Evidence map›Paper›PMID 41309473›Full record

Observational studyBMJ open2025

Longitudinal trends in burnout among healthcare professionals during the COVID-19 pandemic: a 4-year prospective cohort study in a tertiary medical centre in Taiwan.

Shao-Yun Lee, Wan-Ting Hsu, Wen Chao Ho, Yu-Li Lin, Cheng-Fu Lin, Chun-Li Wang, Hsin-En Ho, Pin-Kuei Fu, Wei-Min Chu, Yu-Tse Tsan

Abstract readObservational Study
In one paragraph

Observational study in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Anxiety disorders: a cross-sectional study of clinical and biological associations.Journal of neural transmission (Vienna, Austria : 1996) · 2026
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Shao-Yun LeeDepartment of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.ORCID http://orcid.org/0000-0002-8034-3489
Wan-Ting HsuDepartment of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Wen Chao HoSchool of Public Health, China Medical University, Taichung, Taiwan.ORCID http://orcid.org/0000-0002-6095-3335
Yu-Li LinSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Cheng-Fu LinDepartment of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.ORCID http://orcid.org/0000-0003-3341-7315
Chun-Li WangDepartment of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Hsin-En HoDepartment of Family medicine, Taichung Armed Forces General Hospital, Taichung, Taiwan.
Pin-Kuei FuDepartment of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.ORCID http://orcid.org/0000-0002-9416-4094
Wei-Min ChuDepartment of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan janyuhjer@gmail.com williamchu0110@gmail.com.ORCID http://orcid.org/0000-0001-9870-8362
Yu-Tse TsanDivision of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan janyuhjer@gmail.com williamchu0110@gmail.com.ORCID http://orcid.org/0000-0001-9148-8811

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study aimed to investigate the evolution of burnout levels and cardiovascular risk among healthcare professionals during the COVID-19 pandemic, identifying associated risk factors, with a particular focus on the impact of working hours, job roles and working units.

designA longitudinal, observational study was conducted.

settingThe study was carried out in a medical centre in central Taiwan, encompassing various healthcare settings.

participantsA total of 1502 healthcare workers participated, including nurses, medical technicians, resident doctors, attending physicians and administrative staff. Participants were selected based on consistent completion of a 4-year questionnaire, with exclusion criteria for those who did not complete. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measured was burnout levels using the Chinese version of the Copenhagen Burnout Inventory. The secondary outcome was cardiovascular risk calculated from employees' health check-up data using the Framingham Risk Score.

resultsCardiovascular risk showed an upward trend over 4 years. Personal and work-related burnout significantly decreased from 2019 to 2020 but increased from 2020 to 2022, aligning with changes in weekly working hours. Nurses exhibited the most pronounced fluctuations, likely due to their younger average age, shorter professional tenure and frequent direct patient contact, which may heighten vulnerability to pandemic-related stressors. In contrast, attending physicians demonstrated age as a protective factor against burnout, as greater seniority, clinical experience and professional maturity may buffer stress and foster resilience. Participants who worked in COVID-related units generally had elevated burnout levels and working hours. During the initial outbreak in 2020, employees working in COVID-related units had reduced working hours but stable burnout levels, while employees in non-COVID-related units experienced decreased burnout.

conclusionsThis study highlights the critical impact of long working hours on burnout among healthcare professionals during the COVID-19 pandemic. Nurses emerged as a vulnerable group, sensitive to pandemic-induced changes, while attending physicians exhibited more resilience. COVID-related units face greater stress and are less likely to benefit from reductions in patient numbers and working hours during the pandemic. Our findings underscore the urgent need for tailored interventions, such as regulated work hours, flexible scheduling and enhanced organisational and peer support, to protect healthcare workers' well-being. These strategies can strengthen workforce resilience and sustainability in future public health crises.

Indexed as

Burnout, ProfessionalCOVID-19Health PersonnelAdultCardiovascular DiseasesFemaleHumansLongitudinal StudiesMaleMiddle AgedProspective StudiesRisk FactorsSARS-CoV-2Surveys and QuestionnairesTaiwanTertiary Care CentersBurnoutBurnout, ProfessionalCOVID-19Observational StudyOccupational Stress

Identifiers

PMID41309473
PMCPMC12666135

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.