Burnout and risk factors in Southeast Asian gastroenterologists: A multi-national study in the COVID-19 era

Background and Aim: The coronavirus disease-2019 (COVID-19) pandemic has placed significant stress on gastroenterologists worldwide. However, its toll on the mental health of gastroenterologists within Southeast Asia was unknown. A mixed methods, multi-national study was conducted to elucidate the prevalence of burnout and its stressors within the region. Methods: A survey was disseminated electronically to 1761 gastroenterologists via the gastroenterology and endoscopy societies of Brunei, the Philippines, Indonesia, Malaysia, Singapore, and Thailand from September 1 to December 7, 2020. This included the 22-item Maslach Burnout Inventory to detect burnout. Ethical approval was granted. Quantitative and qualitative data were collected. Logistic regression identified associations between variables and burnout. Qualitative data were analyzed by content analysis method. Results: The response rate was 38.8%;66.6% reported significant stress. The regional prevalence of burnout was 17.1% although inter-country variation existed (Fig. 1A). Depression, being a trainee, public sector work, and the lack of awareness or access to mental health support services increased burnout risk significantly (Fig. 1B). The 50.1% of gastroenterologists were unaware of or did not have access to support services. The onset of depression intra-pandemic was 2.1%;the pre-pandemic prevalence was 2.2%. Stressors commonly involved service requirements (53.2%), difficult relationships with patients and relatives (23.0%), and difficult relationships with colleagues (20.5%). Specific to the pandemic, the three most common stressors were fear of getting infected (39.7%), reduced income (28.0%), and stringent infection control measures adding to workload (18.5%). Conclusion: Burnout is common in gastroenterologists in Southeast Asia;however;better safeguards for mental health are urgently needed.