Institute for Health Management, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.
Institute for Health Management, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
BMJ Open. 2022 Oct 10;12(10):e064687. doi: 10.1136/bmjopen-2022-064687.
This national-level study aimed to determine the prevalence and risk factors of burnout, as well as the coping strategies among nurses in the Ministry of Health (MOH) Malaysia.
Using a complex sampling design, a two-stage stratified cluster sampling was performed to recruit MOH nurses between August and November 2019.
A total of 2428 nurses from 32 hospitals and 28 district health offices answered the questionnaires based on Maslach Burnout Inventory for Human Services and Brief COPE. Complex sampling analysis was applied.
The outcome of interest was the prevalence of burnout and its three domains of emotional exhaustion (EE), depersonalisation (DP) and low personal accomplishment. ORs using 95% CIs were calculated. Significant factors at the univariate level were entered into the multivariate logistic regression to identify independent predictors of burnout.
One in four (24.4%) nurses experienced burnout. Younger, single, and childless nurses had a higher prevalence of burnout. Shift working nurses were 1.6 times more likely to develop burnout. Those who performed >6 night shifts per month were 1.5 times more predisposed to burnout (95% CI 1.01 to 2.36; p<0.05). While encountering traumatic events at work led to 4.2 times (95% CI 2.31, 7.63; p<0.05) higher risk of burnout, those who received post-traumatic psychological support were better protected. The use of dysfunctional coping strategies was detrimental as it was positively correlated with EE and DP.
Addressing modifiable stressors of burnout at individual and institutional levels identified in this study can be potentially beneficial in reducing burnout and its undesirable effects among nurses. Interventions that promote positive coping strategies should be implemented. Organisational-driven efforts must target the improvement of work schedules for nurses and the establishment of a structured debriefing service for post-trauma counselling.
本国家级研究旨在确定马来西亚卫生部（MOH）护士的 burnout 患病率和风险因素，以及应对策略。
采用复杂抽样设计，于 2019 年 8 月至 11 月间进行两阶段分层聚类抽样，招募 MOH 护士。
共有 2428 名来自 32 家医院和 28 家地区卫生办公室的护士回答了基于 Maslach 职业倦怠量表和 Brief COPE 的问卷。采用复杂抽样分析。
四分之一（24.4%）的护士经历了 burnout。年轻、单身和无子女的护士 burnout 患病率更高。轮班护士发生 burnout 的可能性高 1.6 倍。每月轮班超过 6 次的护士发生 burnout 的可能性高 1.5 倍（95%CI 1.01 至 2.36；p<0.05）。在工作中遇到创伤性事件会导致 burnout 风险增加 4.2 倍（95%CI 2.31 至 7.63；p<0.05），而接受创伤后心理支持的护士则受到更好的保护。使用功能失调的应对策略会导致倦怠情绪和去人性化呈正相关，从而产生不良影响。
针对本研究中确定的个体和机构层面的 burnout 可调节压力源采取措施，可能有助于减少护士 burnout 及其不良影响。应实施促进积极应对策略的干预措施。以组织为导向的努力必须针对改善护士的工作时间表和建立结构化的创伤后咨询辅导服务。
