Determining levels of nurse burnout during the COVID-19 pandemic and Lebanon's political and financial collapse

Michael Clinton; Karen Bou-Karroum; Myrna Abdullah Doumit; Nathalie Richa; Mohamad Alameddine

doi:10.1186/s12912-021-00789-8

Determining levels of nurse burnout during the COVID-19 pandemic and Lebanon's political and financial collapse

BMC Nurs. 2022 Jan 4;21(1):11. doi: 10.1186/s12912-021-00789-8.

Authors

Michael Clinton¹, Karen Bou-Karroum², Myrna Abdullah Doumit³, Nathalie Richa⁴, Mohamad Alameddine⁵

Affiliations

¹ Hariri School of Nursing, American University of Beirut, Beirut, Lebanon. mc42@aub.edu.lb.
² Faculty of Health Sciences, Department of Health Management and Policy, American University of Beirut, Beirut, Lebanon.
³ Alice Ramez Chagoury School of Nursing, Lebanese American University, Byblos, Lebanon.
⁴ Order of Nurses in Lebanon, Beirut, Lebanon.
⁵ University of Sharjah, College of Health Sciences, Sharjah, United Arab Emirates.

Abstract

Background: The COVID-19 pandemic compounded political and financial pressures on the nursing workforce in Lebanon. The government resigned in October 2019 in response to the popular uprising that called for an end to corruption and economic mismanagement 5 months before the first COVID-19 case appeared in the country. The continuing crises and the added stress of COVID-19 has increased the risk of occupational burnout and turnover in the nursing workforce. Therefore, valid and reliable measurement is imperative to determine burnout levels, prioritize intervention, and inform evidence-based workforce policy and practice. The primary aim of the study was to delineate burnout levels and cut-points in a national sample of nurses to inform workforce policies and prioritize interventions.

Methods: Multidimensional and unidimensional Rasch analyses of burnout data collected from a national convenience sample of 457 hospital nurses 9-12 months after Lebanon's political and economic collapse began. The data were collected in July-October 2020.

Results: Multidimensional Rasch analysis confirmed that the Copenhagen Burnout Inventory has three highly correlated unidimensional scales that measure personal burnout, work-related burnout, and client-related burnout. Except for a ceiling effect of ~ 2%, the three scales have excellent measurement properties. For each scale, Rasch rating scale analysis confirmed five statistically different nurse burnout levels. The mean personal burnout scores and work-related burnout scores (50.24, 51.11 respectively) were not higher than those reported in the international literature. However, the mean client-related burnout score of 50.3 was higher than reported for other countries. Compared with a baseline study conducted at the beginning of Lebanon's political and economic crises, only client-related burnout scores were higher p. <.01.

Conclusions: The CBI scales are reliable and valid measures for monitoring nurse burnout in crises torn countries. Stakeholders can use the CBI scales to monitor nurse burnout and prioritize burnout interventions. Urgent action is needed to reduce levels of client-related burnout in Lebanon's nursing workforce.

Keywords: Burnout; COVID-19; Compound stressors; Intervention priorities; Nurses.