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BMC public health
Oct 22, 2019;19 (1): 1337.

Burnout among healthcare providers in the complex environment of the Middle East: a systematic review.

Z Chemali, F L Ezzeddine, B Gelaye, M L Dossett, J Salameh, M Bizri, B Dubale, G Fricchione
Author Information
  1. Z Chemali: Departments of Neurology and Psychiatry, Massachusetts General Hospital, Boston, MA, USA. zelchemali@mgh.harvard.edu. ORCID
  2. F L Ezzeddine: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  3. B Gelaye: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  4. M L Dossett: Benson-Henry Institute for Mind Body Medicine and, Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA.
  5. J Salameh: Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
  6. M Bizri: Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon.
  7. B Dubale: Department of Psychiatry, Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia.
  8. G Fricchione: Department of Psychiatry, Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA, USA.
PMID: 31640650 DOI: 10.1186/s12889-019-7713-1

Abstract

BACKGROUND: Burnout is a syndrome characterized by emotional exhaustion, increased depersonalization, and a diminished sense of personal accomplishment due to chronic emotional stress at work. Burnout impacts job satisfaction, job performance, vulnerability to illnesses, and interpersonal relationships. There is a gap in the systematic data on the burden of burnout among healthcare professionals from different sectors of healthcare in Middle Eastern countries. Our objective was to examine the burden of burnout among healthcare providers in the Middle East, how it was assessed, which sectors were included, and what interventions have been used.
METHODS: Articles were found through a systematic review of search results including PubMed, Web of Science (Thomson Reuters), and PsycINFO (EBSCO) using search terms reflecting burnout in Middle Eastern countries among populations of healthcare providers. Studies were included if they examined a quantitative measure of burnout among healthcare providers in the Middle East.
RESULTS: There were 138 articles that met our inclusion criteria for this systematic review. Studies focused on burnout in the Middle East among physicians (N = 54 articles), nurses (N = 55), combined populations of healthcare workers (N = 22), and medical students (N = 7). The Maslach Burnout Inventory was the most common tool to measure burnout. Burnout is common among physicians, nurses, and other healthcare professionals, with prevalence estimates predominantly ranging between 40 and 60%. Burnout among healthcare providers in the Middle East is associated with characteristics of their work environments, exposure to violence and terror, and emotional distress and low social support.
CONCLUSIONS: Burnout is highly prevalent among healthcare providers across countries in the Middle East. Previous studies examining burnout in this region have limitations in their methodology. More thoroughly developed epidemiologic studies of burnout are necessary. Health system strengthening is needed in a region that has endured years of ongoing conflict, and there is an urgency to design and implement programs that tackle burnout among health professionals.

