Introduction
Methods
Study selection and criteria for inclusion
Data extraction and quality assessment
Findings
Burnout among physicians
1st author, Year | Country | Study population | Burnout assessment | Reported burnout | Main findings |
---|---|---|---|---|---|
Coker, 2010 [55] | Nigeria | Physicians at a psychiatric hospital (N = 24) | MBI | 12.5% reported burnout on emotional exhaustion, 33.3% on depersonalization, and 25% on low personal accomplishment. 23.6% reported high overall burnout. | 8.3% of physicians also reported high scores on the Psycho-Physiological Symptoms Checklist. |
Liebenberg, 2018 [56] | South Africa | Physicians at rural district hospitals (N = 36) | MBI-HSS | Emotional exhaustion (mean ± SD): 30.5 ± 11.0 Depersonalization: 14.6 ± 6.0 Personal accomplishment: 34.1 ± 6.0 81% reported burnout, with 31% reporting high burnout on all subscales. | Mean scores on the emotional exhaustion and depersonalization subscales were significantly greater than normative scores. Mean personal accomplishment scores did not differ from normative values. |
Lrago, 2018 [57] | Ethiopia | Physicians at public hospitals (N = 491) | MBI-HSS | Emotional exhaustion (mean ± SD): 27.2 ± 8.0 Depersonalization: 12.9 ± 5.3 Personal accomplishment: 25.1 ± 6.6 65.2% reported high emotional exhaustion, 85.1% high depersonalization, and 91% low personal accomplishment. | Age, recognition from hospital managers, monthly salary, and number of patients observed per week were associated with emotional exhaustion (p < 0.05). Monthly salary and working in a primary hospital were associated with personal accomplishment (p < 0.05). Age, working in primary hospital, support from family and organization, monthly salary and professional training were associated with depersonalization (p < 0.05). |
Ogundipe, 2014 [58] | Nigeria | Physicians undergoing residency training in a tertiary hospital (N = 204) | MBI | 45.6% reported burnout on emotional exhaustion, 57.8% on depersonalization, 61.8% on personal accomplishment. | Participants who reported emotional distress were more likely to report burnout (OR = 6.97; 95% CI:3.28–14.81). Those who did not report doctor/doctor conflict were less likely to have depersonalization (OR = 0.36; 95% CI:0.17–0.76). Advanced age (OR = 0.66; 95% CI:0.47–0.95) and adequate support from management (OR = 0.45; 95% CI:0.22–0.90) were protective of burnout subscale of reduced personal accomplishment. |
Opoku, 2014 [59] | Ghana | Physicians from web-based survey (N = 200) | Abbreviated MBI | Emotional exhaustion (mean ± SD): 9.1 ± 2.6 Depersonalization: 5.2 ± 2.1 Personal accomplishment: 5.8 ± 1.6 Total burnout: 20.0 ± 4.5 | Overall career satisfaction (measured using physician work life survey) was negatively associated with emotional exhaustion (β = − 0.178, p < 0.001), low personal accomplishment (β = − 0.126, p < 0.01), and depersonalization (β = − 0.733, p < 0.05). |
Peltzer, 2003 [60] | South Africa | Physicians (N = 402) | MBI | Emotional exhaustion (mean ± SD) 24.2 ± 10.8 Depersonalization: 11.4 ± 6.7 Personal accomplishment: 17.4 ± 6.8 | The job stress index was found to be a predictor for emotional exhaustion (p < 0.001) and depersonalization (p < 0.001) but not personal accomplishment. Sex, age, race, length of service, and marital status were significantly associated with burnout subscales (p < 0.05). |
Rajan, 2018 [61] | South Africa | Physicians working in public sector emergency centers (N = 93) | MBI-HSS | Emotional exhaustion (mean ± SD): 31.7 ± 10.3 Depersonalization: 13.4 ± 6.2 Personal accomplishment: 34.9 ± 6.5 | Sex and relationship status were not significantly associated with burnout scores. There were significantly higher depersonalization scores among physicians in the moderate to high risk group who were less than 40 years of age, compared to those who were 40 years old and above (87% vs 61%, p < 0.05). Those with two or less years of experience had a significantly higher probability of leaving in the next five years compared to those with more experience (62% vs. 39%, p < 0.05). |
