Relationship between nurse burnout, patient and organizational outcomes: Systematic review

Jun, Jin; Ojemeni, Melissa M.; Kalamani, Richa; Tong, Jonathan; Crecelius, Matthew L.

doi:10.1016/j.ijnurstu.2021.103933

Cited by 217 publications

(199 citation statements)

References 61 publications

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“…The observed decrease in negative psychological effects over the study period is consistent with previous studies with a longer follow-up period, although these same studies highlight that an important proportion of individuals will experience ongoing psychological effects ( Allan et al, 2020 , McAlonan et al, 2007 , Stuijfzand et al, 2020 , Wu et al, 2009 ). This has the potential to increase levels of sickness and staff attrition, and negatively affect patient safety ( Dyrbye et al, 2019 , Hall et al, 2016 , Jun et al, 2021 , Kinman et al, 2020 ). A further concern is that at T3, one-third reported having had a COVID-19 infection, of whom 35.2% reported that they had not yet fully recovered.…”

Section: Discussionmentioning

confidence: 99%

The impact of COVID-19 on the wellbeing of the UK nursing and midwifery workforce during the first pandemic wave: A longitudinal survey study

Couper

Murrells

Sanders

et al. 2022

International Journal of Nursing Studies

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Background The specific challenges experienced by the nursing and midwifery workforce in previous pandemics have exacerbated pre-existing professional and personal challenges, and triggered new issues. We aimed to determine the psychological impact of the COVID-19 pandemic on the UK nursing and midwifery workforce and identify potential factors associated with signs of post-traumatic stress disorder. Methods A United Kingdom national online survey was conducted at three time-points during the first wave of the COVID-19 pandemic between April and August 2020 (T1 and T2 during initial wave; T3 at three-months following the first wave). All members of the UK registered and unregistered nursing and midwifery workforce were eligible to participate. The survey was promoted via social media and through organisational email and newsletters. The primary outcome was an Impact of Events Scale-Revised score indicative of a post-traumatic stress disorder diagnosis (defined using the cut-off score ≥33). Multivariable logistic regression modelling was used to assess the association between explanatory variables and post-traumatic stress disorder. Results We received 7840 eligible responses (T1- 2040; T2- 3638; T3- 2162). Overall, 91.6% participants were female, 77.2% were adult registered nurses, and 28.7% were redeployed during the pandemic. An Impact of Events Scale-Revised score ≥33 (probable post-traumatic stress disorder) was observed in 44.6%, 37.1%, and 29.3% participants at T1, T2, and T3 respectively. At all three time-points, both personal and workplace factors were associated with probable post-traumatic stress disorder, although some specific associations changed over the course of the pandemic. Increased age was associated with reduced probable post-traumatic stress disorder at T1 and T2 (e.g. 41-50 years at T1 odds ratio (OR) 0.60, 95% confidence interval (CI) 0.42-0.86), but not at T3. Similarly, redeployment with inadequate/ no training was associated with increased probable post-traumatic stress disorder at T1 and T2, but not at T3 (T1 OR 1.37, 95% CI 1.06-1.77; T3 OR 1.17, 95% CI 0.89-1.55). A lack of confidence in infection prevention and control training was associated with increased probable post-traumatic stress disorder at all three time-points (e.g. T1 OR 1.48, 95% CI 1.11-1.97). Conclusion A negative psychological impact was evident 3-months following the first wave of the pandemic. Both personal and workplace are associated with adverse psychological effects linked to the COVID-19 pandemic. These findings will inform how healthcare organisations should respond to staff wellbeing needs both during the current pandemic, and in planning for future pandemics.

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Section: Discussionmentioning

confidence: 99%

The impact of COVID-19 on the wellbeing of the UK nursing and midwifery workforce during the first pandemic wave: A longitudinal survey study

Couper

Murrells

Sanders

et al. 2022

International Journal of Nursing Studies

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“…Physical and psychological ill-health have been extensively associated to burnout, including cardiovascular and metabolic disease problems [ 9 , 10 , 11 ], musculoskeletal disorders [ 12 , 13 ], need for recovery [ 14 ] and depressive and sleep symptoms [ 15 , 16 , 17 , 18 ]. Negative occupational outcomes associated with burnout include sickness absences [ 19 , 20 , 21 ], poor job performance [ 22 , 23 ], turnover intentions [ 24 , 25 , 26 ] and worker and patient negative safety outcomes [ 27 , 28 ]. Moreover, burnout is often considered a social problem, especially in welfare states, where national social health systems cover sickness absence and work-related health problems [ 2 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Psychometric Properties of the Italian Version of the Burnout Assessment Tool (BAT)

