Skip to main content
Download PDF

Fear of COVID-19 associated with burnout syndrome in dentists of the Health Directorate of the National Police of Peru: a cross-sectional study at national level under multivariable regression model

BMC Public Health volume 24, Article number: 1488 (2024) Cite this article

Abstract

Background

During the pandemic, many police dentists had the crucial responsibility of ensuring law and order while providing dental care by taking government-approved health measures to stop the spread of the coronavirus. The aim of this study was to assess the association between the fear of COVID-19 and Burnout syndrome in Peruvian dentists belonging to the Health Department of the National Police of Peru (PNP), taking into account possible confounding variables.

Methods

This cross-sectional and analytical study included 182 PNP dentists. The Fear COVID-19 Scale assessed fear of COVID-19 and the Maslach Burnout Inventory Test assessed burnout syndrome. The association between the fear of COVID-19 and Burnout syndrome (self-fulfilment) was analyzed using Spearman's Rho. A multivariable Poisson regression model with a robust variance estimation method was employed to evaluate the impact of fear of COVID-19 on the various dimensions of Burnout syndrome, considering possible confounding variables. The statistical significance level was set at p < 0.05.

Results

Under bivariate analysis, fear of COVID-19 was significantly linked with low direct intensity toward emotional exhaustion (Rho = 0.325, p < 0.001), very low direct intensity toward depersonalization (Rho = 0.180, p = 0.015), and very low inverse intensity toward self-fulfilment (Rho =—0.186, p = 0.012). Under multivariable analysis, it was observed that dentists who exhibited fear of COVID-19 were 3.4 and 3.7 times more likely to experience emotional exhaustion and depersonalization, respectively (APR = 3.40, 95% CI: 1.74—6.63 and APR = 3.68, 95% CI: 1.31—10.37), as compared to those who did not display fear of COVID-19. Moreover, none of the potential confounding factors were found to have a significant impact on emotional exhaustion (p > 0.05), depersonalization (p > 0.05), and self-fulfilment (p > 0.05).

Conclusion

Fear of COVID-19 was significantly associated with emotional exhaustion and depersonalization, and inversely associated with self-fulfilment. PNP dentists who exhibited fear of COVID-19 were at greater risk for emotional exhaustion and depersonalization. In developing Burnout syndrome, no significant impact was observed from factors such as age, gender, marital status, children, hierarchy, years of service, work area, private practice, work over 40 h per week, type of service, work performed, sport practice and daily exercise time.

Peer Review reports

Background

The COVID-19 pandemic significantly impacted the mental well-being of populations due to the need to implement health measures such as social distancing and limited access to medical and psychological resources to control the spread of the disease, leading to feelings of isolation and loneliness [1]. Additionally, material and economic scarcities were exacerbated, requiring adaptation to teleworking and remote learning [2]. Furthermore, the infodemic spread by certain media outlets has contributed to the increased prevalence of psychological disorders [3].

Dental professionals have been placed in the "very high exposure risk" category by the Occupational Safety and Health Administration (OSHA) due to their exposure to known or suspected sources of the SARS-CoV-2 virus during specific procedures that generate contaminated bioaerosols [4,5,6]. Due to this, many dentists limited their professional services to emergency or urgent care in accordance with national guidelines [5].

During the pandemic, both healthcare personnel and members of the police and military were exposed to COVID-19 and joined the frontlines in the battle against the virus [7]. Police officers carried the crucial responsibility of ensuring public order and compliance with government-approved sanitary measures to halt the spread of the coronavirus [8,9,10]. This situation led to an increase in the number of police officers infected with the coronavirus as they came into contact with potentially infected individuals. This increases the risk of the virus spreading to their families and the PNP healthcare workers who exclusively care for them [7, 9, 11].

On 16 May 2020, a Health Directive was approved in Peru to establish dental procedures and biosecurity measures to reduce the risks of COVID-19 transmission in health facilities nationwide [12]. This aspect also included PNP dentists who did not have comorbidity, as they were required to provide dental care to police officers and their immediate family members. Furthermore, certain PNP dentists were directed towards additional duties such as diagnosis, promotion, health prevention, and administrative activities as per the requirements of the service in various health facilities linked to the Police Health Directorate [12].

By March 2023, Peru had reported 4,487,553 cases of infection and 219,539 deaths [13]. During this time, various COVID-19 variants emerged, including XBB, which resulted from the genetic recombination of two Omicron variants [14]. Likewise, the Ministry of the Interior reported that over 520 PNP officers died due to COVID-19, while around 39,000 contracted the disease during the health emergency [10]. Consequently, even after the health emergency, mandatory measures were issued to maintain surveillance, prevention, and control of workers' health at risk of exposure to SARS-CoV-2 in all national health facilities [15].

Concurrent with the risk of infection faced by PNP dentists, they experienced substantial workloads, inadequate resources, extended work hours, sleep disruptions, and a lack of work-life balance. These factors, along with their risk of COVID-19 infection, may have contributed to adverse psychological outcomes such as post-traumatic stress disorder, insomnia, anxiety, depression, fear of COVID-19, and burnout syndrome [10, 16, 17]. Burnout Syndrome is a psychological syndrome that develops as a negative reaction to work stressors, composed of a combination of emotional exhaustion, depersonalization and low self-fulfilment [16, 18]. Emotional exhaustion is linked to an individual's stress experience, which results in a reduction in emotional and physical resources. Depersonalization, or cynicism, results in work detachment as a response to burnout overload, and a loss of enthusiasm and passion for work. The lack of self-fulfilment is characterized by feelings of low professional efficacy and a lack of productivity in personal work [16, 18]. Considering their position within the police force, PNP dentists were likely exposed to work and organizational stressors [19], which may have had an impact on the quality of their professional service and the overall well-being of their institution [16].

Therefore, the aim of this study was to assess the association between the fear of COVID-19 and Burnout syndrome in Peruvian dentists belonging to the Health Department of the National Police of Peru (PNP), taking into account possible confounding variables. Considering as a null hypothesis that there is no association between fear of COVID-19 and Burnout syndrome in Peruvian dentists belonging to the Health Department of the PNP.

Methods

Study design

This cross-sectional analytical study was conducted on the entire population of dentists of the Health Directorate of the National Police of Peru between February and May 2023, according to the STROBE guidelines [20].