Schweitzer, 1994 [62] | South Africa | Junior physicians (N = 126) | One question worded: “Do you ever feel so emotionally exhausted that you feel negative about yourself and about your job and lose the feeling of concern for your patients?” | 77.8% had experienced burnout, 52.4% were experiencing burnout at current job, and 61% experienced burnout at a previous job. | Physician Stress Inventory (PSI) score was significantly higher among participants with burnout (p < 0.001). Doctors who were able to communicate with the majority of patients had lower burnout than those who could not (p = 0.04) and a lower mean PSI score (p = 0.04). |
Stassen, 2013 [63] | South Africa | Advanced life support paramedics (N = 40) | CBI | Work related burnout (mean ± SD): 44.3 ± 16.8 Personal burnout: 48.0 ± 16.7 Patient care related burnout: 35.6 ± 16.2 Overall burnout: 42.9 ± 14.0 38% reported work related burnout, 53% reported personal burnout, 23% reported patient care related burnout, and 30% reported overall burnout . | Burnout was not significantly associated with gender, employment sector, years of experience, or qualifications. |
Stodel, 2011 [64] | South Africa | Junior physicians at a children’s hospital (N = 22) | MBI | Emotional exhaustion (mean ± SD): 37.7 ± 8.9 Depersonalization: 12.6 ± 5.6 Personal accomplishment: 32.1 ± 5.8 | The mean scores on the emotional exhaustion (p = 3.29 × 10− 13) and depersonalization (p = 2.35 × 10− 7) subscales were significantly higher compared to a normative sample. Among surveyed participants, 95% reported an intention to leave the hospital. |
Ugwu, 2019 [65] | Nigeria | Physicians at intensive care units of hospitals (N = 183) | Items that had the highest factor loading on emotional exhaustion (‘I feel burned out from my work’) and depersonalization (‘I have become more callous toward people since I took this job’) | 5.5 ± 1.9 (mean ± SD) | Job burnout was significantly related to recovery from job stressors (p < 0.001), and perceived family cohesion (p < 0.01). |
van der Walt, 2015 [66] | South Africa | Anesthetists at a university hospital (N = 124) and in private practice (N = 86) | MBI-HSS | Among hospital anesthetists, 45.2% reported high emotional exhaustion, 50% reported high depersonalization, and 46% reported low personal accomplishment. Among private practice anesthetists, 20.9% reported high emotional exhaustion, 26.7% reported high depersonalization, and 37.2% reported low personal accomplishment. High burnout was identified in 21% of hospital anesthetists and 8.1% of anesthetists in private practice. | Among anesthetists, burnout was not significantly associated with age, gender, or years of experience. |
Burnout among nurses
1st author, Year | Country | Study population | Burnout assessment | Reported burnout | Main findings |
---|---|---|---|---|---|
Amoo, 2008 [68] | Nigeria | Psychiatric nurses (N = 50) and secondary school teachers (N = 50) | Executive Burnout Scale | Among nurses, Total burnout (mean ± SD): 47.4 ± 12.2 General subscale: 21.3 ± 5.7 Somatic subscale: 16.4 ± 5.9 Interpersonal subscale: 9.9 ± 3.0 | Teachers had significantly higher total job burnout, and burnout on the three subscales (general, somatic, and interpersonal) than nurses (p < 0.05). Burnout was not associated with sex, marital status, age and length of service. No significant difference in job satisfaction was observed between the two groups (p = 0.297). |
Asiedu, 2018 [69] | Ghana | Nurses from public hospitals (N = 134) | MBI-GS | 1.7 ± 0.8 (mean ± SD) | Sex, age, number of older dependents, weekend work, work-to-family conflict and family-to-work conflict were significantly associated with burnout (p < 0.05). Work-to-family conflict and family-to-work conflict accounted for 20% of variance in burnout. |
