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Research ArticleOriginal Article
Open Access

Health care worker burnout during the COVID-19 pandemic

A cross-sectional survey study in Saudi Arabia

Loui K. Alsulimani, Abdulrahman M. Farhat, Renad A. Borah, Jumanah A. AlKhalifah, Salman M. Alyaseen, Sumaeah M. Alghamdi and Malak J. Bajnaid
Saudi Medical Journal March 2021, 42 (3) 306-314; DOI: https://doi.org/10.15537/smj.2021.42.3.20200812
Loui K. Alsulimani
From the Department of Emergency Medicine (Alsulimani), from the Faculty of Medicine (Bajnaid), King Abdulaziz University; from the Faculty of Medicine (Borah), Batterjee Medical College, Jeddah; from the Faculty of Medicine (Farhat), Sulaiman Alrajhi College of Medicine, Al Bukairyah; from the Faculty of Medicine (AlKhalifah), King Faisal University, AlAhsaa; from the Faculty of Medicine (Alyaseen), Imam Muhammad ibn Saud Islamic University, Riyadh; and from the Faculty of Medicine (Alghamdi), Albaha University, Albaha, Kingdom of Saudi Arabia.
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  • For correspondence: [email protected]
Abdulrahman M. Farhat
From the Department of Emergency Medicine (Alsulimani), from the Faculty of Medicine (Bajnaid), King Abdulaziz University; from the Faculty of Medicine (Borah), Batterjee Medical College, Jeddah; from the Faculty of Medicine (Farhat), Sulaiman Alrajhi College of Medicine, Al Bukairyah; from the Faculty of Medicine (AlKhalifah), King Faisal University, AlAhsaa; from the Faculty of Medicine (Alyaseen), Imam Muhammad ibn Saud Islamic University, Riyadh; and from the Faculty of Medicine (Alghamdi), Albaha University, Albaha, Kingdom of Saudi Arabia.
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Renad A. Borah
From the Department of Emergency Medicine (Alsulimani), from the Faculty of Medicine (Bajnaid), King Abdulaziz University; from the Faculty of Medicine (Borah), Batterjee Medical College, Jeddah; from the Faculty of Medicine (Farhat), Sulaiman Alrajhi College of Medicine, Al Bukairyah; from the Faculty of Medicine (AlKhalifah), King Faisal University, AlAhsaa; from the Faculty of Medicine (Alyaseen), Imam Muhammad ibn Saud Islamic University, Riyadh; and from the Faculty of Medicine (Alghamdi), Albaha University, Albaha, Kingdom of Saudi Arabia.
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Jumanah A. AlKhalifah
From the Department of Emergency Medicine (Alsulimani), from the Faculty of Medicine (Bajnaid), King Abdulaziz University; from the Faculty of Medicine (Borah), Batterjee Medical College, Jeddah; from the Faculty of Medicine (Farhat), Sulaiman Alrajhi College of Medicine, Al Bukairyah; from the Faculty of Medicine (AlKhalifah), King Faisal University, AlAhsaa; from the Faculty of Medicine (Alyaseen), Imam Muhammad ibn Saud Islamic University, Riyadh; and from the Faculty of Medicine (Alghamdi), Albaha University, Albaha, Kingdom of Saudi Arabia.
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Salman M. Alyaseen
From the Department of Emergency Medicine (Alsulimani), from the Faculty of Medicine (Bajnaid), King Abdulaziz University; from the Faculty of Medicine (Borah), Batterjee Medical College, Jeddah; from the Faculty of Medicine (Farhat), Sulaiman Alrajhi College of Medicine, Al Bukairyah; from the Faculty of Medicine (AlKhalifah), King Faisal University, AlAhsaa; from the Faculty of Medicine (Alyaseen), Imam Muhammad ibn Saud Islamic University, Riyadh; and from the Faculty of Medicine (Alghamdi), Albaha University, Albaha, Kingdom of Saudi Arabia.
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Sumaeah M. Alghamdi
From the Department of Emergency Medicine (Alsulimani), from the Faculty of Medicine (Bajnaid), King Abdulaziz University; from the Faculty of Medicine (Borah), Batterjee Medical College, Jeddah; from the Faculty of Medicine (Farhat), Sulaiman Alrajhi College of Medicine, Al Bukairyah; from the Faculty of Medicine (AlKhalifah), King Faisal University, AlAhsaa; from the Faculty of Medicine (Alyaseen), Imam Muhammad ibn Saud Islamic University, Riyadh; and from the Faculty of Medicine (Alghamdi), Albaha University, Albaha, Kingdom of Saudi Arabia.
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Malak J. Bajnaid
From the Department of Emergency Medicine (Alsulimani), from the Faculty of Medicine (Bajnaid), King Abdulaziz University; from the Faculty of Medicine (Borah), Batterjee Medical College, Jeddah; from the Faculty of Medicine (Farhat), Sulaiman Alrajhi College of Medicine, Al Bukairyah; from the Faculty of Medicine (AlKhalifah), King Faisal University, AlAhsaa; from the Faculty of Medicine (Alyaseen), Imam Muhammad ibn Saud Islamic University, Riyadh; and from the Faculty of Medicine (Alghamdi), Albaha University, Albaha, Kingdom of Saudi Arabia.
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Article Figures & Data

