Relationship between depressive symptoms, burnout, job satisfaction and patient safety culture among workers at a university hospital in the Brazilian Amazon region: cross-sectional study with structural equation modeling

Abstract

BACKGROUND: Workplaces can be sources of mental distress. In healthcare services, this can also affect patients. OBJECTIVE: To assess the prevalence of and factors associated with depressive symptoms, burnout, job satisfaction and patient safety culture and the relationships between these constructs, among healthcare workers. DESIGN AND SETTING: Cross-sectional study in a university hospital in Manaus, Brazil. METHODS: Randomly selected workers were interviewed based on Brazilian-validated tools. We calculated the prevalence ratio (PR) and 95% confidence interval (CI) of depressive symptoms and burnout using Poisson regression with robust variance; and the β-coefficient of safety culture and job satisfaction using linear regression. Outcome relationships were assessed using partial least-squares structural equation modeling. RESULTS: 300 professionals were included; 67.3% were women. The prevalence of depressive symptom was 19.0% (95% CI: 14.5; 23.5%) and burnout, 8.7% (95% CI: 5.2; 12.3%). Lack of work stability increased depression (PR = 1.88; 95% CI: 1.17; 3.01) and burnout (PR = 2.17; 95% CI: 1.03; 4.57); and reduced job satisfaction (β = -11.93; 95% CI: -18.79; -5.07). Depressive symptoms and burnout were positively correlated, as also were job satisfaction and safety culture (P < 0.001); job satisfaction was negatively correlated with burnout (P < 0.001) and depression (P = 0.035). CONCLUSION: Impermanent employment contracts increased depression and burnout and reduced job satisfaction. Job satisfaction reduced poor mental health outcomes and increased safety culture. Job satisfaction and safety culture were directly proportional (one construct increased the other and vice versa), as also were depression and burnout. Better working conditions can provide a virtuous cycle of patient safety and occupational health.

Protective and Vulnerability Factors of Municipal Workers’ Mental Health: A Cross-Sectional Study

“…The produced results aimed to answer the first research question showed that job satisfaction is a protective factor against the onset and development of depressive symptoms, while psychological vulnerability is a vulnerability factor relating to depressive symptoms. In a study conducted by Lopes et al [ 40 ] with a sample of 300 professionals, the results corroborate those of this present study, as job satisfaction was considered a protective factor of mental health. Moreover, a study with 1570 female workers investigating job satisfaction and its association with health status concluded that the presence of depressive symptoms was related to job satisfaction, and that the higher the job satisfaction, the lower the female workers’ perception of depressive symptoms [ 41 ].…”

Relationship between job satisfaction, burnout syndrome and depressive symptoms in physicians: a cross-sectional study based on the employment demand–control model using structural equation modelling

“…In addition, the lack of a unified measurement instrument across countries limits existing interpretations 15. In these socioeconomic contexts, we were also able to investigate the association,25 prevalence26 and evaluation of predictive models that have used variables similar to our study 27 28. Moreover, different theoretical frameworks have attempted to explain the relationship between working conditions and work-related variables in mental health.…”

Prevalence and associated factors of depressive and anxiety symptoms among healthcare workers in the post-pandemic era of COVID-19 at a tertiary hospital in Shenzhen, China: A cross-sectional study

“…Lv et al stated that healthcare workers with high levels of work-family conflict are particularly vulnerable to mental health problems ( 41 ). A study in Brazil also reported a positive relationship between burnout and depressive symptoms among workers at a university hospital ( 19 ). On the one hand, the workload and working hours of healthcare workers would fluctuate as the pandemic evolved, which was inevitable to bring negative effects to their family life ( 85 ) such as increased work-family conflict and thereby increased the level of anxiety symptoms ( 86 ).…”

“…Nurses had a greater likelihood of developing depression than others, but any job type of healthcare worker developed anxiety at equal odds ( 6 ). And studies also revealed that healthcare workers with bachelor's degrees had significantly higher depression and anxiety than those with different education levels ( 19 , 20 ). The intermediate job title was associated with higher anxiety and depression ( 5 ).…”