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УДК: 613.287.1 DOI:10.33920/MED-12-2206-03

Профессиональный стресс и синдром эмоционального выгорания у медицинских работников в период пандемии COVID-19 (обзор литературы)

Бабанов С.А. ФГБОУ ВО «Самарский государственный медицинский университет» Министерства здравоохранения Российской Федерации (ФГБОУ ВО СамГМУ Минздрава России), 443099, Российская Федерация, г. Самара, ул. Чапаевская, 89, https://orcid.org/0000-0002-1667-737X
Сазонова О.В. ФГБОУ ВО «Самарский государственный медицинский университет» Министерства здравоохранения Российской Федерации (ФГБОУ ВО СамГМУ Минздрава России), 443099, Российская Федерация, г. Самара, ул. Чапаевская, 89, https://orcid.org/0000-0002-4130-492X
Гаврюшин М.Ю. ФГБОУ ВО «Самарский государственный медицинский университет» Министерства здравоохранения Российской Федерации (ФГБОУ ВО СамГМУ Минздрава России), 443099, Российская Федерация, г. Самара, ул. Чапаевская, 89, https://orcid.org/0000-0002-0897-7700
Острякова Н.А. ФГБОУ ВО «Самарский государственный медицинский университет» Министерства здравоохранения Российской Федерации (ФГБОУ ВО СамГМУ Минздрава России), 443099, Российская Федерация, г. Самара, ул. Чапаевская, 89, https://orcid.org/0000-0001-5459-691X
Кувшинова Н.Ю. ФГБОУ ВО «Самарский государственный медицинский университет» Министерства здравоохранения Российской Федерации (ФГБОУ ВО СамГМУ Минздрава России), 443099, Российская Федерация, г. Самара, ул. Чапаевская, 89, https://orcid.org/0000-0003-0780-7336

Введение. В условиях риска профессионального инфицирования COVID-19 при непосредственном контакте с источником заболевания возросло нервно-психическое напряжение у медицинских работников, участвующих в оказании помощи больным в период пандемии новой коронавирусной инфекции. Цель исследования — проведение обзора теоретико-методологических основ формирования и развития профессионального выгорания у медицинских работников в эпоху пандемии COVID-19. Материалы и методы. В работе представлен анализ литературных источников, посвященных проблеме синдрома профессионального выгорания у медицинских работников, представленных в Научной электронной библиотеке eLibrary, а также в англоязычной текстовой базе данных медицинских и биологических публикаций PubMed. Проведенный анализ зарубежной литературы показал актуальность данной проблемы, в первую очередь для медицинских работников в эпоху пандемии COVID-19. Результаты. Пандемия новой коронавирусной инфекции связана с множеством причин и факторов, которые могут оказать неблагоприятное воздействие на формирование и развитие профессионального выгорания у медицинских работников: высокая рабочая нагрузка, отсутствие и нехватка СИЗ, угроза и риск заражения новой коронавирусной инфекцией, социальная изоляция, недостаточность (на первом этапе) накопленных знаний о новом малоизученном заболевании.

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36. Zhu N, Zhang D, Wang W, et al.; China Novel Coronavirus Investigating and Research Team. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020 Feb 20;382 (8):727–33. doi: 10.1056/NEJMoa2001017

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39. Simione L and Gnagnarella C. Differences between health workers and general population in risk perception, behaviors, and psychological distress related to COVID-19 spread in Italy. PsyArXiv. 2020. In press.

40. Zhang SX, Liu J, Afshar Jahanshahi A, et al. At the height of the storm: healthcare staff’s health conditions and job satisfaction and their associated predictors during the epidemic peak of COVID-19. Brain Behav Immun. 2020;87:144–6.

41. Delgado D, Wyss Quintana F, Perez G, et al. Personal safety during the COVID-19 pandemic: realities and perspectives of healthcare workers in Latin America. Int J Environ Res Public Health. 2020;17 (8):2798.

42. Prescott K, Baxter E, Lynch C, et al. COVID-19: How prepared are front line healthcare workers in England? J Hosp Infect.2020;105 (2):142–5.

43. Suleiman A, Bsisu I, Guzu H, et al. Preparedness of frontline doctors in Jordan healthcare facilities to COVID-19 outbreak. Int J Environ Res Public Health. 2020;17 (9):3181

44. Chew NWS, Lee GKH, Tan BYQ, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun. 2020;88:559–65.

45. Jiang N, Jia X, Qiu Z, et al. The Influence of efficacy beliefs on interpersonal loneliness among front- 9line healthcare workers during the 2019 novel coronavirus outbreak in China: a crosssectional study. SSRN. 2020. In press

46. Badahdah AM, Khamis F, Mahyijari NA. The psychological well-being of physicians during COVID-19 outbreak in Oman. Psychiatry Res. 2020;289:113053.