Population and selection of participants

The study population consisted of a total of 190 dentists belonging to the Health Department of the National Police of Peru. As we studied the complete populace on a national scale, we did not require a sample size estimate. The ultimate participant count was 182 PNP dentists (N = 182), selected based on the following eligibility criteria:

Inclusion criteria

  • PNP dentists who provided informed consent to voluntarily participate in the study.

  • PNP dentists currently engaged in active duty involving assistance and/or administrative responsibilities.

Exclusion criteria

  • PNP dentists who did not complete the questionnaire.

Variables

Burnout syndrome in its dimensions of emotional exhaustion, depersonalization and self-fulfilment was considered as a dependent variable. Fear of COVID-19 was considered as an independent variable. Possible confounding variables were age [21, 22], gender [23], marital status [24], number of children [25], hierarchy [22], years of service [23], work area [26], private practice [27], work over 40 h per week [28], type of service [22, 26], work performed [16], sport practice [29] and daily exercise time [30]. The cut-off point for age was based on the median, and with regard to years of service, this cut-off point was based on the number of years a police officer needs as a minimum to be able to apply for retirement without financial loss to himself or to the state. Only if he retires after 20 years of service is he entitled to a permanent pension.

Application of the instrument

To evaluate the level of fear of COVID-19 among participants, the "Fear COVID-19 Scale (FCV-19S)" was utilized. The scale is composed of 7 items with responses rated on a Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). The total scores ranged from 7 to 35 and individuals with scores between 17 and 35 are identified as having fear of COVID-19 [31, 32]. The reliability of the scale was evaluated using Cronbach's alpha, obtaining a value of α = 0.884 (95% CI: 0.856—0.908), which is considered acceptable.

The study employed the Maslach Burnout Inventory Test to evaluate Burnout syndrome, which included 22 questions grouped into three dimensions. The emotional exhaustion dimension had nine items (Q1, Q2, Q3, Q6, Q8, Q13, Q14, Q16, and Q20), depersonalization had five items (Q5, Q10, Q11, Q15, and Q22), and self-fulfilment had eight items (Q4, Q7, Q9, Q12, Q17, Q18, Q19, and Q21). Responses were evaluated on a Likert scale ranging from 0 to 6, with 0 indicating never, 1 indicating once a year, 2 indicating once a month, 3 indicating sometimes a month, 4 indicating once a week, 5 indicating sometimes a week, and 6 indicating every day. The ratings for the dimensions of Burnout Syndrome were as follows: Emotional exhaustion ratings ranging from 0 to 18 indicating low or mild levels, from 19 to 26 indicating medium or moderate levels, and from 27 to 54 indicating high or severe levels; Depersonalization ratings ranging from 0 to 5 indicating low levels, from 6 to 9 indicating medium levels, and from 10 to 30 indicating high levels. For self-fulfilment, scores from 40 to 48 were considered low, 34 to 39 were considered medium, and 0 to 33 were considered high [33]. Indications of burnout included a total score of more than 26 points for emotional exhaustion, more than 9 points for depersonalization, and less than 34 points for self-fulfilment [34]. The Cronbach's alpha coefficient was used to determine the internal consistency of the instrument. The result was α = 0.780 (95% CI: 0.731—0.824), which is considered acceptable.

Procedure

The survey was conducted using the Google Forms® platform and distributed to the institutional or personal email address of every dentist in a self-administered manner. If there was no response, the invitation was re-shared to their personal email or WhatsApp®, up to three times within a three-week period. The principal investigator (A.V.S) provided the invitation. Upon clicking the provided web link, dentists were promptly directed to the informed consent, inclusive of the institutional email, phone, and full name of the principal investigator. Participants were also afforded access to ethics committee data. If they chose to consent, they were automatically redirected to the next page, which contained the Questionnaire and accompanying instructions. Participants had the right to decline the invitation or choose not to complete the questionnaire. The data were accessible only to the principal investigator and were securely stored on a digital device to ensure the confidentiality of the data throughout the entire survey process. Only one complete response per dentist was accepted and to prevent duplication, only one response per associated email was allowed. Additionally, participants were requested to enter the initials of their first and last names, along with their age (for instance: AVS56). This was done to avoid duplications in case someone accessed the web link from multiple email addresses. The participants were not given any incentives for their involvement and had access to the link from February 15 through to May 20, 2023.

Data analysis

The statistical calculations were conducted using IBM's Statistical Package for the Social Sciences (SPSS) version 28.0 (IBM, Armonk, New York, USA). The qualitative variables' statistical description utilized absolute and relative frequencies, while the quantitative variables' measures of central tendency and dispersion relied on mean and standard deviation. To assess Burnout Syndrome's three dimensions' correlation with fear of COVID-19, Spearman's Rho was the statistical test employed. Additionally, we utilized Pearson's Chi-square test for the bivariate analysis of categorical variables and Fisher's exact test for expected values less than 5. For the multivariable analysis, we employed a multivariable Poisson regression model with robust variance to assess the impact of fear of COVID-19 on the three dimensions of Burnout syndrome, while considering possible confounding variables. All analyses were conducted with a significance level of p < 0.05.

Ethical aspects

The present study adhered to the bioethical principles outlined in the Declaration of Helsinki related to respect, freedom, nonmaleficence, and confidentiality [35]. Approval was obtained from the Ethics Committee of the Postgraduate School at the Universidad Nacional Federico Villarreal with letter No. 013–2023-UIIE-EUPG-UNFV dated February 13, 2023. Furthermore, participants were requested to provide their voluntary informed consent on the initial page of the online survey.

Results

The dentist response rate for the PNP Health Directorate was 95.8% of the total population, with a mean age of 37.3 ± 10.5 years. Of this group, 52.7% were ≥ 35 years old, 54.4% were female, and 51.6% were single and childless. Within the population, 72.5% held junior officer positions and 76.4% had ≤ 20 years of service. 77.5% of dentists lived in the Peruvian capital, with 58.8% also practicing privately. Seventy-two percent of the personnel worked more than 40 h weekly, with 59.3% employed in the general dental division of the police. Additionally, 39% of all personnel worked in police administrative or support roles. Finally, 64.3% of all personnel engaged in sport practice and 45.1% exercised for no more than 30 min each day (Table 1).

