The buffering role of resilience on burnout, depression, anxiety, and stress among healthcare workers in Sri Lanka

Burnout, depression, anxiety, and stress are overlapping, yet distinct constructs. Mental health problems like depression and anxiety can occur as a consequence of burnout. Resilience, on the other hand, can potentially protect against burnout as well as its mental health consequences. This study aimed to explore the relationship between burnout, depression, anxiety, stress, and resilience among healthcare workers (HCWs), and to investigate the moderating role of resilience against the mental health correlates of burnout. For this purpose, using a cross-sectional design, 318 HCWs from various categories (nurses, midwives, doctors, etc.) recruited from hospital and community settings in two Districts of Sri Lanka during the COVID-19 pandemic were surveyed using the Copenhagen Burnout Inventory (CBI), Depression, Anxiety and Stress Scale (DASS-21), and the Brief Resilience Scale. CBI assessed three domains: personal burnout, work burnout and client burnout. The prevalence of personal, work, and client burnout were 26.4%, 12.9%, and 7.9%, respectively. The prevalence of low, normal, and high resilience was 25.6%, 66.2%, and 8.6%, respectively. All three burnout domains correlated positively with depression, anxiety, and stress. Resilience correlated inversely with all burnout domains and DASS-21 scores. In moderator analysis, higher levels of resilience dampened the effects of client burnout on anxiety, but resilience moderated the psychological consequences of personal burnout in the opposite direction. Our findings indicate notable rates of burnout among Sri Lankan HCWs, and suggest a possible buffering role of resilience against burnout and its psychological consequences.