Unveiling the hidden toll: A study on the psychological and biological impact of burnout in healthcare workers

While most people won’t be surprised to hear that elevated stress levels brought about by the COVID-19 pandemic and staffing shortages have taken a toll on healthcare workers, they may be surprised to hear we actually don’t have a full understanding of its impact

A new study seeks to find answers about the psychological and biological impact of burnout in healthcare workers.

The Royal is allocating part of an anonymous $1.5 million donation received through the Ottawa Community Foundation to a study investigating the psychological and biological toll of burnout and chronic stress in a sample of 100 licensed healthcare workers recruited from Ottawa-area hospitals.

“This research is essential in addressing the escalating rates of burnout in our dedicated health care workers,” says Dr. Florence Dzierszinski, president of the University of Ottawa Institute of Mental Health Research (IMHR) at The Royal and vice-president of research.

“Research is care. By uncovering unique biological markers and fostering a better understanding of chronic stress, we pave the way for targeted interventions and more comprehensive workplace programs to safeguard well-being.”

This study combines the collection of clinical and biological data including neuroimaging at The Royal’s Brain Imaging Centre. The team, which includes co-investigators Dr. Robyn McQuaid, Dr. Zachary Kaminsky, and Dr. Jeanne Talbot, is also examining links between burnout, stress, mental health service use, moral distress, and factors associated with resilience and coping.

It’s a timely topic, says Dr. Jennifer Phillips, the study’s principal investigator and interim scientific director of the University of Ottawa Institute of Mental Health Research at The Royal.

“We know that the rates of burnout are high in healthcare workers,” says Phillips. “Among nurses, physicians and medical trainees, for example, the rates of burnout have increased – now they're higher than they were before the pandemic started.”

The team is still recruiting licensed healthcare workers who work in the Ottawa area to be part of this study. For more information, or to sign up as a participant, email burnoutstudy@theroyal.ca.

What is burnout?

Carleton University Neuroscience Master’s students Chelsea Montgomery and Leen Ghanayem are conducting their thesis through this project. 

Montgomery says burnout is a highly debated topic in healthcare circles because of a lack of consensus regarding its definition and measurement. Some also question whether burnout is a type of depression.

 Leen Ghanayem, Jennifer Phillips, and Chelsea Montgomery
From left to right: Leen Ghanayem, Jennifer Phillips, and Chelsea Montgomery.

“There may be some association but they may actually be two distinct concepts,” says Montgomery. “Part of this project is trying to pinpoint how burnout is its own distinct disorder and maybe has its own unique biological underpinnings compared to depression.”

Common signs or symptoms of burnout in healthcare workers include exhaustion (feeling drained of energy and unable to replenish it), depersonalization (detachment from one’s job and lower feelings of connection and care), and professional inefficacy (a sense of failing at one’s job).

According to Ghanayem, preliminary findings from an initial cohort show high levels of emotional exhaustion, depersonalization, and moral distress among participants. 

Moral distress refers to the impact of challenging experiences that upset a person’s value system or moral beliefs. The effects can be enduring and result in long-lasting emotional and psychological damage. 

"Moral distress is linked to higher burnout, depression, and anxiety, making it a serious and unique concern for healthcare workers," says Ghanayem.

Healthcare workers who participate in this study are followed for one year. Biological and psychological data are collected when the research participants first come on board, with psychological follow-ups at six and 12 months. If a participant develops symptoms over that time, the team hopes to look back at the biological measures to see whether this emergence of symptoms could have been predicted.  

“If we’re able to characterize the physical toll of burnout, we will be in a better position to support healthcare worker well-being,” says Phillips, who adds that specific biological markers could lead to targeted treatments. 

On a larger scale, the team hopes a holistic picture of the true toll of chronic stress on the human body will influence a broader conversation around mental health in the healthcare sector and also contribute to the development of workplace programs to support healthcare worker well-being.

Research participants from the first cohort were excited to take part. “I think a lot of them just appreciate having their voice heard. It’s really touching to hear how excited they are about the study and to be a part of it,” says Montgomery. 

The team is still recruiting licensed healthcare workers who work in the Ottawa area to be part of this study. In particular, they are hoping to enrol more men and more physicians as participants.

“By joining our study we can learn more about burnout in healthcare workers and how to better support healthcare workers in the future,” says Montgomery.

For more information about this study, or to sign up as a participant, email burnoutstudy@theroyal.ca.