Table 1 Sociodemographic characteristics of dentists of the National Police of Peru (PNP)
Full size table

Of the 182 participants, 19.2% (95% CI: 13.5%—25.0%) exhibited burnout syndrome related to emotional exhaustion (high), 9.3% (95% CI: 5.1%—13.6%) related to depersonalization (high), and 6.6% (95% CI: 3.0%—10.2%) related to self-fulfilment (low). Additionally, 24.2% (95% CI: 18.0%—30.4%) of participants reported fear of COVID-19 (Fig. 1).

Fig. 1
figure 1

Frequency of Burnout Syndrome (according to dimensions of emotional exhaustion, depersonalization and self-fulfilment) and fear of COVID-19 in dentists of the PNP Health Directorate

Full size image

Fear of COVID-19 was found to be significantly linked to low direct intensity to emotional exhaustion (Rho = 0.325, p < 0.001), very low direct intensity to depersonalization (Rho = 0.180, p = 0.015), and very low inverse intensity to self-fulfilment (Rho = -0.186, p = 0.012), according to the obtained score correlation (Table 2).

Table 2 Correlation between fear of COVID-19 score and emotional exhaustion, depersonalization and self-fulfilment scores
Full size table

The bivariate analysis indicates a significant association between fear of COVID-19 and age group, marital status, children, hierarchy, years of service, and work performed (p < 0.001, p = 0.020, p < 0.001, p < 0.001, p < 0.001, p < 0.001, and p = 0.002, respectively). Additionally, there is a significant association between the level of emotional exhaustion and hierarchy, years of service, and work area (p = 0.006, p = 0.043, and p = 0.030, respectively). There were significant associations found between gender, marital status, and work area with the level of self-fulfilment (p = 0.046, p = 0.029, and p < 0.001, respectively). Finally, the level of depersonalization was not significantly associated with any of the sociodemographic variables considered in this study (p > 0.05) (Table 3).

Table 3 Levels of Fear of COVID-19, emotional exhaustion, depersonalization and self-fulfilment associated with sociodemographic variables of PNP dentists
Full size table

In the Poisson regression analysis with robust variance, using Prevalence Ratio (PR), Burnout was considered positive for emotional exhaustion (Yes [> 26 points] = 1 / No [≤ 26 points] = 0), depersonalization (Yes [> 9 points] = 1 / No [≤ 9 points] = 0), and lack of self-fulfilment (Yes [< 34 points] = 1 / No [≥ 34 points] = 0). These three variables were studied as the dependent variables, while Fear of COVID-19 (Yes = 1 / No = 0) was studied as the independent variable. Age group, sex, marital status, children, hierarchy, years of service, work area, private practice, working more than 40 h per week, type of service, work performed, sport practice, and daily exercise time were the possible confounding variables. After adjusting the prevalence ratio (APR) of the model, it was found that dentists who displayed fear of COVID-19 were 3.4 and 3.7 times more likely to experience emotional exhaustion and depersonalization (with APRs of 3.40, 95% CI: 1.74–6.63 and 3.68, 95% CI: 1.31–10.37, respectively) as compared to their counterparts who didn't demonstrate COVID-19-related fear. Furthermore, none of the confounding variables were found to be significant factors in emotional exhaustion (p > 0.05), depersonalization (p > 0.05), and lack of self-fulfilment (p < 0.05) (Table 4).

Table 4 Adjusted regression analysis model of emotional exhaustion, depersonalization and self-fulfilment associated with Fear of COVID-19 and sociodemographic variables
Full size table

Discussion

During the COVID-19 pandemic, frontline teams, including health care workers, police, and military personnel, were at a heightened risk of infection due to their direct contact with potentially infected individuals [8, 9]. Dentists, similarly, were exposed to stressors such as working in high-risk environments, inadequate working conditions, and constant concern regarding the availability of personal protective equipment (PPE) to shield them from salivary and blood aerosols [36,37,38]. This situation could result in significant subjective overload, fear, and psychological distress paired with emotional exhaustion, helplessness, depersonalization, negative attitudes towards work and life, and low self-fulfilment [39,40,41]. Therefore, the aim of this study was to assess the association between the fear of COVID-19 and Burnout syndrome in Peruvian dentists belonging to the Health Department of the PNP, taking into account possible confounding variables. Therefore, according to the results obtained, the null hypothesis was rejected.

The study's results reveal Burnout syndrome in 19.2% of all dentists surveyed, with high emotional exhaustion observed. Additionally, high depersonalization was identified in 9.3%, and low self-fulfilment in 6.6% of respondents. These findings contrast with those of Silva et al. [41], who discovered that among Brazilian dentists, 43.4% reported high levels of personal exhaustion, 26.3% indicated high levels of depersonalization, and 81.3% reported low levels of self-fulfilment. This may be attributed to the fact that the present study was conducted at the onset of 2023, during the final phase of the COVID-19 public health crisis in Peru, where accurate information was readily available and a significant proportion of the adult populace had already obtained 3 to 4 immunization shots. In addition, it is possible that the participants in the current study exhibited more resilience due to their experience as police dentists handling dangerous situations [2, 23]. This is in contrast to Silva et al.'s 2020 study [41], which was conducted during the second wave of COVID-19 infections when many dentists were exposed to high levels of anxiety, depression, and stress, resulting in an increase in burnout levels [42, 43].

The present study found that 24.2% of respondents were fearful of COVID-19, which differs from Salehiniya et al.'s [44] report indicating 85% of dentists were scared of contracting the virus. Furthermore, our results were incongruent with Birant and Gümüştaş' study [17], which identified that 78% of dentists were afraid of being infected with COVID-19. These discrepancies may have been due to the fact that these studies were conducted between 2020 and 2021, a period in which dentists were affected by the infodemic and the beginning of the implementation of the vaccination process, which created a degree of uncertainty about the efficacy of the vaccines [45,46,47,48,49].

