The relationship between corona phobia and burnout in critical care nurses during the COVID-19 pandemic: A narrative review

Article Type : Reviews


1 Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Department of Medical-Surgical Nursing, Kashan University of Medical Sciences, Kashan, Iran

3 Department of Geriatric Nursing, Nasibeh Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran

4 Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran


Corona phobia is a term used to explain apprehension and fear associated with COVID-19. Meanwhile, nurses, particularly those working in intensive care units, have a higher frequency of corona phobia and related consequences. Due to the significant prevalence of burnout during the COVID-19 pandemic, this narrative review was conducted to summarize all published articles about the relationship between corona phobia and burnout in critical care nurses during the COVID-19 pandemic. A literature search was conducted using keywords extracted from medical subject headings such as “Corona Phobia”, “Burnout”, “Critical Care Nurses”, and “COVID-19” through online electronic databases including PubMed, Scopus, Web of Science, and Embase from December 1, 2019 to May 12, 2023. Finally, 15 studies met our inclusion criteria. Fainting, tonic immobility, sleeplessness, despair, traumatic stress, hopelessness, and suicidal thoughts are all symptoms associated with corona phobia. Among the reasons for the high incidence of corona phobia among intensive care nurses the high rate of patient admission, workload, and death were mostly mentioned. With these interpretations and considering that several studies pointed to a positive relationship between corona phobia and job burnout, it can be said that the rate of job burnout in nurses in intensive care units during the COVID-19 era was higher than in other nurses. As stated in the research results, a strong correlation exists between corona phobia and occupational burnout. Corona phobia was significantly associated with job positions, professional experience in caring for infectious patients, hospital resources, age, marital status, duration of employment, and degree of education.


1 Introduction

A serious pandemic that has greatly affected public health is COVID-19 [1-7]. Corona phobia is a word given to describe the sense of dread and fear related to the COVID-19 pandemic, based on the few studies which have defined it. People affected by corona phobia show different degrees of depression disorders, general anxiety, and fear of death. [8]. Healthcare workers (HCWs) reported a 34% burnout due to the coronavirus pandemic [9]. Extreme levels of job-related burnout are a risk for HCWs working in infectious disease hospitals on the frontlines of the COVID-19 pandemic [10, 11]. The primary players in the fight against COVID-19 are HCWs, who have to cope with considerable psychological and physical challenges [12]. Job burnout and reduced efficiency may result from the higher disease prevalence, the fear of capturing the disease, the fear of spreading the disease to the people at home, the feeling of guilt, and the increasing disease burden [13]. During this pandemic, HCWs became at a high risk for overwork, exhaustion, and burnout [14, 15]. Psychosomatic disorders, marriage issues, insomnia, alcohol and drug abuse can all be brought on by burnout. Burnout shows up in the workplace as decreased individual or group efficiency, a higher risk of illness, and worse job satisfaction [16]. Burnout also affects creativity, reduces productivity and job efficiency, increases the chances of inaccuracies, and affects judgment [17]. The quality of healthcare offered and healthcare professionals' personal well-being are adversely affected by burnout in intensive care unit professionals. Professional mistakes, job discontent, absenteeism, and poorer patient care are all adverse professional consequences linked to burnout in HCWs [18]. Studies carried out during this pandemic have revealed that HCWs experience high levels of burnout [19, 20]. Major pandemics, like the one we are currently experiencing, have disrupted people's routines and triggered phobic feelings in many individuals all over the world [21]. These mental health disorders such as depression, anxiety, thoughts of suicide, and hopelessness have all been associated with corona phobia [8].

Therefore, HCWs have faced significant psychosocial challenges such as burnout and corona phobia. Thus, this study aimed to evaluate the relationship between corona phobia and burnout in critical care nurses during the COVID-19 pandemic.


2 Methods

This narrative review was conducted via online databases, such as PubMed, Web of Science, Embase, and Scopus, from December 1, 2019, to May 12, 2023. Keywords used for the search were selected using medical subject headings (MeSH) and combined with other target keywords, including "Coronavirus-19 Phobia", "Corona Phobia", "Professional Burnout", "Occupational Burnout", "Career Burnout", "Nurses", "Nursing Personnel", and "Critical Care Nurses". The study evaluated and included all types of English-language published articles potentially related to the article's title. The search was performed by two authors independently. The review did not have the grey literature search due to the uncertainty surrounding such a novel disease condition and the exponential speculation that characterized the pandemic's early stages. Lists of references from eligible studies were evaluated manually to be comprehensive and achieve maximum results. Search results were entered into the EndNote X20 software to manage the data. After removing duplicate studies, the titles, abstracts, and full texts of the eligible articles were evaluated by two researchers independently.


3 Results

A total of 514 articles were obtained initially using database searches. The titles and abstracts were screened to eliminate duplicate studies. After that, the articles were screened according to titles and abstract, which led to the exclusion of 400 articles. Finally, full texts of selected articles were reviewed, and 15 eligible articles were finally included in the review, from which data were extracted for analysis (Figure 1).

Figure 1. Flow diagram of study selection.