Keywords

Burnout Health personnel Middle East

References

  1. Sultan Qaboos Univ Med J. 2013 May;13(2):287-95 [PMID: 23862036]
  2. East Mediterr Health J. 2006 Sep;12(5):662-9 [PMID: 17333807]
  3. Appl Nurs Res. 2017 Apr;34:40-47 [PMID: 28342622]
  4. Am J Forensic Med Pathol. 2017 Sep;38(3):184-188 [PMID: 28691950]
  5. Cureus. 2017 Nov 25;9(11):e1877 [PMID: 29383297]
  6. Southeast Asian J Trop Med Public Health. 2015 Mar;46(2):330-8 [PMID: 26513936]
  7. Ulus Travma Acil Cerrahi Derg. 2015 May;21(3):175-81 [PMID: 26033649]
  8. Nurs Ethics. 2013 Jun;20(4):436-47 [PMID: 23411368]
  9. Int J Evid Based Healthc. 2012 Jun;10(2):126-41 [PMID: 22672602]
  10. Work. 2006;27(1):67-74 [PMID: 16873982]
  11. BMC Health Serv Res. 2014 Jun 13;14:254 [PMID: 24927847]
  12. J Occup Health. 2010;52(1):58-65 [PMID: 19907108]
  13. Asia Pac J Oncol Nurs. 2014 Apr-Jun;1(1):33-39 [PMID: 27981080]
  14. Iran J Psychiatry. 2011 Spring;6(2):70-4 [PMID: 22952525]
  15. Eur J Cancer Care (Engl). 2008 Nov;17(6):524-31 [PMID: 18771533]
  16. Afr J Psychiatry (Johannesbg). 2009 Feb;12(1):71-4 [PMID: 19526650]
  17. Arch Environ Occup Health. 2019;74(3):130-139 [PMID: 29116906]
  18. J Pak Med Assoc. 2015 Feb;65(2):183-91 [PMID: 25842556]
  19. Acad Psychiatry. 2018 Apr;42(2):288-296 [PMID: 29396837]
  20. Iran J Public Health. 2013 Sep;42(9):1034-42 [PMID: 26060665]
  21. Arch Environ Occup Health. 2014;69(3):159-66 [PMID: 24325746]
  22. J Nurs Manag. 2006 May;14(4):289-99 [PMID: 16629843]
  23. East Mediterr Health J. 2016 Mar 15;21(12):906-15 [PMID: 26996364]
  24. J Nurs Manag. 2016 Mar;24(2):235-43 [PMID: 25900394]
  25. J Interprof Care. 2018 Sep;32(5):621-628 [PMID: 29764248]
  26. J Occup Med Toxicol. 2008 Dec 05;3:32 [PMID: 19061497]
  27. Iran J Nurs Midwifery Res. 2016 Jul-Aug;21(4):424-9 [PMID: 27563328]
  28. J Clin Diagn Res. 2016 Apr;10(4):IC01-IC04 [PMID: 27190832]
  29. J Eval Clin Pract. 2016 Feb;22(1):86-92 [PMID: 26563562]
  30. JAMA. 2002 Oct 23-30;288(16):1987-93 [PMID: 12387650]
  31. BMC Health Serv Res. 2012 Nov 22;12:419 [PMID: 23173905]
  32. Int Nurs Rev. 2008 Mar;55(1):62-7 [PMID: 18275537]
  33. J Perianesth Nurs. 2017 Jun;32(3):238-244 [PMID: 28527553]
  34. J Surg Educ. 2015 Sep-Oct;72(5):844-8 [PMID: 25921188]
  35. J Nurs Manag. 2016 Oct;24(7):923-933 [PMID: 27271021]
  36. Pan Afr Med J. 2014 Jun 19;18:164 [PMID: 25422682]
  37. Electron Physician. 2016 Sep 20;8(9):2924-2930 [PMID: 27790345]
  38. Health Care Manage Rev. 2001 Winter;26(1):7-19 [PMID: 11233355]
  39. Saudi J Anaesth. 2012 Jan;6(1):46-51 [PMID: 22412777]
  40. Iran J Nurs Midwifery Res. 2012 Nov;17(7):524-9 [PMID: 23922600]
  41. Cah Sociol Demogr Med. 2010 Oct-Dec;50(4):501-15 [PMID: 21375150]
  42. Int J Nurs Stud. 2003 Nov;40(8):807-27 [PMID: 14568363]
  43. Niger J Clin Pract. 2018 Jul;21(7):875-881 [PMID: 29984719]
  44. Int J Environ Res Public Health. 2018 Dec 10;15(12): [PMID: 30544672]
  45. Curr Opin Anaesthesiol. 2015 Apr;28(2):151-8 [PMID: 25695803]
  46. Iran J Nurs Midwifery Res. 2014 Jul;19(4):360-5 [PMID: 25183975]
  47. Asian Pac J Cancer Prev. 2018 Aug 24;19(8):2135-2139 [PMID: 30139216]
  48. Nurs Health Sci. 2009 Dec;11(4):410-6 [PMID: 19909450]
  49. PLoS One. 2018 Nov 12;13(11):e0206840 [PMID: 30418984]