Likewise, our findings indicated that fear of COVID-19 was significantly associated with low direct intensity with emotional exhaustion, with very low direct intensity with depersonalization, and with very low inverse intensity with self-fulfilment. These findings align with those of Ahorsu et al. [50] and Lacerda et al. [51], who observed a positive correlation between COVID-19 fear and emotional exhaustion and depersonalization in healthcare workers, but a negative correlation with self-fulfilment [50, 51]. This suggests that as perceived threat of COVID-19 rises, emotional exhaustion and depersonalization symptoms likewise increase, albeit in low intensities. However, increasing fear of COVID-19 appears to diminish the sense of self-fulfilment also to a low degree. This observation suggests that Peruvian police dentists may possess a certain level of resilience in the midst of life-threatening danger. Additionally, receiving four vaccine doses may have provided a sense of security against infection [50, 52].

The bivariate analysis revealed a significant correlation between fear of COVID-19 and age group, as well as years of service. These findings mirror those of Teutli-Mellado et al. [21], who observed that dentists over 40 years of age experienced greater levels of fear compared to their 20–40-year-old counterparts. This can be attributed to older dentists feeling more susceptible to infection [21]. Fear of COVID-19 was associated with marital status, as married dentists were afraid of infecting their family members during clinical activities and other duties of enforcement [53, 54]. The number of children was also linked to fear of COVID-19, potentially due to a higher risk of cross-infection among family members [4, 54]. Furthermore, fear of COVID-19 was found to be linked to police hierarchy. The heightened fear among police personnel during the pandemic may be attributed to the greater responsibility placed upon higher-ranking official dentists, who oversee multiple work teams within the PNP. Unlike other hazardous situations, the COVID-19 pandemic has exposed all members of the police force to the same perilous circumstances, irrespective of their rank [22]. Finally, fear of COVID-19 was correlated with the type of work performed. The findings contrast with those of Birant and Gümüştaş [17], who observed that dentists in administrative roles exhibited lower levels of fear of infection [17]. The present study identified that dentists in administrative police roles experienced greater fear of contagion than those in custodial roles. In the final stage of the health emergency, masks were not required, but those providing assistance always had personal protective equipment (PPE) when in contact with patients. This may have provided a heightened sense of security [55].

Based on a multivariable regression analysis, dental police officers who feared COVID-19 were 3.4 and 3.7 times more likely to exhibit emotional exhaustion and depersonalization, respectively, compared to those who did not fear the virus. These findings align with those reported by Zambrano et al. [52], who noted that healthcare professionals with high levels of COVID-19 fear experienced burnout. The pandemic posed a threat to dentists, healthcare professionals, and police officers due to their law enforcement responsibilities and changes in their roles prompted by government directives aimed at reducing the spread of the disease [8, 19, 52]. This may have placed a significant emotional burden on them, which could have negative implications for their psychological health. As a result, these professionals may have experienced increased emotional exhaustion and depersonalization [52, 56].

Although some sociodemographic factors were found to be associated with the emotional exhaustion and depersonalization dimensions of Burnout syndrome according to the bivariate analysis, the multivariable regression analysis observed no significant influence of any confounding variable in any of the three dimensions. This demonstrates that a bivariate association does not always signify causality or influence [57,58,59]. No sociodemographic factor was found to be decisive in the presentation of Burnout characteristics among the respondents. This observation suggests that the fear of COVID-19 experienced by PNP dentists might be a potential risk factor for the development of emotional exhaustion and depersonalization, irrespective of age, gender, family or work conditions, given their arduous and disciplined training to confront critical situations. [22]. However, it should be acknowledged based on the findings that the pandemic did affect their job duties, as the extent of the illness was unforeseen and unprecedented [60, 61]. It must also be acknowledged that the COVID-19 pandemic may have had some negative effects on the mental health and burnout of the workforce, so it is important that police dentists develop resilience, i.e. the personal ability to adapt positively to sudden unexpected events and widespread challenges, as this will enable them to fulfil their duties while protecting their mental health and personal well-being [62,63,64].

One advantage of this study is that all PNP dentists from all over the country were invited to participate, thus providing new and unprecedented results in Peru, which is very important because dental police officers are frontline risk personnel. They endure psychological pressure while trying to balance care with other PNP responsibilities [12, 53], and many also have familial obligations [53]. The obtained results will aid in developing future protocols for the care and training of police health personnel and preparing for emergencies similar to the pandemic, avoiding uncertainties that could affect their mental health and work performance [65].

Limitations of this study include the inability to compare dentists in other sectors, such as the Ministry of Health (MINSA), Social Security, and private entities. Another limitation was that the pre-existence of mental or chronic illnesses was not taken into account, so it is suggested that these be included in future studies, as these factors may have contributed to burnout [66]. Additionally, this cross-sectional research did not allow for the evaluation of the dynamics and sustainability of Burnout syndrome in PNP dentists during and after the pandemic. It is recommended that health and government authorities should conduct regular mental health checkups, provide counseling and psychological support, and offer coping and resilience strategies for PNP dentists to detect any potential changes that may impact their mental health and work productivity [67, 68]. Additionally, longitudinal studies should be conducted to further explore this research topic in the post-pandemic era.

Conclusion

Fear of COVID-19 was significantly associated with emotional exhaustion and depersonalization, and inversely associated with self-fulfilment. PNP dentists who were afraid of COVID-19 were at greater risk for emotional exhaustion and depersonalization. Factors such as age, sex, marital status, children, hierarchy, years of service, work zone, private practice, working over 40 h per week, type of service, work performed, sport practice and daily exercise time were not considered to be influential factors in the development of burnout syndrome.

Availability of data and materials

All data analyzed during this study are available from the corresponding author on reasonable request (cesarcayorojas@gmail.com).

Abbreviations

APR:

Adjusted Prevalence Ratio

CI:

Confidence interval

COVID-19:

COronavirus DIsease 2019

OSHA:

Occupational Safety and Health Administration

PNP:

National Police of Peru

STROBE:

STrengthening the Reporting of OBservational studies in Epidemiology

SPSS:

Statistical Package for the Social Sciences

References

  1. Cayo-Rojas C, Córdova-Limaylla N, Ladera-Castañeda M, Briceño-Vergel G, López-Gurreonero C, Castro-Mena M, et al. Psychological distress facing the COVID-19 pandemic in dental interns from the Peruvian capital: a cross-sectional study under a multivariable regression model. Front Public Health. 2022;10:1–15. https://doi.org/10.3389/fpubh.2022.996921.

