Association between burnout and nurses' quality of life in neonatal intensive care units: During the COVID-19 pandemic

Assessing the impact of the coronavirus pandemic on the mental health status of intensive care unit nurses: a systematic review

INTRODUCTION

The Coronavirus pandemic (COVID-19) was first identified in December 2019 in Wuhan, China, and later caused a severe health crisis, causing massive disruptions to most healthcare systems worldwide. During this pandemic period, the structure of the Intensive Care Unit (ICU) activities changed fast. It was observed that the mental health of ICU nurses reached levels of extreme clinical and psychological concern. This paper aims to shed light on how COVID-19 affected ICU nurses' mental health.

METHODS

A literature review of articles published on this topic from January 2020 to December 2024. English-language, peer-reviewed, mixed-methods, qualitative, and quantitative research on the mental health outcomes of ICU nurses were included while studies without primary data, non-ICU nurses, and non-peer-reviewed publications were excluded. To identify relevant literature, we searched five databases, including PubMed, MEDLINE, CINAHL, Web of Science, and Embase. Additionally, grey literature sources, including Google Scholar and Research Gate, were also searched. Narrative synthesis was used to evaluate both quantitative and qualitative data.

RESULTS

A total of 23 articles were reviewed. The most prevalent mental health issues were depression, anxiety, fear, and post-traumatic stress disorder (PTSD). The effects of burnout, illness, exhaustion, physical strain, sleep disturbances, and ongoing job stress were equally detrimental to the health of ICU nurses. The nurses' health declined as a result of the new procedures and working environment, the enormous workload, the continued exhaustion, the concerns for their families and themselves being infected by COVID-19, the social reaction, and seeing the death toll rise.

CONCLUSION

The COVID-19 pandemic had a negative impact on nurses' mental health well-being such as stress, depression, post-traumatic stress disorder, insomnia, anxiety, and fear. Sustainable support systems, networks and plans ought to be made available. Due to unique working conditions of ICU nurses and in readiness for similar pandemics in future, legislators should focus on the mental health of ICU nurses because they play a critical role in managing public health crises as frontline health solders.

Effectiveness of a Brief Mindfulness-Based Intervention on Compassion Fatigue and Compassion Satisfaction in Pediatric Nurses

BACKGROUND

Unlike other medical practitioners, nurses working in pediatric intensive care units face uniquely challenging workplace conditions because they care for preterm newborns and critically ill patients. These workplace challenges led to increased compassion fatigue (i.e., burnout and secondary traumatic stress) and decreased compassion satisfaction. Compassion fatigue and compassion satisfaction strongly influence the quality of care and patient outcomes, and these need to be addressed through effective interventions such as mindfulness-based interventions.

AIM

This study aimed to examine the impact of a brief mindfulness-based intervention on compassion fatigue and compassion satisfaction among pediatric intensive care nurses.

METHODS

A quasi experimental study with a pretest posttest design was used to recruit 204 nurses: 102 in the intervention group and 102 in the control group with randomization by hospital (n = 4). The brief mindfulness-based intervention was delivered over 6 weeks. Data were collected using a demographics questionnaire and the Professional Quality of Life Scale, Version 5.

RESULTS

The intervention group's mean scores of burnout and secondary traumatic stress were significantly lower postinterventions compared with the control group. Similarly, the mean compassion satisfaction score for the intervention group indicated a significant improvement post-intervention compared with the control group. Additional evidence for the effectiveness of the intervention was the disappearance of low compassion satisfaction, high burnout, and high secondary traumatic stress categorizations postintervention in the intervention group, contrary to the control group.

LINKING EVIDENCE TO ACTION

Implementing brief mindfulness-based interventions can improve pediatric intensive care nurses' well-being by reducing burnout and secondary traumatic stress while enhancing compassion satisfaction. By using the study's findings, nurse managers can make these practices essential for high-quality care and effective workforce management.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: ACTRN12622000389707.

Differentiating Occupational Burnout Among Chinese Nurses: Moderating Roles in Nursing Work Environment and Perceived Care Quality

Objective: To investigate and identify different profiles of occupational burnout among Chinese nurses and explore how these burnout profiles moderate the relationship between the nursing work environment and perceived care quality. Methods: Cross-sectional data retrieved from the Chinese Nursing Work Environment Survey (C-NWES) were used for analysis. Variables of interest included occupational burnout, the nursing work environment, nurses' perceived care quality, and demographic characteristics. Latent profile analysis was employed to identify potential profiles of occupational burnout, which were subsequently used as moderating variables to explore the relationship between the nursing work environment and perceived care quality. Results: Four profiles of occupational burnout were identified among Chinese nurses: Self-Fulfillment profile (38.3%), Emotional Exhaustion profile (37.7%), Lack of Accomplishment profile (16.6%), and Self-Isolation profile (7.4%). Among these, nurses in the Self-Fulfillment profile showed the greatest responsiveness to changes in the work environment, followed by those in the Self-Isolation profile, with the Emotional Exhaustion profile being the least responsive. Conclusions: The findings highlight the need for tailored interventions to address the specific needs of distinct nurse groups experiencing burnout, enabling organizations to improve nurses' well-being, work performance, and patient care quality.