47. Wu Y, Wang J, Luo C, et al. A comparison of burnout frequency among oncology physicians and nurses working on the front lines and usual wards during the COVID-19 epidemic in Wuhan, China. J Pain Symptom Manage. 2020;60 (1):e60–5.

48. Cao J, Wei J, Zhu H, et al. A study of basic needs and psychological wellbeing of medical workers in the fever clinic of a tertiary general hospital in Beijing during the COVID-19 outbreak. Psychother Psychosom. 2020:1–3.

49. Huang Y and Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res. 2020;288:112954.

50. Liu Q, Luo D, Haase JE, et al. The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study.Lancet Glob Health. 2020;8 (6):E790–8

51. Sun N, Wei L, Shi S, et al. A qualitative study on the psychological experience of caregivers of COVID-19 patients. Am J Infect Control.2020;48 (6):592–8.

52. Sethi BA, Sethi A, Ali S, et al. Impact of coronavirus disease (COVID-19) pandemic on health professionals. Pak J Med Sci.2020;36 (COVID19-S4).

53. Jin YH, Huang Q, Wang YY, et al. Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: a cross-sectional survey. Mil Med Res.2020;7 (1):24.

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8. Wu YC, Chen CS, Chan YJ. The outbreak of COVID-19: An overview. J Chin Med Assoc. 2020 Mar;83 (3):217–20. doi: 10.1097/JCMA.0000000000000270

9. Opening address by the Director-General at a COVID-19 press briefing on March 11, 2020. Published online at WHO.int. (In Russ.)]. https://www.who.int/ru/dg/speeches/detail/ who-director-general-s-opening-remarks-at-the-media-briefing-onCOVID-19–11 march-2020

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11. Vieira, C. M.; Franco, O. H.; Restrepo, C. G.; Abel, T. COVID-19: The forgotten priorities of the pandemic. Maturitas 2020, 136, 38–41. [Google Scholar] [CrossRef ]

12. Macintyrea CR: On a knife’s edge of a COVID-19 pandemic: is containment still possible. Public Health Res Pract. 2020; 30

13. Brooks SK, Webster RK, Smith LE, et al.: The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet 2020; 395:912–920Crossref, Medline, Google Scholar

14. Lai J, Ma S, Wang Y. Factors associated with mental health outcomes among health care workers exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020;3 (3):e203976. doi: 10.1001/jamanetworkopen.2020.3976

15. Khan S, Siddique R, Bai AAQ, Li Z, Li H, Shereen MA, et al. The spread of novel coronavirus has created an alarming situation worldwide. J Infect Public Health. 2020;13 (4) 469–71. doi: 10.1016/j. jiph.2020.03.005

16. Sun N, Shi S, Jiao D. A Qualitative study on the psychological experience of caregivers of COVID-19 patients. Am J Infect Control. 2020 48 (6):592–8. doi: 10.1016/j.ajic.2020.03.018

17. Yin X, Zeng L. A study on the psychological needs of nurses caring for patients with coronavirus disease 2019 from the perspective of the existence, relatedness, and growth theory. Int J Nurs Sci. 2020. doi: 10.1016/j.ijnss.2020.04.002

18. Misra A. Doctors and healthcare workers at frontline of COVID 19 epidemic: admiration, a pat on the back, and need for extreme caution. Diabetes Metab Syndr. 2020;14 (3):255–6. doi: 10.1016/j. dsx.2020.03.006

19. Alsubaie S, Temsah MH, Al-Eyadhy AA, Gossady I, Hasan GM, Al-rabiaah A, et al. Middle East Respiratory Syndrome Coronavirus epidemic impact on healthcare workers’ risk perceptions, work and personal lives. J Infect Dev Ctries. 2019;13:920–926. doi: 10.3855/jidc.11753

20. Perlis RH. Exercising Heart and Head in Managing Coronavirus Disease 2019 in Wuhan. JAMA Netw Open. 2020;3 (3):e204006. doi: 10.1001/jamanetworkopen.2020.4006

21. Kang L, Ma S, Chen M, et al. Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: a cross sectional study. Brain Behav Immun. 2020;87:11–7.

