The Burnout and Professional Deformation of Latvian Healthcare Workers during the COVID-19 Pandemic at the Traumatology and Orthopaedics Hospital

Round 1

Reviewer 1 Report

This study has evaluated the burnout and professional deformation of healthcare workers during COVID-19 outbreak. The result would be interesting to readers. However, there are several issues should be addressed.

1. the title should reflect the design of the study as well as the religion that the study carried out.

2. introduction should be shortened. Line 61, the sentence should not be a single paragraph.

3. methods. The specific hospital should be pointed out.

4. How many workers are in the hospital? How much percent of workers that responded the survey? Why aren't other people doing this survey? Is bias induced in this process?

5. When is this study carried out? Before or during the outbreak? The duration of outbreak should also be added.

6. A detailed stratification of workers would be better. For example, physician from ICU, respiratory department, infectious disease department, etc.

7. y-axis (meaning and unit) of figure 1 and 2 are not clear.

8. It would be better if the authors represent the results of correlation analysis in a table.

9. The discussion should be expanded. The following points should be discussed in detail: strength and limitation of the study, interpretation of the data, future direction of study or implication of the findings.

Author Response

1. punkts: pētījuma nosaukums tika mainīts, ņemot vērā jūsu piezīmi.

 

2. punkts: Ievads tika saīsināts saskaņā ar tiesneša ieteikumiem.

 

3. punkts: Pētījuma metodē tika norādīts tās slimnīcas nosaukums, kurā tika veikts pētījums .

Point 4: The hospital has a total of 467 employees. 267 of them are healthcare workers - 82 traumatologists - orthopedic surgeons, 29 residents, 131 nurses, 25 nurses' assistants. Out of the total number of employees, 200 are not medical personnel - 38 sanitarians, 162 technical support personnel, who are not healthcare workers. Out of 267 medical personnel, 199 healthcare workers participated in this research. The completed questionnaires from four respondents from the sample were excluded since they were incomplete. 195 valid questionnaires were valid for the study. That makes up 73% of the hospital's healthcare workers.

Point 5: The research was conducted in the period from 11.01.2022 – 30.01.2022. It was the third wave of the outbreak of the Covid 19 pandemic in Latvia.

6. punkts: Paldies par šo ieteikumu. Šāda informācija būtu ļoti interesanta un noderīga. Diemžēl demogrāfiskajos datos tika apkopota informācija par ārstējošās personas dzimumu, vecumu, darba stāžu veselības aprūpē, profesiju.

7. punkts: pirmajā attēlā X ass ir punktu skaits, Y ass skalas. Otrajā attēlā X ass ir procenti, Y ass ir skalas.

8. punkts: Korelācijas datu analīze papildus tika sniegta tabulas veidā, lai informācija būtu pēc iespējas skaidrāka.

9. punkts: Paldies par komentāru. Diskusijas daļa tika papildināta ar pētījuma spēku, ierobežojumiem, datu interpretāciju un pētījuma virzību nākotnē.

Reviewer 2 Report

The authors have made an interesting attempt on “Burnout and professional deformation among healthcare workers during COVID-19 pandemic.” The manuscript is interesting; however, the authors need to justify the scientific writing manuscript. Some of the general comments are provided below:
 

1.     Did the authors obtain any ethical approval to get intrahospital information?

2.     Authors should improve the introduction to elaborate their work with related examples from the literature.

3.     What is the representative minimum sample size for the population required for statistical analysis?

4.     In order to make it more understandable, the authors should define the terms aggression, authoritarianism, demonstrativeness, and conservatism.

5.     It will be interesting to relate the results of burnout and professional deformation with age and experience of HCWs.

6.     Discussion is more general and shorter; it should discuss other similar studies with COVID-19 or other diseases and present a comparison with current study.

 

7.     The limitations of this study should be included. 

Author Response

Point 1: Ethics committee approval was obtained. Research application no. 34/2022/1.

 

Point 2: Thank you. The introduction was supplemented with a wider description of the literature.

Point 3: The hospital has a total of 467 employees. 267 of them are healthcare workers - 82 traumatologists - orthopaedic surgeons, 29 residents, 131 nurses, 25 nurses' assistants. Out of the total number of employees, 200 are not medical personnel - 38 sanitarians, 162 technical support personnel, who are not healthcare workers. Out of 267 medical personnel, 199 healthcare workers participated in this research. The completed questionnaires from four respondents from the sample were excluded since they were incomplete. 195 valid questionnaires were valid for the study. That makes up 73% of the hospital's healthcare workers.

Point 4: Definitions of aggression, authoritarianism, demonstrativeness and conservatism were included in the publication.

Point 5: Thank you for your valuable advice. This was not done in this study, but I included it in the Discussion section for future research purposes, as it is really important.

