The Prevalence of Nurses’ Emotional Exhaustion during COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Rana Alaseeri; Omar Ghazi Baker; Maram Banakhar

doi:10.14710/nmjn.v13i1.46399

DOI: https://doi.org/10.14710/nmjn.v13i1.46399

The Prevalence of Nurses’ Emotional Exhaustion during COVID-19 Pandemic: A Systematic Review and Meta-Analysis

*Rana Alaseeri

- Nursing College, King Saud University, Saudi Arabia

Omar Ghazi Baker

- Community, Psychiatric & Mental Health Nursing Department, College of Nursing, King Saud University, Saudi Arabia

Maram Banakhar

- Public Health Nursing Department, King Abdulaziz University, Saudi Arabia

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

BibTex Citation Data :

@article{NMJN46399,
    author = {Rana Alaseeri and Omar Baker and Maram Banakhar},
    title = {The Prevalence of Nurses’ Emotional Exhaustion during COVID-19 Pandemic: A Systematic Review and Meta-Analysis},
    journal = {Nurse Media Journal of Nursing},
  volume = {13},
    number = {1},
    year = {2023},
    keywords = {Burnout; COVID-19; emotional exhaustion; nurses},
    abstract = {  Background:  Nurses in many countries face a high prevalence of psychological pressure while caring for COVID-19 patients. Several determinants of emotional exhaustion leading to occupational burnout risk were documented. However, a recent review examining nurses’ emotional exhaustion during the COVID-19 pandemic is lacking in nursing literature.   Purpose:  This review aimed to examine the prevalence of nurses’ emotional exhaustion during the COVID-19 pandemic. This review also describes the organizational contributing factors to nurses’ emotional exhaustion.   Methods:  A systematic review and meta-analysis of the literature following the PRISMA guidelines was conducted in March 2022. Four databases, including PubMed, ProQuest Platform, Wiley, and Google Scholar, were searched from 1 January 2020 to 28 February 2022. The prevalence of nurses’ emotional exhaustion (EE) was pooled using random effect meta‐analyses. The quality appraisal of the studies was done using the Joanna Briggs Institute (JBI) checklist. Data analysis utilized a random effect model to evaluate the pooled effects of the studies due to the high heterogeneity between results.   Results:  Nine studies were included with a total number of 16,810 subjects surveyed, of whom, 8,150 (48.50%) met the criteria for emotional exhaustion. Based on the standard effect model, the pooled estimate for EE prevalence was 48.9% (95% CI:48.1% to 49.6%). Several organizational factors contributing to nurses’ emotional exhaustion included working in critical care units or isolation wards, longer working hours in COVID-19 quarantine units, night shifts, working with confirmed or suspected co-workers, monthly salary income, and inadequate hospital resources.  Conclusion:  This review found that nurses were suffering from high to moderate emotional exhaustion levels during the COVID-19 pandemic. Furthermore, several organizational factors influence this emotional exhaustion. These findings highlight the necessity for urgent interventions to decrease psychological impacts on frontline nurses.},
   issn = {2406-8799},   pages = {95--108}  doi = {10.14710/nmjn.v13i1.46399},
    url = {https://ejournal.undip.ac.id/index.php/medianers/article/view/46399}
}

Citation Format:

Abstract

Background: Nurses in many countries face a high prevalence of psychological pressure while caring for COVID-19 patients. Several determinants of emotional exhaustion leading to occupational burnout risk were documented. However, a recent review examining nurses’ emotional exhaustion during the COVID-19 pandemic is lacking in nursing literature.

Purpose: This review aimed to examine the prevalence of nurses’ emotional exhaustion during the COVID-19 pandemic. This review also describes the organizational contributing factors to nurses’ emotional exhaustion.

Methods: A systematic review and meta-analysis of the literature following the PRISMA guidelines was conducted in March 2022. Four databases, including PubMed, ProQuest Platform, Wiley, and Google Scholar, were searched from 1 January 2020 to 28 February 2022. The prevalence of nurses’ emotional exhaustion (EE) was pooled using random effect meta‐analyses. The quality appraisal of the studies was done using the Joanna Briggs Institute (JBI) checklist. Data analysis utilized a random effect model to evaluate the pooled effects of the studies due to the high heterogeneity between results.

