Women More Likely to Face Burnout in Health Care, System-Wide Solutions Are Needed to Address Issues

Women in health care occupations are more likely to endure a significant amount of stress and burnout compared with their male counterparts, said authors of a February 2024 study published in Global Advances in Medicine and Health.^1,2 Additionally, the authors also observed that specific factors such as job satisfaction, psychological health, and work-life integration or balance were also identified as having a direct correlation to their well-being.^1,2

Image credit: Rene L/peopleimages.com | stock.adobe.com

According to the study authors, women make up approximately 80% of the overall growth in the health care field since the turn of the century. With this global increase, concerns regarding their well-being have also increased.^1,2 Because women play multiple roles within society, they are more likely to experience mental health issues that are a cause of pressure and stress they feel to succeed in both their home life and work environment. Such issues can result in psychological distress, burnout within their working environment, depression and anxiety, rapid turnover, and even suicidal thoughts.²

For this literature review, authors evaluated a total of 71 studies from PubMed that were published in 26 countries between 1979 and 2022. The research enrolled adult women (broadly defined to include anyone who primarily identifies as a woman, regardless of their assigned sex at birth) aged 18 to 74 years who worked as nurses, physicians, clinical social workers, and mental health professionals. Well-being related occurrences such as quality of life, stress, resiliency, burnout, and wellness were also assessed.² Additionally, the investigators noted that at the time of its publication, the study was the first comprehensive analysis to examine the relationship between work-related stress and the well-being of women within health care professions, not just nationally, but worldwide.¹

According to the authors, the health care workplace may amplify the stress that women face because they are often working long hours and multiple shifts, while balancing their job’s demands alongside family responsibilities—such as childcare and housework—that often fall on women.^1,2 The authors also observed that women, compared with their male colleagues, were often assigned patients who had complex medical problems, which can take more time and emotional energy, therefore, increasing their stress.¹ Although these are not cures, the investigators noted that restorative sleep, physical activity, and a healthy diet can help mitigate job stress; however, system-wide solutions will need to involve solutions developed by policymakers specifically designed to prevent burnout and issues such as health care workforce shortages.^1,2

“Human beings are not equipped to handle the combined, intense pressures in health care in part due to the pressure to not take time to care for yourself,” Leigh A Frame, PhD, MHS, associate director of the George Washington Resiliency & Well-Being Center, said in a news release.¹

Further, a December 2023 study published in the Scandinavian Journal of Psychology³ outlined the signs of burnout while emphasizing tools that can help mitigate it, and possibly help with early intervention.^3,4 They acknowledge that although burnout is recognized as an occupational issue by the World Health Organization, it accurately identifying it can be difficult. The study evaluated a 23-item Burnout Assessment Tool (BAT) as well as a short 12-item version to investigate a sample of participants from Norway, of which just under half (49.54%) were women. The tools were intended to identify the early warning signs of burnout in this population, and addressed 4 main groups of risk factors: exhaustion, mental distancing, cognitive impairment, and emotional impairment.^3,4

The findings revealed that there was a bifactor exploratory structural equation modeling solution—burnout global factor and the 4 specific burnout component factors—best explained the data for both BAT versions. Additionally, both BAT versions were observed to correlate highly with each other and another burnout measure, which was an indication of convergent validity. Additionally, the BAT models achieved a full measurement invariance based on gender. The investigators said that the results showed that burnout can act as a mediator in proposed job demands, and such models can provide as preliminary evidence of predictive validity of burnout.³

For some people, according to the investigators, burnout can be stopped, and solutions can help improve their situation.^3,5 Particularly, the findings indicated that a lower percentage struggled with exhaustion in connection with their work. The authors also emphasized that the BAT tools are not intended to be used as diagnostic methods, but instead, a method of educating the individual on their potential burnout risk. Additionally, they note that the methods may not be generalizable because the methods were only evaluated in Norway.^3,4

