INTRODUCTION: The COVID-19 pandemic has compounded the global crisis of stress and burnout among healthcare workers . But few studies have empirically examined the factors driving these outcomes in Africa . Our study examined associations between perceived preparedness to respond to the COVID-19 pandemic and healthcare worker stress and burnout and identified potential mediating factors among healthcare workers in Ghana .
METHODS: Healthcare workers in Ghana completed a cross-sectional self-administered online survey from April to May 2020; 414 and 409 completed stress and burnout questions, respectively . Perceived preparedness, stress, and burnout were measured using validated psychosocial scales . We assessed associations using linear regressions with robust standard errors .
RESULTS: The average score for preparedness was 24 (SD = 8.8), 16.3 (SD = 5.9) for stress, and 37.4 (SD = 15.5) for burnout . In multivariate analysis, healthcare workers who felt somewhat prepared and prepared had lower stress (ß = -1.89 , 95% CI: -3.49 to -0.30 and ß = -2.66 , 95% CI: -4.48 to -0.84) and burnout (ß = -7.74 , 95% CI: -11.8 to -3.64 and ß = -9.25 , 95% CI: -14.1 to -4.41) scores than those who did not feel prepared . Appreciation from management and family support were associated with lower stress and burnout, while fear of infection was associated with higher stress and burnout . Fear of infection partially mediated the relationship between perceived preparedness and stress/burnout, accounting for about 16 to 17% of the effect .
CONCLUSIONS: Low perceived preparedness to respond to COVID-19 increases stress and burnout, and this is partly through fear of infection . Interventions, incentives, and health systemic changes to increase healthcare workers' morale and capacity to respond to the pandemic are needed.