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Cited by 17Healthcare professionals’ stress and burnoutOccupational Health and BurnoutStress and Burnout Research

Burnout in emergency department staff: The prevalence and barriers to intervention

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Naidoo, Reshen, Schoeman, Renata·2023·South African Journal of Psychiatry
DOI 10.4102/sajpsychiatry.v29i0.2095PMC PMC10623583
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Abstract

Background: Burnout impacts patient care and staff well-being. Emergency department (ED) staff are at an elevated risk for burnout. Despite an acceleration in burnout research due to the coronavirus disease 2019 (COVID-19) pandemic, there is limited data on the nature and prevalence of burnout in the South African emergency medicine setting. Aim: This study determined the prevalence of burnout in ED staff (doctors, nurses and non-clinical staff) at Tygerberg Hospital and explored staff awareness and utilisation of interventions. Setting: The study was conducted at Tygerberg Hospital, South Africa. Methods: This cross-sectional study used the Maslach Burnout Inventory to assess burnout via a self-administered electronic survey in a convenience sample of 109 ED staff. Quantitative data were analysed with descriptive and inferential statistics. Qualitative data were analysed using thematic analysis. Results: A total of 46 participants (45.10%) experienced burnout, with 73 participants (71.57%) at high risk for emotional exhaustion or depersonalisation. The prevalence of burnout in doctors was 57.89%, non-clinical staff was 25.93%, and nursing staff was 50.00%. Burnout was higher in doctors and nursing staff compared to non-clinical staff, with high emotional exhaustion and depersonalisation found in interns and specialist professional nurses. The level of intervention awareness was 41.8% and the level of intervention utilisation was 8.82%. Thematic analysis identified awareness, accessibility and reactive utilisation as barriers to utilisation with opportunities to reduce burnout and enhance resilience. Conclusion: Coordinated health system and organisational efforts are required to optimise intervention strategies to reduce burnout. Contribution: Guidance on the design and planning of intervention strategies considering at risk groups, intervention-related factors, and non-clinical staff.

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  • Burnout in Sub-Saharan Africa is driven primarily by structural conditions rather than individual weakness.

    “These findings echo broader regional evidence that burnout in Sub-Saharan Africa is driven primarily by structural conditions rather than individual weakness (12, 38).”

    From Management strategies for healthcare worker burnout in Sub-Saharan Africa: an integrative review (2026) · cites this paper as [38]

    The Introduction says organisational factors are the predominant contributor to healthcare-worker burnout, and the Discussion identifies work overload and staff shortages as stresses beyond employees’ control. But the study was conducted at one South African hospital, so it does not establish that structural conditions are the primary driver across Sub-Saharan Africa. (LLM, conf=0.87)