Results: Nine studies were included with a total number of 16,810 subjects surveyed, of whom, 8,150 (48.50%) met the criteria for emotional exhaustion. Based on the standard effect model, the pooled estimate for EE prevalence was 48.9% (95% CI:48.1% to 49.6%). Several organizational factors contributing to nurses’ emotional exhaustion included working in critical care units or isolation wards, longer working hours in COVID-19 quarantine units, night shifts, working with confirmed or suspected co-workers, monthly salary income, and inadequate hospital resources.

Conclusion: This review found that nurses were suffering from high to moderate emotional exhaustion levels during the COVID-19 pandemic. Furthermore, several organizational factors influence this emotional exhaustion. These findings highlight the necessity for urgent interventions to decrease psychological impacts on frontline nurses.

Fulltext View|Download

Keywords: Burnout; COVID-19; emotional exhaustion; nurses

Article Metrics:

Article Info

Section: Articles

Language : EN

In Vol 13, No 1 (2023): (April 2023)

Recent articles

Effects of Patient and Family-Centered Care on Quality of Care in Pediatric Patients: A Systematic Review Filipino Nursing Students’ Health Promoting Behaviors during Pandemic Health Care Providers’ Perceptions of the Ministry of Health’s Organizational Readiness for Change Editorial Back Matter Editorial Front Matter More recent articles

Most cited articles

A Systematic Review of the Selected Evidences on the Effectiveness of Inter-professional Education (IPE) in Developing Interprofessional Learning Environment PERAN SERTA KELUARGA PADA LANSIA YANG MENGALAMI POST POWER SYNDROME Review: Factors Relating to Nurses’ Caring Behaviors for Dying Patients Music and Music Intervention for Therapeutic Purposes in Patients with Ventilator Support; Gamelan Music Perspective Purpose, Quality, and Value in Critical Realist Research within Nurse Education More cited articles

