Exploring the relationships between resilience, burnout, work engagement, and intention to leave among nurses in the context of the COVID-19 pandemic: a cross-sectional study

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Abstract

Background

Nurses have faced significant personal and professional stressors during the COVID-19 pandemic that have contributed to increased rates of burnout, intention to leave, and poorer work engagement. Resilience has been identified as a critical factor influencing job outcomes; however, the dynamics of this association have not yet been investigated within the context of the Thai workforce. The study objective was to determine the associations between resilience and job outcomes, including burnout, intention to leave, and work engagement among nurses working in Thailand during the COVID-19 pandemic.

Methods

This cross-sectional study gathered data from a sample of 394 registered nurses employed across 12 hospitals. The research instruments comprised the Connor–Davidson Resilience Scale (CD-RISC), the Maslach Burnout Inventory-Health Services Survey (MBI-HSS), a questionnaire assessing the intention to leave the job, and the Utrecht Work Engagement Scale (UWES). To determine the associations among the measured variables, multivariate logistic regression analyses were conducted.

Results

One-third of nurses experienced emotional exhaustion and depersonalization, and about half experienced reduced personal accomplishment; one-tenth of nurses intended to leave their job. Nurses who exhibited higher levels of resilience were found to have a significantly reduced likelihood of experiencing high emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment. Conversely, these nurses were more likely to report higher levels of work engagement than their less resilience.

Conclusion

The COVID-19 pandemic offers important lessons learned about promoting the well-being of the nursing workforce and protecting against adverse job outcomes. While we identified resilience as a significant predictor of several nurse outcomes, other work environment factors should be considered. Government and hospital administrations should allocate resources for individual and organizational-level interventions to promote resilience among frontline nurses so that hospitals will be better prepared for the next public health emergency and patient and nurse outcomes can be optimized.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-024-01958-1.

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Most cited references 41

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Psychological Resilience

David Fletcher, Mustafa Sarkar (2013)

The purpose of this paper is to review and critique the variety of definitions, concepts, and theories of psychological resilience. To this end, the narrative is divided into three main sections. The first considers how resilience has been defined in the psychology research literature. Despite the construct being operationalized in a variety of ways, most definitions are based around two core concepts: adversity and positive adaptation. A substantial body of evidence suggests that resilience is required in response to different adversities, ranging from ongoing daily hassles to major life events, and that positive adaptation must be conceptually appropriate to the adversity examined in terms of the domains assessed and the stringency of criteria used. The second section examines the conceptualization of resilience as either a trait or a process, and explores how it is distinct from a number of related terms. Resilience is conceptualized as the interactive influence of psychological characteristics within the context of the stress process. The final section reviews the theories of resilience and critically examines one theory in particular that is commonly cited in the resilience literature. Future theories in this area should take into account the multiple demands individuals encounter, the meta-cognitive and -emotive processes that affect the resilience-stress relationship, and the conceptual distinction between resilience and coping. The review concludes with implications for policy, practice, and research including the need to carefully manage individuals’ immediate environment, and to develop the protective and promotive factors that individuals can proactively use to build resilience.

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Frontline nurses’ burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: A large-scale cross-sectional study

Deying Hu, Yue Kong, Wengang Li … (2020)

Background During the Coronavirus Disease 2019 (COVID-19) pandemic, frontline nurses face enormous mental health challenges. Epidemiological data on the mental health statuses of frontline nurses are still limited. The aim of this study was to examine mental health (burnout, anxiety, depression, and fear) and their associated factors among frontline nurses who were caring for COVID-19 patients in Wuhan, China. Methods A large-scale cross-sectional, descriptive, correlational study design was used. A total of 2,014 eligible frontline nurses from two hospitals in Wuhan, China, participated in the study. Besides sociodemographic and background data, a set of valid and reliable instruments were used to measure outcomes of burnout, anxiety, depression, fear, skin lesion, self-efficacy, resilience, and social support via the online survey in February 2020. Findings On average, the participants had a moderate level of burnout and a high level of fear. About half of the nurses reported moderate and high work burnout, as shown in emotional exhaustion (n = 1,218, 60.5%), depersonalization (n = 853, 42.3%), and personal accomplishment (n = 1,219, 60.6%). The findings showed that 288 (14.3%), 217 (10.7%), and 1,837 (91.2%) nurses reported moderate and high levels of anxiety, depression, and fear, respectively. The majority of the nurses (n = 1,910, 94.8%) had one or more skin lesions, and 1,950 (96.8%) nurses expressed their frontline work willingness. Mental health outcomes were statistically positively correlated with skin lesion and negatively correlated with self-efficacy, resilience, social support, and frontline work willingness. Interpretation The frontline nurses experienced a variety of mental health challenges, especially burnout and fear, which warrant attention and support from policymakers. Future interventions at the national and organisational levels are needed to improve mental health during this pandemic by preventing and managing skin lesions, building self-efficacy and resilience, providing sufficient social support, and ensuring frontline work willingness.