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  1. [2]West CP, Dyrbye LN, Shanafelt TD. Physician burnout: Contributors, consequences and solutions. J Intern Med. 2018; 283(6): 516– 529. 10.1111/joim.12752 29505159 · DOI · Paper page
  2. [3]De Hert S. Burnout in healthcare workers: Prevalence, impact and preventative strategies. Local Reg Anesth. 2020; 13: 171– 183. 10.2147/LRA.S240564 33149664 PMC7604257 · DOI · Paper page
  3. [4]Mangory KY, Ali LY, Rø KI, Tyssen R. Effect of burnout among physicians on observed adverse patient outcomes: A literature review. BMC Health Serv Res. 2021; 21(1): 369. 10.1186/s12913-021-06371-x 33879135 PMC8057942 · DOI
  4. [6]Chor WPD, Ng WM, Cheng L, et al. Burnout amongst emergency healthcare workers during the COVID-19 pandemic: A multi-center study. Am J Emerg Med. 2021; 46: 700– 702. 10.1016/j.ajem.2020.10.040 33129643 PMC7584488 · DOI
  5. [7]Basu S, Qayyum H, Mason S. Occupational stress in the ED: A systematic literature review. Emerg Med J. 2017; 34(7): 441– 447. 10.1136/emermed-2016-205827 27729392 · DOI
  6. [8]Lacy BE, Chan JL. Physician burnout: The hidden health care crisis. Clin Gastroenterol Hepatol. 2018; 16(3): 311– 317. 10.1016/j.cgh.2017.06.043 28669661 · DOI
  7. [9]Gualano MR, Sinigaglia T, lo Moro G, et al. The burden of burnout among healthcare professionals of intensive care units and emergency departments during the COVID-19 pandemic: A systematic review. Int J Environ Res Public Health. 2021; 18(15): 8172. 10.3390/ijerph18158172 34360465 PMC8346023 · DOI
  8. [11]Zerden L, Lombardi B, Richman E, Forte A, McCollum M. Addressing burnout among the frontline healthcare workforce during COVID-19: A scoping review and expert interviews. J Health Hum Serv Adm. 2021; 44(4): 302– 332. 10.37808/jhhsa.44.4.3 · DOI
  9. [12]Rehder K, Adair KC, Sexton JB. The science of health care worker burnout: Assessing and improving health care worker well-being. Arch Pathol Lab Med. 2021; 145(9): 1095– 1109. 10.5858/arpa.2020-0557-RA 34459858 · DOI
  10. [13]Mahmood SBZ, Zahid A, Nasir N, Tahir M, Ghouri U, Almas A. Triggering and protective factors of burnout in medical resident physicians in a lower-middle-income country: A cross-sectional study. Ann Med Surg (Lond). 2021; 67: 102500. 10.1016/j.amsu.2021.102500 34188912 PMC8219648 · DOI
  11. [14]Yıldırım M, Solmaz F. COVID-19 burnout, COVID-19 stress and resilience: Initial psychometric properties of COVID-19 Burnout Scale. Death Stud. 2022; 46(3): 524– 532. 10.1080/07481187.2020.1818885 32915702 · DOI
  12. [15]Liebenberg AR, Coetzee JF, Conradie HH, Coetzee JF. Burnout among rural hospital doctors in the Western Cape: Comparison with previous South African studies. Afr J Prim Health Care Fam Med. 2018; 10(1): e1– e7. 10.4102/phcfm.v10i1.1568 PMC6018597 29943596 · DOI
  13. [16]Clark P, Hulse B, Polivka BJ. Resilience, moral distress, and job satisfaction driving engagement in emergency department nurses. J Nurs Adm. 2022; 52(2): 112– 117. 10.1097/NNA.0000000000001111 35060953 · DOI
  14. [17]Van de Ruit C, Lahri S, Wallis LA. Clinical teams’ experiences of crowding in public emergency centres in Cape Town, South Africa. Afr J Emerg Med. 2020; 10(2): 52– 57. 10.1016/j.afjem.2019.12.004 32612908 PMC7320195 · DOI
  15. [18]Rajan S, Engelbrecht A. A cross-sectional survey of burnout amongst doctors in a cohort of public sector emergency centres in Gauteng, South Africa. Afr J Emerg Med. 2018; 8(3): 95– 99. 10.1016/j.afjem.2018.04.001 30456156 PMC6223592 · DOI
  16. [19]Robertson LJ, Maposa I, Somaroo H, Johnson O. Mental health of healthcare workers during the COVID-19 outbreak: A rapid scoping review to inform provincial guidelines in South Africa. S Afr Med J. 2020; 110(10): 1010– 1019. 10.7196/SAMJ.2020.v110i10.15022 33205731 · DOI
