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Nurses’ burnout and associated risk factors during the COVID-19 pandemic: A systematic review and meta-analysis
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Abstract
Abstract Aims To examine the nurses' burnout and associated risk factors during the COVID‐19 pandemic. Design We followed the Cochrane criteria and the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines for this systematic review and meta‐analysis. Data Sources PubMed, Scopus, ProQuest, Cochrane COVID‐19 registry, CINAHL and pre‐print services (medRχiv and PsyArXiv) were searched from January 1 to November 15, 2020 and we removed duplicates. Review Methods We applied a random effect model to estimate pooled effects since the heterogeneity between results was very high. Results Sixteen studies, including 18,935 nurses met the inclusion criteria. The overall prevalence of emotional exhaustion was 34.1%, of depersonalization was 12.6% and of lack of personal accomplishment was 15.2%. The main risk factors that increased nurses' burnout were the following: younger age, decreased social support, low family and colleagues readiness to cope with COVID‐19 outbreak, increased perceived threat of Covid‐19, longer working time in quarantine areas, working in a high‐risk environment, working in hospitals with inadequate and insufficient material and human resources, increased workload and lower level of specialized training regarding COVID‐19. Conclusion Nurses experience high levels of burnout during the COVID‐19 pandemic, while several sociodemographic, social and occupational factors affect this burnout. Impact We found that burnout among nurses is a crucial issue during the COVID‐19 pandemic. There is an urgent need to prepare nurses to cope better with COVID‐19 pandemic. Identification of risk factors for burnout could be a significant weapon giving nurses and health care systems the ability to response in a better way against the following COVID‐19 waves in the near future.
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“This burden appears to have peaked during the most demanding periods of the COVID-19 pandemic”
From What do we really know about addressing burnout among healthcare workers? Maybe less than we think (2026) · cites this paper as [6]
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“It was similar to a recent meta-analysis (8.7% in HCWs) [43], but was much lower than the 35.4% reported in the first wave in the US [44].”
From Seroprevalence of COVID-19 and Psychological Distress among Front Liners at the Universiti Malaysia Sabah Campus during the Third Wave of COVID-19 (2022) · cites this paper as [43]
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“although burnout in the healthcare field was already a long-standing issue before the pandemic.6,7”
From What do we really know about addressing burnout among healthcare workers? Maybe less than we think (2026) · cites this paper as [6]
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“During the pandemic, their workload and healthcare roles expanded, adding additional pressure to the workplace [14,15].”
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“Te pandemic has exacerbated global concerns about nursing shortages due to heightened workloads [4].”
Yalçın, B., Sarıköse, S., Göktepe, N., & Türkmen, E. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-12711-y · Cited by 5
“Gala-nis et al. [30] revealed that nurses during the COVID 19 pandemic experienced depersonalization and low personal accomplishment, but not to a greater extent than nurses working in a stressful environment.”
Duff, J., Grant, L. C., Gilchrist, H., & Jones, K. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11133730 · Cited by 4
“The subsequent fall to 57% is also likely to have been impacted by the pandemic, although in the opposite direction, and perhaps contributed to staff exhaustion [61] and high COVID-19 sickness rates as the pandemic progressed.”
Burnout in Critical Care Nurses in the Covid-19 Pandemic
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“According to the results of a meta-analysis that examined 16 studies, it was found that poor working conditions, including increased workload and working hours, increased the burnout levels of nurses (Galanis et al. 2021).”
Dikobe, J. M., Moagi, M. M., & Sehularo, L. A. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20065078 · Cited by 4
Public views on healthcare workers' burnout before and during COVID‐19: A comparative study
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El Burnout Post Pandemia COVID-19 en el Desempeño Laboral de las Instituciones de Educación Superior
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Robotic Cholecystectomy Remains Safe and Effective After Regular Staffing Hours
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“Globally, health care professionals, especially nurses, have reported that they feel higher levels of stress and severe burnout due to increased demands during the COVID-19 pandemic (e.g., Arnetz et al., 2020; Galanis et al., 2021; Martin et al., 2023; Murat et al., 2021).”
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“The combination of these aspects triggered serious psychological problems in front-line nurses during the pandemic [9, 10].”
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“Occupational factors included the level of specialized training, working conditions, and role conflict/ambiguity (Galanis et al., 2021).”
Social support improves nurses’ resilience: a cross-sectional study in GreecePreprint
Galanis, P., Katsiroumpa, A., Vraka, I. S., Siskou, O. C., Konstantakopoulou, O., Katsoulas, T. A., Gallos, P., & Καϊτελίδου, Δ. (2023) · medRxiv · doi:10.1101/2023.04.03.23288089 · Cited by 4
“Moreover, psychological issues such as depression, anxiety, stress, sleep disturbances, and burnout are prevalent among nurses especially during the COVID-19 pandemic (Al Maqbali et al., 2021; Chen & Meier, 2021; Galanis et al., 2021).”
Self-citationNurses, Psychological Distress, and Burnout: Is There an App for That?
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COVID-19 related complications
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Intervention to Enhance Resilience among Nurse Managers: A Systematic Review
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Empowerment, Resilience, and Burnout Among Nurses With Recovered COVID‐19: A Multicountry Study
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“A systematic review and meta-analysis highlighted that working in high-risk environments, longer working times in quarantine areas, and inadequate material and human resources signifcantly increased burnout levels among nurses [50].”
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“Yet, an increase in workload has been identified as a risk factor for burnout [46,47].”
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Metadata
- Authors
- Galanis, P., Vraka, I., Fragkou, D., Bilali, A., & Kaitelidou, D.
- Affiliations
- National and Kapodistrian University of Athens (GR)
- Panagiotis & Aglaia Kyriakou Children's Hospital (GR)
- Center for Health Services Management and Evaluation Department of Nursing School of Health Sciences National and Kapodistrian University of Athens Athens Greece
- Corresponding author
- Galanis, Petros
- Venue
- Journal of Advanced Nursing
- Publisher
- Wiley
- Published
- 2021-03-25
- Volume
- 77
- Issue
- 8
- Pages
- 3286-3302
- ISSN
- 0309-2402 (ISSN-L)
- 1365-2648
- PMC
- PMC8250618
- OpenAlex
- W3147264347
- Cited by
- 993
- References
- 100
- Citations by year
- 2026: 87 · 2025: 162 · 2024: 236 · 2023: 293 · 2022: 179 · 2021: 33
- FWCI
- 24.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Advanced Nursing (publishedVersion)
- medRxiv (acceptedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Burnout
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Keywords
- nurse burnout, COVID-19 pandemic, emotional exhaustion, depersonalization, personal accomplishment, risk factors, social support, workload, threat perception, COVID-19 training, nurses
- MeSH terms
- Burnout, Psychological, COVID-19, SARS-CoV-2, Burnout, Professional, Humans, Nurses, Risk Factors, Pandemics
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