Prevalence of burnout in mental health nurses in China: A meta-analysis of observational studies

Prevalence of burnout among physiotherapists: a systematic review and meta-analysis

BACKGROUND

Work-related burnout is a significant concern amongst healthcare professionals, including physiotherapists. It can negatively impact on both staff well-being and the quality of care delivered to patients.

OBJECTIVES

To estimate the prevalence of burnout among physiotherapists.

DATA SOURCES

PubMed, CINAHL, Web of Science, Embase, Scopus and PsycINFO, from inception to February 1st, 2022.

STUDY SELECTION OR ELIGIBILITY CRITERIA

Studies reporting burnout prevalence among physiotherapists.

DATA EXTRACTION AND DATA SYNTHESIS

Prevalence of burnout. Sub-analyses were performed grouping studies based on countries where surveys were conducted, classified as developed or developing countries. The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale.

RESULTS

32 studies were included in the systematic review and 31 in the meta-analysis, enrolling a total of 5984 physiotherapists from 17 countries. Pooled prevalence (95% confidence interval) of burnout was 8% (4-15). Prevalence figures for Maslach Burnout Inventory dimensions were: (i) emotional exhaustion, 27% (21-34) (ii) depersonalization, 23% (15-32) (iii) low personal accomplishment, 25% (15-40). Both overall and single components prevalence was higher, although not significantly, in studies from developing than in developed countries.

LIMITATIONS

Tools used to assess burnout and cut-off scores chosen to identify the burnout prevalence differed across studies.

CONCLUSION AND IMPLICATIONS OF KEY FINDINGS

Prevalence of burnout reported by physiotherapists appears high worldwide, in particular in developing countries, and compares with that reported by nurses and physicians. Substantial heterogeneity in the prevalence of burnout, in its definition and assessment methods across studies, and limited quality of most studies precludes drawing definitive conclusions.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42022307876 CONTRIBUTION OF THE PAPER.

Risk and prediction of job burnout in responding nurses to public health emergencies

BACKGROUND

In public health emergencies, nurses are vulnerable to adverse reactions, especially job burnout. It is critical to identify nurses at risk of burnout early and implement interventions as early as possible.

METHODS

A cross-sectional survey of the hospitals in Xiangyang City was conducted in January, 2023 using stratified cluster sampling. Anonymized data were collected from 1584 working nurses. The Impact of Events Scale-Revised (IES-R) and the Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS) were used to evaluate the post-traumatic stress disorder (PTSD) and burnout of nurses in public health emergencies. Logistic regression analysis was established to screen for risk factors of burnout, and a nomogram was developed to predict the risk of burnout. A calibration curve and the area under the receiver operating characteristic (ROC) curve were used to validate the nomogram internally.

RESULTS

This study showed that only 3.7% of nurses were completely free of PTSD during a public health emergency. We found that PTSD varied by age, marital status, procreation status, length of service, employee status, and whether working in the ICU. The nurses aged 30 ~ 40 years old, single, married without children, non-regular employees, worked for less than three years or worked in the ICU had higher levels of PTSD. Regarding the prevalence of burnout, 27.4%, 48.5%, and 18.6% of nurses had a high level of emotional exhaustion (EE), depersonalization (DP), and diminished personal accomplishment (PA), respectively. There, 31.1% of nurses had more than two types of job burnout. The number of night shifts, the type of hospital, marital status, and the severity of PTSD were all associated with higher rates of exhaustion among nurses. As a graphical representation of the model, a nomogram was created and demonstrated excellent calibration and discrimination in both sets (AUC = 0.787).

CONCLUSIONS

This study confirmed the PTSD and burnout are common problems for in-service nurses during public health emergencies and screened out the high-risk groups of job burnout. It is necessary to pay more attention nurses who are single and working in general hospitals with many night shifts, especially nurses with severe PTSD. Hospitals can set up nurses' personal health records to give timely warnings to nurses with health problems, and carry out support interventions to relieve occupational stress.

Latent profile analysis of nurses' perceived professional benefits in China: a cross-sectional study

OBJECTIVE

To identify profiles of nurses' perceived professional benefits as well as their predictors.

DESIGN

Cross-sectional study.

SETTING

The study was carried out online in China.

METHODS

From 6 July to 27 July 2022, a total of 1309 registered nurses participated in the survey by convenient sampling. We collected the Nurses' Perceived Professional Benefits Questionnaire and demographic data. Using latent profile analysis (LPA), subgroups of nurses' perceived professional benefits were identified. Moreover, univariate and multinomial logistic regression analyses were conducted to find the factors that were linked with the profiles.