  17. [20]Deng D, Naslund JA. Psychological impact of COVID-19 pandemic on frontline health workers in low- and middle-income countries. Harv Public Health Rev (Camb). 2020; 28: 1– 18. 10.54111/0001/Z1 PMC7785092 33409499 · DOI
  18. [21]Bradford L, Glaser G. Addressing physician burnout and ensuring high-quality care of the physician workforce. Obstet Gynecol. 2021; 137(1): 3– 11. 10.1097/AOG.0000000000004197 33278277 · DOI
  19. [22]Montgomery A, Panagopoulou E, Esmail A, Richards T, Maslach C. Burnout in healthcare: The case for organisational change. BMJ. 2019; 366(July): 1– 5. 10.1136/bmj.l4774 31362957 · DOI · Paper page
  20. [23]Rotenstein LS, Torre M, Ramos MA, et al. Prevalence of burnout among physicians a systematic review. JAMA. 2018; 320(11): 1131– 1150. 10.1001/jama.2018.12777 30326495 PMC6233645 · DOI · Paper page
  21. [24]Dubale BW, Friedman LE, Chemali Z, et al. Systematic review of burnout among healthcare providers in sub-Saharan Africa. BMC Public Health. 2019; 19(1): 1247. 10.1186/s12889-019-7566-7 31510975 PMC6737653 · DOI · Paper page
  22. [25]MacKanga JR, Mouendou Mouloungui EG, Iba-Ba J, Pottier P, Moussavou Kombila JB, Boguikouma JB. Burnout level and associated factors in a sub-Saharan African medical setting: Prospective cross-sectional survey. BMC Med Educ. 2020; 20(1): 1– 9. 10.1186/s12909-020-02194-2 PMC7488344 32912195 · DOI
  23. [26]Rossouw L, Seedat S, Emsley RA, Suliman S, Hagemeister D. The prevalence of burnout and depression in medical doctors working in the Cape Town Metropolitan Municipality community healthcare clinics and district hospitals of the Provincial Government of the Western Cape: A cross-sectional study. S Afr Fam Pract. 2013; 55(6): 567– 573. 10.1080/20786204.2013.10874418 · DOI
  24. [27]Klopper HC, Coetzee SK, Pretorius R, Bester P. Practice environment, job satisfaction and burnout of critical care nurses in South Africa. J Nurs Manag. 2012; 20(5): 685– 695. 10.1111/j.1365-2834.2011.01350.x 22823225 · DOI · Paper page
  25. [28]Van der Colff JJ, Rothmann S. Burnout of registered nurses in South Africa. J Nurs Manag. 2014; 22(5): 630– 642. 10.1111/j.1365-2834.2012.01467.x 23405857 · DOI
  26. [29]Clinchamps M, Auclair C, Prunet D, et al. Burnout among hospital non-healthcare staff influence of job demand-control-support, and effort-reward imbalance. J Occup Environ Med. 2021; 63(1): E13– E20. 10.1097/JOM.0000000000002072 33149005 · DOI
  27. [30]Cook LJ, Hassem T, Laher S, Variava T, Schutte E. Mental health experiences of healthcare professionals during COVID-19. SA J Ind Psychol. 2021; 47: 1– 10. 10.4102/sajip.v47i0.1865 · DOI
  28. [31]Marques MM, Alves E, Queirós C, Norton P, Henriques A. The effect of profession on burnout in hospital staff. Occup Med (Lond). 2018; 68(3): 207– 210. 10.1093/occmed/kqy039 29546385 · DOI
  29. [32]Pollock A, Campbell P, Cheyne J, et al. Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: A mixed methods systematic review. Cochrane Database Syst Rev. 2020; 11(11): CD013779. 10.1002/14651858.CD013779 33150970 PMC8226433 · DOI · Paper page
  30. [35]Affleck E, Wagner JE. Structural determinants of health workforce burnout. Healthc Manage Forum. 2022; 35(4): 243– 247. 10.1177/08404704221093889 35603868 · DOI
  31. [36]Cohen J. A power primer. Psychol Bull. 1992; 112(1): 155– 159. 10.1037//0033-2909.112.1.155 19565683 · DOI · Paper page
  32. [39]Maslach C, Jackson SE. The measurement of experienced burnout. J Organ Behav. 1981; 2(2): 99– 113. 10.1002/job.4030020205 · DOI · Paper page
