Sociodemographic and work-related factors associated with psychological resilience in South African healthcare workers: a cross-sectional study.

BACKGROUND: Psychological resilience facilitates adaptation in stressful environments and is an important personal characteristic that enables workers to navigate occupational challenges. Few studies have evaluated the factors associated with psychological resilience in healthcare workers. OBJECTIVES: To determine the prevalence and factors associated with psychological resilience in a group of South African medical doctors and ambulance personnel. MATERIALS AND METHODS: This analytical cross-sectional study used secondary data obtained from two studies conducted among healthcare workers in 2019 and 2022. Self-reported factors associated with resilience, as measured by the Connor-Davidson Resilience Scale-10 (CD-RISC-10), were evaluated. R statistical software was used for analysing the data and performing statistical tests. RESULTS: A total of 647 healthcare workers were included in the study, of which 259 were doctors and 388 were ambulance personnel. Resilience scores were low overall (27.6 ± 6.6) but higher for ambulance personnel (28.0 ± 6.9) than for doctors (27.1 ± 6.0) (p = 0.006). Female gender (OR 1.94, 95%CI 1.03-3.72, p = 0.043), job category (OR 6.94 95%CI 1.22-60.50, p = 0.044) and overtime work (OR 13.88, 95%CI 1.61-368.00, p = 0.044) significantly increased the odds of low resilience for doctors. Conversely, salary (OR 0.13, 95%CI 0.02-0.64, p = 0.024) and current smoking status (OR 0.16, 95%CI 0.02-0.66, p = 0.027) significantly reduced the odds of low resilience amongst doctors. In addition, only previous alcohol use significantly reduced the odds of low resilience for ambulance personnel (OR 0.44, 95%CI 0.20-0.94, p = 0.038) and overall sample (OR 0.52, 95%CI 0.29-0.91, p = 0.024). CONCLUSIONS: Resilience was relatively low in this group of South African healthcare workers. The strong association between low resilience and individual and workplace factors provides avenues for early intervention and building resilience among healthcare workers.

Prevalence and determinants of burnout among South African doctors during the COVID-19 pandemic.

Background: Burnout, resulting from chronic workplace stress that has been unsuccessfully managed, has previously been documented in doctors. The coronavirus disease 2019 (COVID-19) pandemic has increased occupational challenges faced by doctors, potentiating their risk for burnout. Aim: This study aimed to determine the prevalence and determinants of burnout among medical doctors during the COVID-19 pandemic. Setting: Three public sector hospitals in Gqeberha, South Africa. Methods: A cross-sectional study of 260 voluntary participants was conducted. Participants completed self-administered electronic questionnaires. Logistic regression analysis was performed to explore the determinants of burnout. Results: The prevalence of burnout in this study was 78%. Burnout was significantly associated with being a medical intern or community-service medical officer (adjusted odd ratio [AOR] = 6.72, 1.71-26.40), being in the lowest income band (AOR = 10.78, 2.55-45.49), and using alcohol to manage work-related stress (AOR = 3.01, 1.12-8.04). Job-related factors associated with burnout were experiencing high conflict at work (AOR = 5.04, 1.92-13.20) and high role ambiguity and role conflict (AOR = 4.49, 1.98-10.18). Low support at work (AOR = 9.99, 3.66-27.23), medium job satisfaction (AOR = 5.38, 2.65-10.93) and medium support at work (AOR = 3.39, 1.71-6.73) were positively associated with burnout. Participants with medium (AOR = 0.28, 0.10-0.80) and high levels of resilience (AOR = 0.08, 0.03-0.25) were protected against burnout. Coronavirus disease 2019-related factors were not significantly associated with burnout. Conclusion: The burnout prevalence among South African medical doctors at public hospitals during the COVID-19 pandemic was high and strongly associated with job stress factors. Contribution: Given the increased prevalence of burnout among doctors and the strong associations with job stress factors, mitigation of burnout requires targeted organisational interventions.

Prevalence and determinants of burnout among South African doctors during the COVID-19 pandemic

Background: Burnout, resulting from chronic workplace stress that has been unsuccessfully managed, has previously been documented in doctors. The coronavirus disease 2019 (COVID-19) pandemic has increased occupational challenges faced by doctors, potentiating their risk for burnout. Aim: This study aimed to determine the prevalence and determinants of burnout among medical doctors during the COVID-19 pandemic. Setting: Three public sector hospitals in Gqeberha, South Africa. Methods: A cross-sectional study of 260 voluntary participants was conducted. Participants completed self-administered electronic questionnaires. Logistic regression analysis was performed to explore the determinants of burnout. Results: The prevalence of burnout in this study was 78%. Burnout was significantly associated with being a medical intern or community-service medical officer (adjusted odd ratio [AOR] = 6.72, 1.71­26.40), being in the lowest income band (AOR = 10.78, 2.55­45.49), and using alcohol to manage work-related stress (AOR = 3.01, 1.12­8.04). Job-related factors associated with burnout were experiencing high conflict at work (AOR = 5.04, 1.92­13.20) and high role ambiguity and role conflict (AOR = 4.49, 1.98­10.18). Low support at work (AOR = 9.99, 3.66­27.23), medium job satisfaction (AOR = 5.38, 2.65­10.93) and medium support at work (AOR = 3.39, 1.71­6.73) were positively associated with burnout. Participants with medium (AOR = 0.28, 0.10­0.80) and high levels of resilience (AOR = 0.08, 0.03­0.25) were protected against burnout. Coronavirus disease 2019-related factors were not significantly associated with burnout. Conclusion: The burnout prevalence among South African medical doctors at public hospitals during the COVID-19 pandemic was high and strongly associated with job stress factors. Contribution: Given the increased prevalence of burnout among doctors and the strong associations with job stress factors, mitigation of burnout requires targeted organisational interventions.

The Correlates of Post-Traumatic Stress Disorder in Ambulance Personnel and Barriers Faced in Accessing Care for Work-Related Stress.

We investigated factors associated with increased risk for post-traumatic stress disorder (PTSD) in ambulance personnel and the barriers faced in accessing support for work-related stress (WRS). A cross-sectional study of 388 ambulance personnel used self-administered questionnaires to assess for PTSD and level of occupational stressors: Impact of Event Scale-Revised, Emergency Medical Services (EMS) Critical Incident Inventory, EMS Chronic Stress Questionnaire, SF-36 Quality of Life and the Connor-Davidson Resilience Scale. The prevalence of PTSD in the study population was 30%. The participants were predominantly female (55%), with a median age of 38 (IQR; 31-44) years. PTSD was associated with smoking (OR = 1.76, 95% CI: 1.05-2.95), illicit drug use (OR = 16.4, 95% CI: 1.87-143.86) and problem drinking (OR = 3.86, 95% CI: 1.80-8.23). A self-reported mental health condition (OR = 3.76, 95% CI: 1.96-7.21), being treated for a medical condition (OR = 1.95, 95% CI: 1.22-3.11), exposure to critical incident stress (OR = 4.27, 95% CI: 2.24-8.15) and chronic WRS (OR = 4.46, 95% CI: 1.93-10.31) were associated with PTSD risk. Barriers to seeking help included concerns that services were not confidential and the negative impact on the participant's career. The increased levels of WRS, strong associations with substance use and barriers to accessing care offer starting points for workplace interventions to reduce the impact of PTSD in ambulance personnel.