The impact of moral resilience on nurse turnover intentions: the mediating role of job burnout in a cross-sectional study

BACKGROUND

High nursing staff turnover is a critical issue that negatively impacts the quality of care and patient safety. Turnover intentions, a key predictor of actual turnover, reflect an individual's likelihood of leaving their current position. Understanding the underlying mechanisms driving nurse turnover intentions is crucial for developing targeted interventions to stabilize the nursing workforce globally.

OBJECTIVES

This study aims to explore the relationship between moral resilience, job burnout, and turnover intentions among nurses, focusing on the mediating role of job burnout in this relationship.

DESIGN

This study employed a quantitative, cross-sectional design.

METHODS

A convenience sample of 322 registered nurses was recruited from two tertiary hospitals in China between August and October 2023. Data were collected using the Chinese version of the Rushton Moral Resilience Scale (Chi-RMRS), the Maslach Burnout Inventory (MBI), and the Turnover Intention Scale. Data analyses were conducted using SPSS 26.0 and Amos 21.0. The study followed the STROBE guidelines for observational research.

ETHICAL CONSIDERATION

Before the commencement of data collection, the Institutional Review Board of Hunan Traditional Chinese Medical College (YXLL202401004) granted ethical approval.

RESULTS

The proposed model exhibited an excellent fit to the data, with fit indices as follows: χ2/df = 1.819, CFI = 0.977, TLI = 0.961, RMSEA = 0.072 (90% confidence interval [CI]: 0.033 to 0.107). The structural equation model revealed that moral resilience was inversely associated with job burnout and turnover intentions. Furthermore, job burnout fully mediated the relationship between moral resilience and turnover intentions (β = -0.473, p = 0.007). Further analysis indicated that the depersonalization component of job burnout was the sole mediator in the relationship between moral resilience and turnover intention (β = -3.934, 95% CI [-5.837, -1.932]).

CONCLUSION

The findings indicate that moral resilience among nurses is negatively associated with turnover intentions, with this effect fully mediated by the depersonalization dimension of job burnout. Enhancing moral resilience in nurses may be valuable strategy for healthcare administrators to mitigate job burnout and subsequently reduce turnover intentions.

The Effect of Neonatal Intensive Care Nurses' Attitudes Towards Palliative Care on Death Anxiety and Burnout: An Analytic Cross-Sectional Study

This study aimed to determined the effect of neonatal intensive care nurses' attitudes towards palliative care on death anxiety and burnout. This was an analytic cross-sectional study conducted with 215 neonatal intensive care nurses working a children's hospital with Turkey's largest NICU bed capacity. The mean Neonatal Palliative Care Attitude Scale total score was 3.04 ± 0.78, and the mean scores of the organization, resources, and clinician subscales were 3.16 ± 0.86, 2.87 ± 0.80, and 3.10 ± 0.97, respectively. The participants' mean Death Anxiety Scale score was 57.65 ± 21.46, and the mean Burnout Inventory score was 39.21 ± 17.61. The organization subscale explained 17% of the variance in death anxiety, and the organization and resources subscales explained 31% of the variance in burnout. Neonatal intensive care nurses' palliative care attitudes are moderate; they face obstacles in providing and improving their attitudes in this field. The high level of obstacles increases nurses' death anxiety and burnout.

Nurses' Job Burnout and Resilience in Neonatal Intensive Care Units

PURPOSE

To assess the relationship between job burnout and resilience among nurses working in neonatal intensive care units (NICUs) in Oman.

BACKGROUND

NICUs induce a significant amount of stress that predisposes nurses to a substantial degree of burnout. Resilience can play a role in reducing the effects of job burnout. A limited number of studies have examined job burnout and resilience among NICU nurses.

METHODS

A cross-sectional survey design was utilized. The Maslach Burnout Inventory was used to assess burnout, and the Brief Resilience Scale was used to assess perceptions of resilience. Pearson correlation was used to assess the relationship between job burnout and resilience.

