Burnout and Turnover Intention in Critical Care Professionals During the COVID-19 Pandemic in Japan: A Cross-sectional Survey

Kuriyama, Akira; Sakuraya, Masaaki; Kinjo, Masashi; Santanda, Takushi; Yoshino, Tomomi; Ouchi, Kenjiro; Suyama, Shinichi; Yoshino, Shunpei; Saito, Shinroku; Yokoyama, Toshiki; Beppu, Satoru; Iwanaga, Wataru; Takei, Toshinobu; Kataoka, J.; Egawa, Yuko; Muramatsu, Kumiko; Jackson, Jeffrey L.; Onodera, Makoto

doi:10.1513/annalsats.202201-029oc

Cited by 15 publications

(12 citation statements)

References 55 publications

(68 reference statements)

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“…Both organizational and individual interventions bring value to managing work-related stress, improving well-being at work, and alleviating fatigue and moral distress, thereby allowing to decrease the prevalence of burnout in ICU professionals [ 57 ]. High resilience capacities and strong perceived support from the hospital have also been shown to be associated with lower odds of burnout and turnover intention while the presence of burnout increased turnover intention [ 58 ]. To promote a policy of reduction of psychosocial risks in the ICU environment, some scientific societies have initiated a call to action to enhance the critical care community’s interest in reducing the prevalence of BOS and promoting a healthy work environment in the ICU [ 7 ].…”

Section: Limitationsmentioning

confidence: 99%

High-level burnout in physicians and nurses working in adult ICUs: a systematic review and meta-analysis

et al. 2023

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Purpose The prevalence of burnout in intensive care unit (ICU) professionals is difficult to establish due to the variety of survey instruments used, the heterogeneity of the targeted population, the design of the studies, and the differences among countries regarding ICU organization. Methods We performed a systematic review and meta-analysis examining the prevalence of high-level burnout in physicians and nurses working in adult ICUs, including only studies that use the Maslach Burnout Inventory (MBI) as a tool to evaluate burnout and involving at least 3 different ICUs. Results Twenty-five studies with a combined population of 20,723 healthcare workers from adult ICUs satisfied the inclusion criteria. Combining 18 studies including 8187 ICU physicians, 3660 of them reported a high level of burnout (prevalence 0.41, range 0.15–0.71, 95% CI [0.33; 0.5], I 2 97.6%, 95% CI [96.9%; 98.1%]). The heterogeneity can be at least in part explained by the definition of burnout used and the response rate as confirmed by the multivariable metaregression done. In contrast, there was no significant difference regarding other factors such as the study period (before or during the coronavirus disease 2019 (COVID-19) pandemic), the income of the countries, or the Healthcare Access and Quality (HAQ) index. Combining 20 studies including 12,536 ICU nurses, 6232 of nurses were reporting burnout (prevalence 0.44, range 0.14–0.74, [95% CI 0.34; 0.55], I 2 98.6% 95% CI [98.4%; 98.9%]). The prevalence of high-level burnout in ICU nurses for studies performed during the COVID-19 pandemic was higher than that reported for studies performed before the COVID-19 pandemic (0.61 [95% CI, 0.46; 0.75] and 0.37 [95% CI, 0.26; 0.49] respectively, p = 0.003). As for physicians, the heterogeneity is at least in part explained by the definition used for burnout using the MBI but not by the number of participants. When compared, the prevalence of high-level burnout was not different between ICU physicians and ICU nurses. However, the proportion of ICU nurses with a high level of emotional exhaustion was higher than for ICU physicians (0.42 [95% CI, 0.37; 0.48] and 0.28 [0.2; 0.39], respectively, p = 0.022). Conclusion According to this meta-analysis, the prevalence of high-level burnout is higher than 40% in all ICU professionals. However, there is a great heterogeneity in the results. To evaluate and to compare preventive and therapeutic strategies, there is the need to use a consensual definition of burnout when using the MBI instrument. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-023-07025-8.