Tables

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    Table 1

    - Comparison of participants characteristics by gender in a sample of health care workers in Saudi Arabia.

    CharacteristicsTotalGenderP-value
    Female n (%)Male n (%)
    Total population646398 (100)248 (100.0)N/A
    Age Mean (SD): 34.1 (9.5)
     22 to 2615686 (21.6(70 (28.2)0.004
     27 to 3118199 (24.9)82 (33.1)
     32 to 3914498 (24.6)46 (18.5)
     40 and above165115 (28.9)50 (20.2)
    Nationality
     Saudi348156 (39.2)192 (77.4)<0.0001
     Non-Saudi298242 (60.8)56 (22.6)
    Administration region of employment
     Riyadh region450304 (76.4)146 (58.9)<0.0001
     Mecca region8234 (8.5)48 (19.4)
     Eastern region7546 (11.6)29 (11.7)
     Other regions3914 (3.5)25 (10.1)
    Marital status
     Single294183 (46.0)111 (44.8)0.070
     Married337201 (50.5)136 (54.8)
     Divorced1211 (2.8)1 (0.4)
     Widowed33 (0.8)0 (0.0)
    Number of children
     No children351208 (52.3)143 (57.7)<0.0001
     One child11181 (20.4)30 (12.1)
     2 to 3 children13792 (23.1)45 (18.1)
     More than 3 children4717 (4.3)30 (12.1)
    Department you are working in (during Coronavirus disease 2019 [COVID-19])
     Other5429 (7.3)25 (10.1)0.439
     Emergency department10266 (16.6)36 (14.5)
     Intensive care unit5530 (7.5)25 (10.1)
     Infectious department1910 (2.5)9 (3.6)
     Surgical departments10764 (16.1)43 (17.3)
     Medical departments309199 (50.0)110 (44.4)
    How many years have you been working as a healthcare provider?
     Less than one year14675 (18.8)71 (28.6)<0.0001
     1-5 years14676 (19.1)70 (28.2)
     5-10 years11582 (20.6)33 (13.3)
     More than 10 years239165 (41.5)74 (29.8)
    Social status of the family:
     Less than 10,000 Saudi Riyal/month233186 (46.7)47 (19.0)<0.0001
     From 10,001 to 20,000 Saudi Riyal/month236138 (34.7)98 (39.5)
     From 20,001 to 40,000 Saudi Riyal/month12456 (14.1)68 (27.4)
     More than 40,000 Saudi Riyal/month5318 (4.5)35 (14.1)
    What’s your usual working hours per week?
     <40 h11659 (14.8)57 (23.0)<0.0001
     40-49 h391271 (68.1)120 (48.4)
     50-59 h7334 (8.5)39 (15.7)
     60-69 h3721 (5.3)16 (6.5)
     70 and more2913 (3.3)16 (6.5)
    Comorbidities/chronic diseases
     Yes142104 (26.1)38 (15.3)0.001
     None504294 (73.9)210 (84.7)
    Have your working hours increased during the Coronavirus disease 2019 [COVID-19]) pandemic?
     Yes305180 (45.2)125 (50.4)0.200
     No341218 (54.8)123 (49.6)
    Previous experience in working during pandemics? (SARS, H1N1, MERS)
     Yes241150 (37.7)91 (36.7)0.799
     No405248 (62.3)157 (63.3)
    Do you smoke?
     Yes10728 (7.0)79 (31.9)<0.0001
     I quit3411 (2.8)23 (9.3)
     No505359 (90.2)146 (58.9)
    Sleeping hours per day (on average):
     More than 84323 (5.8)20 (8.1)0.342
     6 to 8364218 (54.8)146 (58.9)
     4 to 6230151 (37.9)79 (31.9)
     Less than 496 (1.5)3 (1.2)
    During the past 3 months, how many patients with COVID-19 infection were you exposed to?
     None12470 (17.6)54 (21.8)0.013
     1 to 5183128 (32.2)55 (22.2)
     6 to 108757 (14.3)30 (12.1)
     11 to 207248 (12.1)24 (9.7)
     21 to 405527 (6.8)28 (11.3)
     More than 4012568 (17.1)57 (23.0)
    How many times were you tested for COVID-19?
     None354230 (57.8)124 (50.0)0.004
     1176114 (28.6)62 (25.0)
     26232 (8.0)30 (12.1)
     3 to 54819 (4.8)29 (11.7)
     More than 563 (0.8)3 (1.2)
    Did you test positive for COVID-19?
     Yes6032 (8.0)28 (11.3)0.213
     No359218 (54.8)141 (56.9)
     Did not test227148 (37.2)79 (31.9)
    Have you had any specific training related to the COVID-19 pandemic?
     Yes325177 (44.5)148 (59.7)<0.0001
     No321221 (55.5)100 (40.3)
    Do you feel you are being pushed to deal with COVID-19 patients?
     Yes205123 (30.9)82 (33.1)0.759
     No313193 (48.5)120 (48.4)
     Not sure12882 (20.6)46 (18.5)
    Has your institution made psychological or mental health support available to you?
     Yes280197 (49.5)83 (33.5)<0.0001
     No235123 (30.9)112 (45.2)
     I don’t know13178 (19.6)53 (21.4)
    • View popup
    Table 2

