The DOI matches its Crossref record; 101 of the 101 references it cites were found in a registry or an index.
Nurses’ burnout and associated risk factors during the COVID-19 pandemic: A systematic review and meta-analysis
Open accessPublished version of a preprint
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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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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]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
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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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Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000097 · Cited by 64,042
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722
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(2009) · PubMed Central · Cited by 44,859
Wang, G., Ma, R., Qiao, G., Wada, K., Aizawa, Y., & Satoh, T. (2015) · Integrative Medicine International · doi:10.1159/000368408 · Cited by 18,762
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(2019) · doi:10.1002/9781119536604 · Cited by 14,828
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Maslach, C., & Jackson, S. E. (1981) · Journal of Organizational Behavior · doi:10.1002/job.4030020205 · Cited by 14,496
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Research works printed but not linked: 4
- 10.1101/2020.09.11.20192773 · DOI
- 10.1101/2020.08.26.20182378 · DOI
- International Council of Nurses, 2020, ICN confirms 1,500 nurses have died from COVID‐19 in 44 countries and estimates that healthcare worker COVID‐19 fatalities worldwide could be more than 20,000
- National Nurses United, 2020, Sins of ommision. How government failures to track Covid‐19 data have led to more than 1,700 health care worker deaths and jeopardize public health
Cited by
Sorted by citations
A Systematic Review and Meta-Analysis of Burnout Among Healthcare Workers During COVID-19
Ghahramani, S., Lankarani, K. B., Yousefi, M., Heydari, K., Shahabi, S., & Azmand, S. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.758849 · Cited by 293
“One study summarized the prevalence of nurse burnout during pandemics (29).”
BackgroundExamining the Impact of the COVID-19 Pandemic on Burnout and Stress Among U.S. Nurses
Martin, B., Kaminski-Ozturk, N., O’Hara, C., & Smiley, R. A. (2023) · Journal of Nursing Regulation · doi:10.1016/s2155-8256(23)00063-7 · Cited by 284
“The main drivers of nurses’ intent to leave are frequently identified as more durable issues or problems, such as insufficient staffing levels, desire for higher pay, not feeling listened to or supported at work, and the emotional toll of the job (Lasater et al., 2021; Galanis et al., 2021; Murat et al., 2021; Berlin,…”
BackgroundResultGualano, M. R., Sinigaglia, T., Moro, G. L., Rousset, S., Cremona, A., Bert, F., & Siliquini, R. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18158172 · Cited by 277
“Some sociodemographic variables such as age and female gender have been often found to be associated with burnout, both before the pandemic among ICU/ED workers [34] and during the pandemic among general HCWs [46].”
BackgroundChutiyami, M., Cheong, A. M. Y., Salihu, D., Bello, U. M., Ndwiga, D. W., Maharaj, R., Naidoo, K., Kolo, M. A., Jacob, P., Chhina, N., et al. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.804525 · Cited by 206
Magnavita, N., Chirico, F., Garbarino, S., Bragazzi, N. L., Santacroce, E., & Zaffina, S. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18084361 · Cited by 188
“A systematic review and meta-analysis, published in March 2021 [44], identified 16 studies on nurses working with COVID-19 patients.”
Background
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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