RESULTS

A total of 173 staff nurses participated. Participants reported low levels of emotional exhaustion and depersonalization but moderate levels on the personal accomplishment subscale. Nurses reported moderate levels of resilience. Emotional exhaustion and depersonalization were negatively correlated with resilience, while personal accomplishment was positively correlated with resilience.

CONCLUSION

This study demonstrated that enhancing resilience can reduce the effect of burnout among NICU nurses.

IMPLICATIONS FOR PRACTICE AND RESEARCH

Enhancing levels of resilience among NICU nurses, in addition to providing adequate managerial support and good collegial relations, is essential to reduce their perceived job burnout.

Moral Resilience Reduces Levels of Quiet Quitting, Job Burnout, and Turnover Intention among Nurses: Evidence in the Post COVID-19 Era

The aim of the study was to examine the impact of moral resilience on quiet quitting, job burnout, and turnover intention among nurses. A cross-sectional study was implemented in Greece in November 2023. The revised Rushton Moral Resilience Scale was used to measure moral resilience among nurses, the Quiet Quitting Scale to measure levels of quiet quitting, and the single-item burnout measure to measure job burnout. Moreover, a valid six-point Likert scale was used to measure turnover intention. All multivariable models were adjusted for the following confounders: gender, age, understaffed department, shift work, and work experience. The multivariable analysis identified a negative relationship between moral resilience and quiet quitting, job burnout, and turnover intention. In particular, we found that increased response to moral adversity and increased moral efficacy were associated with decreased detachment score, lack of initiative score, and lack of motivation score. Additionally, personal integrity was associated with reduced detachment score, while relational integrity was associated with reduced detachment score, and lack of initiative score. Moreover, response to moral adversity was associated with reduced job burnout. Also, increased levels of response to moral adversity were associated with lower probability of turnover intention. Moral resilience can be an essential protective factor against high levels of quiet quitting, job burnout, and turnover intention among nurses. This study was not registered.

The relationship between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the COVID-19 pandemic

Objectives

Workplace violence is a major issue in society, business and healthcare settings. It adversely affects both employee safety and their ability to provide healthcare services.

Aim

This study examined the association between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the COVID-19 pandemic.

Methods

We collected data from 513 nurses. We conducted 'Process Macro' analysis. Firstly, we included three mediators in the model: job satisfaction, workplace violence and emotional exhaustion. Secondly, we used work hours and anxiety as moderators of the relationship between workplace violence and turnover intention.

Results

The findings revealed statistical significance that job satisfaction and workplace violence mediated the relationship between emotional exhaustion and nurse turnover intentions. Work hours and anxiety also moderated the relationship between workplace violence and nurses' turnover intention.

Conclusion

Respondents indicated that they were most affected by verbal violence during this time. Workplace violence is a negative factor that affects nurses' work, affecting them physically and psychologically. This occupational risk should be considered when evaluating nurses exposed to violence, as it affects job satisfaction and turnover intentions. The main theoretical contribution of this research is the identification of the association between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the COVID-19 pandemic. It is clear that the research findings will be useful for healthcare professionals. The findings may have practical implications for healthcare administrators and their staff.

Quality of Life and Wellbeing Parameters of Academic Dental and Nursing Personnel vs. Quality of Services