  50. Nurs Health Sci. 2009 Sep;11(3):263-70 [PMID: 19689634]
  51. Nurs Health Sci. 2010 Dec;12(4):444-9 [PMID: 21210922]
  52. Int J Adolesc Med Health. 2018 Mar 3;32(3): [PMID: 29500920]
  53. Mayo Clin Proc. 2015 Dec;90(12):1600-13 [PMID: 26653297]
  54. Nurs Ethics. 2002 May;9(3):269-78 [PMID: 12035432]
  55. Ren Fail. 2014 Aug;36(7):1038-42 [PMID: 24831740]
  56. Int J Health Care Qual Assur. 2014;27(3):223-30 [PMID: 25786186]
  57. J Hum Ergol (Tokyo). 2001 Dec;30(1-2):357-62 [PMID: 14564908]
  58. BMC Health Serv Res. 2017 Jun 15;17(1):407 [PMID: 28619081]
  59. Adv Emerg Nurs J. 2012 Jul-Sep;34(3):272-82 [PMID: 22842970]
  60. Saudi Med J. 2018 May;39(5):528 [PMID: 29738017]
  61. Turk J Anaesthesiol Reanim. 2016 Oct;44(5):258-264 [PMID: 27909607]
  62. Isr J Health Policy Res. 2019 Jan 04;8(1):2 [PMID: 30609943]
  63. Oman Med J. 2013 Jul;28(4):252-4 [PMID: 23904917]
  64. Dynamics. 2012 Winter;23(4):25-31 [PMID: 23342935]
  65. Acad Med. 2009 Feb;84(2):269-77 [PMID: 19174684]
  66. J Nurs Manag. 2016 Sep;24(6):708-17 [PMID: 27189515]
  67. Electron Physician. 2016 Jul 25;8(7):2625-32 [PMID: 27648189]
  68. Arch Environ Occup Health. 2017 May 4;72(3):173-177 [PMID: 27120565]
  69. Iran J Nurs Midwifery Res. 2013 Jul;18(4):294-7 [PMID: 24403925]
  70. J Ren Care. 2019 Jun;45(2):120-128 [PMID: 30811110]
  71. J Epidemiol Glob Health. 2016 Sep;6(3):177-85 [PMID: 26644345]
  72. Issues Ment Health Nurs. 2011;32(4):234-42 [PMID: 21355758]
  73. Work. 2015;51(4):839-47 [PMID: 24962300]
  74. J Adv Nurs. 2008 Jan;61(1):100-106 [PMID: 18034813]
  75. J Family Med Prim Care. 2018 Mar-Apr;7(2):435-441 [PMID: 30090790]
  76. Fam Pract. 2014 Feb;31(1):44-50 [PMID: 24148815]
  77. Ann Intern Med. 2002 Mar 5;136(5):358-67 [PMID: 11874308]
  78. Oncol Nurs Forum. 2016 Jul 1;43(4):E161-9 [PMID: 27314199]
  79. Nurs Ethics. 2019 May;26(3):809-822 [PMID: 28814140]
  80. N Am J Med Sci. 2016 Feb;8(2):75-81 [PMID: 27042604]
  81. Emerg Med Australas. 2018 Aug;30(4):517-522 [PMID: 29436766]
  82. East Mediterr Health J. 2013 May;19(5):426-34 [PMID: 24617120]
  83. East Mediterr Health J. 2017 Feb 21;23(1):40-45 [PMID: 28244060]
  84. Complement Ther Med. 2018 Jun;38:61-66 [PMID: 29857881]
  85. Int J Med Educ. 2017 Apr 26;8:144-150 [PMID: 28454079]
  86. Nephrol Nurs J. 2011 Jan-Feb;38(1):65-77; quiz 78 [PMID: 21469556]
  87. Isr J Psychiatry Relat Sci. 2013;50(3):174-80 [PMID: 24622476]
  88. East Mediterr Health J. 2009 Jan-Feb;15(1):190-7 [PMID: 19469443]
  89. Int J Nurs Pract. 2015 Dec;21(6):847-57 [PMID: 24779558]
  90. Support Care Cancer. 2017 May;25(5):1607-1614 [PMID: 28084531]
  91. Int J Clin Pharm. 2011 Feb;33(1):92-100 [PMID: 21365401]
  92. Palliat Support Care. 2018 Dec;16(6):677-684 [PMID: 29254511]
  93. Acad Med. 2014 Mar;89(3):443-51 [PMID: 24448053]
  94. Iran J Nurs Midwifery Res. 2017 Jan-Feb;22(1):41-45 [PMID: 28382057]
  95. J Cancer Educ. 2012 Dec;27(4):786-9 [PMID: 22923383]
  96. PLoS One. 2017 Oct 4;12(10):e0185781 [PMID: 28977041]
  97. Nurs Midwifery Stud. 2015 Sep;4(3):e27766 [PMID: 26576442]
  98. Saudi Med J. 2010 Mar;31(3):313-6 [PMID: 20231940]
  99. Saudi Med J. 2017 Aug;38(8):832-836 [PMID: 28762436]
  100. Appl Nurs Res. 2018 Oct;43:93-97 [PMID: 30220371]
  101. Eur Psychiatry. 2019 Jan;55:36-42 [PMID: 30384110]