“We have found that approximately 13% of Norwegian employees are at high risk of burnout. Not addressing the risk of employee burnout in time can have long-term consequences,” Leon De Beer, associate professor, work and organizational psychology in the department of psychology at the Norwegian University of Science and Technology (NTNU), said in a news release. “Previously, we have not had a detailed enough measurement tool for use in both the field of practice and research that identifies workers who are at risk of burnout.”⁴

Because burnout is a recurring experience for those within health care, a recent Pharmacy Times^® survey asked 160 pharmacists in various settings—community chain, community independent, health system, other, and unemployed at the time of response—about their experiences with burnout and the symptoms they experienced, key drivers of burnout, and whether their employers were addressing working conditions. Although survey takers were not asked to report their gender, all respondents had reported experiencing burnout.⁵

When rated on a scale of 1 to 10, the average reported level of experienced burnout was 7.25, and the most common symptoms reported were irritability (n = 120), lack of energy or productivity (n = 115), reluctance to go to work (n = 104), and cynicism (n = 100). Top drivers of burnout included workload (17.4%), management (14.6%), and lack of work/life balance (14.1%), with other self-reported drivers including lack of trained staff, challenges with providers or other departments, too much administrative work, and the profit-driven health care system. Most respondents wanted to take on new responsibilities at their workplace, but felt they were unable to do so because of their current workload.⁵

Additionally, burnout has been driven by the COVID-19 pandemic, with pharmacists having to adapt to the growing demands and fewer resources.⁵ The pharmacists were asked to report the COVID-19 pandemic’s influence on burnout and whether that contributed to understaffed health systems, and interestingly, the surveyed population rated their burnout as a 4.91 prior to the pandemic. Both ratings are significantly impacting the broad pharmacy workforce, with approximately 85% (n = 136) considering alternative career paths because of their burnout.⁵

According to the survey findings, some companies and health systems have taken some steps to help improve workplace conditions and burnout levels; however, just 36.9% of respondents said that their company has taken steps toward improvement, whereas 58.8% reported the opposite. Additionally, 4.4% said they were unsure. Of the pharmacists working for companies that have made steps toward improvement, 46.3% reported they were ineffective and 9.4% said that they were.⁵ Although this sample is not as large as other surveys and studies, this only further illustrates the need for policymakers, companies, and health care employers to implement effective methods to help prevent or mitigate burnout.^1,2,5

“We can deal with burnout through individual treatment, but it is of little use if people return to a workplace where the demands are too high and there are few resources. It is then highly likely that the employee will become ill again. Therefore, it is important to create good working conditions and structures that safeguard the health of employees,” Marit Christensen, professor at the department of psychology, NTNU, said in the news release.⁴

REFERENCES

1. George Washington University. Women in healthcare face significantly higher burnout rates compared to their male colleagues. News release. February 22, 2024. Accessed October 16, 2024. https://www.eurekalert.org/news-releases/1034563

2. Karakcheyeva V, Willis-Johnson H, Corr PG, Frame LA. The Well-Being of Women in Healthcare Professions: A Comprehensive Review. Glob Adv Integr Med Health. 2024;13:27536130241232929. Published 2024 Feb 10. doi:10.1177/27536130241232929

3. De Beer LT, Christensen M, Sørengaard TA, Innstrand ST, and Schaufeli WB (2024), The psychometric properties of the Burnout Assessment Tool in Norway: A thorough investigation into construct-relevant multidimensionality. Scand J Psychol, 65: 479-489. doi.org:10.1111/sjop.12996

4. Norwegian University of Science and Technology. Burnout: identifying people at risk. News release. February 15, 2024. Accessed October 16, 2024. https://www.eurekalert.org/news-releases/1034094

5. Slideshow: Pharmacists Report Burnout is a Major Driver of Understaffing in Pharmacy Times Survey. Pharmacy Times. July 16, 2024. Accessed October 16, 2024. https://www.pharmacytimes.com/view/slideshow-pharmacists-report-burnout-is-a-major-driver-of-understaffing-in-pharmacy-times-survey