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Multicenter Study
. 2018 Feb 21;13(2):e0192983.
doi: 10.1371/journal.pone.0192983. eCollection 2018.

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

Maria H Kim  1   2 , Alick C Mazenga  1 , Katie Simon  1   2 , Xiaoying Yu  3 , Saeed Ahmed  1   2 , Phoebe Nyasulu  1 , Peter N Kazembe  1   2 , Stanley Ngoma  4 , Elaine J Abrams  5   6
Affiliations
Multicenter Study

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

Maria H Kim et al. PLoS One. .

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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Relationship of burnout (moderate/high EE or moderate/high DP) to self-reported suboptimal patient care practices and attitudes.
See this image and copyright information in PMC

References

    1. HIV/AIDS Data and Statistics [http://www.who.int/hiv/data/en/]
    1. UNAIDS: Global AIDS Update 2016. In. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS; 2016.
    1. Kruse GR, Chapula BT, Ikeda S, Nkhoma M, Quiterio N, Pankratz D, et al. Burnout and use of HIV services among health care workers in Lusaka District, Zambia: a cross-sectional study. Hum Resour Health 2009, 7(1):2303–2310. - PMC - PubMed
    1. Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M, et al. Human resources for health: overcoming the crisis. The Lancet 2004, 364(9449):1984–1990. - PubMed
    1. Maddison AR, Schlech WF. Will universal access to antiretroviral therapy ever be possible? The health care worker challenge. Can J Infect Dis Med Microbiol 2010, 21(1):e64–69. - PMC - PubMed

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