    Article  Google Scholar 

  2. World Health Organization. Mental Health and COVID-19: early evidence of the pandemic’s impact. 2022. Available online en: https://apps.who.int/iris/bitstream/handle/10665/352189/WHO-2019-nCoV-Sci-Brief-Mental-health-2022.1-eng.pdf?sequence=1&isAllowed=y. Accessed 22 Jan 2023.

  3. Yoshioka T, Okubo R, Tabuchi T, Odani S, Shinozaki T, Tsugawa Y. Factors associated with serious psychological distress during the COVID-19 pandemic in Japan: a nationwide cross-sectional internet-based study. BMJ Open. 2021;11:1–9. https://doi.org/10.1136/bmjopen-2021-051115.

    Article  Google Scholar 

  4. Morales-Montoya M, Córdova-Limaylla N, Briceño-Vergel G, Ladera-Castañeda M, Garcia-Luna G, Cachay-Criado H, et al. Psychological impact on dental students and professionals in a Lima population during COVID-19s wave: a study with predictive models. Sci Rep. 2022;12:1–12. https://doi.org/10.1038/s41598-022-18899-x.

    Article  CAS  Google Scholar 

  5. Seneviratne CJ, Lau MWJ, Goh BT. The role of dentists in COVID-19 is beyond dentistry: Voluntary medical engagements and future preparedness. Front Med. 2020;7:1–7. https://doi.org/10.3389/fmed.2020.00566.

    Article  Google Scholar 

  6. Evaristo-Chiyong T, Mattos-Vela MA, Agudelo-Suárez AA, et al. General labor well-being in Latin American dentists during the COVID-19 pandemic. Int J Environ Res Public Health. 2022;19:1–15. https://doi.org/10.3390/ijerph19106317.

    Article  CAS  Google Scholar 

  7. Mejía C, Coronel L, Meza-Roque G, Chacón J, Gallardo G, Ramírez M. Factors associated with fear of pandemic information received by Peruvian police and military personnel. Rev Cubana Med Milit. 2023;52:1–13. Available online: https://revmedmilitar.sld.cu/index.php/mil/article/view/2109. Accessed 13 Jan 2023.

    Google Scholar 

  8. Tehrani N. The psychological impact of COVID-19 on police officers. Police J. 2022;95:73–87. https://doi.org/10.1177/0032258X211039975.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Valladares-Garrido MJ, Zapata-Castro LE, Picón-Reategui CK, et al. Association between working time and burnout syndrome in Peruvian military during the second epidemic wave of COVID-19. Int J Environ Res Public Health. 2022;19:1–14. https://doi.org/10.3390/ijerph192013614.

    Article  Google Scholar 

  10. Newspaper “El Peruano”. Esencial labor de la Policía. 2021. Available online: https://www.elperuano.pe/noticia/113851-esencial-labor-de-la-policia. Accessed 22 Jan 2023.

  11. Yassin A, AlOmari M, Al-Azzam S, Karasneh R, Abu-Ismail L, Soudah O. Impact of social media on public fear, adoption of precautionary behaviors, and compliance with health regulations during COVID-19 pandemic. Int J Environ Health Res. 2021;32:2027–39. https://doi.org/10.1080/09603123.2021.1935778.

    Article  CAS  PubMed  Google Scholar 

  12. Ministerio de Salud. Directiva Sanitaria Nº 100/MINSA/2020/DGIESP “Manejo de la atención estomatológica en el contexto de la pandemia por COVID-19”. 2020. Available online: https://cdn.www.gob.pe/uploads/document/file/716209/DIRECTIVA_SANITARIA_N_100-MINSA-2020-DGIESP.pdf. Accessed 29 Jan 2023.

  13. Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). COVID-19 dashboard Peru. 2023. Available from: https://www.arcgis.com/apps/dashboards/bda7594740fd40299423467b48e9ecf6. Accessed 13 Jul 2023.

  14. Instituto Nacional de Salud Pública (INS). Informe Técnico N°019- 2023-ESG-LRNVIN-DEET-CNSP/INS “Actualización de la identificación de variantes circulantes de SARS-CoV-2 en el Perú”. 2023. Available online: https://cdn.www.gob.pe/uploads/document/file/4550939/Informe%20Tecnico%20N%C2%B0019-2023.pdf?v=1683901400. Accessed 22 May 2023.

  15. Ministerio de Salud. Directiva Administrativa Nº339-MINSA/DGIESP-2023 “Directiva administrativa que establece las disposiciones para la vigilancia, prevención y control de la salud de los trabajadores con riesgo de exposición a SARS-CoV2”. 2023. Available online: https://cdn.www.gob.pe/uploads/document/file/4039316/Directiva%20Administrativa%20N%C2%B0%20339-MINSA/DGIESP-2023.pdf?v=1673536189. Accessed 29 Jan 2023.

  16. Lasalvia A, Amaddeo F, Porru S, Carta A, Tardivo S, Bovo C, et al. Levels of burn-out among healthcare workers during the COVID-19 pandemic and their associated factors: a cross-sectional study in a tertiary hospital of a highly burdened area of north-east Italy. BMJ Open. 2021;11:1–12. https://doi.org/10.1136/bmjopen-2020-045127.

    Article  Google Scholar 

  17. Birant S, Gümüştaş B. Evaluation of the fear and anxiety caused by the COVID-19 outbreak among dentists. BAUN Sağ Bil Derg. 2022;11:83–90. https://doi.org/10.53424/balikesirsbd.980946.

    Article  Google Scholar 

  18. Juárez-García A. Síndrome de burnout en personal de salud durante la pandemia COVID-19: un semáforo naranja en la salud mental. Salud UIS. 2022;52:432–9.

    Google Scholar 

  19. Turgoose D, Glover N, Maddox L. Burnout and the Psychological Impact of Policing: Trends and Coping Strategies. In P. Barbosa Marques, M. Paulino (Eds.), Police Psychology: New Trends in Forensic Psychological Science (1ª ed.). 2022;63–86. https://doi.org/10.1016/B978-0-12-816544-7.00004-8.

  20. Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement: guidelines for reporting observational studies. Gac Sanit. 2008;22:144–50. https://doi.org/10.1157/13119325.