22. Goulia P, Mantas C, Dimitroula D, Mantis D, Hyphantis T. General hospital staff worries, perceived sufficiency of information and associated psychological distress during the A/H1N1 influenza pandemic. BMC Infect Dis. 2010;10:322. doi: 10.1186/1471 2334 10 322

23. Vyas KJ, Delaney EM, Webb-Murphy JA, Johnston SL. Psychological Impact of Deploying in Support of the U. S. Response to Ebola: a systematic review and meta-analysis of past outbreaks. Military Med. 2016;181 (11-12):1515–31. doi: 10.7205/MILMED–D-15–00473

24. Maunder RG, Lancee WJ, Balderson KE. Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerg Infect Dis 2006; 2 (12): 924–32. doi: 10.3201/eid1212.060584

25. Chan AOM, Huak CY. Psychological impact of the 2003 severe acute respiratory syndrome outbreak on healthcare workers in a medium size regional general hospital in Singapore. Occup Med (Lond). 2004;54 (3):190–6. doi: 10.1093/occmed/kqh027

26. Nickell LA, Crighton EJ, Tracy CS. Psychosocial effects of SARS on hospital staff: survey of a large tertiary care institution. CMAJ. 2004;170 (5):793–8. doi: 10.1503/cmaj.1031077

27. Tam CW, Pang EP, Lam LC, Chiu HF. Severe acute respiratory syndrome (SARS) in Hong Kong in 2003: stress and psychological impact among healthcare workers. Psychol Med. 2004;34 (7):1197–204. doi: 10.1017/s0033291704002247

28. Khalid I, Khalid TJ, Qabajah MR, Barnard AG, Qushmaq IA. Healthcare Workers Emotions, Perceived Stressors and Coping Strategies During MERS-CoV Outbreak. Clin Med Res. 2016;14 (1):7–14. doi: 10.3121/cmr.2016.1303

29. Tam CW, Pang EP, Lam LC, Chiu HF. Severe acute respiratory syndrome (SARS) in Hong Kong in 2003: stress and psychological impact among healthcare workers. Psychol Med. 2004;34 (7):1197–204. doi: 10.1017/s0033291704002247

30. Park JS, Lee EH, Park NR, Choi YH. Mental health of nurses working at a government-designated hospital during a MERS-CoV outbreak: a cross-sectional study. Arch Psychiatr Nurs. 2018;32:2–6. doi: 10.1016/j.apnu.2017.09.006

31. Duan L, Zhu G: Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry 2020; 7:300–302Crossref, Medline, Google Scholar

32. Xiao H: The effects of social support on sleep quality of medical staff treating patients with coronavirus disease 2019 (COVID-19) in January and February 2020 in China. Med Sci Monit 2020; 26: e923549–1 — e923549-8Crossref, Google Scholar

33. Kang L, Li Y, Hu S, Chen M, Yang C, Yang BX, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry. 2020;7 (3):pp.e14. doi: 10.1016/S2215–0366 (20) 30047 X

34. Liu C-Y, Yang Y-z, Zhang X–M, et al. The prevalence and influencing factors for anxiety in medical workers fighting COVID-19 in China: a cross-sectional survey. Available at SSRN 3548781. 2020;148: e98.

35. Lu W, Wang H, Lin Y, et al. Psychological status of medical workforce during the COVID-19 pandemic: a cross-sectional study. Psychiatry Res. 2020;288:112936

36. Zhu N, Zhang D, Wang W, et al.; China Novel Coronavirus Investigating and Research Team. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020 Feb 20;382 (8):727–33. doi: 10.1056/NEJMoa2001017

37. Guo J, Liao L, Wang B, et al. Psychological effects of COVID-19 on hospital staff: a national cross-sectional survey of China Mainland. Available at SSRN 3550050. 2020. In press.

38. Dai Y, Hu G, Xiong H, et al. Psychological impact of the coronavirus disease 2019 (COVID-19) outbreak on healthcare workers in China. medRxiv. 2020. In press

39. Simione L and Gnagnarella C. Differences between health workers and general population in risk perception, behaviors, and psychological distress related to COVID-19 spread in Italy. PsyArXiv. 2020. In press.

40. Zhang SX, Liu J, Afshar Jahanshahi A, et al. At the height of the storm: healthcare staff’s health conditions and job satisfaction and their associated predictors during the epidemic peak of COVID-19. Brain Behav Immun. 2020;87:144–6.