Ahola, K., Toppinen-Tanner, S., & Seppänen, J. (2017). Interventions to alleviate burnout symptoms and to support return to work among employees with burnout: Systematic review and meta-analysis. Burnout Research, 4, 1–11. https://doi.org/10.1016/j.burn.2017.02.001
Ahorsu, D. K., Lin, C., Marznaki, Z. H., & Pakpour, A. (2021). The association between fear of COVID‐19 and mental health: The mediating roles of burnout and job stress among emergency nursing staff. Nursing Open, 9(2), 1147–1154. https://doi.org/10.1002/nop2.1154
Aiken, L. H., Sermeus, W., Van den Heede, K., Sloane, D. M., Busse, R., McKee, M., Bruyneel, L., Rafferty, A. M., Griffiths, P., Moreno-Casbas, M. T., Tishelman, C., Scott, A., Brzostek, T., Kinnunen, J., Schwendimann, R., Heinen, M., Zikos, D., Sjetne, I. S., Smith, H. L., & Kutney-Lee, A. (2012). Patient safety, satisfaction, and quality of hospital care: Cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ, 344(2), e1717–e1717. https://doi.org/10.1136/bmj.e1717
Al Maqbali, M., Al Sinani, M., & Al-Lenjawi, B. (2021). Prevalence of stress, depression, anxiety and sleep disturbance among nurses during the COVID-19 pandemic: A systematic review and meta-analysis. Journal of Psychosomatic Research, 141, 110343. https://doi.org/10.1016/j.jpsychores.2020.110343
Al-Rabiaah, A., Temsah, M.-H., Al-Eyadhy, A. A., Hasan, G. M., Al-Zamil, F., Al-Subaie, S., Alsohime, F., Jamal, A., Alhaboob, A., Al-Saadi, B., & Somily, A. M. (2020). Middle East Respiratory Syndrome-Corona Virus (MERS-CoV) associated stress among medical students at a university teaching hospital in Saudi Arabia. Journal of Infection and Public Health, 13(5), 687–691. https://doi.org/10.1016/j.jiph.2020.01.005
Bandyopadhyay, S., Baticulon, R. E., Kadhum, M., Alser, M., Ojuka, D. K., Badereddin, Y., Kamath, A., Parepalli, S. A., Brown, G., Iharchane, S., Gandino, S., Markovic-Obiago, Z., Scott, S., Manirambona, E., Machhada, A., Aggarwal, A., Benazaize, L., Ibrahim, M., Kim, D., & Tol, I. (2020). Infection and mortality of healthcare workers worldwide from COVID-19: a systematic review. BMJ Global Health, 5(12), e003097. https://doi.org/10.1136/bmjgh-2020-003097
Bao, Y., Sun, Y., Meng, S., Shi, J., & Lu, L. (2020). 2019-nCoV epidemic: Address mental health care to empower society. The Lancet, 395(10224), e37–e38. https://doi.org/10.1016/S0140-6736(20)30309-3
Bellanti, F., Lo Buglio, A., Capuano, E., Dobrakowski, M., Kasperczyk, A., Kasperczyk, S., Ventriglio, A., & Vendemiale, G. (2021). Factors related to nurses’ burnout during the first wave of Coronavirus Disease-19 in a university hospital in Italy. International Journal of Environmental Research and Public Health, 18(10), 5051. https://doi.org/10.3390/ijerph18105051
Chen, R., Sun, C., Chen, J., Jen, H., Kang, X. L., Kao, C., & Chou, K. (2020). A large‐scale survey on trauma, burnout, and posttraumatic growth among nurses during the COVID‐19 Pandemic. International Journal of Mental Health Nursing, 30(1), 102-116. https://doi.org/10.1111/inm.12796
Clinton, M., Bou-Karroum, K., Doumit, M. A., Richa, N., & Alameddine, M. (2022). Determining levels of nurse burnout during the COVID-19 pandemic and Lebanon’s political and financial collapse. BMC Nursing, 21(1), 11. https://doi.org/10.1186/s12912-021-00789-8
Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020). Burnout in nursing: A theoretical review. Human Resources for Health, 18(1), 1–17. https://doi.org/10.1186/s12960-020-00469-9
Galanis, P., Vraka, I., Fragkou, D., Bilali, A., & Kaitelidou, D. (2021). Nurses’ burnout and associated risk factors during the COVID‐19 pandemic: A systematic review and meta‐analysis. Journal of Advanced Nursing, 77(8), 3286–3302. https://doi.org/10.1111/jan.14839
Hu, D., Kong, Y., Li, W., Han, Q., Zhang, X., Zhu, L. X., Wan, S. W., Liu, Z., Shen, Q., Yang, J., He, H.-G., & Zhu, J. (2020). Frontline nurses’ burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: A large-scale cross-sectional study. Eclinical Medicine, 24, 100424. https://doi.org/10.1016/j.eclinm.2020.100424
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.‏
JBI. (2021). Critical appraisal tools | Joanna Briggs Institute. Jbi.global. https://jbi.global/critical-appraisal-tools
Joo, J. Y., & Liu, M. F. (2021). Nurses’ barriers to caring for patients with COVID‐19: a qualitative systematic review. International Nursing Review, 68(2), 202–213. https://doi.org/10.1111/inr.12648
