The relationship between burnout syndrome and low back pain, neck pain and mood status in hospital workers in the COVID-19 pandemic

Abstract

Objectives: Burnout syndrome is expected among healthcare workers facing extended periods of physical and psychological stress. Physical and psychosocial factors affect the aetiology of healthcare workers’ musculoskeletal pain. This study aimed to determine healthcare workers’ burnout syndrome levels at a hospital during the COVID-19 pandemic, investigating burnout syndrome’s relationship with lower back pain, neck pain, depression and anxiety.

Methods: This prospective observational study employed a Google Forms questionnaire, and 120 training and research hospital employees volunteered to participate. The questionnaire included the Maslach Burnout Inventory, Pain-Visual Analog Scale, Neck Disability Index, Oswestry Disability Questionnaire and Hospital Anxiety and Depression Scale.

Results: Fifty-four participants (45%) had moderate emotional exhaustion, and 20 (16%) had severe emotional exhaustion. Eighty-two (68%) had mild depersonalisation and 38 (32%) had moderate depersonalisation, and 120 (100%) had severe reduced personal accomplishment. Moreover, 68.3% of volunteers complained of neck pain over the last year, while 51.7% complained of lower back pain. Relationships were observed between: emotional exhaustion, lower back pain, neck pain, lower back disability, neck disability, anxiety scores and depression scores; depersonalisation, neck pain, anxiety scores and depression scores; and personal accomplishment, neck pain, neck disability, back disability, anxiety scores and depression scores. Lower back disability was significantly higher among participants not infected with the SARS-CoV-2. Anxiety was significantly higher among participants infected with the SARS-CoV-2.

Conclusions: Burnout is a risk factor for musculoskeletal pain among healthcare workers. Therefore, healthcare workers require physical and psychological support during crises such as pandemics.

Keywords

• Burnout syndrome
• Covid-19
• healthcare workers
• low back pain
• neck pain
• depression

References

1. 1. World Health Organization. Coronavirus disease (COVID-2019) situation reports. 2020.
2. 2. Chen R, Sun C, Chen JJ, Jen HJ, Kang XL, Kao CC, et al. A large-scale survey on trauma, burnout, and posttraumatic growth among nurses during the COVID-19 pandemic. Int J Ment Health Nurs 2021;30:102-16.
3. 3. Arnetz JE, Goetz CM, Arnetz BB, Arble E. Nurse reports of stressful situations during the COVID-19 pandemic: qualitative analysis of survey responses. Int J Environ Res Public Health 2020;17:8126.
4. 4. Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic: a review. Asian J Psychiatr 2020;51:102119.
5. 5. Huang JZ, Han MF, Luo TD, Ren AK, Zhou XP. [Mental health survey of medical staff in a tertiary infectious disease hospital for COVID-19]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2020; 38(3): 192-195. [Article in Chinese]
6. 6. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020;3:e203976.
7. 7. Lin K, Yang BX, Luo D, Liu Q, Ma S, Huang R, et al. The mental health effects of COVID-19 on health care providers in China. Am J Psychiatry 2020;177:635-6.
8. 8. Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol 2001;52:397-422.

9. 9. Montero-Marin J, Prado-Abril J, Piva Demarzo MM, Gascon S, García-Campayo J. Coping with stress and types of burnout: explanatory power of different coping strategies. PLoS One 2014;9:e89090.
10. 10. Richardson A, McNoe B, Derrett S, Harcombe H. Interventions to prevent and reduce the impact of musculoskeletal injuries among nurses: a systematic review. Int J Nurs Stud 2018;82:58-67.
11. 11. Ahlberg-Hultén GK, Theorell T, Sigala F. Social support, job strain and musculoskeletal pain among female health care personnel. Scand J Work Environ Health 1995;21:435-9.
12. 12. Richardson A, McNoe B, Derrett S, Harcombe H. Interventions to prevent and reduce the impact of musculoskeletal injuries among nurses: a systematic review. Int J Nurs Stud 2018;82:58-67.
13. 13. Slezáková Z, Vörösová G, Mičinová G. Burnout syndrome in neurological nursing. Clin Soc Work Health Interv 2016;7:36-46.
14. 14. Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976) 2000;25:2940-52; discussion 2952.
15. 15. Yakut E, Düger T, Öksüz Ç, Yörükan S, Ureten K, Turan D, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine 2004;29:581-5.
16. 16. Telci EA, Karaduman A, Yakut Y, Aras B, Simsek IE, Yagli N. The cultural adaptation, reliability, and validity of neck disability index in patients with neck pain: a Turkish version study. Spine (Phila Pa 1976);34;1732-5.
17. 17. Snaith RP. The Hospital Anxiety And Depression Scale. Health Qual Life Outcomes 2003;1:29.
18. 18. Giusti EM, Pedroli E, D'Aniello GE, Badiale CS, Pietrabisse G, Manna C, et al. The psychological impact of the COVID-19 outbreak on health professionals: a cross-sectional study. Front Psychol 2020;11:1684.
19. 19. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, Wu J, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020;3:e203976.
20. 20. Norlund S, Reuterwall C, Höög J, Lindahl B, Janlert U, Birgander LS. Burnout, working conditions and gender--results from the northern Sweden MONICA Study. BMC Public Health 2010;10:326.
21. 21. Barello S, Palamenghi L, Graffigna G. Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic. Psychiatry Res 2020;290:113129.
22. 22. Abdelhafiz AS, Ali A, Ziady HH, Maaly AM, Alorabi M, Sultan EA. Prevalence, associated factors, and consequences of burnout among Egyptian physicians during COVID-19 pandemic. Front Public Health 2020;8:590190.
23. 23. Zerbini G, Ebigbo A, Reicherts P, Kunz M, Messman H. Psychosocial burden of healthcare professionals in times of COVID-19 - a survey conducted at the University Hospital Augsburg. Ger Med Sci 2020;18: Doc05.
24. 24. Moitra M, Rahman M, Collins PY, Gohar F, Weaver M, Kinuthia J, Rössler W, et al. Mental health consequences for healthcare workers during the COVID-19 pandemic: a scoping review to draw lessons for LMICs. Front Psychiatry 2021;12:602614.
25. 25. Luceño-Moreno L, Talavera-Velasco B, Garcia-Albuerne Y, Martin-Garcia J. Symptoms of posttraumatic stress, anxiety, depression, levels of resilience and burnout in Spanish health personnel during the COVID-19 pandemic. Int J Environ Res Public Health 2020;17:5514.
26. 26. Eriksen W. The prevalence of musculoskeletal pain in Norwegian nurses’ aides. Int Arch Occup Environ Health 2003;76:625-30.
27. 27. Smith DR, Mihashi M, Adachi Y, Koga H, Ishitake T. A detailed analysis of musculoskeletal disorder risk factors among Japanese nurses. J Safety Res 2006;37:195-200.
28. 28. Ahlberg-Hultén GK, Theorell T, Sigala F. Social support, job strain and musculoskeletal pain among female health care personnel. Scand J Work Environ Health 1995;21:435-9.
29. 29. Disser NP, De Micheli AJ, Schonk MM, Konnaris MA, Piacentini AN, Edon DL, et al. Musculoskeletal consequences of COVID-19. J Bone Joint Surg Am 2020;102:1197-204.
30. 30. Iacovides A, Fountoulakis KN, Moysidou C, Ierodiakonou C. Burnout in nursing staff: is there a relationship between depression and burnout? Int J Psychiatry Med 1999;29:421-33.