Attention Deficits in Healthcare Workers with Non-Clinical Burnout: An Exploratory Investigation

Abstract

Burnout syndrome is characterized by exhaustion, cynicism, and reduced effectiveness. Workers with high burnout scores who continue their professional activities are identified as experiencing non-clinical burnout (NCB), which includes early stages where burnout symptoms (BNS) are present but not yet severe enough to necessitate work leave. This study aimed to investigate the impact of BNS on attention performance among healthcare workers (HCWs) at a COVID-19 reference hospital during the pandemic. The Maslach Burnout Inventory (MBI) was applied to assess the three burnout dimensions. The Continuous Visual Attention Test (CVAT) evaluated four different attention subdomains. Participants were divided into two groups based on their scores on the MBI: controls and NCB. Thirteen controls were matched with 13 NCB subjects based on age, sex, and HCW category. This sample (n = 26, 65% male) consisted of 11 physicians and 15 nursing professionals with a mean age of 35.3 years (standard deviation = 5.47). NCB subjects had higher impulsivity than controls. There were not any significant group differences in the other attention subdomains. We found significant correlations between impulsivity and all burnout dimensions: higher absolute scores in BNS are associated with higher impulsivity. We concluded that NCB leads to executive attention deficits.

Keywords: attention deficits; burnout; executive functions; healthcare professionals; impulsivity.

Figure 1

Flowchart explaining the study design. Abbreviations: CVAT, Computerized Visual Attention Test; MBI, Maslach Burnout Inventory; OE, omission errors; FA, focused attention; CE, commission errors; HI, hyperactivity/impulsivity factor; RT, reaction time; ALT, alertness; VRT, intraindividual reaction time variability; SA, sustained attention; EX = mean exhaustion; CY, mean cynicism; PE, mean personal efficacy; HCW, healthcare workers; NCB, non-clinical burnout.

Figure 2

Schematic overview of the CVAT showing the target (star) and non-target (diamond). The CVAT begins with on-screen instructions (A): “In this test, the computer alternately displays the indicated figures in the center of the screen. You must press the spacebar using your dominant hand as fast as you can whenever the star appears in the center of the screen. If the other figure appears, you should not press the space bar”. Both the target (B) and the non-target (C) remained on the screen for 250 milliseconds (ms). The test consists of 90 trials, with either of the two figures presented in each trial. The interstimulus interval is 1 s, resulting in a total test duration of 1.5 min. Key variables include Omission Errors (OE), Commission Errors (CE), average Reaction Time of correct responses (RT), and Intraindividual Variability of Reaction Time (VRT, standard deviation of the RTs during the test). The CVAT [46] is available for research and clinical use by licensed psychologists. Requests for access can be made to the corresponding author Prof. Sergio L. Schmidt. There are versions in English, Spanish, and Portuguese. CVAT: Continuous Visual Attention Test.

Figure 3

Means of each CVAT variable according to the group (raw data). Data are expressed as the mean ± standard error of the mean. Abbreviations: CE, commission errors; OE, omission errors; RT, reaction time; VRT, intraindividual reaction time variability. Group differences reached significance for the CE variable.