Quality of life (QOL) is based on one's perception of one's position in life with respect to one's goals, expectations, standards, and concerns. It is also influenced by one's culture and value system, workflow, and workplace situation; in turn, QOL influences the quality of service one is able to provide. In this study, we aim to report on dental and nursing academics' QOL and wellbeing at the end of the third year of the COVID-19 pandemic. There are several studies on the impact of the COVID-19 pandemic on health professionals (nurses and dentists), but it is important to investigate their quality of life three years later; furthermore, knowledge about academic staff is very limited. The World Health Organization Quality of Life-BREF Scale (WHOQOL-BREF) tool, recording the physical, psychological, social, and environmental dimensions of QOL, was used. The WHOQOL-BREF was modified using a spiritual coaching/mentoring approach in a two-step design and validation procedure. The modified SHQOL-BREF (Spiritual Healthcare version) designed for this study was uploaded and filled in online during April-June 2023. The staff (N = 120, 75% female) of the Departments of Dentistry (44.2%) and Nursing (55.8%) of the National and Kapodistrian University of Athens participated anonymously. QOL in terms of physical health was reported at a higher level (M = 72.2 points) compared to social relationships (M = 69 points), psychological health (M = 65 points), and environment (M = 59 points) (scores reported on a 0-100 scale). Overall, QOL was rated at 66 points, while satisfaction with one's health was at 72 points. Job satisfaction (M1 = 3.2) and spirituality (M2 = 3.0) were reported at a medium level on a five-point scale, while personal beliefs and values were reported at a high level (M3 = 4.0). The four areas of QOL are associated with job satisfaction, personal beliefs, and spirituality. Participant age presented a significant moderate-strong effect on physical health (F (3.97) = 2.89, p < 0.05, η2p = 0.08) and on the environment (F (3.97) = 2.80, p < 0.05, η2p = 0.08), and marital status had a significant effect on social relationships (F (1.97) = 9.66, p < 0.05, η2p = 0.09). Married participants reported consistently higher levels of QOL compared to single participants, for all age groups. The department had a significant moderate effect on social relationships (F (1.97) = 5.10, p < 0.05, η2p = 0.05), and education had a significant moderate-strong effect on psychological health (F (2.97) = 3.74, p < 0.05, η2p = 0.07). PhD-level participants in both departments presented higher levels of psychological health compared to those with lower educational levels. Also, participants from the Department of Dentistry reported higher levels of social relationship QOL in all educational groups compared to the Department of Nursing. Overall, according to our findings, PhD participants generally had better psychological health. Those under 40 years of age had higher levels of physical health and environmental quality of life, while married participants and those from the Department of Dentistry had higher levels of social interactions than those from the Department of Nursing. Strategic planning on sustainability and QOL initiatives should be introduced after the COVID-19 pandemic for dental and nursing academic personnel to promote resilience and QOL scores. Enhancing the QOL of academic staff is essential for developing health promotion activities at universities and can help boost performance among staff and students.

Occupational and Psychological Factors Associated With Burnout in Night Shift Nurses

OBJECTIVE

Providing inpatient nursing care inevitably involves night shift work. However, night shift work nurses often face psychiatric health problems such as burnout. If night shift work is an essential work type for nurses, it is necessary to select personnel suitable for night shift work or establish improvement measures such as psychiatric intervention through psychiatric evaluation. The objective of this study was to identify factors that could be interventional among factors affecting burnout in shift-working nurses.

METHODS

A total of 231 night shift female nurses participated in this study. A questionnaire survey was given to assess their general characteristics. To assess burnout, the Maslach Burnout Inventory-General Survey Korean version was adopted. In addition, several mental health scales were used to identify individual psychological characteristics. To identify variables associated with the presence of burnout, odds ratios were calculated using a logistic regression model taking three dimensions of burnout as a dependent variable after adjusting for psychological and occupational factors.

RESULTS

High resilience was a significant preventive factor in the three dimensions of burnout. Regarding occupational factor, the longer the duration of employment, the higher depersonalization, but the professional efficacy was good.

CONCLUSION

Our results indicate that resilience and social support could be prevention factors for burnout. This study is meaningful in examining items that require active intervention and support for burnout targeting night shift nurses who are indispensable for patient care.

Burnout among French pediatric healthcare workers during the COVID-19 pandemic

The objectives of our study were: (1) to establish the prevalence of burnout among French pediatric healthcare workers during the COVID-19 pandemic; (2) to identify the psychosocial factors that predict burnout in these healthcare workers. To achieve these objectives, a total of 99 physicians and 55 nurses from various French pediatric services completed a protocol questioning socio-demographic characteristics, the specific stress of pediatric care workers, the stress related to the COVID-19 pandemic, occupational stress (JSS), coping strategies (WCC-R) and burnout (MBI). Descriptive analyses (frequencies, means, and standard deviations) were used to address objectives (1). Multiple linear regressions were performed to address objective (2). The prevalence of burnout was 48% (95% CI [40-56]). Occupational stress and stress related to working conditions were the main factors predicting emotional exhaustion. Being female, years of practice, social support-seeking and stress related to confrontation with suffering and death negatively and significantly predicted depersonalization. Being a nurse, problem-focused coping and the sense of impact of the pandemic on the daily work significantly predicted personal accomplishment. In conclusion, our study showed a high prevalence of burnout among French pediatric healthcare workers, but the impact of the pandemic on this prevalence did not seem significant.

Impact of, and mitigation measures for, burnout in frontline healthcare workers during disasters: A mixed-method systematic review

BACKGROUND

Burnout is a global concern for the healthcare community, especially following a disaster response. It is a major obstacle to providing safe and quality health care. Avoiding burnout is essential to ensuring adequate healthcare delivery and preventing psychological and physical health problems and errors among healthcare staff.

AIMS

This study aimed to determine the impact of burnout on healthcare staff working on the frontline in a disaster context, including pandemics, epidemics, natural disasters, and man-made disasters; and to identify interventions used to mitigate burnout among those healthcare professionals before, during, or after the disaster.