3.1 Effects of the COVID‐19 pandemic on the critical care nurses

During the COVID-19 outbreak, nurses were on the front lines of dealing with this virus; as a result, this disease was viewed as a significant threat to the mental health of this group of healthcare team personnel due to psychological and physical hazards, sacrifices, and loss of family and colleagues [22]. The absence of medical professionals, medical supplies and equipment, drugs, and personal protection equipment increased stress and other psychological disorders among health team employees, particularly nurses [23, 24]. Because of their critical role in caring for a large number of sick patients during the COVID-19 pandemic, intensive care nurses were more vulnerable to psychological disorders than other nurses due to complying with prevention strategies to prevent virus spread, insufficient personal protective equipment, compliance with new diagnostic and treatment protocols, and providing care in a stressful and high-pressure environment. [25, 26]. Corona phobia causes emotional fatigue, pessimism, and other psychotic illnesses in nurses [12, 27]. Among the causes of the prevalence of corona phobia among intensive care nurses, it can be mentioned that following the propagation of this pandemic, the rate of patients requiring hospitalization in the intensive care unit increased significantly, and these nurses were facing more with the death of their patients [27].


3.2 Corona phobia in critical care nurses during the COVID-19 pandemic

The COVID-19 outbreak began in Wuhan, China, in December 2019 and infected people worldwide. Because of the psychological, economic, and societal ramifications, the spread of this virus is regarded as one of the most catastrophic diseases of the century, with a global impact on mental health [28]. The emergence of phobic reactions is one of the emotional challenges associated with COVID-19 illness [12]. Corona phobia is a mental condition caused by the spread of COVID-19, and it is defined as the fear and intense and inefficient anxiety response about COVID-19, with symptoms such as syncope, tonic immobility, insomnia, depression, tension, agonizing accompanied by feelings of despair and suicidal thoughts [12, 27, 29].


3.3 Burnout in critical care nurses during the COVID-19 pandemic

Nurses were considered the first line of defense against COVID-19, as they suffered from the psychological effects of the disease's spread, such as fear of contracting and infecting their loved ones, discrimination, fatigue, depression, post-traumatic stress disorder, and job burnout [27, 28]. Job burnout is a state of physical, mental, and emotional powerlessness produced by misusing one's talents. It arises due to the rising strain caused by the job in the individual, which eventually leads to a loss of interest, motivation, and pessimism toward his employment [22, 27, 30]. Among the signs of job burnout is a decline in a person's sense of success, depersonalization, emotional fatigue, and aggressive behaviors [31, 32]. Job burnout affects healthcare providers, including nurses, for various reasons, including job requirements, incompatibility between work and incentives, organizational inequalities, unsuitable working hours, and the influence of environmental factors [12, 27]. Lack of social support, young age, the greater perceived threat of this condition, and lack of preparation in oneself and one's family to deal with it are all risk factors for burnout among nurses [23]. Nursing job burnout's effects include increased medical errors, an overall reduction in job satisfaction, individual performance, insomnia, psychosomatic diseases, marital issues, and alcohol misuse [12]. According to recent studies, burnout was more common among nurses in intensive care units, notably during the COVID-109 pandemic [23, 27, 28]. Job burnout among these nurses would increase the risk of abandoning their positions and hurting the quality-of-service delivery and personal life [27, 33]. Corona phobia, on the other hand, disrupts nurses' cognitive, physical, and emotional balance, resulting in depression symptoms in various physical and mental dimensions, disability and lack of motivation, decreased life satisfaction, and a lack of experiencing positive emotions. As a result, the emergence of corona phobia in nurses during the COVID-19 pandemic, which causes symptoms of rage, exhaustion, depression, insomnia, stress, and anxiety, is regarded as one of the reasons that increase job burnout among them [22, 24, 31].


3.4 The relationship between corona phobia and burnout in critical care nurses during the COVID-19 pandemic

The spread of the COVID-19 virus has prompted concern among people, particularly medical personnel, due to its intensity and worries about the threat to people's health. Corona phobia, conversely, is an authoritarian state of unintentional fear and anxiety about an event related to mental health issues such as anxiety, sadness, and hopelessness [12]. Along with corona phobia, burnout is highlighted, which refers to work-related pressures caused by prolonged exposure to stressful conditions at work [34]. Long-term exposure to the stress of the COVID-19 pandemic and the anxiety of being infected with the OVID-19 virus, the fear of running out of personal protective equipment in hospitals, and the lack of effective drugs to treat the disease all contribute to the association between corona phobia and job burnout. And over time, it frequently results in emotional tiredness, a loss of excitement for work, and a sense of helplessness [35].


4 Conclusions

According to the findings of this study, there is a significant link between corona phobia and occupational burnout. The following characteristics are connected with corona phobia: job position, work experience in caring for infectious patients, hospital resources, age, marital status, duration of job experience, and degree of education. It is suggested that in future studies, research should be carried out to investigate more closely the relationship between corona phobia and the factors affecting it, as well as the impact of corona phobia and its relationship with psychological problems.



Not applicable.


Authors’ contributions

Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work: AZK, MDT, AMN, FZ, SBR; Drafting the work or revising it critically for important intellectual content: AZK, MDT, AMN, FZ, SBR; Final approval of the version to be published: AZK, MDT, AMN, FZ, SBR; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: AZK, MDT, AMN, FZ, SBR.





Ethics approval and consent to participate

Not applicable.


Competing interests

We do not have potential conflicts of interest with respect to the research, authorship, and publication of this article.


Availability of data and materials

The datasets used during the current study are available from the corresponding author on request.


This is an open access article under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (CC BY-NC 4.0).

© 2023 The Author(s).

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Volume 1, Issue 3
October 2023
Pages 138-142
  • Receive Date: 17 June 2023
  • Revise Date: 10 July 2023
  • Accept Date: 13 July 2023
  • First Publish Date: 01 October 2023
  • Publish Date: 01 October 2023