Institut für Health Care & Public Management

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Browsing Institut für Health Care & Public Management by Person "Daneshvar, Elahe"

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    Workplace stressors and well-being of healthcare workers during the COVID-19 pandemic
    (2025) Daneshvar, Elahe; Sousa-Poza, Alfonso
    Health systems worldwide are facing a host of complex and multifaceted challenges, ranging from aging populations and patient safety to rapid evolution of therapeutic technologies and the need to sustain uninterrupted operations. Central to addressing these issues is the critical role of healthcare workers (HCWs) whose well-being is fundamental to the efficiency, resilience, and sustainability of healthcare delivery. The COVID-19 pandemic has brought these challenges to the forefront, exposing the vulnerabilities of health systems and reinforcing the urgent need to prioritize HCWs’ mental and physical health. This dissertation addresses this pressing concern through three scholarly papers, each exploring distinct dimensions of HCWs’ wellbeing during the COVID-19 pandemic: (I) sources of anxiety, (II) workplace stressors and burnout, and (III) global prevalence and risk factors for burnout. The relevance and sequencing of these three papers provide a comprehensive and cohesive understanding of anxiety and burnout as two pressing and growing concerns among HCWs, along with their contributing factors and actionable interventions. The first two studies investigate these phenomena within Iran—a context marked by resource constrains due to embargos—offering valuable insights into the local drivers of anxiety and burnout and their workplace-related stressors. This scope is expanded in the third paper through a systematic review of global research, providing a comparative understanding of burnout prevalence and risk factors across diverse healthcare settings. The first study investigates the sources of anxiety among HCWs in Iran, adapting the Stanford University School of Medicine’s classification framework. Surveying 723 HCWs, it confirms the relevance of the eight previously identified anxiety sources while revealing four additional stressors specific to the Iranian context: high workload, financial concerns, health risks (both physical and emotional), and inadequate leadership support. The findings highlight the disproportionate burden on women, nurses, and frontline workers, emphasizing the need for stronger organizational support and leadership engagement in resource-constrained healthcare settings. The second study examines workplace stressors and burnout among HCWs in Iran, finding a striking burnout prevalence of 67.41%. Using the Copenhagen Burnout Inventory and the components of the Job Demand-Control-Support model, it identifies excessive workload, limited job control, and poor leadership communication as key contributors to burnout. Frontline workers, married individuals, and women are particularly vulnerable. The study reframes burnout as a systematic issue rather than individual failing, underscoring the need for structural interventions such as workload redistribution, increased job autonomy, and improved communication strategies. It calls for leadership-driven initiatives to enhance HCWs’ resilience and prevent long-term workforce depletion. The third study extends this examination globally, systematically reviewing 64 studies from 16 countries to assess burnout prevalence and risk factors. Burnout rates frequently exceeded 50%, with frontline workers, nurses, and younger HCWs facing the highest risks. Common stressors included excessive job demands, insufficient resources including inadequate institutional support. The review also highlights sever health consequences linked to burnout, including stress, anxiety, depression, and physical ailments such as chronic headaches and sleep disturbance. Furthermore, burnout was closely associated with increased turnover intentions, threatening health system sustainability. Collectively, these studies identify critical gaps in existing organizational support structures, and provides actionable insights for addressing them. By integrating findings across diverse methodologies and contexts, the dissertation contributes to the growing body of literature on HCWs' well-being. The practical implications are clear: healthcare organizations and policymakers must adopt a proactive, comprehensive approach to support HCWs. This includes targeted interventions to alleviate foundational stressors, fostering supportive leadership, and strengthening organizational resilience to better prepare for future public health crises. By bridging the specific challenges of resource-limited settings with broader, universal trends, this dissertation highlights actionable pathways to enhance HCWs’ well-being and ensure the resilience of health systems in times of crisis. In doing so, it provides an evidence-based foundation for policymakers, healthcare leaders, and researchers to develop sustainable strategies that not only safeguard HCWs but also strengthen health systems, advance public health, and ultimately benefiting society as a whole.