Buitendach, 2011 [70] | Namibia | Nurses from two private hospitals (N = 191) | MBI-GS | Exhaustion (mean ± SD): 11.3 ± 8.6 Cynicism: 4.6 ± 4.8 Professional efficacy: 25.5 ± 10.5 | Job satisfaction was associated with emotional exhaustion and cynicism. The interaction of problem-focused coping and job satisfaction were significant predictors of emotional exhaustion (p < 0.05) |
Coetzee, 2013 [71] | South Africa | Nurses at private and public national referral hospitals (N = 1187) | Emotional Exhaustion subscale of MBI | 45.8% report high levels of burnout on emotional exhaustion subscale | Nurses with more favorable practice environments were less likely to report high burnout (OR = 0.55; 95% CI: 0.41–0.75). Nurses who worked at public hospitals were more likely to have burnout compared to those at private hospitals (53.8% vs. 40.6%; p < 0.001). |
Davhana-Maselesele, 2008 [72] | South Africa | Nurses caring for HIV-positive and AIDS patients (N = 174) | MBI | Mean for personal accomplishment, emotional exhaustion and depersonalization were 52, 33 and 29%, respectively | High measures of depression, sadness, fatigue and low energy were found among nurses. |
Engelbrecht, 2008 [73] | South Africa | Nurses at clinics and community health centers (N = 542) | MBI-HSS | Emotional exhaustion (mean ± SD): 31.3 ± 9.3 Depersonalization: 17.8 ± 4.9 Personal accomplishment: 20.3 ± 6.8 | Availability of resources, time pressure of workload, and conflict and social relations predicted 21% of the variance in emotional exhaustion and 8% of the variance in depersonalization scores. Availability of resources and time pressure of workload predicted 14% of variance in personal accomplishment. |
Ezenwaji, 2019 [74] | Nigeria | Nurses at hospitals (N = 393) | Oldenburg Burnout Inventory | Mean burnout score of male nurses was 3.2 ± 0.1 and female nurses was 3.2 ± 0.1 | Sex, age, work experience, and work environment were not significantly associated with burnout scores. |
Gandi, 2011 [75] | Nigeria | Nurses at hospitals (N = 373) | MBI-GS | Among men: Emotional exhaustion (mean ± SD):2.3 ± 1.3 Depersonalization: 0.6 ± 0.7 Personal accomplishment: 5.1 ± 1.1 Among women: Emotional exhaustion (mean ± SD): 2.5 ± 1.3 Depersonalization: 0.8 ± 0.9 Personal accomplishment: 5.2 ± 0.8 | Sex was not significantly associated with burnout scores. The relationship between work characteristics and burnout was mediated by work-home interference and home-work interference. |
Gorgens-Ekermans, 2012 [76] | South Africa | Nurses (N = 122) | MBI | Emotional exhaustion (mean ± SD): 13.6 ± 11.0 Depersonalization: 6.6 ± 5.3 Personal accomplishment: 34.1 ± 9.9 | Emotional management and emotional control, as measured by the Swinburne University Emotional Intelligence test, were associated with self-reported stress and burnout subscales (p < 0.01). Workload was a significant predictor of emotional exhaustion (β = 0.547, p = < 0.001) and work/family interface as a source of stress was a significant predictor of depersonalization (β = 0.296, p = 0.004). Emotional intelligence was a moderator of the relationship between stress and burnout, explaining 59.5% of the variance in the emotional exhaustion and 23.9% of the variance in the depersonalization subscale of burnout. |
Heyns, 2003 [77] | South Africa | Nurses caring for patients with Alzheimer’s disease (N = 226) | MBI | Emotional exhaustion (mean ± SD): 14.3 ± 10.3 Depersonalization: 4.5 ± 5.6 Personal accomplishment: 36.3 ± 8.2 26% reported high emotional exhaustion, 21% high depersonalization, and 66% low personal accomplishment. | Sense of Coherence Scale, Fortitude Questionnaire scores, age, years of experience, hours of work, hours of direct attention to patients, qualifications and institution predicted scores on the burnout subscales (p < 0.01). |
