Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Original Investigation

Anxiety and burnout in anesthetists and intensive care unit nurses during the COVID-19 pandemic: a cross-sectional study

Ansiedade e burnout em anestesistas e enfermeiros de unidade de terapia intensiva durante a pandemia de COVID-19: um estudo transversal

Sultan Acar Sevinc; Seyhan Metin; Nermin Balta Basi; Ayse Surhan Cinar; Melis Turkel Ozkan; Sibel Oba

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This study aimed to measure the levels of anxiety and burnout among healthcare workers, including attending physicians, residents, and nurses, in intensive care units during the coronavirus disease 2019 (COVID-19) pandemic.

This is a cross-sectional survey analysis of healthcare workers in our institution. Data were collected on demographic variables, COVID-19 symptoms and test, disease status, anxiety level (assessed by the Beck Anxiety Inventory), and burnout level (measured by the Maslach Burnout Inventory). Subscales of the burnout inventory were evaluated separately.

A total of 104 participants completed the survey. Attending physicians, residents, and nurses constituted 25%, 33.7%, and 41.3% of the cohort, respectively. In comparison to untested participants, those tested for COVID-19 had a lower mean age (p =  0.02), higher emotional exhaustion and depersonalization scores (p =   0.001, 0.004, respectively), and lower personal accomplishment scores (p =  0.004). Furthermore, moderate to severe anxiety was observed more frequently in tested participants than untested ones (p =  0.022). Moderate or severe anxiety was seen in 23.1% of the attending physicians, 54.3% of the residents, and 48.8% of the nurses (p =  0.038). Emotional exhaustion, personal accomplishment, and depersonalization scores differed depending on the position of the healthcare workers (p =  0.034, 0.001, 0.004, respectively).

This study revealed higher levels of anxiety and burnout in younger healthcare workers and those tested for COVID-19, which mainly included residents and nurses. The reasons for these observations should be further investigated to protect their mental health.


Anesthetist;  Anxiety;  Burnout syndrome;  COVID-19;  Intensive care unit


Justificativa: Este estudo teve como objetivo medir os níveis de ansiedade e esgotamento entre os profissionais de saúde, incluindo médicos assistentes, residentes e enfermeiros, em unidades de terapia intensiva durante a pandemia da doença por coronavírus 2019 (COVID-19). Métodos: Trata-se de uma pesquisa transversal com análise de profissionais de saúde em nossa instituição. Os dados foram coletados sobre variáveis demográficas, sintomas e teste de COVID-19, status da doença, nível de ansiedade (avaliado pelo Inventário de Ansiedade de Beck) e nível de burnout (medido pelo Maslach Burnout Inventory). As subescalas do inventário de burnout foram avaliadas separadamente. Resultados: Um total de 104 participantes completaram a pesquisa. Médicos assistentes, residentes e enfermeiros constituíram 25%, 33,7% e 41,3% da coorte, respectivamente. Em comparação com os participantes não testados, aqueles testados para COVID-19 tiveram uma idade média mais baixa (p= 0,02), maiores pontuações de exaustão emocional e despersonalização (p =0,001, 0,004, respectivamente) e menores pontuações de realização pessoal (p = 0,004). Além disso, ansiedade moderada a grave foi observada com mais frequência nos participantes testados do que nos não testados (p = 0,022). Ansiedade moderada ou grave foi observada em 23,1% dos médicos assistentes, 54,3% dos residentes e 48,8% dos enfermeiros (p = 0,038). Os escores de exaustão emocional, realização pessoal e despersonalização diferiram de acordo com a posição dos profissionais de saúde (p = 0,034, 0,001, 0,004, respectivamente). Conclusão: Este estudo revelou níveis mais elevados de ansiedade e burnout em profissionais de saúde mais jovens e testados para COVID-19, que incluíram principalmente residentes e enfermeiros. As razões para essas observações devem ser mais investigadas para proteger sua saúde mental.


Anestesista; Ansiedade; Síndrome de Burnout; COVID-19; Unidade de Tratamento Intensivo


1 Coronavirus disease (COVID-19) pandemic 2020 [cited 19.10.2020]. Available from:

2 M. Di Tella, A. Romeo, A. Benfante, et al. Mental health of healthcare workers during the COVID-19 pandemic in Italy J Eval Clin Pract, 26 (2020), pp. 1583-1587

3 M.Y. Si, X.Y. Su, Y. Jiang, et al. Psychological impact of COVID-19 on medical care workers in China Infect Dis Poverty, 9 (2020), p. 113

4 N.W.S. Chew, G.K.H. Lee, B.Y.Q. Tan, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak Brain Behav Immun, 88 (2020), pp. 559-565

5 S. Pappa, V. Ntella, T. Giannakas, et al. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis Brain, Behavior, and Immunity, 88 (2020), pp. 901-907