Jose, S., Dhandapani, M., & Cyriac, M. C. (2020). Burnout and resilience among frontline nurses during COVID-19 pandemic: A cross-sectional study in the Emergency Department of a Tertiary Care Center, North India. Indian Journal of Critical Care Medicine, 24(11), 1081–1088. https://doi.org/10.5005/jp-journals-10071-23667
Kabakleh, Y., Zhang, J., Lv, M., Li, J., Yang, S., Swai, J., & Li, H.-Y. (2020). Burnout and associated occupational stresses among Chinese nurses: A cross-sectional study in three hospitals. PLOS ONE, 15(9), e0238699. https://doi.org/10.1371/journal.pone.0238699
Kakemam, E., Chegini, Z., Rouhi, A., Ahmadi, F., & Majidi, S. (2021). Burnout and its relationship to self‐reported quality of patient care and adverse events during COVID‐19: A cross‐sectional online survey among nurses. Journal of Nursing Management, 29(7), 1974–1982. https://doi.org/10.1111/jonm.13359
Kang, L., Li, Y., Hu, S., Chen, M., Yang, C., Yang, B. X., Wang, Y., Hu, J., Lai, J., Ma, X., Chen, J., Guan, L., Wang, G., Ma, H., & Liu, Z. (2020). The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. The Lancet Psychiatry, 7(3), e14. https://doi.org/10.1016/S2215-0366(20)30047-X
Lee, H.-F., Kuo, C.-C., Chien, T.-W., & Wang, Y.-R. (2016). A meta-analysis of the effects of coping strategies on reducing nurse burnout. Applied Nursing Research, 31, 100–110. https://doi.org/10.1016/j.apnr.2016.01.001
Liu, Q., Shen, D., Chen, S., & Liu, J. (2020). Supporting frontline nurses during the fight against COVID-19. Journal of the American Psychiatric Nurses Association, 26(6), 525-526. https://doi.org/10.1177/1078390320946825
Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., & Stewart, L. A. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4(1). https://doi.org/10.1186/2046-4053-4-1
Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V. G., Papoutsi, E., & Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia among healthcare workers during the covid-19 pandemic: A systematic review and meta-analysis. Brain, Behavior, And Immunity, 88, 901–907. https://doi.org/10.1016/j.bbi.2020.05.026
Sagherian, K., Steege, L. M., Cobb, S. J., & Cho, H. (2020). Insomnia, fatigue and psychosocial well‐being during COVID‐19 pandemic: A cross‐sectional survey of hospital nursing staff in the United States. Journal of Clinical Nursing. 10.1111/jocn.15566. https://doi.org/10.1111/jocn.15566
Salari, N., Khazaie, H., Hosseinian-Far, A., Ghasemi, H., Mohammadi, M., Shohaimi, S., Daneshkhah, A., Khaledi-Paveh, B., & Hosseinian-Far, M. (2020). The prevalence of sleep disturbances among physicians and nurses facing the COVID-19 patients: A systematic review and meta-analysis. Globalization and Health, 16(1), 1-14. https://doi.org/10.1186/s12992-020-00620-0
Susila, I. M. D. P., & Laksmi, I. A. A. (2022). Prevalence and associated factors of burnout risk among emergency nurses during COVID-19 pandemic. Babali Nursing Research, 3(1), 7–14. https://doi.org/10.37363/bnr.2022.3169
Wan, Z., Lian, M., Ma, H., Cai, Z., & Xianyu, Y. (2022). Factors associated with burnout among Chinese nurses during COVID-19 epidemic: A cross-sectional study. BMC Nursing, 21(1). https://doi.org/10.1186/s12912-022-00831-3
WHO. (2022). WHO COVID-19 dashboard. World Health Organization. https://covid19.who.int/
World Health Organization: WHO. (2021, October 20). Health and care worker deaths during COVID-19. Who.int; World Health Organization: WHO. https://www.who.int/news/item/20-10-2021-health-and-care-worker-deaths-during-covid-19
Zhan, Y., Ma, S., Jian, X., Cao, Y., & Zhan, X. (2020). The current situation and influencing factors of job stress among frontline nurses assisting in Wuhan in fighting COVID-19. Frontiers in Public Health, 8, 579866. https://doi.org/10.3389/fpubh.2020.579866
Zhang, L., Chai, L., Zhao, Y., Wang, L., Sun, W., Lu, L., Lu, H., & Zhang, J. (2021). Burnout in nurses during the COVID-19 pandemic in China: New challenges for public health. Bioscience Trends, 15(2), 129–131. https://doi.org/10.5582/bst.2021.01099
Zhang, X., Song, Y., Jiang, T., Ding, N., & Shi, T. (2020). Interventions to reduce burnout of physicians and nurses. Medicine, 99(26), e20992. https://doi.org/10.1097/md.0000000000020992
Zhou, L.-L., Zhang, S.-E., Liu, J., Wang, H.-N., Liu, L., Zhou, J.-J., Bu, Z.-H., Gao, Y.-F., Sun, T., & Liu, B. (2022). Demographic factors and job characteristics associated with burnout in chinese female nurses during controlled COVID-19 period: A cross-sectional study. Frontiers in Public Health, 9, 757113. https://doi.org/10.3389/fpubh.2021.757113