Ifeagwazi, 2005 [78] | Nigeria | Nurses from a teaching hospital (N = 91) | MBI | Total burnout (mean ± SD): widowed nurses: 3.1 ± 0.3 married nurses: 2.6 ± 0.5 | Widowed nurses reported significantly higher burnout than married nurses (p < 0.001). There were significant differences between hospital units on mean burnout symptoms reported (p < 0.01), with nurses on the operating theater unit having higher mean burnout scores than nurses on the postnatal, casualty, labor, surgical and out-patient units. Nurses on intensive care unit had higher mean burnout than on the postnatal unit. |
Khamisa, 2015 [79] | South Africa | Nurses from two private and two public hospitals (N = 895) | MBI-HSS | Not reported | Staffing issues explain the highest variance in emotional exhaustion (16%), depersonalization (13%) and personal accomplishment (10%) subscales. Emotional exhaustion and personal accomplishment are associated with somatic symptoms explaining 21% of the variance in general health. In a follow-up survey, lack of support is associated with burnout (OR = 4.37, 95% CI: 2.89–6.62), and patient care is associated with job satisfaction (OR = 2.63, 95% CI: 1.35–5.16) [84]. |
Lasebikan, 2012 [81] | Nigeria | Hospital nurses (N = 270) | MBI | 39.1% had high burnout on the emotional exhaustion subscale, 29.2% in depersonalization and 40.0% on reduced personal accomplishment. | Doctor/nurse conflict (OR = 3.1, 95% CI: 1.9–6.3), inadequate nursing personnel (OR = 2.6, 95% CI: 1.5–5.1), and frequent night duties (OR = 3.1, 95% CI: 1.7–5.6) were predictors of burnout on the emotional exhaustion subscale. Doctor/nurse conflict (OR = 3.4, 95% CI: 2.2–7.6) and frequent night duties (OR = 2.4, 95% CI: 1.5–4.8) were predictors of burnout on the depersonalization subscale. High nursing hierarchy (OR = 2.7, 95% CI: 1.5–4.8), poor wages (OR = 2.9, 95% CI: 1.6–5.6), and frequent night duties (OR = 2.3, 95% CI: 2.3–4.5) were predictors of burnout on the reduced personal accomplishment subscale. |
Levert, 2000 [82] | South Africa | Nurses at psychiatric hospitals (N = 94) | MBI | Emotional exhaustion (mean ± SD): 29.9 ± 12.9 Depersonalization: 9.6 ± 4.6 Personal accomplishment: 19.2 ± 8.3 | Emotional exhaustion was associated with nurses’ workload, lack of support from colleagues, role conflict and role ambiguity (p < 0.05). Personal accomplishment was associated with role conflict (p = 0.015). Depersonalization was associated with work load, lack of support from colleagues, role conflict and role ambiguity (p < 0.05). |
Mashego, 2016 [83] | South Africa | Hospital nurses (N = 83) | ProQOL, burnout subscale | 30.7 ± 5.3 (mean ± SD) | 92% had moderate burnout. Burnout score was not associated with age, marital status, education level, or years of working in the maternity ward. |
Mbambo, 2003 [84] | South Africa | Nurses in a District Health System (N = 60) | Observer coded according to Exhaustion-Disengagement Model | Not reported | Hospital nurses have higher job demands and lower job resources compared to primary healthcare nurses. Hospital nurses run a greater risk of exhaustion and disengagement. |
Mbanga, 2018 [85] | Cameroon | Nurses at state-owned and private hospitals (N = 143) | Oldenburg Burnout Inventory | 38.4 ± 5.7 (mean ± SD) | In univariable regression analyses, being in a relationship was significantly protective, predicting 3.8% of variation in burnout syndrome (p = 0.029). |
Mefoh, 2019 [86] | Nigeria | Nurses at a tertiary healthcare hospital (N = 283) | MBI-HSS | Not reported | Emotion-focused coping was positively associated with burnout subscales of emotional exhaustion (β = 0.32, p = 0.01), and depersonalization (β = 0.18, p = 0.01). Emotion focused coping was not significantly associated with burnout subscale of reduced personal accomplishment (β = − 0.10, p = 0.45). However, the interaction effect of age and emotion-focused coping on reduced personal accomplishment was significant (β = 0.03, p = 0.04). |