  102. Int J Occup Saf Ergon. 2016;22(2):283-90 [PMID: 27075269]
  103. Palliat Support Care. 2016 Aug;14(4):393-401 [PMID: 26466981]
  104. J Holist Nurs. 2016 May 30;35(3):214-220 [PMID: 27241132]
  105. Ann Gen Psychiatry. 2016 Nov 14;15:33 [PMID: 27895699]
  106. Inquiry. 2017 Jan 1;54:46958017724944 [PMID: 28844166]
  107. Acad Psychiatry. 2016 Feb;40(1):38-45 [PMID: 26246222]
  108. Ann Intern Med. 2001 Jul 17;135(2):145-8 [PMID: 11453722]
  109. PLoS One. 2016 Dec 8;11(12):e0167648 [PMID: 27930726]
  110. Adv Biomed Res. 2014 Jan 24;3:44 [PMID: 24627852]
  111. Pediatr Int. 2008 Aug;50(4):546-51 [PMID: 19143981]
  112. BMC Public Health. 2019 Sep 11;19(1):1247 [PMID: 31510975]
  113. Clin Exp Emerg Med. 2015 Dec 28;2(4):217-225 [PMID: 27752601]
  114. Ann Afr Med. 2010 Oct-Dec;9(4):226-9 [PMID: 20935422]
  115. Curr Psychiatry Rep. 2008 Feb;10(1):73-9 [PMID: 18269898]
  116. Iran Red Crescent Med J. 2016 Jul 09;18(10):e25390 [PMID: 28180014]
  117. BMC Health Serv Res. 2014 Jul 28;14:325 [PMID: 25066375]
  118. Neuropsychiatr Dis Treat. 2017 Jun 15;13:1533-1540 [PMID: 28670122]
  119. Work. 2015 Jun 5;51(2):315-9 [PMID: 24962296]
  120. J Ren Care. 2009 Sep;35(3):134-40 [PMID: 19689695]
  121. Health Soc Care Community. 2017 Nov;25(6):1805-1816 [PMID: 28627051]
  122. J Appl Psychol. 2008 May;93(3):498-512 [PMID: 18457483]
  123. Fam Pract. 2008 Aug;25(4):245-65 [PMID: 18622012]
  124. Int J Nurs Stud. 2005 Jul;42(5):549-55 [PMID: 15921986]
  125. Psychiatry Res. 2017 Jun;252:284-288 [PMID: 28288439]
  126. J Hosp Med. 2013 Nov;8(11):653-64 [PMID: 24167011]
  127. Cancer. 2016 Dec 1;122(23):3705-3714 [PMID: 27509210]
  128. Can J Nurs Res. 2019 Jun;51(2):72-83 [PMID: 30396277]
  129. Aging Ment Health. 2017 Mar;21(3):327-335 [PMID: 26496232]
  130. Psychooncology. 2015 Aug;24(8):926-31 [PMID: 25640592]
  131. BMC Med Educ. 2019 Jan 25;19(1):34 [PMID: 30683088]
  132. Saudi Med J. 2005 Aug;26(8):1180-2 [PMID: 16127509]
  133. Med Oncol. 2010 Sep;27(3):968-74 [PMID: 19784801]
  134. Int J Nurs Pract. 2012 Feb;18(1):68-76 [PMID: 22257333]
  135. Eur J Oncol Nurs. 2011 Sep;15(4):358-63 [PMID: 20863757]
  136. Psychooncology. 2008 Jun;17(6):570-6 [PMID: 17935146]
  137. J Clin Nurs. 2019 May;28(9-10):1868-1878 [PMID: 30653765]
  138. Med Care. 2018 Dec;56(12):976-984 [PMID: 30339573]
  139. Int J Environ Res Public Health. 2013 May 31;10(6):2214-40 [PMID: 23727902]
  140. Postgrad Med J. 2010 May;86(1015):266-71 [PMID: 20448222]
  141. BMC Med Educ. 2018 Aug 2;18(1):180 [PMID: 30071835]
  142. Int Nurs Rev. 2010 Dec;57(4):485-92 [PMID: 21050201]
  143. Adm Policy Ment Health. 2012 Sep;39(5):341-52 [PMID: 21533847]
  144. Saudi Med J. 2018 Mar;39(3):296-300 [PMID: 29543309]
  145. Ann Saudi Med. 2013 Sep-Oct;33(5):451-6 [PMID: 24188938]
  146. J Adv Med Educ Prof. 2018 Oct;6(4):162-167 [PMID: 30349827]
  147. Iran J Kidney Dis. 2016 Nov;10(6):395-404 [PMID: 27903999]
  148. J Behav Med. 1995 Dec;18(6):581-99 [PMID: 8749987]
  149. Acta Med Iran. 2015;53(4):214-9 [PMID: 25871018]
  150. J Occup Health. 2011;53(6):455-64 [PMID: 21952297]
  151. Community Ment Health J. 2014 Apr;50(3):354-61 [PMID: 23982180]
  152. Psychooncology. 2009 May;18(5):543-8 [PMID: 18942658]
  153. Int J Surg. 2010;8(5):336-41 [PMID: 20171303]