METHOD

A mixed methods systematic review was used and included a joint analysis and synthesis of data from qualitative and quantitative studies. The was guided by the preferred reporting items for systematic review and meta-analyses (PRISMA) of qualitative and quantitative evidence. Several databases were searched, for example, Medline, Embase, PsycINFO, Web of Science, Scopus, and CINAHL. The quality of included studies was assessed using the Mixed Method Appraisal Tool (MMAT), version 2018.

RESULTS

Twenty-seven studies met the inclusion criteria. Thirteen studies addressed the impact of burnout in relation to disasters and highlighted the association between burnout and the physical or mental well-being of healthcare workers, work performance, and workplace attitude and behavior. Fourteen studies focused on different burnout interventions including psychoeducational interventions, reflection and self-care activities, and administering a pharmacological product.

LINKING EVIDENCE TO ACTION

Stakeholders should consider reducing risk of burnout among healthcare staff as an approach to improving quality and optimizing patient care. The evidence points to reflective and self-care interventions having a more positive effect on reducing burnout than other interventions. However, most of these interventions did not report on long-term effects. Further research needs to be undertaken to assess not only the feasibility and effectiveness but also the sustainability of interventions targeted to mitigate burnout in healthcare workers.

Psychosocial Burden and Quality of Life of Surveyed Nurses during the SARS-CoV-2 Pandemic

This study analyzes the impact of occupational burnout on the quality of life (QOL) of nurses surveyed during the SARS-CoV-2 pandemic. A total of 668 active nurses employed in public hospitals in Podkarpackie voivodeship (Poland) were surveyed. Throughout the pandemic, all wards where responders worked had a division into so-called "clean" and "dirty" zones, as well as balanced working hours. The research used the authors' survey questionnaire Maslach Burnout Inventory (MBI) and the Polish version of the World Health Organization Quality of Life Instrument Short Form (WHOQOL-BREF). Descriptive statistics were used in the analysis of the collected material, while correlations between ordinal or quantitative variables were made using Spearman's-rho coefficient. According to 94.0% of respondents, stress is an integral part of the nursing profession. The mean of the respondents' MBI burnout was 50.83 +/- 9.05 pts. The respondents' overall quality of life also averaged 65.74 +/- 13.12 pts. There were negative statistically significant correlations between the MBI and BREF domains, most of which were characterized by clear strengths of association. Higher exhaustion in various occupational aspects is associated with poorer quality of life in individual domains.

Burnout in Intensive Care Nurses during the COVID-19 Pandemic: A Scoping Review on Its Prevalence and Risk and Protective Factors

BACKGROUND

The COVID-19 pandemic has strained hospitals and healthcare workers engaged in combating the virus with limited knowledge and resources. Intensive care unit (ICU) nurses are among the healthcare workers most affected by the pandemic and are at risk for developing burnout syndrome.

OBJECTIVE

The present study aims to explore burnout symptoms prevalence among ICU nurses and to identify the individual, organizational, and contextual risk, and protective factors of burnout in ICU nurses during the COVID-19 pandemic.

METHODS

A scoping review was conducted by searching PubMed, Scopus, and Web of Science. Only papers with empirical data and referred to ICU nurses were included. A total of 350 initial results were yielded, and 40 full texts were screened. Twelve papers constituted the final sample in the analysis.

RESULTS

High levels of symptoms of burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) were registered among ICU nurses during the COVID-19 pandemic. Increased workload, lack of equipment, social stigma, and fear of contagion emerged as key risk factors. Social support from leaders and colleagues, professional recognition, use of personal protective tools, and witnessing patients' successful recovery emerged as major protective factors.

CONCLUSIONS

The results may inform the development of timely actions to counter burnout in ICU nurses during this COVID-19 pandemic and in a post-COVID-19 scenario.

Burnout and Nursing Care: A Concept Paper

Burnout comprises a series of undetermined physical and psychosocial symptoms caused by an excessive energy requirement at work-it is a crisis in relationships with work itself and not necessarily a concern with underlying clinical disorders related to workers. Professions involving human interactions commonly involve emotional engagement, especially when the cared-for person needs assistance and support, as is the primary concern in the nursing profession. To some extent, the acknowledgment of the phenomena of burnout and how it affects people is sometimes addressed from a biomedical perspective. This concept paper aims to describe the burnout concept and reflect on the impact on nurses. Our intention with this reflection, considering the burnout impact on nurses, is to support a paradigm change in the prevention and management of burnout in healthcare contexts, promoting and fostering the well-being of nurses.