The prevalence of burnout among pulmonologists or respiratory therapists pre- and post-COVID-19: a systematic review and meta-analysis

Figures & data

Figure 1. PRISMA flow of study selection. A total of 2859 records were identified from PubMed (n = 422), EMBASE (n = 820), PsycINFO (n = 77), CENTRAL (n = 27), Scopus (n = 432) and Web of Science (n = 1081). There were 1088 duplicates removed. The remaining 1771 records went through title-and-abstract reviews. We excluded 1662 records due to reasons presented in the figure. Therefore, 109 records were further evaluated by full-text reviews. Ninety-four were excluded because of reasons in the above column. One additional paper was found by screening the reference lists of the included studies. Thus, 16 studies were included in the final analysis.

Table 1. Information of the included studies (n = 16).

Study	Period	COVID-19	Setting	Center	Specialty	Level	Response rate, %
Shbeer and Ageel [19]	2021 August–November	Amidst	Saudi Arabia	Multiple	ICU	RT	69.3
Spirczak et al. [30]	2020 July–August	Amidst	United States	Multiple	Respiratory care department	RT	84.8
Siraj et al. [31]	2021 March–May	Amidst	Saudi Arabia	Multiple	Respiratory therapy programs	RT students	69.9
Roberts and coworkers [14]	2020 July–2021 May	Amidst	United States	Single	ICU	RT	NA
Kerlin [32]	2020 July, 2020 October, 2021 January	Amidst	United States	Multiple	ICU	RT	54
Ahmad et al. [33]	2020 November	Amidst	Saudi Arabia	Multiple	NA	RT	60.8
Omar et al. [20]	2021 January	Amidst	Qatar	Multiple	ICU	RT	36.4
Castro et al. [21]^b	2021 April–May	Amidst	Italy	Single	NA	RT	84.2
Alhaykan [22]	2020 December–2021 January	Amidst	United States	Multiple	NA	RT	NA
Algarni et al. [23]	2021 September–November	Amidst	Saudi Arabia	Single	Respiratory care department	RT	66.0
Sharp et al. [24]	2019 January–February	Pre-	United States	Multiple	Pulmonary, PCCM, CCM	Fellow	51.4
Miller et al. [25]^a	2021 January–March	Amidst	United States	Multiple	NA	RT	37.0
Zhou et al. [26]	2020 March–May	Amidst	China	Single	Pulmonary	Physician	96.2
Piracha et al. [27]^a	NA	NA	United Kingdom	Multiple	NA	Physician	NA
Fumis et al. [28]	2015 August–September	Pre-	Brail	Single	ICU	RT	72.7
Austria-Corrales et al. [29]^b	2009 April–May	Pre-	Mexico	Single	Respiratory medicine	Resident	NA

CCM: critical care medicine; ICU: intensive critical care; NA: not available; PCCM: pulmonary critical care medicine; RT: respiratory therapist.

^a Full texts were not available and information was extracted from the abstract.

^b Texts were not in English and translated into English by Google translation.

Table 2. The measure, definition and prevalence of burnout of the included studies (n = 16).

Study	Instrument	Definition of burnout in high level	No. of total	No. of burnout	Prevalence, %	High EE	High DP	Low PA
Shbeer and Ageel [19]	MBI	NA (cut-off, EE ≥ 28, DP ≥ 11, PA ≤ 29)	12	6	50	6	4	4
Spirczak et al. [30]	ProQOL	Score of burnout questions ≥ 42	218	128	59^a	NA
Siraj et al. [31]	MBI	EE ≥ 27, DP ≥ 10 and PA ≤ 33	559	436	78	291	330	307
Roberts and coworkers [14]	NA	NA	108	82	75	NA
Kerlin [32]	WBI, SPFI	SPFI ≥ 1.33, or WBI ≥ 4	100	74	74	NA
Ahmad et al. [32]	MBI	EE ≥ 38, DP ≥ 18 and PA ≤ 33	152	68	45	68	51	71
Omar et al. [20]	MBI	EE ≥ 27, or DP ≥ 13, or PA ≤ 33	84	45	54	22	8	38
Castro et al. [21]	MBI	EE ≥ 22, DP ≥ 7 and PA ≤ 34	9	8	89	NA
Alhaykan [22]	MBI	EE ≥ 27, DP ≥ 10 and PA ≤ 33	295	100	34	197	139	192
Algarni et al. [23]	MBI	NA (cut-off, EE ≥ 27, DP ≥ 10, PA ≤ 33)	66	65	98	51	65	48
Sharp et al. [24]	MBI 2-item	Either item ≥ 1 week	502	276	55	NA
Miller et al. [25]	NA	NA	1114	880	79	NA
Zhou et al. [26]	MBI	EE ≥ 27 and/or DP ≥ 10 (PA < 33)	125	61	49	56	34	36
Piracha et al. [27]	NA	NA	110	59	54	NA
Fumis et al. [28]	MBI	EE ≥ 27, DP ≥ 10 and PA ≤ 33	57	12	21	NA
Austria-Corrales et al. [29]	MBI	EE ≥ 26, DP ≥ 10 and PA ≤ 34	99	36	36	NA

DP: depersonalization; EE: emotional exhaustion; MBI: Maslach Burnout Inventory; NA: not available; PA: personal accomplishment; ProQOL: professional quality of life scale; SPFI: Stanford Professional Fulfilment Index; WBI: Well-Being Index.

^a Sum of burnout in medium and high level.

Figure 2. Forest plot of the overall prevalence of burnout. The included studies reported a total of 3610 responding individuals and 2100 burnouts. The pooled prevalence of burnout was 61.7% (95% CI, 48.6–73.2%; I² = 96.3%). The pooled prevalence of burnout during COVID-19 was significantly higher than it was prior to the outbreak (68.4% vs. 41.6%, p = .01).

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Data availability statement

Data sharing is not applicable to this article as no datasets were generated or analysed during the current study.