Prevalence and risk factors of burnout symptoms among nurses during the COVID-19 pandemic: an updated systematic review and meta-analysis

Abstract

Background: COVID-19 has been a substantial challenge for nurses globally, as they have gone through prolonged crisis times where they were continually under immense psychological pressure. Working in these conditions for months and years has resulted in an increase in the prevalence of job burnout among nurses. This systematic review was conducted to provide solid evidence on the prevalence of burnout and its related factors among nursing staff in different parts of the world after the occurrence of the COVID-19 pandemic. Methods: Several electronic databases were searched, between January 2020 and September 15, 2024, for relevant studies, namely MEDLINE, Web of Science, Embase, Scopus, ScienceDirect, ProQuest, APA PsycINFO, Google Scholar, and EBSCOhost Research Platform. Multiple search keywords were defined for the search process. The Newcastle–Ottawa Scale was used to evaluate the quality of each study included. Our main outcome was the prevalence of burnout in nurses during COVID-19. We subsequently analyzed our data by age (< 30 vs. ≥ 30 years), country income levels (defined based on the World Bank Classification for the 2023 fiscal year), and culture (Western vs. Non-Western). We used RevMan software, developed by Cochrane, to perform the statistical analysis. The outcomes were assessed using odds ratios (OR) with corresponding 95% confidence intervals (CI) to ensure accurate and reliable estimates. Results: Data from the 19 studies and 11 countries indicated an overall burnout prevalence rate of 59.5% in the nurse population during COVID-19. In addition, analyses of 37 studies and 15,015 nurses revealed a pooled prevalence rate for emotional exhaustion of 36.1%. Analyses of 36 studies involving 14,864 nurses showed a pooled prevalence rate for depersonalization of 32.4%. Finally, data from 36 studies and 14,864 participants found a pooled prevalence rate for reduced personal accomplishment of 33.3%. Regarding subgroup analysis of total burnout by nurses’ characteristics, our results demonstrated that nurses working in higher income countries reported significantly higher prevalence rates of burnout relative to those working in low- and lower-to-middle-income countries. Those working in a Western context exhibited significantly higher risk for overall burnout compared to those working in a non-Western context. Finally, comparisons across age groups noted significantly higher levels of burnout among nurses aged 30 years and above compared to those aged < 30 years. Conclusion: This review urges nursing leaders’ intervention, hospital administrators, and policymakers to minimize and prevent burnout among nurses, especially during crises times such as the COVID-19 pandemic. This review also encourages further research into efficient evidence-based interventions to support nurses and combat burnout in the nursing profession.