key: cord-0978529-llhat91t authors: Pereira, José Manuel; Cristiana, Silva; Davide, Freitas; Ana, Salgado title: Burnout among Portuguese radiographers during the COVID-19 pandemic date: 2021-05-18 journal: Radiography (Lond) DOI: 10.1016/j.radi.2021.05.001 sha: 114e57950961caf886690e0606651b8ef52c746f doc_id: 978529 cord_uid: llhat91t Introduction The COVID-19 pandemic has had a global impact, including in health services, placing health professionals under enormous tension, pressure, and stress. Professionals involved in the care, diagnosis, and treatment of COVID-19-infected patients have been subject to emotional and physical distress that can potentially enhance the development of occupational diseases. The aim of this study was to assess the impact of the COVID-19 pandemic on the incidence of burnout among Portuguese radiographers. Methods This was a cross-sectional, quantitative study. Burnout levels were estimated using the Maslach Burnout Inventory-Human Services Survey, composed of 22 questions. Specific questions were developed to characterize the socio-demographic situation and the impact of the pandemic on the radiographers. Data were descriptively analyzed and Mann-Whitney and Kruskal-Wallis tests were used for correlation analysis. Results The study sample comprised 386 radiographers, 68.7% of whom where female and 31.3% male. The mean sample age was 36.3(±9.1) years. A total of 43.5% and 45.5% of subjects had a high level of emotional exhaustion and depersonalization, respectively, and 59.8% experienced low personal accomplishment. Altogether, 23.3% of study participants were at high risk of burnout in the three dimensions assessed and 77.2% in at least one. Conclusion Study results showed that radiographers were at high risk of developing burnout in the COVID-19 pandemic setting. Health institutions should actively monitor these professional’s mental health and develop restorative strategies that enable their emotional wellbeing, preventing absenteeism and increasing patients’ quality of care. Implications for practice Burnout of health professionals has a strong impact on health services organization, resulting in increased absenteeism and error probability, frequent work delays, low productivity and job satisfaction, inter- and intra-professional conflicts, high job turnover, high job quit, and decreased quality of care perceived by users. On March 2, 2020, with confirmation of the first COVID-19 case in Portugal, the country had to quickly adjust to the pandemic contingencies 1 . Due to its high transmissibility and mortality in certain risk groups, 2 According to the World Health Organization (WHO), 8096 individuals had SARS between November 8, 2002 and July 21, 2003 5 , 774 of whom died, resulting in a 9.6% mortality rate 6 . A high level of psychological stress was identified in health professionals caring for patients during that outbreak, related to feelings of vulnerability, concern for one's health and for the health of relatives and friends, The psychological impact on health professionals when dealing with COVID-19 patients may lead to pathological conditions 8 , including burnout 3,9 . Radiographers are one of the professional groups actively participating in these patients' management 9 . Burnout is a syndrome characterized by high emotional exhaustion (EE), depersonalization (DP), and low personal accomplishment (PA) resulting from professional activity 10 . It generally starts with emotional overload caused by everyday events occurring in the workplace, which induce feelings of wear off and energy loss. To cope with the emotional distress, health professionals tend to adopt a set of attitudes that promote emotional distance from J o u r n a l P r e -p r o o f patients, treating them with indifference and depersonalization 10,11 . This emotional turmoil is perceived by the individual as failure in professional competence, leading to reduced PA 10, 11 . The aim of this study was to evaluate the impact of the COVID-19 pandemic on the incidence of burnout among Portuguese radiographers. This was a cross-sectional, quantitative study of the incidence of burnout among radiographers during the COVID-19 pandemic. Data was collected through an online questionnaire that was disseminated to radiographers working in Portugal through professional associations and social and digital platforms between items divided into three-dimensional subscales. Participants were instructed to rate items using a 7-point Likert scale (with zero meaning "never" and six meaning "every day") 11 . Each dimension was classified as high, moderate, or low, according to the final score and cut-off-values 13 presented in Table 1 . Data were analyzed using SPSS-26 (IBM, USA). Quantitative variables were described using measures of central tendency and dispersion and qualitative variables through their absolute and relative frequencies. An association analysis was performed between scores obtained in each dimension and the remaining variables, through the application of the non-parametric Mann-Whitney and Kruskal-Wallis tests, whenever appropriate, and using an α=0.05 significance level. Participants were asked to rate some aspects related to this using a 10-point scale, in which 1 corresponded to 'weak' and 10 to 'excellent' ( Table 3) . The increased viral contagion introduced an additional concern to health professionals, both due to the risk of acquiring the disease and to the possibility of being a vehicle of virus spread. Infection prevention and control committees can play a key role, by providing clear, accurate, and timely information on how health professionals should proceed to be able to return to their families and on social strategies they can adopt at home to minimize contagion risk 3 . Having periodic meetings with team leaders to discuss the problems that most concern radiographers and develop joint solutions to tackle them represents an important inter-peer support strategy 20 . Defining multidisciplinary teams which include mental health professionals responsible for accompanying professionals and developing restorative strategies is key for prevention of mental health issues 21,24,30 . The main limitation of this study is its sample size. Even so, its results can serve as an indicator of the current national situation and should be analyzed jointly with data retrieved from other health professionals. This study's results point to a high risk of burnout among radiographers, with almost 80% presenting a high score in at least one of the dimensions assessed. SARS-CoV-2 / COVID-19:Relatório da Situação nº1. Sitio da Direção Geral da Saúde: Direção Geral da Saúde Clinical course and risk factors for Prevention of burnout: New perspectives Applied & Preventive Psychology Quando o trabalho ameaça o bem-estar do trabalhador High rates of burnout among maternal health staff at a referral hospital in Malawi: A crosssectional study Relatório Social do Ministério da Saúde e do Serviço Nacional de Saúde 2018: Ministério da Saúde Registados 3.681 profissionais de saúde infetados com Covid-19 Understanding the burnout experience: recent research and its implications for psychiatry Risco de burnout nos técnicos de radiologia das unidades de saúde do Porto Estudo do stress nos técnicos de radiologia. TDT Online Magazine Stress relacionado com o trabalho e burnout em técnicos de radiologia The authors thank the National Associations that represent the Portuguese Radiographers and participated in the dissemination of the questionnaire for this study, NUCLIRAD, ATARP and APIMR. This research received no specific grant from funding agencies in the public, commercial, or not-for-profit sectors.