Okwaraji, 2014 [87] | Nigeria | Nurses at a tertiary health institution (N = 210) | MBI | 42.9% high emotional exhaustion, 47.6% depersonalization, and 53.8% reduced personal accomplishment. | Burnout was significantly higher among nurses who were women, older than 35 years old, not married, and those with nursing certificates compared to those with nursing degrees or nursing officers (p < 0.01). |
Pienaar, 2011 [88] | South Africa | Nurses from 225 clinics (N = 542) | MBI | Emotional exhaustion (mean ± SD): 31.3 ± 9.3 Depersonalization: 17.8 ± 4.9 Personal accomplishment: 20.3 ± 6.8 | Burnout subscale scores were associated with intention to quit nursing jobs (p < 0.001) |
Roomaney, 2017 [89] | South Africa | Nurses at a large tertiary hospital (N = 110) | MBI | Not reported | Workload, job status, and interpersonal conflict at work significantly explained more than one-third of the variance on the emotional exhaustion subscale of burnout (R2 = 0.39, p = 0.001). Interpersonal conflict, workload, organizational constraints and HIV stigma significantly explained the depersonalization subscale (R2 = 0.33, p = 0.001). Job status and organizational constraints significantly predicted personal accomplishment subscale (R2 = 0.18, p = 0.001). |
van der Colff, 2014 [90] | South Africa | Nurses in private, public, hospital, community, psychiatric and management sectors (N = 818) | MBI | Emotional exhaustion (mean ± SD): 22.2 ± 11.3 Depersonalization: 7.2 ± 5.9 Personal accomplishment: 34.5 ± 7.6 | Exploratory factor analysis resulted in a three-factor structure of burnout. Statistically significant differences were found in burnout levels with regard to language, age, rank, job satisfaction, reciprocity, full-time employment and specialized training (p < 0.01). |
van der Doef, 2012 [91] | Kenya, Tanzania, and Uganda | Nurses in private and public hospitals (N = 309) | MBI | 32.1% reported burnout | In comparison with a reference Dutch population, the East African nurses have higher emotional exhaustion (t = 13.2, p < 0.001) and depersonalization (t = 3.60, p < 0.001). East African nurses had lower scores on personal accomplishment than the reference population (t = 11.34, p < 0.001). Job conditions explain 17% of the variance on the emotional exhaustion subscale. A higher workload (β = −0.21, p < 0.01), lower social support from colleagues (β = − 0.15, p < 0.05) and problems concerning information provision (β = − 0.20, p < 0.001) are associated with higher emotional exhaustion. 7.4% of the variance in personal accomplishment is explained by job conditions. Higher decision latitude (β = − 0.15, p < 0.05) and better interdepartmental cooperation (β = − 0.17, p < 0.05) are associated with higher personal accomplishment. Job conditions fail to explain a significant proportion of the variance on depersonalization. |
van Doorn, 2016 [92] | Nigeria | Nurses at an international health organization (N = 214) | Emotional exhaustion subscale of the MBI | 4.8 ± 1.6 (mean ± SD) | Emotional exhaustion was significantly associated with gender, age, job demands, and lack of supervisor support (p < 0.01). |
van Wijk, 1997 [93] | South Africa | Nurses at military institutions (N = 46) | Not specified | 34% reported a ‘burnout experience’ within the past 3 months | Burnout was more common among registered nurses (46%) compared to enrolled (35%) or assistant nurses (21.4%). Nurses in isolated areas had higher burnout compared to nurses in more populated areas (44 vs. 26%, respectively). Burnout was higher among younger nurses. |
