ALBANY, N.Y., US: Mental health support is now a great priority for many employers who wish to show their commitment to promoting well-being in the workplace. However, burn-out among healthcare staff continues to be a cause for concern and may lead to issues such as high employee turnover, absenteeism, depression and a greater likelihood of medical errors, thus threatening patient safety. Putting mental health in the spotlight, recent research examined the levels of burn-out experienced during the COVID-19 pandemic by oral health providers at non-profit dental facilities in the US serving low-income families or individuals. It also highlighted contributing factors and strategies used to increase workforce resilience.
The report, published by the Oral Health Workforce Research Center at the University at Albany’s Center for Health Workforce Studies, used data from the 2021 online survey by Health Choice Network that included information on clinicians working in 25 community health centres across the US. The survey gathered information on 588 respondents, including those working in primary care, oral health, and mental and behavioural health settings. Oral health clinicians totalled 33 dentists, 12 dental hygienists and 25 dental assistants.
It found that the prevalence of burn-out during the COVID-19 pandemic was uniformly high across all clinician types. Namely, 79.3% of the oral health providers reported burn-out, similarly to 80.1% of the surveyed primary care providers and 76.2% of mental and behavioural health providers. Most of the oral health providers attributed their burn-out to a chaotic work environment and a lack of effective teamwork in their organisation.
Seeking to better assess the environmental and personal factors that contributed to burn-out among oral health providers, the researchers then conducted in-depth interviews with 26 people working in various positions at non-profit dental organisations throughout the US in 2022. The goal of the interviews was to collect information about the impact of COVID-19-related stressors on dental staff’s stress and anxiety levels and to determine whether burn-out and stress affected employee recruitment and retention.
Among the environmental factors that had an impact on dental staff were the lack of uniformity in policies and requirements and the uncertainty about infection pathways. Factors such as school and day care centre closures, loss of jobs in families, illness and death from COVID-19, and isolation from social interactions also contributed to poor mental health.
At the organisational level, reported stressors were mostly related to the difficulties with obtaining and financing personal protective equipment, the changing guidelines related to aerosol-generating procedures, the reassignment of clinicians to non-traditional roles, staff furloughs and workforce shortages.
Finally, regarding individual-level stressors, nearly all the respondents suggested that the lack of day care and in-person schools was a huge issue, especially for single parents and women. It was also one of the main reasons that forced dental assistants and hygienists to leave the profession.
“It’s not only important to be aware of burn-out, but to understand the reasons why health workers are experiencing it,” said Center for Health Workforce Studies Director Dr Jean Moore. “Once specific stressors have been identified, then strategies to address them at both organisational and personal levels can be implemented to reduce burn-out for these providers,” she continued.
To address the stressors, organisations implemented various strategies to promote well-being and self-care among workers. These included more vacation time, additional pay, more break time for staff and more flexible work schedules for parents.
Further research is needed to assess the prevalence of burn-out in dentistry and potential work- and family-related factors associated with burn-out, using a nationally representative sample of dentists, hygienists and assistants.
Editorial note:
The report, which includes information on both the survey and the interviews, is titled Identifying Strategies to Improve Oral Health Workforce Resilience and can be viewed here.
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