Burnout level and predictors for biopsychosocial, spiritual and occupational factors among critical care nurses at a tertiary hospital in Johor Bahru

Abstract

Burnout has been getting a lot of national and global interest recently as it is a condition that affects workers in a wide variety of professions, including nurses in the healthcare sector. Critical care nurses are considered vulnerable to burnout compared to nurses in other areas. Burnout is a threat to them and can be related to many factors. Therefore, this study aims to determine the burnout level and the predictors of burnout among critical care nurses. A quantitative, cross-sectional study was conducted among 152 critical care nurses in a tertiary hospital in Johor Bahru. A set of questionnaires containing biopsychosocial characteristics, spiritual characteristics, occupational characteristics, and the Maslach Burnout Inventory was used to identify the level of burnout and the associated factors. Data analysis was done through the Chi-square test for bivariate analysis to identify the associated factors and it was further extended to multiple logistic regression to determine the factors that could predict the burnout level. The findings showed that 25.7% of the critical care nurses had a high level of emotional exhaustion, 16.4% had a high level of depersonalization, and 34.9% had a low level of personal accomplishment. The biopsychosocial characteristics, which consisted of the amount of stress in life, anxiety disorder, supervisor support, sense of belonging to the workplace, and the number of children, were significantly associated with the level of burnout. For spiritual characteristics, it was found that attending religious activity and incorporating religion into other dealings in life were associated with the level of burnout. Occupational characteristics of nurse-to-patient ratio, frequency of overtime per week, and self-rated job satisfaction were associated with the level of burnout. The predictors contributing to emotional exhaustion of burnout among critical care nurses were determined as follows: experiencing a stressful life (OR=4.231, 95% CI=0.702-2.182; p<0.001), working in ED (OR=0.001; 95% CI=18.185-15.616; p<0.001), nurse-to-patient ratio of 1:1 (OR=0.001; 95% CI=20.075-13.849; p<0.001) and nurse-to-patient ratio1:2 1 (OR=0.001; 95% CI=19.866-14.041; p<0.001), and unsatisfied with the job (OR=11.372; 95% CI=0.974-3.889; p<0.001). Meanwhile, the predictor factor of personal accomplishment is having a strong sense of belonging in the workplace (OR=0.244; 95% CI=2.563-0.257; p<0.017) and the predictor factors for depersonalization are working less than 5 hours of overtime per week (OR=0.046; 95% CI=5.251-0.913; p<0.005) and unsatisfied with the job (OR=3.226; 95% CI=2.230-0.113; p<0.030). The critical care nurses experienced average to high levels of burnout. Unlike biopsychosocial and occupational characteristics, this study demonstrated that no spiritual characteristics were found to be a predictor. Promoting a healthy workplace requires preventive measures and intervention programs by the administrator to continually improve the nurses’ health, safety, and well-being, ultimately leading to patients’ safety. Keywords: burnout, emotional exhaustion, depersonalization, personal accomplishment, critical care nurse.