Why do some health professionals not feel 'burnt out' despite being subjected to very stressful situations?

After the Covid pandemic, burnout among healthcare professionals has become a public health problem with significant repercussions for society. Being on the verge of despair leads professionals to make more diagnostic and therapeutic errors; it also exposes them to a greater risk of depression and they are more likely to consume toxic substances. However, there are doctors and nursing staff who manage to be resilient despite being subjected to the same stressful conditions as their "burnt-out" colleagues. Why? What is it that differentiates one group from the other when it comes to dealing with these situations?

A team of the Universitat Oberta de Catalunya (UOC), led by Oriol Yuguero, from the e-RLab research group at the UOC's eHealth Center and head of the Emergency Department at the Arnau de Vilanova Hospital, together with the Galatea Foundation, have been selected via the "la Caixa" Foundation Social Observatory's Conecta call to launch a new study in which they will try to answer this question.

The aim is to understand what characteristics people with low levels of burnout have in order to develop initiatives that alleviate the syndrome, and to promote and implement these initiatives in the training of these groups.

"The pandemic showed that, when faced with similar situations of stress and exhaustion, there are professionals who do not burn out. This led us to ask ourselves what factors could be helping them to protect themselves. Was it the fact of having a better social life? A particular personality trait? Or maybe a better sense of humour? Or was it because they were involved in more group activities, like singing in a choir?" said Yuguero, who has been researching burnout for more than 10 years.

Aim: to improve the mental health and well-being of healthcare professionals

In this new research project that they will now begin, "we want to see to what extent each individual's personality is important or whether there are specific aspects, such as greater optimism, that protect them against burning out, as this could pave the way for making proposals to the Catalan Department of Health to promote activities that reduce burnout," said Yuguero.

The study is open to doctors and nurses from all parts of Catalonia. Volunteers will answer a questionnaire once a month over six months to assess their degree of burnout. The researchers hope to recruit more than 40 professionals with a low level of burnout, who will participate in a second, more qualitative phase to see what they have in common.

In addition, immersive virtual reality will be used to evaluate the response of professionals to simulated situations associated with stress and burnout, such as having to communicate bad news to patients and their families, or the diagnosis of a terminal illness in a young person. The aim will be to better understand how they deal with it and try to extract knowledge to develop tools to train future specialists and help to treat those who already suffer from burnout.

Identikit picture of professionals with a low level of burnout

"During this period we'll also try to determine the profile of people who don't burn out. To see what they have in common, in case there's something we can improve in the healthcare system," said Yuguero. "Or, if it they deal with it better because they do certain activities, such as sports or dance classes, we can design measures to intervene."

This is the first project with a focus on the resilience of healthcare personnel to be conducted in Spain. The UOC researchers will carry it out together with the Galatea Foundation, which works to protect the health and well-being of all healthcare professionals. Staff from this body will help to organize the sessions, given their extensive experience in supporting professionals who are burnt out or are at risk of suffering from mental health problems.

"Doctors and other healthcare professionals have been trained to care for others but have had hardly any training in looking after themselves. This fact, together with the knowledge they've acquired, distances them from the perception that they may have problems," said Toni Calvo, director of the Galatea Foundation. "We must stop fostering the idea that these professionals are invulnerable. Their knowledge and unquestionable vocation to serve aren't enough for the challenges and risk factors of their work," he added, and emphasized: "Taking care of yourself to continue caring for others isn't an option; it's an ethical and deontological imperative. This study will allow us to examine in greater depth the factors that protect against burnout and look for tools to make professional practice healthier".

Burnout, a serious and common problem

A study carried out in Catalonia showed that burnout among emergency service professionals had increased by 10 points after the pandemic, a situation that also occurred among primary care professionals, two of the groups most involved in the containment of Covid. According to data from the 2021 Galatea Foundation Report, 47.1% of doctors and 58.3% of nurses are at risk of mental health problems.

This is a major issue for public health, because it not only has an impact on occupational health, but also has a negative effect on care. Burnout, which takes sufferers to the edge of despair, mainly affects middle-aged professionals, who are supposedly at the peak of their careers.

When people in this sector burn out, they cannot recover without psychological help or support. That is why, Yuguero insisted, it is so important to intervene. "Many people don't ask for help because they're not able even to recognize that they have this problem, or because there's still a certain stigma in confessing that you don't feel well. Through this project we'll try to help this group and provide treatment."

This UOC research contributes to Sustainable Development Goal (SDG) 3, Good Health and Well-being.

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