Conceptualisation of job-related wellbeing, stress and burnout among healthcare workers in rural Ethiopia: a qualitative study.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Burnout, Professional* ; Job Satisfaction* ; Mental Health*; Health Personnel/*psychology; Adult ; Community Health Workers/psychology ; Ethiopia ; Female ; Humans ; Male ; Middle Aged ; Personnel Turnover ; Qualitative Research ; Rural Health Services ; Workload

Background: Wellbeing of healthcare workers is important for the effective functioning of health systems. The aim of this study was to explore the conceptualisations of wellbeing, stress and burnout among healthcare workers in primary healthcare settings in rural Ethiopia in order to inform the development of contextually appropriate interventions.
Methods: A qualitative study was conducted in a rural zone of southern Ethiopia. A total of 52 frontline primary healthcare workers participated in in-depth interviews (n = 18) or Focus Group Discussions (FGDs) (4 groups, total n = 34). There were 35 facility based healthcare professionals and 17 community-based health workers. Data were analysed using thematic analysis.
Results: Most participants conceptualised wellbeing as absence of stress rather than as a positive state. Many threats to wellbeing were identified. For facility-based workers, the main stressors were inadequate supplies leading to fears of acquiring infection and concerns about performance evaluation. For community health workers, the main stressor was role ambiguity. Workload and economic self-sufficiency were a concern for both groups. Burnout and its symptoms were recognised and reported by most as a problem of other healthcare workers. Derogatory and stigmatising terms, such as "chronics", were used to refer to those who had served for many years and who appeared to have become drained of all compassion. Most participants viewed burnout as inevitable if they continued to work in their current workplace without career progression. Structural and environmental aspects of work emerged as potential targets to improve wellbeing, combined with tackling stigmatising attitudes towards mental health problems. An unmet need for intervention for healthcare workers who develop burnout or emotional difficulties was identified.
Conclusion: Ethiopian primary healthcare workers commonly face job-related stress and experience features of burnout, which may contribute to the high turnover of staff and dissatisfaction of both patients and providers. Recent initiatives to integrate mental healthcare into primary care provide an opportunity to promote the wellbeing of healthcare workers and intervene to address burnout and emotional problems by creating a better understanding of mental health.

Lancet. 2011 Oct 22;378(9801):1502-14. (PMID: 22008425)
Lancet. 2009 Aug 22;374(9690):595-7. (PMID: 19699996)
Soc Sci Med. 2000 Aug;51(3):321-34. (PMID: 10855920)
BMC Nurs. 2016 Jun 16;15:39. (PMID: 27313502)
Int J Ment Health Syst. 2008 Oct 28;2(1):15. (PMID: 18954470)
Occup Med (Lond). 2009 May;59(3):159-66. (PMID: 19270043)
PLoS Med. 2016 Apr 12;13(4):e1001991. (PMID: 27070913)
BMC Psychiatry. 2011 Apr 21;11:68. (PMID: 21510852)
Nurse Educ Today. 2004 Feb;24(2):105-12. (PMID: 14769454)
Aust J Rural Health. 2010 Jun;18(3):102-9. (PMID: 20579020)
Br J Psychiatry. 2012 Sep;201(3):239-46. (PMID: 22790677)
Annu Rev Psychol. 2001;52:397-422. (PMID: 11148311)
Hum Resour Health. 2013 Aug 14;11:37. (PMID: 23945073)
Hum Resour Health. 2013 Feb 21;11:8. (PMID: 23433226)
Hum Resour Health. 2013 Jul 17;11:34. (PMID: 23866770)
J Ayub Med Coll Abbottabad. 2008 Jul-Sep;20(3):135-9. (PMID: 19610539)
PLoS Med. 2012;9(12):e1001359. (PMID: 23300387)
Occup Med (Lond). 1998 May;48(4):237-50. (PMID: 9800422)
Lancet. 2004 Nov 27-Dec 3;364(9449):1984-90. (PMID: 15567015)
World Psychiatry. 2016 Jun;15(2):103-11. (PMID: 27265691)
Tunis Med. 2013 Jan;91(1):44-9. (PMID: 23404597)
ISRN Nurs. 2012;2012:402157. (PMID: 22619733)
Res Nurs Health. 1995 Apr;18(2):179-83. (PMID: 7899572)
Emerg Med J. 2004 Sep;21(5):568-72. (PMID: 15333532)
BMC Health Serv Res. 2015;15 Suppl 1:S3. (PMID: 26062735)
Occup Med (Lond). 2012 Mar;62(2):145-7. (PMID: 22121245)
Br J Psychiatry. 2016 Jan;208 Suppl 56:s4-12. (PMID: 26447174)
Hum Resour Health. 2014 Aug 09;12:43. (PMID: 25106497)
Soc Psychiatry Psychiatr Epidemiol. 2001 Jun;36(6):299-303. (PMID: 11583460)
PLoS One. 2016 Jul 08;11(7):e0159015. (PMID: 27391946)
J Gen Intern Med. 2008 Oct;23(10):1581-8. (PMID: 18618195)
Nurs Health Sci. 2013 Sep;15(3):398-405. (PMID: 23480423)
J Assoc Nurses AIDS Care. 2002 Jul-Aug;13(4):84-6. (PMID: 12149888)
PLoS One. 2014 Feb 18;9(2):e88437. (PMID: 24558389)
Hum Resour Health. 2005 Aug 10;3:6. (PMID: 16092964)
J Adv Nurs. 2006 Feb;53(3):304-10. (PMID: 16441535)
BMJ Open. 2015 Aug 23;5(9):e008331. (PMID: 26359284)
PLoS One. 2016 Feb 22;11(2):e0149428. (PMID: 26900945)

Keywords: Burnout; Ethiopia; Healthcare workers; Job related stress; Primary care; Stress; Stressor; Wellbeing

Date Created: 20170621 Date Completed: 20180301 Latest Revision: 20231112

20231112

PMC5477383

10.1186/s12913-017-2370-5

28629360