RESULTS

The survey was validly completed by 1309 nurses, with a 92.9% effective return rate. The findings of the LPA demonstrated three unique profiles: low-perceived professional benefits (11.8%), moderate-perceived professional benefits (57.1%) and high-perceived professional benefits (31.1%). There was a correlation between marital status, the number of night shifts per month and leadership role.

CONCLUSIONS

According to our research, registered nurses have three unique professional benefit profiles. In order to sustain the nursing workforce, despite the fact that nurses get a high level of professional benefits, interventions are necessary to increase nurses' perception of their professional value.

The application and effect of predictive nursing in the prevention of accidental events during operations for SMI patients

OBJECTIVE

To explore the status and influencing factors of job burnout among psychiatric nurses and provide a reference for hospital managers to carry out occupational and psychological interventions.

METHODS

Between September 2021 and September 2022, the psychiatric nurses in Wuhan Wudong Hospital (Wuhan Second Psychiatric Hospital) were selected as research participants using convenience sampling. The Chinese version of the nursing burnout scale was used to investigate the psychiatric nurses in the hospital, and a multiple linear regression analysis was performed on the factors affecting job burnout.

RESULTS

Among the 121 psychiatric nurses, 57.85 % had no or only mild job burnout, 36.36 % had mild to moderate job burnout and 5.79 % had severe job burnout. The one-way analysis of variance indicated that there were statistical differences in the scores in terms of marital status, educational background, working years, income, work departments and shifts (p < 0.05). The multiple linear regression analysis indicated that the main influencing factors of job burnout were working years and work department (p < 0.05).

CONCLUSION

The detection rate of nurses' job burnout in the featured psychiatric hospital was 42.10 %. The main influencing factors of job burnout were working years and work department, and targeted intervention can be carried out according to these two factors.

Effect of online modified mindfulness-based stress reduction training on the resilience of nursing interns in China

AIM

This study aimed to adopt online mindfulness-based stress reduction (MBSR) training to increase the resilience of nursing interns and help them to achieve a smooth transition.

DESIGN

A one-group pretest-posttest study design was used.

METHODS

A total of 119 college nursing interns were recruited from 12 tertiary hospitals in Beijing on Feb.20, 2021. The MBSR training was organized into 4 weeks of courses, conducted online using Tencent Meeting and taught by a certified teacher at the Oxford Mindfulness Centre. Resilience was assessed before and 2 weeks after the training, respectively, using Resilience Scale for Chinese Adolescents via an online questionnaire tool.

RESULTS

Seventy-nine college nursing interns finished both of the resilience questionnaire surveys. The mean resilience values before and after the training were 98.7 ± 13.69 and 104.57 ± 16.64 respectively. The 4-week online MBSR training considerably increased the resilience of nursing interns. This can be an effective measure to maintain a balanced state among nursing interns and help them smoothly transition from school to clinical practice. No Patient or Public Contribution.

Burnout and depression of medical staff: A chain mediating model of resilience and self-esteem

BACKGROUND

Although the relationship between burnout and depression is well-known and frequently studied, the specific mechanisms by which burnout develops into depression have not been fully established. Based on theoretical and empirical research on resilience and self-esteem, this study constructs a chain mediating model to test whether they play a mediating role in burnout and depression among medical staff.

METHODS

A cross-sectional study with a sample consisting of 602 medical staff was carried out by convenient sampling method. They all completed a self-report questionnaire with demographic information, burnout, resilience, self-esteem and depression. SPSS26 and Mplus8.3 were used to analyze the data.

RESULTS

Burnout was found to positively predict depression of medical staff and negatively predict resilience and self-esteem. Resilience was a mediator between burnout and depression. Self-esteem was also a mediator between them. Meanwhile, resilience and self-esteem had a chain mediating effect on burnout and depression.

LIMITATIONS

The cross-sectional study does not permit causal inferences. And the data used is self-reported.

CONCLUSIONS

Burnout takes a toll on resilience and self-esteem, which can eventually lead to depression. These findings contribute to the understanding of the predictive effects of burnout on mental health and provide practical implications for the prevention and intervention of mental health among medical staff.

Mental health status of mental health nurses in China: Results from a national survey

INTRODUCTION

It has been acknowledged in China that actions should be taken immediately to ease the critical shortage of psychiatric nurses. However, with national data lacking, little is known about nurses' mental health status.

AIM

To evaluate psychiatric nurses' mental health status by measuring their burnout, depression, anxiety and stress.

METHODS

All psychiatric nurses in the 41 selected hospitals in China were invited to participate in the survey. The Maslach Burnout Inventory-Human Service Survey and Depression Anxiety Stress Scale were used to assess variables of interest.