Point 6: Discussion section was supplemented with similar studies and compared with the current study.

Point 7: The publication included limitations of the study.

Reviewer 3 Report

I have some issues with the paper:

(1) some of the wording and phrasing is awkward; for example, "articles" should be referred to as "items" (in a questionnaire); also Lines 98-104 are worked in an awkward and therefore unclear manner; for example, "four questionnaires were excluded" really should say, "the completed questionnaires from four respondents from the sample were excluded since they were incomplete .

(2) no hypotheses are stipulated at the end of the introduction section.

(3) the internal consistency reliability estimates via Cronbach's Alpha which are reported are low.

(4) the word "deformation" is an unusual one at least in America, so you might want to rename the survey to something else.

Author Response

Point 1: Words "articles" was referred by "items". The following sentence "four questionnaires were excluded" was changed to "the completed questionnaires from four respondents from the sample were excluded since they were incomplete”. According to the recommendations of the referee.

Point 2: Thanks for the note. The introductory part was supplemented with research questions: what level of emotional burnout do health care workers have? what are the signs of professional deformity in health care personnel? What statistically significant associations and differences exist between burnout and professional strain in a sample of physicians and nurses?

Point 3: Thank you for your comment. Cronbach's alpha was changed to low in the publication.

Point 4: In the scientific literature, the combination of words Professional deformation is used. I would be very grateful for advice on how this term is correctly defined in America, so that I can make the appropriate corrections.

Reviewer 4 Report

Title: “Burnout and professional deformation among healthcare workers during COVID-19 Pandemic”.

Summary: Covid-19 pandemic created lot of chaos around the world. In this manuscript authors tried to investigate emotional burnout and professional deformation of the health care workers. This concept was studied by using Maslach Burnout Inventory Human Services Survey. This survey assesses aggression, authoritarianism, demonstrativeness, conservatism. This survey shown a high level of emotional burnout, a medium level of depersonalization and least level of personal achievement reduction. Data shown that health organizations play an important role in the mental wellbeing of health care workers. 

Strengths:

1.    Highlighting the stress of the health care workers caused by pandemic, so that preventive measures can be taken. 

2.    Cronbach's alpha coefficient was used to find out the level of reliability for each scale of the occupational deformation survey.

Weakness: 

1.    Fig. 1 and 2 need to be improved.

2.    Sample size is less.

3.    In general, the nature of the work of health care workers is very tiring. It’s very challenging for management to reduce the stress to health care workers. 

4.    Table 1 need to be improved.

Author Response

1. In the first figure, the X-axis is the number of points, the Y-axis scales. In the second figure, the X-axis is percentages, the Y-axis is scales.
2. Table No. 1 was improved.

Round 2

Reviewer 1 Report

I have not found a point-to-point response.

Some responses are not in English, thus I can not read.

The authors need to upload a point-to-point response, and then I can make a descion. 

Author Response

Point 1: The title of the study was changed in consideration of your remark.

 

Point 2: The introduction was shortened according to the recommendations of the referee.

 

Point 3: In the research method, the name of the hospital where the study was conducted was indicated.

Point 4: The hospital has a total of 467 employees. 267 of them are healthcare workers - 82 traumatologists - orthopedic surgeons, 29 residents, 131 nurses, 25 nurses' assistants. Out of the total number of employees, 200 are not medical personnel - 38 sanitarians, 162 technical support personnel, who are not healthcare workers. Out of 267 medical personnel, 199 healthcare workers participated in this research. The completed questionnaires from four respondents from the sample were excluded since they were incomplete. 195 valid questionnaires were valid for the study. That makes up 73% of the hospital's healthcare workers.

Point 5: The research was conducted in the period from 11.01.2022 – 30.01.2022. It was the third wave of the outbreak of the Covid 19 pandemic in Latvia.

Point 6: Thanks for this suggestion. This kind of information would be very interesting and useful. Unfortunately, demographic data collected information about the gender, age, length of service in health care, profession of the treating person.

Point 7: In the first figure, the X-axis is the number of points, the Y-axis scales. In the second figure, the X-axis is percentages, the Y-axis is scales.

Point 8: Correlation data analysis was additionally presented in the form of a table, so that the information is as clear as possible.

Point 9: Thank you for your comment. The discussion part was supplemented with the study's strength, limitations, data interpretation and future direction of the study.

Reviewer 2 Report

The authors have modified the manuscript and now it is acceptable for the publication. 

 

Author Response

Thank you very much for your time.

Reviewer 3 Report

I feel that your made revisions which addressed the concerns I expressed in my initial review.

Author Response

Thank you very much for your time.

Round 3

Reviewer 1 Report

I am satisfied with the current form of the manuscript.