A cross sectional study : assessment of levels of burnout amongst health care workers in Tshwane public clinics

Abstract

Background: South Africa is a country with the unique quadruple burden of disease and a shortage of health care workers (HCWs). This increased HCWs: patient ratio creates an excessive workload on HCWs. HCWs that are trying to compensate for the shortage may be more vulnerable to suffer burnout. The aim of the study was to measure burnout among HCWs at Tshwane clinics; compare the difference in burnout among the clinics; and identify possible reasons and root causes of burnout. Method: A cross sectional study was conducted on Tshwane HCWs in 4 public clinics. A shortened burnout Maslach inventory questionnaire was used for data collection amongst HCWs. A structured interview was conducted with management to clarify uncertainties raised or observed during data collection. Approval was granted by the University of Pretoria, Faculty of Health Research Ethics Committee. Results: Of the n=289 targeted, 69% (n=199) received questionnaires. 31% did not return the questionnaires or returned it unanswered. 14% did not complete all sections of the questionnaires handed out. A final sample size of n=109 of the 199 was achieved from the 4 clinics that took part in the study. Nurses represented 57.8% of participants studied. Years of experience, occupational status and type of clinic had a significant influence on burnout variables. High depersonalization, emotional exhaust and total burnout with a median of 3.29, 3.38 and 9.14 respectively, were observed. High depersonalization (p=0,0024) and low personal accomplishment (p=0,0034) were observed to have a significant influence on occupational status. Clinic 4 was ranked the highest for emotional exhaustion, depersonalisation and personal accomplishment. Conclusion: It should be noted that clinics where employees suffered the most burnout were those that operate for 24 hours. The possible root causes of burnout might be workload and moral constrains. Recommendations: The National Department of Health should invest more resources to reduce workload. A program to identify HCWs that may suffer burnout needs to be implemented to assist and manage HCWs with burnout.