Survey-based longitudinal analysis of burnout and behavioral profiles in a single Brazilian pediatric intensive care unit during and after the COVID-19 pandemic.

Burnout, characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, is common among healthcare workers, particularly in pediatric intensive care units (PICUs). Longitudinal data from low- and middle-income countries are limited. Repeated cross-sectional surveys were conducted among PICU staff at a Brazilian public hospital from 2020 to 2023 using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Participants were classified into behavioral profiles (engaged, ineffective, overextended, disengaged, burnout). Emotional exhaustion increased from 2.47 ± 1.17 in 2020 to 3.33 ± 1.30 in 2023 (p = 0.027), while depersonalization rose from 1.13 ± 1.07 to 1.86 ± 0.98 (p = 0.014). Personal accomplishment declined from 4.62 ± 0.79 to 4.11 ± 0.84 (p = 0.048). Overextended staff increased from 22.5% to 44%, whereas engaged workers fell from 45% to 16%. Burnout worsened over time among PICU staff in this Brazilian tertiary center. Protected breaks, peer support, and AI-assisted monitoring may help preserve staff wellbeing and workforce stability in resource-limited settings.