6 M.Y. Chong, W.C. Wang, W.C. Hsieh, et al. Psychological impact of severe acute respiratory syndrome on health workers in a tertiary hospital Br J Psychiatry, 185 (2004), pp. 127-133

7 C.W. Tam, E.P. Pang, L.C. Lam, et al. Severe acute respiratory syndrome (SARS) in Hong Kong in 2003: stress and psychological impact among frontline healthcare workers Psychol Med, 34 (2004), pp. 1197-1204

8 S.M. Lee, W.S. Kang, A.R. Cho, et al. Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients Compr Psychiatry, 87 (2018), pp. 123-127

9 A.S. Nyssen, I. Hansez, P. Baele, et al. Occupational stress and burnout in anaesthesia Br J Anaesth., 90 (2003), pp. 333-337

10 M.T. Kluger, K. Townend, T. Laidlaw Job satisfaction, stress and burnout in Australian specialist anaesthetists Anaesthesia, 58 (2003), pp. 339-345

11 M.C. Poncet, P. Toullic, L. Papazian, et al. Burnout syndrome in critical care nursing staff Am J Respir Crit Care Med, 175 (2007), pp. 698-704

12 M.L. Mealer, A. Shelton, B. Berg, et al. Increased Prevalence of Post-traumatic Stress Disorder Symptoms in Critical Care Nurses American Journal of Respiratory and Critical Care Medicine, 175 (2007), pp. 693-697

13 A.T. Beck, N. Epstein, G. Brown, et al. An inventory for measuring clinical anxiety: psychometric properties J Consult Clin Psychol, 56 (1988), pp. 893-897

14 M. Ulusoy, N.H. Sahin, H. Erkmen Turkish Version of the Beck Anxiety Inventory: Psychometric Properties Journal of Cognitive Psychotherapy, 12 (1998), pp. 163-172

15 L.J. Julian Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A) Arthritis Care Res (Hoboken), 63 Suppl 11 (2011), pp. S467-72

16 C. Maslach, S.E. Jackson, R.L. Schwab Maslach burnout inventory: manual Consulting Psychologists Press, Palo Alto (1986)

17 C. Ergin Maslach tükenmişlik ölçeğinin Türkiye sağlık personeli normları Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi, 4 (1996), pp. 28-33

18 K. Doulougeri, K. Georganta, A. Montgomery “Diagnosing” burnout among healthcare professionals: Can we find consensus? Cogent Medicine, 3 (2016), p. 1

19 M C. Maslach Tükenmişlik Ölçeği Sağlık Personeli Türkiye Normlarının Silahlı Kuvvetler Sağlık Personeli Tükenmişlik Puanları İle Karşılaştırılmalı Olarak İncelenmesi Toplum ve Hekim, 17 (2002), pp. 212-216

20 K. El-Boghdadly, D.J.N. Wong, R. Owen, et al. Risks to healthcare workers following tracheal intubation of patients with COVID-19: a prospective international multicentre cohort study Anaesthesia, 75 (2020), pp. 1437-1447

21 M.C.C. Lee, S. Thampi, H.P. Chan, et al. Psychological distress during the COVID-19 pandemic amongst anaesthesiologists and nurses Br J Anaesth, 125 (2020), pp. e384-e386

22 J. Que, L. Shi, J. Deng, et al. Psychological impact of the COVID-19 pandemic on healthcare workers: a cross-sectional study in China Gen Psychiatr, 33 (2020), Article e100259

23 The Problem with Cut Offs for the Maslach Burnout Inventory 2018 [cited 15.10.2020]. Available from:

24 B. Chiron, E. Michinov, E. Olivier-Chiron, et al. Job satisfaction, life satisfaction and burnout in French anaesthetists J Health Psychol, 15 (2010), pp. 948-958

25 M. Vargas, G. Spinelli, P. Buonanno, et al. Burnout Among Anesthesiologists and Intensive Care Physicians: Results From an Italian National Survey Inquiry, 57 (2020), Article 46958020919263

26 L. Kang, Y. Li, S. Hu, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus Lancet Psychiatry, 7 (2020), Article e14

27 Q. Chen, M. Liang, Y. Li, et al. Mental health care for medical staff in China during the COVID-19 outbreak The Lancet Psychiatry, 7 (2020), pp. e15-e16

28 F. Chirico, G. Nucera, N. Magnavita Protecting the mental health of healthcare workers during the COVID-19 emergency BJPsych International, 18 (2021), p. E1

29 Ruh Sağlığı Destek Sistemi 2020 [cited 15.10.2020]. Available from:

30 J.R. Sneyd, S.E. Mathoulin, E.P. O’Sullivan, et al. Impact of the COVID-19 pandemic on anaesthesia trainees and their training Br J Anaesth, 125 (2020), pp. 450-455

31 M. Roycroft, D. Wilkes, S. Pattani, et al. Limiting moral injury in healthcare professionals during the COVID-19 pandemic Occupational Medicine, 70 (2020), pp. 312-314

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