Burnout and self-reported suboptimal patient care amongst health care workers providing HIV care in Malawi

Maria H. Kim, Alick C. Mazenga, Katie Simon, Xiaoying Yu, Saeed Ahmed, Phoebe Nyasulu, Peter N. Kazembe, Stanley Ngoma, Elaine J. Abrams

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background The well-documented shortages of health care workers (HCWs) in sub-Saharan Africa are further intensified by the increased human resource needs of expanding HIV treatment programs. Burnout is a syndrome of emotional exhaustion (EE), depersonalization (DP), and a sense of low personal accomplishment (PA). HCWs’ burnout can negatively impact the delivery of health services. Our main objective was to examine the prevalence of burnout amongst HCWs in Malawi and explore its relationship to self-reported suboptimal patient care. Methods A cross-sectional study among HCWs providing HIV care in 89 facilities, across eight districts in Malawi was conducted. Burnout was measured using the Maslach Burnout Inventory defined as scores in the mid-high range on the EE or DP subscales. Nine questions adapted for this study assessed self-reported suboptimal patient care. Surveys were administered anonymously and included socio-demographic and work-related questions. Validated questionnaires assessed depression and at-risk alcohol use. Chi-square test or two-sample t-test was used to explore associations between variables and self-reported suboptimal patient care. Bivariate analyses identified candidate variables (p < 0.2). Final regression models included variables with significant main effects. Results Of 520 HCWs, 62% met criteria for burnout. In the three dimensions of burnout, 55% reported moderate-high EE, 31% moderate-high DP, and 46% low-moderate PA. The majority (89%) reported engaging in suboptimal patient care/attitudes including making mistakes in treatment not due to lack of knowledge/experience (52%), shouting at patients (45%), and not performing diagnostic tests due to a desire to finish quickly (35%). In multivariate analysis, only burnout remained associated with self-reported suboptimal patient care (OR 3.22, [CI 2.11 to 4.90]; p<0.0001). Conclusion Burnout was common among HCWs providing HIV care and was associated with self-reported suboptimal patient care practices/attitudes. Research is needed to understand factors that contribute to and protect against burnout and that inform the development of strategies to reduce burnout.

Original languageEnglish (US)
Article numbere0192983
JournalPLoS One
Volume13
Issue number2
DOIs
StatePublished - Feb 1 2018
Externally publishedYes

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Malawi
patient care
health care workers
Health care
Patient Care
HIV
Depersonalization
Delivery of Health Care
Africa South of the Sahara
Chi-Square Distribution
Sub-Saharan Africa
Routine Diagnostic Tests
cross-sectional studies
diagnostic techniques
health services
human resources
multivariate analysis
Health Services
demographic statistics
Multivariate Analysis

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Kim, M. H., Mazenga, A. C., Simon, K., Yu, X., Ahmed, S., Nyasulu, P., ... Abrams, E. J. (2018). Burnout and self-reported suboptimal patient care amongst health care workers providing HIV care in Malawi. PLoS One, 13(2), [e0192983]. https://doi.org/10.1371/journal.pone.0192983

Burnout and self-reported suboptimal patient care amongst health care workers providing HIV care in Malawi. / Kim, Maria H.; Mazenga, Alick C.; Simon, Katie; Yu, Xiaoying; Ahmed, Saeed; Nyasulu, Phoebe; Kazembe, Peter N.; Ngoma, Stanley; Abrams, Elaine J.

In: PLoS One, Vol. 13, No. 2, e0192983, 01.02.2018.

Research output: Contribution to journalArticle

Kim, MH, Mazenga, AC, Simon, K, Yu, X, Ahmed, S, Nyasulu, P, Kazembe, PN, Ngoma, S & Abrams, EJ 2018, 'Burnout and self-reported suboptimal patient care amongst health care workers providing HIV care in Malawi', PLoS One, vol. 13, no. 2, e0192983. https://doi.org/10.1371/journal.pone.0192983
Kim, Maria H. ; Mazenga, Alick C. ; Simon, Katie ; Yu, Xiaoying ; Ahmed, Saeed ; Nyasulu, Phoebe ; Kazembe, Peter N. ; Ngoma, Stanley ; Abrams, Elaine J. / Burnout and self-reported suboptimal patient care amongst health care workers providing HIV care in Malawi. In: PLoS One. 2018 ; Vol. 13, No. 2.
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AU - Ahmed, Saeed

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N2 - Background The well-documented shortages of health care workers (HCWs) in sub-Saharan Africa are further intensified by the increased human resource needs of expanding HIV treatment programs. Burnout is a syndrome of emotional exhaustion (EE), depersonalization (DP), and a sense of low personal accomplishment (PA). HCWs’ burnout can negatively impact the delivery of health services. Our main objective was to examine the prevalence of burnout amongst HCWs in Malawi and explore its relationship to self-reported suboptimal patient care. Methods A cross-sectional study among HCWs providing HIV care in 89 facilities, across eight districts in Malawi was conducted. Burnout was measured using the Maslach Burnout Inventory defined as scores in the mid-high range on the EE or DP subscales. Nine questions adapted for this study assessed self-reported suboptimal patient care. Surveys were administered anonymously and included socio-demographic and work-related questions. Validated questionnaires assessed depression and at-risk alcohol use. Chi-square test or two-sample t-test was used to explore associations between variables and self-reported suboptimal patient care. Bivariate analyses identified candidate variables (p < 0.2). Final regression models included variables with significant main effects. Results Of 520 HCWs, 62% met criteria for burnout. In the three dimensions of burnout, 55% reported moderate-high EE, 31% moderate-high DP, and 46% low-moderate PA. The majority (89%) reported engaging in suboptimal patient care/attitudes including making mistakes in treatment not due to lack of knowledge/experience (52%), shouting at patients (45%), and not performing diagnostic tests due to a desire to finish quickly (35%). In multivariate analysis, only burnout remained associated with self-reported suboptimal patient care (OR 3.22, [CI 2.11 to 4.90]; p<0.0001). Conclusion Burnout was common among HCWs providing HIV care and was associated with self-reported suboptimal patient care practices/attitudes. Research is needed to understand factors that contribute to and protect against burnout and that inform the development of strategies to reduce burnout.

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