    Article  Google Scholar 

  21. Teutli-Mellado KM, Espinosa-de-Santillana IA, Campos-Rivera NH. Percepción de Miedo al COVID-19 en Estomatólogos Generales y Especialistas. Int J Odontostomat. 2023;17:117–23. https://doi.org/10.4067/S0718-381X2023000200117.

    Article  Google Scholar 

  22. Martínez-Cuazitl A, Martínez-Salazar IN, Maza-De La Torre G, et al. Burnout syndrome in a military tertiary hospital staff during the COVID-19 contingency. Int J Environ Res Public Health. 2022;19:1–18. https://doi.org/10.3390/ijerph19042229.

    Article  CAS  Google Scholar 

  23. Özarslan M, Caliskan S. Attitudes and predictive factors of psychological distress and occupational burnout among dentists during COVID-19 pandemic in Turkey. Curr Psychol. 2021;40:3113–24. https://doi.org/10.1007/s12144-021-01764-x.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Teme LS, Yildiz T, Eti Aslan F. The effect of marital status on burnout levels of nurses: A meta-analysis study. J Clin Med Kaz. 2020;4:51–6. https://doi.org/10.23950/1812-2892-JCMK-00786.

    Article  Google Scholar 

  25. Aydın A, Kulakaç N, Aydın Sayılan A. The effect of COVID-19 anxiety levels of healthcare professionals on the quality of working life and related factors. Int J Clin Pract. 2021;75:1–6. https://doi.org/10.1111/ijcp.14889.

    Article  CAS  Google Scholar 

  26. Tham R, Pascoe A, Willis K, Kay M, Smallwood N. Differences in psychosocial distress among rural and metropolitan health care workers during the COVID-19 pandemic. Aust J Rural Health. 2022;30:683–96. https://doi.org/10.1111/ajr.12873.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Creager J, Coutinho AJ, Peterson LE. Associations between burnout and practice organization in family physicians. Ann Fam Med. 2019;17:502–9. https://doi.org/10.1370/afm.2448.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Lin RT, Lin YT, Hsia YF, Kuo CC. Long working hours and burnout in health care workers: non-linear dose-response relationship and the effect mediated by sleeping hours-A cross-sectional study. J Occup Health. 2021;63:1–13. https://doi.org/10.1002/1348-9585.12228.

    Article  CAS  Google Scholar 

  29. Moueleu Ngalagou PT, Assomo-Ndemba PB, Owona Manga LJ, Owoundi Ebolo H, Ayina Ayina CN, Lobe Tanga MY, et al. Burnout syndrome and associated factors among university teaching staff in Cameroon: Effect of the practice of sport and physical activities and leisures. Encéphale. 2019;45:101–6. https://doi.org/10.1016/j.encep.2018.07.003.

    Article  CAS  PubMed  Google Scholar 

  30. Reche C, De Francisco C, Martínez-Rodríguez A, Ros-Martínez A. Relación entre variables sociodemográficas y deportivas, dependencia del ejercicio y Burnout: un estudio preliminar en deportistas. An Psicol. 2018;34:398–404. https://doi.org/10.6018/analesps.34.2.289861.

    Article  Google Scholar 

  31. Huarcaya-Victoria J, Villarreal-Zegarra D, Podestá A, Luna-Cuadros M. Psychometric Properties of a Spanish Version of the Fear of COVID-19 Scale in General population of Lima. Peru Int J Ment Health Addict. 2022;20:249–62. https://doi.org/10.1007/s11469-020-00354-5.

    Article  PubMed  Google Scholar 

  32. Castro-Pérez Vargas AM, Céspedes-Porras J, Echeverri-Junca LH, Córdova-Limaylla NE, López-Gurreonero C, Castro-Mena MJ, et al. Depression, anxiety and stress associated with fear of COVID-19 in Peruvian dental students: a multivariate analysis with 12 sociodemographic factors. J Int Soc Prev Comunidad Dent. 2022;13:208–20. https://doi.org/10.4103/jispcd.JISPCD_295_21.

    Article  Google Scholar 

  33. Gonçalves F, Gaudêncio M. Burnout y calidad de vida en profesionales sanitarios portugueses que trabajan en oncología y cuidados paliativos: un estudio preliminar. MC Palliat Care. 2023;22:1–9. https://doi.org/10.1186/s12904-023-01273-7.

    Article  Google Scholar 

  34. Ibar C, Fortuna F, Gonzalez D, Jamardo J, Jacobsen D, Pugliese L, et al. Evaluation of stress, burnout and hair cortisol levels in health workers at a University Hospital during COVID-19 pandemic. Psychoneuroendocrinology. 2021;128:1–7. https://doi.org/10.1016/j.psyneuen.2021.105213.

    Article  CAS  Google Scholar 

  35. World Medical Association. World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA. 2013;310:2191–4. https://doi.org/10.1001/jama.2013.281053.

    Article  CAS  Google Scholar 

  36. Melzow F, Mertens S, Todorov H, Groneberg DA, Paris S, Gerber A. Aerosol exposure of staff during dental treatments: a model study. BMC Oral Health. 2022;22:1–6. https://doi.org/10.1186/s12903-022-02155-9.

    Article  CAS  Google Scholar 

  37. Cayo-Rojas CF, Baltazar-Sánchez CA. Dental clinical recommendations against COVID-19, according to scientific evidence. Rev Haban Cienc Méd. 2020;19:e3283_E.

    Google Scholar 

  38. Santome-Pariona J, Briceño-Vergel G, Córdova-Limaylla N, Ladera-Castañeda M, Huamani-Echaccaya J, Tolmos-Valdivia R, et al. Factors associated with the level of knowledge about biosafety against COVID-19 in Peruvian dental students: a cross-sectional study under a multivariable regression model. Int J Environ Res Public Health. 2023:1–14. https://doi.org/10.3390/ijerph20115938.

  39. Pasiga BD. Relationship knowledge transmission of COVID-19 and fear of dental care during pandemic in South Sulawesi, Indonesia. Pesqui Bras Odontopediatria Clín Integr. 2021;21:1–12. https://doi.org/10.1590/pboci.2021.017.

    Article  CAS  Google Scholar 

  40. Lurcov R, Pop LM, Ciavoi G, Iorga M. Evaluating the Practice of Preventive Behaviors and the Fear of COVID-19 among Dentists in Oradea Metropolitan Area after the First Wave of Pandemic; a Cross-Sectional Study. Healthcare. 2021;9:1–15. https://doi.org/10.3390/healthcare9040443.