Last update:

No citation recorded.

Last update: 2024-11-01 05:22:11

No citation recorded.

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Journal Author(s) Rights

In order for the Department of Nursing, Faculty of Medicine, Universitas Diponegoro to publish and disseminate research articles, we need non-exclusive publishing rights (transferred from the author(s) to the publisher). This is determined by a publishing agreement between the author(s) and the Department of Nursing, Faculty of Medicine, Universitas Diponegoro. This agreement involves the transfer or licensing of the copyright for publishing to the publisher, while authors still retain significant rights to use and share their own published articles. The Department of Nursing, Faculty of Medicine, Universitas Diponegoro supports the need for authors to share, disseminate, and maximize the impact of their research through these rights in any databases.

As the author(s), you have rights to a wide range of uses of your article, including use by your employing institution or company. These author rights can be exercised without the need to obtain specific permission. Authors publishing in the Nurse Media Journal of Nursing have extensive rights to use their works for teaching and scholarly purposes without needing to seek permission, including:

use for classroom teaching by the author or the author’s institution and presentation at a meeting or conference, including distributing copies to attendees;
use for internal training by the author’s company;
distribution to colleagues for their research use;
use in a subsequent compilation of the author’s works;
inclusion in a thesis or dissertation;
reuse of portions or extracts from the article in other works (with full acknowledgment of the final article);
preparation of derivative works (other than for commercial purposes) (with full acknowledgment of the final article);
voluntary posting on open websites operated by the author or the author’s institution for scholarly purposes;

following the open access license of the Creative Commons CC BY-SA License.

Authors, readers, and third parties can copy and redistribute the material in any medium or format, as well as remix, transform, and build upon the material for any purpose, even commercially, but they must give appropriate credit (including the name of the creator and attribution parties, detailed information about the authors, a copyright notice, an open access license notice, a disclaimer notice, and a link to the material), provide a link to the license, and indicate if changes were made. The publisher will indicate any modification of the material (if any) and retain an indication of previous modifications using a CrossMark Policy and information about Erratum-Corrigendum notifications.

Authors, readers, and third parties can read, print, and download, redistribute or republish the article (e.g., display it in a repository), translate the article, download it for text and data mining purposes, reuse portions or extracts from the article in other works, sell or reuse it for commercial purposes, remix, transform, or build upon the material. They must distribute their contributions under the same license as the original Creative Commons Attribution-ShareAlike (CC BY-SA).

Copyright Transfer Agreement for Publishing (Publishing Right)

The Authors submitting a manuscript do so on the understanding that if accepted for publication, non-exclusive right for publishing (publishing right) of the article shall be assigned/transferred to Publisher of the Nurse Media Journal of Nursing (Department of Nursing, Faculty of Medicine, Universitas Diponegoro).

Upon acceptance of an article, authors will be asked to complete a 'Copyright Transfer Agreement for Publishing (CTAP)'. An e-mail will be sent to the Corresponding Author confirming receipt of the manuscript together with a 'Copyright Transfer Agreement for Publishing' form by online version of this agreement.

Nurse Media Journal of Nursing and Department of Nursing, Faculty of Medicine, Universitas Diponegoro, the Editors and the Editorial Board make every effort to ensure that no wrong or misleading data, opinions or statements be published in the journal. In any way, the contents of the articles and advertisements published in the Nurse Media Journal of Nursing are sole and exclusive responsibility of their respective authors and advertisers.

Please note that even though we ask for a transfer of copyright for publishing (CTAP), our journal Author(s) retain (or are granted back) significant scholarly rights as mentioned before.

The Copyright Transfer Agreement for Publishing (CTAP) Form can be downloaded here: [Copyright Transfer Agreement for Publishing (CTAP) Form NMJN 2024]

The copyright form should be signed electronically and send to the Editorial Office in the form of original e-mail below:

Dr. Meira Erawati (Editor-in-Chief)
Editorial Office of Nurse Media Journal of Nursing
Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Jl. Prof. Soedarto, Tembalang, Semarang, Central Java, Indonesia 50275
Telp.: +62-24-76480919; Fax.: +62-24-76486849
E-mail: media_ners@live.undip.ac.id

(This policy statements has been updated at 24th January 2024)

The Prevalence of Nurses’ Emotional Exhaustion during COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Journal Author(s) Rights

Copyright Transfer Agreement for Publishing (Publishing Right)

OFFICE INFORMATION