Secondary traumatic stress and burnout in healthcare workers during COVID-19 outbreak

Marzetti, F.; Vagheggini, G.; Conversano, C.; Miccoli, M.; Gemignani, A.; Ciacchini, R.; Panait, E.; Orru, G.

Aims: To assess the level of professional burnout and secondary traumatic stress, and to identify potential risk or protective factors among health care workers (HCWs) during the coronavirus disease 2019 (COVID-19) outbreak. Materials and Methods: This cross-sectional study, based on an online survey, collected demographic data and mental distress outcomes from 184 HCWs from May 1st, 2020, to June,15th, 2020, from 45 different countries. The degree of secondary traumatization was assessed using the Secondary Traumatic Stress Scale (STSS), the degrees of perceived stress and burnout were assessed with Perceived Stress Scale (PSS) and Maslach Burnout Inventory Human Service Survey (MBI-HSS) respectively. Stepwise multiple regression analysis was performed to identify potential risk and protective factors for STS. Results: 184 HCWs (M=90; Age mean: 46.45; SD:11.02) completed the survey. A considerable proportion of HCWs had symptoms of secondary traumatic stress (41.3%), emotional exhaustion (56.0%), and depersonalization (48.9%). The prevalence of secondary traumatic stress in frontline HCWs was 47.5% while in HCWs working in other units it was 30.3% (p<.023); additionally, the prevalence of the same outcome was 67.1% for the HCWs exposed to patients' death and 32.9% for those HCWs which were not exposed to the same condition (p<.001). In stepwise multiple regression analysis, perceived stress, emotional exhaustion and exposure to patients' death remained as significant predictors in the final model for secondary traumatic stress (adjusted R2 =0.537, p<0.001). Conclusions: During the current COVID-19 pandemic, HCWs facing patients' physical pain, psychological suffering, and death are more likely to develop secondary traumatization.