Wilson, 1989 [94] | Zimbabwe | Nurses (N = 83) | MBI | Not reported | Internal-External externality score was significantly related to personal accomplishment subscale (r = −0.24, p < 0.05), depersonalization subscale (r = 0.03, p < 0.05), and total burnout (r = 0.20, p < 0.05) but unrelated to the emotional exhaustion subscale (r = 0.03). |
Burnout among combined populations of healthcare workers
First Author, Year | Country | Study population | Burnout assessment | Reported burnout | Main findings |
---|---|---|---|---|---|
Bhagavathula, 2018 [96] | Ethiopia | Healthcare workers at a teaching hospital (N = 248) | MBI | Emotional exhaustion (mean ± SD): 5.4 ± 1.2 Inefficacy: 5.1 ± 1.7 Cynicism: 4.8 ± 2.0 13.7% reported overall burnout. | Burnout was associated with age (p = 0.008), number of patients treated per day (p < 0.001), and shift work (p < 0.001). In multivariable analyses, sex, marital status, profession, and work experience were significantly associated with burnout subscales (p < 0.01). |
Biksegn, 2016 [97] | Ethiopia | Healthcare workers at a teaching hospital (N = 334) | CBI | 50.3 ± 17.2 (mean ± SD) | Nurses had the highest prevalence (82.8%) of burnout and laboratory technicians had the lowest (2.8%). Job insecurity, history of physical illness, low interest in profession, poor relationship status with managers, worry of contracting infection or illness and physical/verbal abuse were predictors of burnout. |
Bonenberger, 2014 [98] | Ghana | Healthcare workers (N = 256) | Instrument to measure motivation with 7 outcome constructs, including burnout | 3.3 ± 1.0 (mean ± SD) | Motivation and job satisfaction were significantly associated with career development (OR = 0.56, 95% CI: 0.36–0.86), workload (OR = 0.58, 95% CI: 0.34–0.99), management (OR = 0.51, 95% CI: 0.30–0.84), organizational commitment (OR = 0.36, 95% CI: 0.19–0.66), and burnout (OR = 0.59, 95% CI: 0.39–0.91). |
Crabbe, 2004 [99] | South Africa | Healthcare workers in trauma unit of a hospital (N = 38) | MBI | 61% had high emotional exhaustion, 50% high depersonalization, and 50% high reduced personal accomplishment | At least half of respondents reported high professional burnout in all 3 MBI subscales. |
Fiadzo, 1997 [100] | Ghana | Healthcare workers (N = 287) | MBI | Not reported | Study provides support for burnout progression model |
Kim, 2018 [101] | Malawi | Healthcare workers providing clinical care for HIV-positive patients (N = 520) | MBI | 62% met criteria for total burnout, with 55% reporting moderate-high emotional exhaustion, 31% moderate-high depersonalization, and 46% low-moderate personal accomplishment. | Burnout was associated with self-reported suboptimal patient care (OR = 3.22, 95% CI: 2.11–4.90; p < 0.0001) |
Kokonya, 2014 [102] | Kenya | Healthcare workers at a national hospital (N = 345) | Compassion Fatigue Self-Test | 95.4% reported high burnout | 96.7% of medical practitioners and 94.1% of nurses reported high burnout. Burnout was not significantly associated with participants’ sex, age, marital status, religion, education, or number of years as a healthcare provider. |
Kruse, 2009 [103] | Zambia | Healthcare providers (N = 483 active clinical staff completed questionnaire; N = 50 in focus groups, N = 4 interviews) | Occupational burnout measured on 5-item scale | 51% of respondents reported occupational burnout | Occupational burnout was associated with having another job (RR = 1.4, 95% CI: 1.2–1.6) and knowing a co-worker who left in the last year (RR = 1.6, 95% CI: 1.3–2.2). |
Ledikwe, 2018 [104] | Botswana | Healthcare workers at a public health facility (N = 1348) | MBI-GS | Professional efficacy (mean ± SD): 4.9 ± 1.1 Exhaustion: 2.3 ± 1.7 Cynicism: 2.4 ± 1.4 | Overall job satisfaction assessed by the Job In General Scale was significantly higher for healthcare workers who participated in 7 or more activities as part of the Botswana’s Workplace Wellness Program (WWP) compared with those who did not participate in any activities (p = 0.004). Stress levels (p = 0.006), measured on the Stress in General scale, and exhaustion (p < 0.001), measured on the MBI, were significantly lower among those with high participation in WWP activities. |
