Currently submitted to: JMIR Nursing
Date Submitted: Mar 9, 2025
Open Peer Review Period: Mar 20, 2025 - May 15, 2025
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Role of Burnout and Health Beliefs in COVID-19 Vaccine Decisions Among Healthcare Workers: A Large Language Model-Based Text Analysis
ABSTRACT
Background:
Burnout among healthcare workers affects the well-being and decision making, influencing public health outcomes. Understanding the relationship between burnout, health beliefs and COVID-19 vaccine decisions among healthcare workers is essential for identifying at-risk staff, providing targeted support, and addressing workplace challenges to prevent further escalation of burnout related issues.
Objective:
This study examines how burnout, health beliefs, and COVID-19 vaccine decisions among healthcare workers. Building on our previously developed Health Belief Model (HBM) classifier, based on the HBM framework, which explains how individual perceptions of health risks and benefits influence behavior, we focused on key HBM constructs, including the perceived severity of COVID-19, perceived barriers to vaccination, and their relationship to burnout.
Methods:
We analyzed open-ended comments from 1,501 vaccine-hesitant nurses using data from the Nurses' Health Study surveys. Finetuning Llama3, an open-source Large Language Model with few-shot prompts, we further categorized these comments into burnout dimensions—Emotional Exhaustion, Depersonalization, and Inefficacy—based on the Maslach Burnout Inventory framework. Leveraging Annotation Guidelines-based Knowledge Augmentation and Reasoning-Aware Self-Consistency.
Results:
The model achieved a high weighted accuracy of 92% and an F1 Score of 91% for Depersonalization. Emotional Exhaustion accounted for 52% of comments, correlating strongly with perceived severity (59%) and barriers to vaccination (43%). Demographic analyses revealed significant variations in burnout prevalence, with older age groups reporting greater burnout.
Conclusions:
This study highlights the relationship between burnout and vaccine decisions among healthcare workers, uncovering areas for further exploration. By exploring the complex interplay between psychological strain and vaccine hesitancy, this study sets the stage for developing transformative interventions and policies that could redefine workforce resilience and public health strategies.
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Copyright
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