Physician burnout in the context of the COVID-19 pandemic: prevalence and associated factors among resident doctors and consultants in Delta State, Nigeria

Burnout is a state of emotional, physical, and mental exhaustion caused by long-standing, poorly managed workplace stress. Resident doctors (RDs) and consultants provide specialized medical care, and the strain of their job predisposes them to the three domains of burnout: Emotional Exhaustion (EE), Depersonalization (DP), and diminished Personal Accomplishment (PA). Globally, this public health crisis worsened with the overwhelming effect of COVID-19 on health systems. This study assessed the prevalence and associated factors of burnout among RDs and Consultants in tertiary hospitals in Delta State, Nigeria, during the pandemic. A cross-sectional design was employed. Previously validated instruments (the Maslach Burnout Toolkit, and the Pandemic Experience and Perception Survey) were used to collect data via an online survey. The questionnaire was sent to physicians selected by a multistage sampling. The proportion of participants with a high grade in each of the domains of burnout was obtained. Stepwise analyses from bivariate to multivariate were done to obtain adjusted odds ratios. The prevalence of high-grade burnout in EE, DP, and PA was 35.1%, 13.2%, and 33.3% respectively. Relative to those ≤ 30 years, the age group 41 - 50 years had less likelihood of high EE (AOR 0.050; 95% CI 0.004 - 0.651). Other independent predictors of EE were manageable workload (AOR 0.094; 95% CI 0.027 - 0.328), reward for work (AOR 0.427; 95% CI 0.205 - 0.892), and good leadership (AOR 0.525; 95% CI 0.113 - 0.929). This study suggests that the determinants of burnout among RDs and consultants are mainly contextual factors in the work setting. Future interventions to control physician burnout in Nigerian healthcare systems should be geared towards promoting an institutional culture of leadership, manageable workloads, and appropriate rewards for good performance.