  33. [40]Naudé JLP, Rothmann S. The validation of the Maslach Burnout Inventory – Human Services Survey for emergency medical technicians in Gauteng. SA J Ind Psychol. 2004; 30(3): a167. 10.4102/sajip.v30i3.167 · DOI
  34. [42]Worley JA, Vassar M, Wheeler DL, Barnes LLB. Factor structure of scores from the maslach burnout inventory: A review and meta-analysis of 45 exploratory and confirmatory factor-analytic studies. Educ Psychol Meas. 2008; 68(5): 797– 823. 10.1177/0013164408315268 · DOI
  35. [44]Pereira SdS, Fornés-Vives J, Unda-Rojas SG, Pereira-Junior GA, Juruena MF, Cardoso L. Confirmatory factorial analysis of the Maslach Burnout Inventory – Human Services Survey in health professionals in emergency services. Rev Lat Am Enfermagem. 2021; 29: e3386. 10.1590/1518-8345.3320.3386 33439946 PMC7798392 · DOI
  36. [45]Lim WY, Ong J, Ong S, et al. The Abbreviated Maslach Burnout Inventory can overestimate burnout: A study of anesthesiology residents. J Clin Med. 2019; 9(1): 61. 10.3390/jcm9010061 31888017 PMC7020051 · DOI
  37. [46]Dyrbye LN, West CP, Shanafelt TD. Defining burnout as a dichotomous variable. J Gen Intern Med. 2009; 24(3): 440. 10.1007/s11606-008-0876-6 19130150 PMC2642563 · DOI
  38. [50]Verougstraete D, Hachimi Idrissi S. The impact of burn-out on emergency physicians and emergency medicine residents: A systematic review. Acta Clin Belg. 2020; 75(1): 57– 79. 10.1080/17843286.2019.1699690 31835964 · DOI
  39. [51]Zhang Q, Mu M, He Y, Cai Z, Li Z. Burnout in emergency medicine physicians: A systematic review and meta-analysis. Medicine (Baltimore). 2020; 99(32): e21462. 10.1097/MD.0000000000021462 32769876 PMC7593073 · DOI
  40. [52]Gómez-Urquiza JL, De la Fuente-Solana EI, Albendín-García L, Vargas-Pecino C, Ortega-Campos EM, Cañadas-De la Fuente GA. Prevalence of burnout syndrome in emergency nurses: A meta-analysis. Crit Care Nurse. 2017; 37(5): e1– e9. 10.4037/ccn2017508 28966203 · DOI
  41. [53]Dzau VJ, Kirch DG, Nasca TJ. To care is human – Collectively confronting the clinician-burnout crisis. N Engl J Med. 2018; 378(4): 312– 314. 10.1056/NEJMp1715127 29365296 · DOI
  42. [54]Sultana A, Sharma R, Hossain MM, Bhattacharya S, Purohit N. Burnout among healthcare providers during COVID-19: Challenges and evidence-based interventions. Indian J Med Ethics. 2020; V(4): 1– 6. 10.20529/IJME.2020.73 34018959 · DOI
  43. [55]Roomaney R, Steenkamp J, Kagee A. Predictors of burnout among HIV nurses in the Western Cape. Curationis. 2017; 40(1): e1– e9. 10.4102/curationis.v40i1.1695 PMC6091648 28697615 · DOI
  44. [56]Kelly LA, Gee PM, Butler RJ. Impact of nurse burnout on organizational and position turnover. Nurs Outlook. 2021; 69(1): 96– 102. 10.1016/j.outlook.2020.06.008 33023759 PMC7532952 · DOI

Cited by

Sorted by citations

Authors
Naidoo, R., & Schoeman, R.
Affiliations
Stellenbosch University (ZA)
Corresponding author
Naidoo, Reshen
ORCID
Venue
South African Journal of Psychiatry
Publisher
AOSIS
Published
2023-10-23
Volume
29
Pages
2095-2095
ISSN
  • 1608-9685 (ISSN-L)
  • 2078-6786
DOI
10.4102/sajpsychiatry.v29i0.2095
PMC
PMC10623583
OpenAlex
W4387878470
Cited by
17
References
10
Citations by year
2026: 6 · 2025: 6 · 2024: 5
FWCI
6.02
Type
journal article
Language
en
Open access
Licence
Locations
  • South African Journal of Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
  • Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
Keywords
burnout, emergency department staff, burnout prevalence, emotional exhaustion, depersonalization, employee awareness, nurses, physicians, non-clinical staff, resilience, Tygerberg Hospital

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