Consiglio

Mazzetti

Schaufeli

2021

IJERPH

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The most popular instrument to measure burnout is the Maslach Burnout Inventory (MBI). Recently, to overcome some of the limitations of the MBI, a new instrument has been proposed, namely the Burnout Assessment Tool (BAT, Schaufeli, Desart & De Witte, 2020). The purpose of this study is to examine the psychometric properties of the Italian version of the BAT. This tool is comprised of a set of four core dimensions (BAT-C; i.e., exhaustion, mental distance, cognitive and emotional impairment) and two secondary symptom dimensions (BAT-S; i.e., psychological and psychosomatic complaints). Data were collected on a sample of 738 participants from heterogeneous sectors and professional roles. In the sample women were slightly overrepresented (52.9%), the participants had a mean age of 41.57 years (SD = 10.51) and a mean organizational tenure of 9.65 years (SD = 8.50). The reliability and factorial structure of the BAT-C and BAT-S, together with the convergent and discriminant validity of BAT-C and MBI were explored, as well as the incremental validity to the BAT-C, over and beyond the MBI. Our results confirmed the factorial validity of a two-factor second-order factor model (BAT-C and BAT-S) represented by 4 first-order factors in the case of BAT-C and 2 first-order factors for BAT-S. Results also attested that BAT-C explains additional variance of the BAT-S, above and beyond what is explained by the MBI-GS. All in all, this study provided evidence that the Italian version of BAT represents a reliable and valid tool for measuring burnout in the work context.

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“…With the increasing pressure of medical industry, relatively insufficient proportion of nurses, stressful work, frequent three shifts, high work standards, high level of risks, many emergencies, and long-term high vigilance contribute to the high incidence of burnout [ 5 , 6 ]. Burnout has a great impact on nurses’ work, which is manifested as decreased enthusiasm for the care of patients (emotional exhaustion) [ 7 ], being detached and insensate to the care and strained relationship with patients, intensified conflict with colleagues (cynicism) [ 8 ], meaningless nursing work, decline in self-esteem and passive neglect of work (decreased professional efficacy) [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

The item network and domain network of burnout in Chinese nurses

Ren

Wang

et al. 2021

BMC Nurs

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Background As a common social phenomenon, nurses’ occupational burnout has a high incidence rate, which seriously affects their mental health and nursing level. The current assessment mostly uses the total score model and explores the influence of external factors on burnout, while the correlation between burnout items or dimensions is less explored. Ignoring the correlation between the items or dimensions may result in a limited understanding of nurse occupational burnout. This paper explores the item and dimension network structure of the Maslach Burnout Inventory-General Survey (MBI-GS) in Chinese nurses, so as to gain a deeper understanding of this psychological construct and identify potential targets for clinical intervention. Methods A total of 493 Chinese nurses were recruited by cluster sampling. All participants were invited to complete the survey on symptoms of burnout. Network analysis was used to investigate the item network of MBI-GS. In addition, community detection was used to explore the communities of MBI-GS, and then network analysis was used to investigate the dimension network of MBI-GS based on the results of community detection. Regularized partial correlation and non-regularized partial correlation were used to describe the association between different nodes of the item network and dimension network, respectively. Expected influence and predictability were used to describe the relative importance and the controllability of nodes in both the item and dimension networks. Results In the item network, most of the strongly correlated edges were in the same dimension of emotional exhaustion (E), cynicism (C) and reduced professional efficacy (R), respectively. E5 (Item 5 of emotional exhaustion, the same below) “I feel burned out from my work”, C1 “I have become more callous toward work since I took this job”, and R3 “In my opinion, I am good at my job” had the highest expected influence (z-scores = 0.99, 0.81 and 0.94, respectively), indicating theirs highest importance in the network. E1 “I feel emotionally drained from my work” and E5 had the highest predictability (E1 = 0.74, E5 = 0.74). It shows that these two nodes can be interpreted by their internal neighbors to the greatest extent and have the highest controllability in the network. The spinglass algorithm and walktrap algorithm obtained exactly the same three communities, which are consistent with the original dimensions of MBI-GS. In the dimension network, the emotional exhaustion dimension was closely related to the cynicism dimension (weight = 0.65). Conclusions The network model is a useful tool to study burnout in Chinese nurses. This study explores the item and domain network structure of nurse burnout from the network perspective. By calculating the relevant indicators, we found that E5, C1, and R3 were the most central nodes in the item network and cynicism was the central node in the domain network, suggesting that interventions aimed at E5, C1, R3 and cynicism might decrease the overall burnout level of Chinese nurses to the greatest extent. This study provides potential targets and a new way of thinking for the intervention of nurse burnout, which can be explored and verified in clinical practice.

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Relationship between nurse burnout, patient and organizational outcomes: Systematic review

Cited by 217 publications

References 61 publications

The impact of COVID-19 on the wellbeing of the UK nursing and midwifery workforce during the first pandemic wave: A longitudinal survey study

The impact of COVID-19 on the wellbeing of the UK nursing and midwifery workforce during the first pandemic wave: A longitudinal survey study

Psychometric Properties of the Italian Version of the Burnout Assessment Tool (BAT)

The item network and domain network of burnout in Chinese nurses

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