    Article  Google Scholar 

  41. Silva JKF, Carvalho FM, Azevedo CF, Silva MVS, Lima AIC, Lins-Kusterer L. Burnout among Brazilian Dentists during the COVID-19 Pandemic: A Cross-sectional Study. Clin Pract Epidemiol Ment Health. 2023;19:1–8. https://doi.org/10.2174/17450179-v19-e230717-2023-1.

    Article  Google Scholar 

  42. Owen C, Seddon C, Clarke K, Bysouth T, Jhonson D. The impact of the COVID-19 pandemic on the mental health of dentists in Wales. Br Dent J. 2022;232:44–54. https://doi.org/10.1038/s41415-021-3756-7.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Yslado Méndez R, Nuñez Zarazú Ll, Montané Lopez L, Bobadilla Chávez R, de la Cruz Díaz L, Pinto Flores I, et al. Burnout syndrome, anxiety, depression and occupational well-being among Peru hospital staff during the COVID-19 pandemic. Rev Cubana Invest Bioméd. 2022;41:1-18. Available online http://scielo.sld.cu/pdf/ibi/v41/1561-3011-ibi-41-e2555.pdf. Accessed 28 Mar 2023.

  44. Salehiniya H, Hatamian S, Abbaszadeh H. Mental health status of dentists during COVID-19 pandemic: A systematic review and meta-analysis. Health Sci Rep. 2022;5:1–8. https://doi.org/10.1002/hsr2.617.

    Article  Google Scholar 

  45. Cayo CF, Miranda AS. Higher medical education facing the COVID-19 infodemia. Educ Med Super. 2020;34(3):e2524.

    Google Scholar 

  46. Cayo-Rojas CF, Córdova-Limaylla N, Briceño-Vergel G, Ladera-Castañeda M, Cachay-Criado H, López-Gurreonero C, et al. Psychometric evidence of a perception scale about covid-19 vaccination process in Peruvian dentists: a preliminary validation. BMC Health Serv Res. 2022;22:1–13. https://doi.org/10.1186/s12913-022-08677-w.

    Article  Google Scholar 

  47. Pian W, Chi J, Ma F. The causes, impacts and countermeasures of COVID-19 “Infodemic”: a systematic review using narrative synthesis. Inf Process Manag. 2021;58:1–18. https://doi.org/10.1016/j.ipm.2021.102713.

    Article  Google Scholar 

  48. Gómez Marco J, Álvarez Pasquín M, Martín Martín S. Efectividad y seguridad de las vacunas para el SARS-CoV-2 actualmente disponibles. FMC. 2021;28:442–51. https://doi.org/10.1016/j.fmc.2021.07.001.

    Article  Google Scholar 

  49. Ahmed MA, Jouhar R, Ahmed N, Adnan S, Aftab M, Zafar MS, et al. Fear and Practice Modifications among Dentists to Combat Novel Coronavirus Disease (COVID-19) Outbreak. Int J Environ Res Public Health. 2020;17:1–11. https://doi.org/10.3390/ijerph17082821.

    Article  CAS  Google Scholar 

  50. Ahorsu DK, Lin CY, Marznaki ZH, Pakpour AH. The association between fear of COVID-19 and mental health: the mediating roles of burnout and job stress among emergency nursing staff. Nurs Open. 2022;9:1147–54. https://doi.org/10.1002/nop2.1154.

    Article  PubMed  Google Scholar 

  51. Rezende Lacerda JP, Oliveira de Freitas I, Ferreira e Costa de AY, Andrade Cunha PH, Locarno Falco R, Lopes Moraes LA, da Silva de Jesus LA, Fonseca Lucinda LA. HU rev. 2022;48:1–8. https://doi.org/10.34019/1982-8047.2022.v48.36671.

  52. Zambrano-Bohorquez B, Villarín-Castro AR, Muñoz-Bodas F, Gómez-Rey I. Síndrome de burnout, resiliencia y miedo a la COVID-19 en personal sanitario durante la pandemia por SARS-CoV-2. Rev Clin Med Fam. 2022;15:134–42.

    Google Scholar 

  53. Pramod PB, Sannidhya M, Sanjna R, Chandrashekhar SS. Psychological impact of Covid-19 pandemic on dentists. Afr Health Sci. 2022;22:519–25. https://doi.org/10.4314/ahs.v22i4.58.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Mayer Y, Etgar S, Shifman N, Lurie I. The Fear of COVID-19 Familial Infection Scale: Initial Psychometric Examination. Meas Eval Couns Dev. 2021;55:71–83. https://doi.org/10.1080/07481756.2021.1998780.

    Article  Google Scholar 

  55. Ministerio de Salud Minsa anunció el uso opcional de mascarilla en espacios abiertos y cerrados ventilados.2022 Available online:https://www.gob.pe/institucion/minsa/noticias/653308-minsa-anuncio-el-uso-opcional-de-mascarilla-en-espacios-abiertos-y-cerrados-ventilados. Accessed on 29 Mar 2023.

  56. Guedes HD, Gondim SM, Hirschle AL. Trabalho emocional e engajamento no trabalho em policiais militares: mediação da identidade profissional. Estud Psicol. 2020;25:69–79 Available online: http://pepsic.bvsalud.org/pdf/epsic/v25n1/a07v25n1.pdf. Accessed 28 June 2023.

    Google Scholar 

  57. Zhang W, VanDyke MS. Association Versus Causation. In: Schintler LA, McNeely CL, editors. Encyclopedia of Big Data. Cham: Springer; 2023. p. 1–67. https://doi.org/10.1007/978-3-319-32010-6_15.

  58. Matamoros RA, Ceballos A. Errores conceptuales de estadística más comunes en publicaciones científicas. Ces Med Vet Zootec. 2017;12:211–29. https://doi.org/10.21615/cesmvz.12.3.4.

    Article  Google Scholar 

  59. Roy-García I, Rivas-Ruiz R, Perez-Rodriguez M, Palacios-Cruz L. Correlación: no toda correlación implica causalidad. Rev Alerg Méx. 2020;66:354–60. Available online: https://www.scielo.org.mx/scielo.php?script=sci_arttextandpid=S2448-91902019000300354. Accessed 28 June 2023.