    - Prevalence of burnout among health care workers working during the COVID-19 pandemic.

    PrevalencesN%P-value95% CI
    No work burnout16124.9<0.00010.71 - 0.78
    Work burnout present48575.1  
    Total646100.0  
    • View popup
    Table 3

    - Prevalence of burnout, defined by Copenhagen Burnout Inventory (CBI), by multiple factors among health care workers working during the COVID-19 pandemic.

    CharacteristicsCBI scaleP-value
    No work burnout n (%)Work burnout present n (%)
    Gender
     Female96 (24.1)302 (75.9)0.551
     Male65 (26.2)183 (73.8)
    Age
     22 to 2643 (27.6)113 (72.4)<0.0001
     27 to 3128 (15.5)153 (84.5)
     32 to 3930 (20.8)114 (79.2)
     40 and above60 (36.4)105 (63.6)
    Nationality
     Saudi80 (23.0)268 (77.0)0.219
     Non-Saudi81 (27.2)217 (72.8)
    Administration region of employment
     Riyadh region113 (25.1)337 (74.9)0.771
     Mecca Region17 (20.7)65 (79.3)
     Eastern Region20 (26.7)55 (73.3)
     Other Regions11 (28.2)28 (71.8)
    Marital status
     Single69 (23.5)225 (76.5)0.097
     Married92 (27.3)245 (72.7)
     Divorced0 (0.0)12 (100)
     Widowed0 (0.0)3 (100)
    Number of children
     No children81 (23.1)270 (76.9)0.554
     One child29 (26.1)82 (73.9)
     2 to 3 children36 (26.3)101 (73.7)
     More than 3 children15 (31.9)32 (68.1)
    Social status of the family
     Less than 10,000 Saudi Riyal/month59 (25.3)174 (74.7)0.548
     From 10,001 to 20,000 Saudi Riyal/month52 (22.0)184 (78.0)
     From 20,001 to 40,000 Saudi Riyal/month35 (28.2)89 (71.8)
     More than 40,000 Saudi Riyal/month15 (28.3)38 (71.7)
    Do you smoke?
     Yes22 (20.6)85 (79.4)0.158
     I quit5 (14.7)29 (85.3)
     No134 (26.5)371 (73.5)
    Job title
     Others2 (33.3)4 (66.7)0.001
     Intern36 (35.0)67 (65.0)
     Resident doctor18 (14.6)105 (85.4)
     Specialist doctor9 (32.1)19 (67.9)
     Consultant doctor19 (44.2)24 (55.8)
     Nurse70 (23.3)231 (76.7)
     Paramedic2 (11.1)16 (88.9)
     Allied health care worker2 (14.3)12 (85.7)
     Pharmacist3 (30.0)7 (70.0)
     Other15 (27.8)39 (72.2)0.458
     Emergency department19 (18.6)83 (81.4)
     Intensive care unit13 (23.6)42 (76.4)
     Infectious6 (31.6)13 (68.4)
     Surgical23 (21.5)84 (78.5)
     Medical85 (27.5)224 (72.5)
     Less than one year44 (30.1)102 (69.9)0.002
     1-5 years20 (13.7)126 (86.3)
     5-10 years27 (23.5)88 (76.5)
     More than 10 years70 (29.3)169 (70.7)
    Comorbidities/chronic diseases:
     Yes33 (23.2)109 (76.8)0.600
