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Published on: September 30, 2020
Burnout among French healthcare workers caring for individuals with profound intellectual and multiple
Houria El Ouazzani1,2, Marie-Christine Rousseau2,3, Any Beltran-Anzola1
1Epidemiology and Health Economy Department, Marseille Public University Hospital System, Marseille, France.
Purpose:
Polyhandicap, known as Profound Intellectual Multiple Disabilities, is characterized by profound intellectual impairment and severe motor deficits, leading to a high level of dependence. Caring for these individuals has specific stressors, including lack of patient feedback or recognition, frequent unfavorable clinical trajectories, and complex relationships with families. This study aimed to assess burnout among health care workers caring for persons with PIMD/polyhandicap, to identify associated factors, and to examine the stability of burnout over time within the French EVAL-PLH cohort.
Materials And Method:
This study used complementary cross-sectional (2020) and longitudinal (2015-2020) designs. Burnout was assessed using the Maslach Burnout Inventory among health care workers caring for persons with PIMD/polyhandicap.
Results:
In 2020, 208 health care workers were included; 79 (38%) presented severe burnout according to the French global MBI scoring. Higher emotional exhaustion was associated with self-reported mood disorders, use of mood disorder medication, employment in residential facilities, and more frequent avoidance coping. Higher depersonalization was associated with younger age and more frequent avoidance coping. Lower personal accomplishment was associated with single status and less frequent positive-thinking coping. In the longitudinal subsample (n = 58), 21 HCWs (37%) experienced severe burnout in 2015, of whom 17 (81%) remained severely burned out in 2020; Cohen's kappa indicated moderate agreement between T1 and T2 burnout classifications (κ = 0.539, p < 0.001), while McNemar's test showed no significant change in burnout status over time (p = 0.267).
Conclusion:
Burnout is highly prevalent among health care workers caring for persons with PIMD/polyhandicap and shows partial temporal stability. Addressing modifiable associated factors, such as coping strategies and mental health support, should be a key focus of intervention programs to sustain the workforce and ensure continuity and quality of care for this highly dependent population.
Trial Registration:
Identifier, NCT02400528.
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