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Section: Limitationsmentioning

confidence: 99%

High-level burnout in physicians and nurses working in adult ICUs: a systematic review and meta-analysis

et al. 2023

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“…Perpetrating potentially morally injurious events (PMIEs) and passively witnessing PMIEs during COVID-19 impacted turnover intention for nurses [ 97 ]. Two studies showed that increased scores of psychological resilience were associated with a lower score of professional turnover intention [ 93 , 119 ]. In contrast, two other studies showed that resilience was negatively correlated with the intention to resign [ 106 , 120 ].…”

Section: Resultsmentioning

confidence: 99%

Determinants of intention to leave among nurses and physicians in a hospital setting during the COVID-19 pandemic: A systematic review and meta-analysis

de Vries,

Maniscalco,

Matranga

et al. 2024

PLoS ONE

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Background The global outbreak of COVID-19 has brought to light the profound impact that large-scale disease outbreaks can have on healthcare systems and the dedicated professionals who serve within them. It becomes increasingly important to explore strategies for retaining nurses and physicians within hospital settings during such challenging times. This paper aims to investigate the determinants of retention among nurses and physicians during the COVID-19 pandemic. Method A systematic review of other potential determinants impacting retention rates during the pandemic was carried out. Secondly, a meta-analysis on the prevalence of intention to leave for nurses and physicians during the COVID-19 pandemic. Findings A comprehensive search was performed within four electronic databases on March 17 2023. Fifty-five papers were included in the systematic review, whereas thirty-three papers fulfilled the eligibility criteria for the meta-analysis. The systematic review resulted in six themes of determinants impacting intention to leave: personal characteristics, job demands, employment services, working conditions, work relationships, and organisational culture. The main determinants impacting the intention to leave are the fear of COVID-19, age, experience, burnout symptoms and support. Meta-analysis showed a prevalence of intent to leave the current job of 38% for nurses (95% CI: 26%-51%) and 29% for physicians (95% CI: 21%-39%), whereas intention to leave the profession for nurses 28% (95% CI: 21%-34%) and 24% for physicians (95% CI: 23%-25%). Conclusion The findings of this paper showed the critical need for hospital managers to address the concerning increase in nurses’ and physicians’ intentions to leave during the COVID-19 pandemic. This intention to leave is affected by a complex conjunction of multiple determinants, including the fear of COVID-19 and the confidence in and availability of personal protective equipment. Moreover, individual factors like age, experience, burnout symptoms, and support are maintained in this review. Understanding the influence of determinants on retention during the COVID-19 pandemic offers an opportunity to formulate prospective strategies for retaining nurses and physicians within hospital settings.

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“…The chronological age of the nurses was divided into two categories: 20 s, and 30 years or older. Years of nursing experience has been reported as a variable that influences turnover intention [ 27 , 35 ], with turnover intention in the COVID-19 pandemic higher for nurses with fewer years of experience [ 24 , 36 ]. The present study investigated the distribution of nurses’ years of experience during the COVID-19 pandemic.…”

Section: Methodsmentioning

confidence: 99%

“…A survey of hospitals accepting COVID-19 patients in Japan also showed that the increase in COVID-19 patients had a negative effect on nurses’ mental health and intention to resign [ 26 ]. Japanese critical care professionals have suggested that intensive care unit nurses may experience increased burnout and turnover intention because they routinely bear the responsibility for healthcare during pandemics and are exposed to infection through their close contact with patients [ 27 ]. It is therefore important to identify factors that affect turnover intentions, focusing on the workload of frontline nurses in hospitals receiving COVID-19 patients.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Turnover Intentions of Nurses Working in Japanese Hospitals Admitting COVID-19 Patients

Kitamura

Nakai

2023

Nursing Reports

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Three years after the outbreak of the coronavirus disease (COVID-19) pandemic, turnover among frontline nurses has increased. The participants of this study were nurses at two general hospitals in Ishikawa, Japan, receiving COVID-19 patients. An original self-report questionnaire was created based on previous research. The questionnaire was distributed to 400 nurses, and responses were received from 227 nurses (response rate: 56.8%). The factors influencing turnover intention at the facilities were having less time to relax (odds ratio [OR]: 2.88, 95% confidence interval [CI]: 1.12–7.41) and wanting to receive counseling (OR: 5.21, 95% CI: 1.30–20.91). As a strategy to prevent turnover, nurse managers should provide opportunities for nurses to receive counseling during normal working hours and pay particular attention to changes in nurses’ daily lives, such as changes in the time available for relaxation.

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Burnout and Turnover Intention in Critical Care Professionals During the COVID-19 Pandemic in Japan: A Cross-sectional Survey

Cited by 15 publications

References 55 publications

High-level burnout in physicians and nurses working in adult ICUs: a systematic review and meta-analysis

High-level burnout in physicians and nurses working in adult ICUs: a systematic review and meta-analysis

Determinants of intention to leave among nurses and physicians in a hospital setting during the COVID-19 pandemic: A systematic review and meta-analysis

Factors Associated with Turnover Intentions of Nurses Working in Japanese Hospitals Admitting COVID-19 Patients

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