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Nurses' burnout and associated risk factors during the COVID‐19 pandemic: A systematic review and meta‐analysis

Petros Galanis, Irene Vraka, Despoina Fragkou … (2021)

Aims To examine the nurses' burnout and associated risk factors during the COVID‐19 pandemic. Design We followed the Cochrane criteria and the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines for this systematic review and meta‐analysis. Data Sources PubMed, Scopus, ProQuest, Cochrane COVID‐19 registry, CINAHL and pre‐print services (medRχiv and PsyArXiv) were searched from January 1 to November 15, 2020 and we removed duplicates. Review Methods We applied a random effect model to estimate pooled effects since the heterogeneity between results was very high. Results Sixteen studies, including 18,935 nurses met the inclusion criteria. The overall prevalence of emotional exhaustion was 34.1%, of depersonalization was 12.6% and of lack of personal accomplishment was 15.2%. The main risk factors that increased nurses' burnout were the following: younger age, decreased social support, low family and colleagues readiness to cope with COVID‐19 outbreak, increased perceived threat of Covid‐19, longer working time in quarantine areas, working in a high‐risk environment, working in hospitals with inadequate and insufficient material and human resources, increased workload and lower level of specialized training regarding COVID‐19. Conclusion Nurses experience high levels of burnout during the COVID‐19 pandemic, while several sociodemographic, social and occupational factors affect this burnout. Impact We found that burnout among nurses is a crucial issue during the COVID‐19 pandemic. There is an urgent need to prepare nurses to cope better with COVID‐19 pandemic. Identification of risk factors for burnout could be a significant weapon giving nurses and health care systems the ability to response in a better way against the following COVID‐19 waves in the near future.

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Author and article information

Contributors

Apiradee Nantsupawat: apiradee.n@cmu.ac.th

Journal

Journal ID (nlm-ta): BMC Nurs

Journal ID (iso-abbrev): BMC Nurs

Title: BMC Nursing

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6955

Publication date (Electronic): 29 April 2024

Publication date PMC-release: 29 April 2024

Publication date Collection: 2024

Volume: 23

Electronic Location Identifier: 290

Affiliations

[1 ]Faculty of Nursing, Chiang Mai University, ( https://ror.org/05m2fqn25) Chiang Mai, Thailand

[2 ]Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, ( https://ror.org/00b30xv10) Philadelphia, USA

[3 ]Columbia University School of Nursing, ( https://ror.org/00hj8s172) New York, USA

Article

Publisher ID: 1958

DOI: 10.1186/s12912-024-01958-1

PMC ID: 11057140

PubMed ID: 38685024

SO-VID: b9de7bbf-25c9-4c2b-9ac5-d1708f13d91a

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 11 December 2023

Date accepted : 21 April 2024

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ScienceOpen disciplines: Nursing

Keywords: resilience,burnout,intention to leave,work engagement,thailand,covid-19 pandemic

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ScienceOpen disciplines: Nursing

Keywords: resilience, burnout, intention to leave, work engagement, thailand, covid-19 pandemic

Exploring the relationships between resilience, burnout, work engagement, and intention to leave among nurses in the context of the COVID-19 pandemic: a cross-sectional study

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Most cited references 41

Psychological Resilience

Frontline nurses’ burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: A large-scale cross-sectional study

Nurses' burnout and associated risk factors during the COVID‐19 pandemic: A systematic review and meta‐analysis

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