{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:35:20Z","timestamp":1793392520607,"version":"4.5.0"},"reference-count":45,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T00:00:00Z","timestamp":1610668800000},"content-version":"unspecified","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,1,6]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To determine burn-out levels and associated factors among healthcare personnel working in a tertiary hospital of a highly burdened area of north-east Italy during the COVID-19 pandemic.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Observational study conducted from 21 April to 6 May 2020 using a web-based questionnaire.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Research conducted in the Verona University Hospital (Veneto, Italy).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Out of 2195 eligible participants, 1961 healthcare workers with the full range of professional profiles (89.3%) completed the survey.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary outcome measure<\/jats:title>\n                  <jats:p>Levels of burn-out, assessed by the Maslach Burnout Inventory-General Survey (MBI-GS). Multivariable logistic regression analysis was performed to identify factors associated with burn-out in each MBI-GS dimension (emotional exhaustion, EX; professional efficacy, EF; cynicism, CY).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 38.3% displayed high EX, 46.5% low EF and 26.5% high CY. Burn-out was frequent among staff working in intensive care units (EX 57.0%; EF 47.8%; CY 40.1%), and among residents (EX 34.9%; EF 63.9%; CY 33.4%) and nurses (EX 49.2%; EF 46.9%; CY 29.7%). Being a resident increased the risk of burn-out (by nearly 2.5 times) in all the three MBI subscales and being a nurse increased the risk of burn-out in the EX dimension in comparison to physicians. Healthcare staff directly engaged with patients with COVID-19 showed more EX and CY than those working in non-COVID wards. Finally, the risk of burn-out was higher in staff showing pre-existing psychological problems, in those having experienced a COVID-related traumatic event and in those having experienced interpersonal avoidance in the workplace and personal life.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Burn-out represents a great concern for healthcare staff working in a large tertiary hospital during the COVID-19 pandemic and its impact is more burdensome for front-line junior physicians. This study underlines the need to carefully address psychological well-being of healthcare workers to prevent the increase of burn-out in the event of a new COVID-19 healthcare emergency.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-045127","type":"journal-article","created":{"date-parts":[[2021,1,17]],"date-time":"2021-01-17T12:01:08Z","timestamp":1610884868000},"page":"e045127","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":211,"title":["Levels of burn-out among healthcare workers during the COVID-19 pandemic and their associated factors: a cross-sectional study in a tertiary hospital of a highly burdened area of north-east Italy"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9963-6081","authenticated-orcid":false,"given":"Antonio","family":"Lasalvia","sequence":"first","affiliation":[{"name":"UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy"},{"name":"Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Amaddeo","sequence":"additional","affiliation":[{"name":"Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy"},{"name":"UOC Psicosomatica e Psicologia Medica, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Porru","sequence":"additional","affiliation":[{"name":"Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona and Clinical Unit of Occupational Medicine, Integrated University Hospital of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Carta","sequence":"additional","affiliation":[{"name":"Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona and Clinical Unit of Occupational Medicine, Integrated University Hospital of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Tardivo","sequence":"additional","affiliation":[{"name":"Section of Hygiene, Department of Diagnostic and Public Health, University of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Bovo","sequence":"additional","affiliation":[{"name":"Health Director, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirella","family":"Ruggeri","sequence":"additional","affiliation":[{"name":"UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy"},{"name":"Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Bonetto","sequence":"additional","affiliation":[{"name":"Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,1,17]]},"reference":[{"key":"2025101811430414000_11.1.e045127.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1642"},{"key":"2025101811430414000_11.1.e045127.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2020.05.026"},{"key":"2025101811430414000_11.1.e045127.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2020.04.049"},{"key":"2025101811430414000_11.1.e045127.4","doi-asserted-by":"crossref","DOI":"10.3949\/ccjm.87a.ccc051","article-title":"Burnout of healthcare providers during COVID-19","author":"Bradley","year":"2020","journal-title":"Cleve Clin J Med"},{"key":"2025101811430414000_11.1.e045127.5","first-page":"91","volume-title":"Research in occupational stress and well-being","volume":"3","author":"Leiter","year":"2003"},{"key":"2025101811430414000_11.1.e045127.6","unstructured":"Maslach C , Jackson SE , Leiter MP . 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