Burnout among South African nurses during the peak of COVID-19 pandemic: a holistic investigation.

Abstract

Background: The wellbeing of health care workers (HCWs) has been an ongoing challenge, especially within low and middle-income countries (LMICs) such as South Africa. Evidence suggesting that HCWs are increasingly stressed and burned out is cause for concern. Nurses in particular have been impacted physically, mentally and psychosocially during the recent COVID-19 pandemic. This may leave a disproportionate consequence, affecting various aspects of their wellbeing, thereby justifying a need for a more holistic investigation of the wellbeing of South African nurses and their coping mechanisms during the peak of the pandemic.

Methods: This was a cross-sectional study design. Online self-reported questionnaires were administered in six hospitals, sampled purposively and conveniently from three South African provinces. Using STATA 18.0, the Wilcoxon Ranksum test at 5% alpha compared the wellbeing and coping mechanisms of nursing staff and nursing management during COVID-19's peak. Univariable and multivariable linear regression analyses were performed to determine factors associated with burnout in nurses, at a 95% confidence interval (CI). Validated scales measuring burnout, coping, resilience, as well as mental and physical health were utilised.

Results: Of 139 participants, 112(97.4%) were females, with 91(82%) and 20(18%) being nursing staff and management respectively. The median age of the participants was 43.3 years (n = 112), with a practising duration of 12 years (n = 111). There was a significant difference in the burnout score between nursing staff and nursing management (p = 0.028). In the univariable linear regression model, burnout was significantly (p < 0.05) associated with the Brief COPE Inventory (BCI), Conor-Davidson Resilience Scale (CDRS), Global Mental and Health Scale (GMHS), Global Physical and Health Scale (GPHS) and Hospital Anxiety and Depression Scale (HADS), as well as occupation. In the multivariable linear regression model, burnout was significantly associated with the CDRS [Coeff.=0.7, 95%CI 0.4; 0.9], GMHS [Coeff.=-2.4, 95%CI -3.2; -1.6], GPHS [Coeff.2.1, 95%CI 1.3; 2.9], and HADS [Coeff.=0.7, 95%CI 0.2; 1.2].

Conclusion: Investigating multiple aspects of wellbeing in this study, it's shown that coping and resilience may not be key factors in promoting the wellbeing of South African nurses. However, effective mental health interventions are crucial and should be prioritised to mitigate burnout during future health emergencies. Future studies examining the associations between general health, coping and resilience may help generate further evidence towards holistic interventions aimed at promoting nurses' wellbeing.

Clinical trial number: Not applicable.