Madede, 2017 [105] | Mozambique | Healthcare workers (quantitative: N = 92 baseline and 49 post-intervention; N = 17 qualitative interviews) | MBI | At baseline, 67.1% low, 15.9% moderate, and 17.1% high burnout. After intervention, 71.1% low, 17.8% moderate, 11.1% high burnout. | There were no significant differences in emotional exhaustion between baseline and post intervention, for any intervention groups. Job satisfaction, emotional exhaustion and work engagement showed no significant differences between baseline and post intervention. |
McAuliffe, 2009 [106] | Malawi | Healthcare workers in public and private facilities (N = 153) | MBI | 31% reported high emotional exhaustion, 5% reported high depersonalization, and 45% reported low personal accomplishment | The adequate resources subscale of the Health Care Providers Work Index correlates with emotional exhaustion on the MBI. |
Mutale, 2013 [107] | Zambia | Healthcare workers from health facilities (N = 96) | “I feel emotionally drained at the end of the day” and “Sometimes when I get up in the morning, I dread having to face another day at work.” | Not reported | Burnout was higher among women as compared to men in 2 of the 3 districts. Linear regressions showed major determinants of higher motivation were female (p = 0.008) and working in non-clinical areas (for example, pharmacists or laboratory technicians, p = 0.039). |
Ndetei, 2008 [108] | Kenya | Healthcare workers at a psychiatric hospital (N = 121) | MBI-HSS and MBI-GS | Emotional exhaustion (mean ± SD): 17.2 ± 9.8 Depersonalization: 7.3 ± 5.8 Personal accomplishment: 29.3 ± 10.3 | Emotional exhaustion was significantly associated with younger age (p < 0.001), number of children (p = 0.003), number of years worked (p = 0.049), heavy workload (p < 0.001) and low morale (p = 0.001). Depersonalization was significantly associated with heavy workload (p = 0.034). Reduced personal accomplishment was associated with younger age (p = 0.03). |
Nel, 2013 [109] | South Africa | Healthcare workers at public and private hospitals (N = 511) | MBI-HSS | Emotional exhaustion (mean ± SD): 15.2 ± 7.2 Mental distance: 13.6 ± 9.3 | The proposed structural model shows paths between job demands and job resources; job demands, emotional intelligence and work wellness; job resources, emotional intelligence and work wellness. |
Ojedokun, 2013 [110] | Nigeria | Healthcare workers working in AIDs care (N = 242) | MBI | 66.4 ± 21.5 (mean ± SD) | Burnout was significantly associated with aggressive tendency and perceived fear of AIDS (p < 0.01) |
Olley, 2003 [111] | Nigeria | Healthcare workers at a teaching hospital (N = 260) | MBI | Not reported | Nurses reported higher scores on burnout subscales compared to other healthcare providers (p < 0.05). Significant differences were found between nurses and other healthcare providers on the General Health Questionnaire-12 (p < 0.01) and the State Trait Anxiety Inventory (p < 0.05). |
Thorsen, 2011 [112] | Malawi | Healthcare workers in a referral hospital (N = 101) | MBI-HSS | Emotional exhaustion (mean ± SD): 23.1 ± 9.7 Depersonalization: 6.2 ± 4.8 Personal accomplishment: 37.8 ± 7.5 | Sociodemographic characteristics were not associated with the emotional exhaustion subscale of burnout. For the depersonalization and personal accomplishment subscales, number of children was the only significant predictor (p < 0.05). |
