a rapid turnaround global survey. Public Library of Science One, 2020;15(9):e0238217.https://doi.org/10.1371/journal.pone.0238217
  20. Park SY, Kim B, Jung DS, Jung SI, Oh WS, Kim SW, et al. Psychological distress among infectious disease physicians during the response to the COVID19 outbreak in the Republic of Korea. BioMed Central Public Health, 2020;20(1):1-7. https://doi.org/10.1186/s12889-020-09886-w
  21. Restauri N, Sheridan AD. Burnout and posttraumatic stress disorder in the coronavirus disease 2019 (COVID-19) pandemic: intersection, impact, and interventions. Journal of the American College of Radiology. 2020;17(7):921-6. https://doi.org/10.1016/j.jacr.2020.05.021
  22. Kisa S. Burnout among physicians and nurses during COVID-19 pandemic. European Journal of Environment and Public Health. 2020;4(2):em0055. https ://doi.org/10.29333/ejeph/8447
  23. Ross J. The exacerbation of burnout during COVID19: A major concern for nurse safety. Journal of Perianesthesia Nursing. 2020;35(4):439-40. https://doi.org/10.1016/j.jopan.2020.04.001
  24. Woo HS. Job satisfaction and adaptation of nurses after interdepartment rotation [master's thesis]. Daegu: Yeungnam University; 2016. p. 21-4. http://www.riss.kr/link?id=T14161197
  25. Weiss DS, Marmar CR, Wilson JP, Keane TM. Assessing psychological trauma and PTSD. 2nd ed. New York: The Guilford Press; 2004, p168-71.
  26. Eun HJ, Kwon TW, Lee SM, Kim TH, Choi MR, Cho SJ. A study on reliability and validity of the Korean version of impact of event scale-revised. Journal of Korean Neuropsychiatry Association. 2005; 44(3):303-10. http://www.riss.kr/link?id=A75056419
  27. Maslach C, Jackson SE. Maslach burnout inventory. Palo Alto: Consulting psychologists press; 1981. p.100-2.
  28. Choi HY, Chung NW. Perfectionism tendency, social support, and burnout among counselors. Korean Journal of healthy Psychology. 2003;8(2):279-300. http://www.riss.kr/link?id=A100631832 100631832
  29. 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 Clinic Proceedings. 2015;90(12): 1600-13. http://dx.doi.org/10.1016/j.mayocp.2015.08.023
  30. Kim ON, Choi SY. Factor affecting post-traumatic stress of nurses in direct care for COVID-19 patients. Journal of Korean Clinical Nursing Research. 2021; 27(2):121-9. https://doi.org/10.22650/JKCNR.2021.27.2.121
  31. Moon DJ, Han MA, Park J, Ryu SY. Post-traumatic stress and related factors among hospital nurses during the COVID-19 outbreak in Korea. Psychiatric Quarterly, 2021;92:1381-91. https://doi.org/10.1007/s11126-021-09915-w
  32. Rosner B. Fundamentals of biostatistics. 8th ed. Boston: Cengage Learning; 2015. p. 219.
  33. Chew NW, Lee GK, Tan BY, Jing M, Goh Y, Ngiam NJ, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain, Behavior and Immunity. 2020;88:559-65. https://doi.org/10.1016/j.bbi.2020.04.049
  34. Jiang Y, Hu B, Tu B, Zhuang Q. Late-onset PTSD and coping strategies for frontline nurses during the COVID-19 epidemic in China. Nursing Open. 2021; 8:3055-64. https://doi.org/10.1002/nop2.1018
  35. Wanigasooriya K, Palimar P, Naumann DN, Ismail K, Fellows JL, Logan P, et al. Mental health symptoms in a cohort of hospital healthcare workers following the first peak of the COVID-19 pandemic in the UK. British Journal of Psychiatry Open. 2021;7(1):1-7. https://doi.org/10.1192/bjo.2020.150
  36. Lim HJ, Park KS, Ban HJ, Lee NR, Lee YM, Lee ES, et al. The influence of emotional labor and social support on burnout of clinical nurses. Journal of Digital Convergence. 2017;15(1):255-66. https://doi.org/10.14400/JDC.2017.15.1.255
  37. Jin DR, Lee GY. Experience of nurses at a general hospital in Seoul which is temporarily closed due to COVID-19. The Journal of Korean Academic Society of Nursing Education. 2020;26(4):412-22. https://doi.org/10.5977/jkasne.2020.26.4.412
  38. Heo SH. The relationship between COVID-19 stress and burnout in nurses of tertiary general hospital: Mediating effect of social responsibility [master's thesis]. Seoul: Yonsei University; 2021. p. 20-30. http://www.riss.kr/link?id=T15907050
  39. Kim YJ, Kim CW, Im HB, Lee SY, Kang JH. The relationship of emotional burnout on hospital nursing workload. Journal of the Korea Academia-Industrial cooperation Society. 2019;20(9):93-102. https://doi.org/10.5762/KAIS.2019.20.9.93
  40. Lee TH, Kang KH, Ko YK, Cho SH, Kim EY. Issue and challenges of nurse workforce policy: A critical review and implication. Journal of Korean Academy of Nursing Administration. 2014;20(1):106-16. https ://doi.org/10.11111/jkana.2014.20.1.106
  41. Cha KS, Shin MJ, Lee JY, Chun HK. The role of infection control nurse during emerging infectious disease epidemic: Focusing on the Middle East Respiratory Syndrome. Korean Journal of Healthcare Associated Infection Control and Prevention. 2017;22(1):31-41. https://doi.org/10.14192/kjhaicp.2017.22.1.31
  42. Lee KR. Emergency nurses' experiences over 1 year of the COVID-19 pandemic: A qualitative study. Open Forum Infectious Diseases. 2021;8(1):310-1. https://doi.org/10.1093/ofid/ofab466.620
  43. Liu Q, Luo D, Haase JE, Guo Q, Wang XQ, Liu S, et al. The experiences of health-care providers during the COVID-19 crisis in China: A qualitative study. The Lancet Global Health. 2020;8(6):e790-8. https ://doi.org/10.1016/s2214-109x(20)30204-7
  44. Baek MH. Job stress, job satisfaction, and turnover intention of new nurses at emergency department [master's thesis]. Seoul: Yonsei Univertisy; 2010. p. 27-31. http://www.riss.kr/link?id=T12001195
  45. Chae DH, Park YH, Kang KH, Lee TH. A study on factors affecting cultural competency of general hospital nurses. Journal of Korean Academy of Nursing Administration. 2012;18(1):76-86. http://www.riss.kr/link?id=A102915658 102915658
  46. Kim HJ, Park HR. Factors affecting post-traumatic stress of general hospital nurses after the epidemic of Middle East Respiratory Syndrome infection. Journal of Korean Clinical Nursing Research. 2017;23(2): 179-88. https://doi.org/10.22650/JKCNR.2017.23.2.179
  47. Byun DS, Yom YH. Factors affecting the burnout of clinical nurses: Focused on emotional labor. Journal of Korean Academy of Nursing Administration. 2009; 15(3):444-54. http://koreascience.kr/article/JAKO200934939513025.page
  48. Kim JY. Nurses' experience of Middle East Respiratory Syndrome patients care. Journal of the Korea Academia-Industrial cooperation Society. 2017;18 (10):185-96. https://doi.org/10.5762/KAIS.2017.18.10.185
  49. Lee SY. Understanding and management of burnout. Journal of Korean Neuropsychiatric Association. 2020;59(2):105-14. http://doi.org/10.4306/jknpa.2020.59.2.105