     None128 (25.4)376 (74.6)
    Have your working hours increased during the COVID-19 pandemic?
     Yes45 (14.8)260 (85.2)<0.0001
     No116 (34.0)225 (66.0)
    Previous experience in working during pandemics? (SARS, H1N1, MERS)
     Yes57 (23.7)184 (76.3)0.565
     No104 (25.7)301 (74.3)
    Sleeping hours per day (on average)
     More than 815 (34.9)28 (65.1)0.007
     6 to 8103 (28.3)261 (71.7)
     4 to 643 (18.7)187 (81.3)
     Less than 40 (0.0)9 (100)
    During the past 3 months, how many people with COVID-19 infection were you exposed to?
     None52 (41.9)72 (58.1)<0.0001
     1 to 556 (30.6)127 (69.4)
     6 to 1013 (14.9)74 (85.1)
     11 to 2013 (18.1)59 (81.9)
     21 to 4013 (23.6)42 (76.4)
     More than 4014 (11.2)111 (88.8)
    How many times were you tested for COVID-19?
     None104 (29.4)250 (70.6)0.010
     142 (23.9)134 (76.1)
     28 (12.9)54 (87.1)
     3 to 57 (14.6)41 (85.4)
     More than 50 (0.0)6 (100)
    Did you test positive for COVID-19?
     Yes10 (16.7)50 (83.3)0.133
     No86 (24.0)273 (76.0)
     Did not test65 (28.6)162 (71.4)
    Have you had any specific training related to the COVID-19 pandemic?
     Yes84 (25.8)241 (74.2)0.585
     No77 (24.0)244 (76.0)
    Do you feel you are being pushed to deal with COVID-19 patients?
     Yes20 (9.8)185 (90.2)<0.0001
     No113 (36.1)200 (63.9)
     Not sure28 (21.9)100 (78.1)
    Has your institution made psychological or mental health support available to you?
     Yes79 (28.2)201 (71.8)0.191
     No50 (21.3)185 (78.7)
     I don’t know32 (24.4)99 (75.6)
    • SARS: Severe acute respiratory syndrome, H1N1: swine flu, MERS: Middle East respiratory syndrome

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Saudi Medical Journal: 42 (3)
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Health care worker burnout during the COVID-19 pandemic
Loui K. Alsulimani, Abdulrahman M. Farhat, Renad A. Borah, Jumanah A. AlKhalifah, Salman M. Alyaseen, Sumaeah M. Alghamdi, Malak J. Bajnaid
Saudi Medical Journal Mar 2021, 42 (3) 306-314; DOI: 10.15537/smj.2021.42.3.20200812

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Health care worker burnout during the COVID-19 pandemic
Loui K. Alsulimani, Abdulrahman M. Farhat, Renad A. Borah, Jumanah A. AlKhalifah, Salman M. Alyaseen, Sumaeah M. Alghamdi, Malak J. Bajnaid
Saudi Medical Journal Mar 2021, 42 (3) 306-314; DOI: 10.15537/smj.2021.42.3.20200812
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