RESULTS

38.6% of psychiatric nurses met the criteria for burnout. The rates of depression, anxiety and stress were 26.3%, 36.4% and 12.5%, respectively. It was found that workplace region, educational level, working years, longer working hours and night shifts were associated with risk of burnout and DASS.

CONCLUSIONS

More than a quarter of psychiatric nurses are suffering from burnout, depression or anxiety in China. Policymakers and hospital administrators should design a flexible schedule and restrict working hours for psychiatric nurses to achieve work-life balance.

IMPLICATIONS FOR PRACTICE

The study informs policymakers and administrators on addressing the nursing shortage by identifying nurses immersed in negative emotions and preventing mental health problems.

Gender differences in the experience of burnout and its correlates among Chinese psychiatric nurses during the COVID-19 pandemic: A large-sample nationwide survey

Psychiatric nurses often experience burnout and other mental health symptoms. However, few studies have examined these phenomena and gender-specific associated factors during the COVID-19 pandemic. We surveyed a national sample of psychiatric nurses (N = 8971) from 41 tertiary psychiatric hospitals in China as part of a large national survey conducted during the pandemic. The Maslach Burnout Inventory-Human Service Survey was used to assess burnout and the Depression, Anxiety, and Stress Scale-21 was used to assess mental health symptoms. Binary logistic regression analyses were used to explore factors associated with burnout in the entire sample and separately by gender. The overall prevalence of burnout was 27.27%, with the rate in male psychiatric nurses (32.24%) being significantly higher than that in female psychiatric nurses (25.97%). Many key demographic factors (such as the male gender and marital status), work-related variables (such as a mid-level professional title, having an administrative position, longer working hours, more monthly night shifts, and the perceived negative impact of the COVID-19 pandemic on medical work) were significantly associated with burnout in the whole sample. Moreover, burnout was associated with depression, anxiety, and stress symptoms in the whole sample. Gender-specific factors associated with burnout were also identified: burnout was associated with night shifts in male psychiatric nurses, whereas it was associated with single or married marital status, a mid-level professional title, and having an administrative position among female psychiatric nurses. The high rates of burnout and mental health symptoms in psychiatric nurses need attention from hospital administrators. While mental health symptoms, longer working hours, and the perceived impact of COVID-19 are associated with burnout in both genders, gender-specific factors also warrant special attention when developing gender-specific interventions.

High-Performance Work Systems, Thriving at Work, and Job Burnout among Nurses in Chinese Public Hospitals: The Role of Resilience at Work

The overall purpose of this study is to explore and examine whether high-performance work systems (HPWS) can impact thriving at work and job burnout via resilience at work among nurses in Chinese public hospitals. Specifically, it draws on social exchange theory to conceptualize a positive relationship between HPWS and resilience at work. Then, based on a socially embedded model of thriving at work and knowledge about job burnout in the literature, it further proposes the differentiated mediation roles of resilience at work in the relationship of HPWS to thriving at work and job burnout. A time-lagged survey involving three rounds of data collection with self-reported online questionnaires was employed. A total of 160 nurses from 20 public hospitals in China were invited to participate in the research. Finally, a sample of 845 responses was obtained. The response rate was 52.8%. Multiple regression analyses were conducted to test the hypotheses. It was found that HPWS (time 1) positively impacted resilience at work (time 2). The results also demonstrated that HPWS (time1) enhanced thriving at work (time 3) and reduced job burnout (time 3) via developing resilience at work (time 2). To conclude, being resilient in the workplace is crucial for nurses to enhance thriving at work, and inhabit job burnout among nurses. HPWS is a valid management tool that can be used to cultivate a nurse's resilience at work, which further reduces job burnout and enhance thriving at work.

Prevalence of smartphone addiction among Asian medical students: A meta-analysis of multinational observational studies

BACKGROUND

High prevalence of smartphone addiction among medical students may contribute to adverse physical and mental health outcomes.

AIM

To estimate the prevalence of smartphone addiction, and explore the influencing factors and related mental health symptoms of smartphone addiction among Asian medical students.

DESIGN

Systematic review and meta-analysis.

METHODS

PubMed (MEDLINE), the Cochrane Central Register of Controlled Trials, and EMBASE were searched for relevant literature from the inception to September 10, 2021. Using Stata software 11.0, the meta-analysis of prevalence and the influencing factors of smartphone addiction were determined with 95% confidence intervals.