Grants

  1. K23 AT009218/NCCIH NIH HHS
  2. K23AT009218/NCCIH NIH HHS

MeSH Term

Burnout, Professional
Health Personnel
Humans
Middle East
Prevalence
Journal Article Systematic Review
Article has an altmetric score of 11

Word Cloud

Created with Highcharts 10.0.0amonghealthcareburnoutMiddleBurnoutprovidersEastsystematicemotionalprofessionalscountriesreviewworkjobburdensectorsEasternincludedsearchpopulationsStudiesmeasurearticlesphysiciansnursescommonstudiesregionHealthBACKGROUND:syndromecharacterizedexhaustionincreaseddepersonalizationdiminishedsensepersonalaccomplishmentduechronicstressimpactssatisfactionperformancevulnerabilityillnessesinterpersonalrelationshipsgapdatadifferentobjectiveexamineassessedinterventionsusedMETHODS:ArticlesfoundresultsincludingPubMedWebScienceThomsonReutersPsycINFOEBSCOusingtermsreflectingexaminedquantitativeRESULTS:138metinclusioncriteriafocusedN = 54N = 55combinedworkersN = 22medicalstudentsN = 7MaslachInventorytoolprevalenceestimatespredominantlyranging4060%associatedcharacteristicsenvironmentsexposureviolenceterrordistresslowsocialsupportCONCLUSIONS:highlyprevalentacrossPreviousexamininglimitationsmethodologythoroughlydevelopedepidemiologicnecessarysystemstrengtheningneededenduredyearsongoingconflicturgencydesignimplementprogramstacklehealthcomplexenvironmentEast:personnel

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