Weldegebriel, 2016 [113] | Ethiopia | Healthcare workers at public hospitals (N = 304) | Organizational burnout measured as a subdimension of motivation | 3.6 ± 1.3 (mean ± SD) | Performance review was the only significant predictor of the burnout dimension of motivation. Respondents who never had a performance review conducted had an average decrease of 0.155 units (95% CI: −0.875 to −0.122) in burnout motivation score as compared to those with formal performance assessment. |
Burnout among midwives
First Author, Year | Country | Study population | Burnout assessment | Reported burnout | Main findings |
---|---|---|---|---|---|
Midwives (N = 2) | |||||
Muliira, 2016 [114] | Uganda | Midwives in two rural districts (N = 224) | ProQOL, burnout subscale | 36.9 ± 6.2 (mean ± SD) | Compassion satisfaction was associated with psychological well-being (p < 0.01) and job satisfaction (p < 0.01). Burnout and secondary traumatic stress were associated with education level (p < 0.01), marital status (p < 0.01), involvement in non-midwifery healthcare (p < 0.01), and physical well-being (p < 0.01). |
Rouleau, 2012 [115] | Senegal | Midwives from 22 hospitals (N = 185) | MBI | Emotional exhaustion (mean ± SD): 35.4 ± 9.6 Depersonalization: 11.4 ± 6.1 Personal accomplishment: 39.7 ± 4.8 | Emotional exhaustion was inversely associated with remuneration (p = 0.02) and task satisfaction (p = 0.03). Actively job searching was associated with being dissatisfied with job security (p < 0.01), and voluntary quitting was associated with dissatisfaction with continuing education (p < 0.01). |
Medical and nursing students (N = 7) | |||||
Colby, 2018 [116] | South Africa | Medical students (N = 91) | MBI-HSS | 41.7% had moderate burnout on the depersonalization subscale. 58.2% had high burnout on the personal accomplishment. Equal numbers of participants reported low or high emotional exhaustion (39.6 and 39.6%, respectively). Overall, 46.1% reported high, 33.8% moderate, and 20% low burnout. | There were significant associations between the psychological health subscale of the World Health Organization Quality of Life Assessment and all subscales of the MBI, in particular emotional exhaustion (p < 0.01). |
Gordon, 2016 [117] | South Africa | Oral hygiene students (N = 89) | MBI | Emotional exhaustion (mean ± SD): 3.3 ± 1.8 Depersonalization: 1.3 ± 1.6 Personal accomplishment: 3.7 ± 1.7 | There were significant differences in burnout between 1st, 2nd, and 3rd year students (p = 0.039). |
Mason, 2012 [118] | South Africa | Nursing students (N = 80) | ProQOL, burnout subscale | 63.75% had a moderate to high risk for burnout | Burnout was significantly associated with compassion fatigue and negatively associated with compassion satisfaction (p < 0.01). |
Mathias, 2017 [119] | South Africa | Undergraduate nursing students (N = 67) | ProQOL, burnout subscale | 6% had low levels of burnout, 94% moderate, & none had high burnout | The majority of nursing students experienced average levels of burnout, compassion fatigue, and compassion satisfaction. |
Njim, 2018 [120] | Cameroon | Nursing students (N = 447) | Oldenburg Burnout Inventory | Disengagement (mean ± SD): 17.1 ± 3.1 Exhaustion: 20.9 ± 3.0 | Satisfaction with results and regret with choice of nursing studies were determinants of burnout (p < 0.05) |
Njim, 2019 [121] | Cameroon | Medical students (N = 413) | Oldenburg Burnout Inventory | Disengagement (mean ± SD): 16.6 ± 3.4 Exhaustion: 20.5 ± 3.5 | Marital status, relationship difficulties, cumulative GPA, regretting the choice of medical studies, and recreational drug use significantly predicted burnout (p < 0.05). |
Stein, 2016 [122] | South Africa | Paramedic students (N = 93) | CBI | Work related burnout (mean ± SD): 49.1 ± 12.9 Personal burnout: 53.4 ± 15.0 Patient care related burnout: 34.0 ± 19.5 Overall burnout: 45.2 ± 11.5 31% reported high burnout | There were no significant differences in mean burnout between the 4 academic years of study in work-related, personal, and patient care-related burnout. |