RESULTS

Nineteen articles, published between 2014 and 2019, were included, producing medical student studies from seven different Asian countries. The included studies were conducted in India (n = 11) and Malaysia (n = 3), with China, Saudi Arabia, Turkey, Nepal, and Iran each contributing one study. Among a total of 5,497 medical students, the participants included 3,214 females, of whom 2,181 were medical students with smartphone addiction. The prevalence of smartphone addiction among Asian medical students was 41.93% (95% CI [36.24%, 47.72%]). The influencing factors of smartphone addiction among medical students included gender, duration of smartphone use, smartphone function, and marital status. Ten studies (52.63%) explored related mental health symptoms of smartphone addiction among Asian medical students. Smartphone addiction was positively correlated with poor sleep quality (r = .17-.31), stress (r = .30-.40), anxiety, depression, neuroticism, and general health among Asian medical students.

CONCLUSION

Smartphone addiction is highly prevalent among Asian medical students. Smartphone addiction may adversely affect mental health, resulting in sleep disturbance, stress, anxiety, depression, and neuroticism. It is necessary to take appropriate precautionary actions and interventions to prevent smartphone overuse among medical students.

Demographic Factors and Job Characteristics Associated With Burnout in Chinese Female Nurses During Controlled COVID-19 Period: A Cross-Sectional Study

Background: To investigate the prevalence of burnout syndrome among Chinese female nurses during the controlled coronavirus disease 2019 (COVID-19) period and explore its associated socio-demographic factors and job characteristics. Methods: With the multistage, stratified sampling method, a cross-sectional online survey was conducted from September to October 2020 in China. The survey tool included revised Maslach Burnout Inventory (MBI) with 15 items, socio-demographic and job characteristics. Univariate logistic regression analysis and multivariate factor logistic regression analysis were used to identify the risk factors for burnout of female nurses. Results: During controlled COVID-19 period in China, the overall prevalence of burnout symptoms among Chinese female nurses was 60.2% with a breakdown in severity as follows: 451 (39.8 %) mild, 163 (14.4%) moderate, and 68 (6.0%) severe burnout. Little variance was reported for burnout symptoms according to job tenure (Waldχ ² = 14.828, P < 0.05,odds ratio [OR] <1), monthly salary income (Waldχ ² = 12.460, P < 0.05, OR <1), and night shift (Waldχ ² = 3.821, P < 0.05, OR > 1). Conclusion: Burnout symptoms among Chinese female nurses were prevalent and associated with job tenure, monthly salary income, and night shift. Female nurses who were with shorter job tenure, worked at night shifts, and had lower monthly salaries tended to exhibit increasing high-level burnout than their counterparts. This study serves as an implication for administrators and policy-makers to improve the work conditions of nurses for promoting overall healthcare service quality.

The association between fear of COVID-19 and mental health: The mediating roles of burnout and job stress among emergency nursing staff

Aim

This current study examined the mediation roles of burnout and job stress in the association between fear of COVID‐19 and mental health among emergency nurses.

Design

Cross‐sectional survey.

Methods

A total of 516 emergency nurses with a mean age of 41.18 (SD = 8.24), mostly females (76.16%) and married (78.9%) responded to measures on fear of COVID‐19, burnout, job stress and mental health between 15 September and 7 November 2020.

Results

There was a significantly direct effect between (a) fear of COVID‐19 and mental health, (b) fear of COVID‐19 and mediators (burnout and job stress) and (c) mediators (burnout and job stress) and mental health. Also, there was a significantly indirect effect between fear of COVID‐19 and mental health through job stress, burnout or both.

Conclusions

Fear of COVID‐19 directly and indirectly influenced the mental health of emergency nurses. Therefore, hospital authorities should provide sufficient resources to allay the fears of nurses during this COVID‐19 pandemic period.

Mental health status and quality of life in close contacts of COVID-19 patients in the post-COVID-19 era: a comparative study