41. Delgado D, Wyss Quintana F, Perez G, et al. Personal safety during the COVID-19 pandemic: realities and perspectives of healthcare workers in Latin America. Int J Environ Res Public Health. 2020;17 (8):2798.

42. Prescott K, Baxter E, Lynch C, et al. COVID-19: How prepared are front line healthcare workers in England? J Hosp Infect. 2020;105 (2):142–5.

43. Suleiman A, Bsisu I, Guzu H, et al. Preparedness of frontline doctors in Jordan healthcare facilities to COVID-19 outbreak. Int J Environ Res Public Health. 2020;17 (9):3181

44. Chew NWS, Lee GKH, Tan BYQ, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun. 2020;88:559–65.

45. Jiang N, Jia X, Qiu Z, et al. The Influence of efficacy beliefs on interpersonal loneliness among front- 9line healthcare workers during the 2019 novel coronavirus outbreak in China: a cross-sectional study. SSRN. 2020. In press

46. Badahdah AM, Khamis F, Mahyijari NA. The psychological well-being of physicians during COVID-19 outbreak in Oman. Psychiatry Res. 2020;289:113053.

47. Wu Y, Wang J, Luo C, et al. A comparison of burnout frequency among oncology physicians and nurses working on the front lines and usual wards during the COVID-19 epidemic in Wuhan, China. J Pain Symptom Manage. 2020;60 (1):e60–5.

48. Cao J, Wei J, Zhu H, et al. A study of basic needs and psychological wellbeing of medical workers in the fever clinic of a tertiary general hospital in Beijing during the COVID-19 outbreak. Psychother Psychosom. 2020:1–3.

49. Huang Y and Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res. 2020;288:112954.

50. Liu Q, Luo D, Haase JE, et al. The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study. Lancet Glob Health. 2020;8 (6):E790–8

51. Sun N, Wei L, Shi S, et al. A qualitative study on the psychological experience of caregivers of COVID-19 patients. Am J Infect Control. 2020;48 (6):592–8.

52. Sethi BA, Sethi A, Ali S, et al. Impact of coronavirus disease (COVID-19) pandemic on health professionals. Pak J Med Sci. 2020;36 (COVID19 S4).

53. Jin YH, Huang Q, Wang YY, et al. Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: a cross-sectional survey. Mil Med Res. 2020;7 (1):24.

Среди профессионально обусловленных психологических феноменов особое место отводится синдрому профессионального выгорания [1]. Согласно определению Всемирной организации здравоохранения, синдром профессионального выгорания представляет собой физическое, эмоциональное или мотивационное истощение, характеризующееся нарушением продуктивности в работе, усталостью, бессонницей, повышенной подверженностью соматическим заболеваниям [2, 3].

Цель исследования. Проведение обзора теоретико-методологических основ формирования и развития профессионального выгорания у медицинских работников в эпоху пандемии COVID-19.

В работе представлен анализ литературных источников, посвященных проблеме синдрома профессионального выгорания у медицинских работников, представленных в Научной электронной библиотеке eLibrary, а также в англоязычной текстовой базе данных медицинских и биологических публикаций PubMed. Проведенный анализ зарубежной литературы показал актуальность данной проблемы, в первую очередь для медицинских работников в эпоху пандемии COVID-19.

«Эмоциональное выгорание» — достаточно молодое понятие. Термин «синдром эмоционального выгорания» (СЭВ) (англ. burnout) ввел в обиход американский психиатр Герберт Фрейденбергер в 1974 г. Ранее термин «выгорание» (burnout) употреблялся в разговорной речи для обозначения эффекта хронической зависимости от наркотиков. Герберт Фрейденбергер дал ему название burnout, для характеристики психологического состояния здоровых людей, находящихся в интенсивном и тесном общении с пациентами (клиентами) в эмоционально нагруженной атмосфере при оказании профессиональной помощи. Иногда его переводят на русский язык как «эмоциональное сгорание» или «профессиональное выгорание». Герберт Фрейденбергер описывает «сгорающих» как сочувствующих, гуманных, мягких, увлекающихся, идеалистов, ориентированных на людей, и одновременно неустойчивых, интровертированных, одержимых навязчивыми идеями, «пламенных» и легко солидаризирующихся [4, 5].

Для Цитирования:
Бабанов С.А., Сазонова О.В., Гаврюшин М.Ю., Острякова Н.А., Кувшинова Н.Ю., Профессиональный стресс и синдром эмоционального выгорания у медицинских работников в период пандемии COVID-19 (обзор литературы). Терапевт. 2022;6.
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