    Article  Google Scholar 

  60. Espinoza-Espinoza DAK, Dulanto-Vargas JA, Cáceres-LaTorre OA, et al. Association between periodontal disease and the risk of COVID-19 complications and mortality: a systematic review. J Int Soc Prev Community Dent. 2021;11(6):626–38. https://doi.org/10.4103/jispcd.JISPCD_189_21.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Yıldırım M, Ashraf F. Fear of COVID-19, coronavirus anxiety, COVID-19 burnout, and resilience: examining psychometric properties of COVID-19 burnout scale in Urdu. J Asiático Afr Stud. 2023;0:1–13. https://doi.org/10.1177/00219096231153161.

    Article  Google Scholar 

  62. Safiye T, Vukčević B, Čabarkapa M. Resilience as a moderator in the relationship between burnout and subjective well-being among medical workers in Serbia during the COVID-19 pandemic. Vojnosanit Pregl. 2021;78(11):1207–13. https://doi.org/10.2298/VSP210517070S.

    Article  Google Scholar 

  63. Safiye T, Gutić M, Dubljanin J, Stojanović TM, Dubljanin D, Kovačević A, Zlatanović M, Demirović DH, Nenezić N, Milidrag A. Mentalizing, resilience, and mental health status among healthcare workers during the COVID-19 pandemic: a cross-sectional study. Int J Environ Res Public Health. 2023;20(8): 5594. https://doi.org/10.3390/ijerph20085594.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Cayo-Rojas CF, Agramonte-Rosell R. Social isolation and virtual proximity in the face of the COVID-19 pandemic. Rev Cubana Med Gen Integ. 2021;37(Sup):e1510.

    Google Scholar 

  65. Yupari-Azabache I, Diaz-Ortega JL, Azabache-Alvarado KA, Bardales-Aguirre LB. Logistic model of factors associated with burnout syndrome in health personnel. E global. 2022;21:144–71. https://doi.org/10.6018/eglobal.512491.

    Article  Google Scholar 

  66. Marchand A, Blanc ME. Chronic diseases, age and gender: examining the contribution to burnout symptoms in a sample of 2075 Canadian workers. Int Arch Occup Environ Health. 2020;93:853–61. https://doi.org/10.1007/s00420-020-01534-5.

    Article  PubMed  Google Scholar 

  67. Preti E, Di Mattei V, Perego G, Ferrari F, Mazzetti M, Taranto P, et al. The Psychological Impact of Epidemic and Pandemic Outbreaks on Healthcare Workers: Rapid Review of the Evidence. Curr Psychiatry Rep. 2020;22:1–22. https://doi.org/10.1007/s11920-020-01166-z.

    Article  Google Scholar 

  68. Mediavilla R, Felez-Nobrega M, McGreevy KR, Monistrol-Mula A, Bravo-Ortiz MF, Bayón C, et al. Effectiveness of a mental health stepped-care programme for healthcare workers with psychological distress in crisis settings: a multicentre randomised controlled trial. BMJ Ment Health. 2023;26:1–8. https://doi.org/10.1136/bmjment-2023-300697.

    Article  Google Scholar 

Download references

Acknowledgements

We thank the Investigation Group "Salud Pública—Salud Integral" of the Postgraduate School of the Universidad Nacional Federico Villarreal; and the research team of the School of Stomatology, Universidad Privada San Juan Bautista, Lima, Peru, for their constant support in the preparation of this manuscript.

Funding

Self-financed.

Author information

Authors and Affiliations

  1. Research Group “Salud Pública – Salud Integral”, Postgraduate School, Universidad Nacional Federico Villarreal, Lima, Peru

    Arturo Verástegui-Sandoval, Marysela Ladera-Castañeda, Miriam Castro-Rojas & Alberto Cornejo-Pinto

  2. Professional Academic School of Dentistry, Faculty of Health Sciences, Universidad Privada Norbert Wiener, Lima, Peru

    Arturo Verástegui-Sandoval, Flor Aquiles-Barzola & Heriberto Machco-Pasmiño

  3. School of Stomatology, Universidad Privada San Juan Bautista, Lima, Peru

    Gissela Briceño-Vergel & César Cayo-Rojas

  4. Faculty of Stomatology, Universidad Inca Garcilaso de La Vega, Lima, Peru

    Luis Cervantes-Ganoza

Authors
  1. Arturo Verástegui-Sandoval
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Flor Aquiles-Barzola
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Heriberto Machco-Pasmiño
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marysela Ladera-Castañeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gissela Briceño-Vergel
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Miriam Castro-Rojas
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alberto Cornejo-Pinto
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Luis Cervantes-Ganoza
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. César Cayo-Rojas
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

A.V.S. conceived the research idea; A.V.S., G.B.V., M.L.C., and C.C.R elaborated the manuscript; A.V.S., F.A.B. and H.M.P. collected and tabulated the information; M.C.R., F.A.B., H.M.P. and L.C.G. carried out the bibliographic search; C.C.R. and A.C.P. interpreted the statistical results; A.V.S., M.L.C., G.B.V., L.C.G. and C.C.R. helped in the development from the discussion; A.V.S., G.B.V., M.L.C., M.C.R., A.C.P., and C.C.R. performed the critical revision of the manuscript. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to César Cayo-Rojas.

Ethics declarations

Ethics approval and consent to participate

The present study adhered to the bioethical principles outlined in the Declaration of Helsinki related to respect, freedom, nonmaleficence, and confidentiality. Approval was obtained from the Ethics Committee of the Postgraduate School at the Universidad Nacional Federico Villarreal with letter No. 013–2023-UIIE-EUPG-UNFV dated February 13, 2023. Furthermore, participants were requested to provide their voluntary informed consent on the initial page of the online survey.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Verástegui-Sandoval, A., Aquiles-Barzola, F., Machco-Pasmiño, H. et al. Fear of COVID-19 associated with burnout syndrome in dentists of the Health Directorate of the National Police of Peru: a cross-sectional study at national level under multivariable regression model. BMC Public Health 24, 1488 (2024). https://doi.org/10.1186/s12889-024-18979-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12889-024-18979-9

Keywords

BMC Public Health

ISSN: 1471-2458

Contact us