Close contacts of those with COVID-19 (CC) may experience distress and long-lasting mental health effects. However, the mental health status and quality of life (QOL) in CC have not been adequately examined. This study examined the mental health status and QOL in CC during the post-COVID-19 period. This cross-sectional study comprised 1169 CC and 1290 who were non-close contacts (non-CC). Demographic data were collected; depression, fatigue, post-traumatic stress symptoms (PTSS) and QOL were assessed using the Patient Health Questionnaire - 9 items (PHQ-9), fatigue numeric rating scale, Post-Traumatic Stress Disorder Checklist - 17 items (PCL-17), and the World Health Organization Quality of Life Questionnaire - brief version (WHOQOL-BREF), respectively. Analysis of covariance was used to compare depressive symptoms, QOL, fatigue, and PTSS between the CC and non-CC groups. Multiple logistic regression analyses were performed to determine the independent correlates for depression, fatigue, PTSS, and QOL in the CC group. Compared to the non-CC group, the CC group reported significantly more severe depression (F(1, 2458) = 5.58, p = 0.018) and fatigue (F(1, 2458) = 9.22, p = 0.002) in the post-COVID-19 period. No significant differences in PTSS and QOL between the CC and non-CC groups were found (F(1, 2458) = 2.93, p = 0.087 for PTSS; F(1, 2458) = 3.45, p = 0.064 for QOL). In the CC group, younger age, financial loss due to COVID-19, and perception of poor or fair health status were significantly associated with depression and fatigue, while frequent use of mass media was significantly associated with fatigue. In conclusion, close contacts of COVID-19 patients experienced high levels of depression and fatigue in the post-COVID-19 period. Due to the negative effects of depression and fatigue on daily functioning, early detection and timely interventions should be provided to this neglected population.

Burnout and Emotional Intelligence in Neurosurgical Advanced Practice Providers Across the United States: A Cross-Sectional Analysis

OBJECTIVE

Although much research has examined nursing and physician burnout, the advanced practice provider (APP) population has not yet been studied. The goal of the present study was to survey APPs in neurosurgery to determine whether greater emotional intelligence (EI) is protective against burnout.

METHODS

An 80-item survey was created that incorporated the Maslach Burnout Inventory Human Services Survey for Medical Personnel, the Trait Emotional Intelligence Questionnaire-short form, and original questions developed by us. The collective survey was distributed, administered, and collected using the web-based REDCap (Research Electronic Data Capture) platform. Statistical analyses were completed using a comparison between participants with and without burnout.

RESULTS

A total of 106 neurosurgical APPs (26 men, 80 women) completed the survey, of whom, 57 (54%) reported current burnout. High average scores for personal accomplishment and global EI were inversely related to burnout (P = 0.034 and P = 0.003, respectively). In addition, the following factors were associated with burnout: inadequate support staff in the work place (P = 0.008), inadequate time off work (P < 0.001), inadequate administrative time (P = 0.009), not experiencing support from one's supervisor (P = 0.017), insufficient time for continuing medical education (P < 0.001), an inability to separate work from personal time (P < 0.001), and an inability to advance within one's professional field (P = 0.043).

CONCLUSIONS

For neurosurgical APPs, EI is protective against burnout. Many opportunities exist at the individual and organizational level to alleviate burnout among neurosurgical APPs. Targeted strategies to improve work-life balance, EI, support systems, and opportunities for career development among neurosurgical APPs might enhance employment satisfaction and reduce burnout.

Resilience and burnout in healthcare students and inpatient psychiatric nurses: A between-groups study of two populations

BACKGROUND

Stressful environments can have significant effects on an individual and lead to burnout. Psychological consequences of burnout include trauma reactions, depression, anxiety and substance use disorders. Resilience, a protective mechanism can mitigate the negative impact of burnout.

METHOD

This study utilizes an exploratory correlational design to determine whether or not there is 1) a similar correlation between resilience and burnout between psychiatric nurses working in a high stress environment and students who are naive to the high stress academic environment and 2) a higher level of resilience in the psychiatric nurses compared to the healthcare students.

RESULTS

A significant inverse relationship was observed with respect to resilience and burnout in both the professional nurse and student groups. However, the inpatient psychiatric nurse group was not found to have a higher level of resilience than the student group, when controlling for age.

CONCLUSION

This suggests that resilience to burnout is not related to the work environment but life experience (age) was found to be a factor related resilience in this sample.

Professional values and professional quality of life among mental health nurses: A cross-sectional study

This study aims to investigate the relationship between the professional values and professional quality of life of nurses working in mental health units. This descriptive, cross-sectional, and correlational study was conducted with a sample of 120 nurses working in mental health units of one regional, one public, and one university hospital in western Turkey. Data were collected using an introductory information form, the Nurses Professional Values Scale-Revised, and the Professional Quality of Life-IV Scale. A statistically positive relationship was found between nurses' professional values, compassion satisfaction, and burnout. Nurses' professional values, education level, whether considering changing units, and allocation of time to social life were significant predictors of professional quality of life, explaining 44% of the total variance for Compassion Satisfaction and 24% for Burnout. Whether considering changing units was the most important predictor of compassion satisfaction, and truth value was the most important predictor of burnout. Nurses providing care based on professional values were found to have higher compassion satisfaction and burnout levels, and nurses with higher compassion satisfaction were found to experience less compassion fatigue.