Kok Niek, Hoedemaekers Cornelia, Fuchs Malaika, Cornet Alexander D, Ewalds Esther, Hom Harold, Meijer Esther, Meynaar Iwan, van Mol Margo, van Mook Walther, van der Steen-Dieperink Mariëlle, van Zanten Arthur, van der Hoeven Hans, van Gurp Jelle, Zegers Marieke
Radboud University Medical Centre, IQ Health Science Department, Radboud University Medical Centre, Nijmegen, the Netherlands.
Radboud University Medical Centre, Department of Intensive Care, Radboud University Medical Centre, Nijmegen, the Netherlands.
J Crit Care. 2025 Feb;85:154981. doi: 10.1016/j.jcrc.2024.154981. Epub 2024 Nov 27.
Organizational culture is considered a protective factor against burnout among ICU professionals. The aim of this study is to study the association between organizational culture as a potential antecedent to previously found mediating risk factors for burnout, namely, work-life balance and moral distress.
Multicenter cross sectional study in eleven Dutch ICUs. The primary outcome measure was the core symptom of burnout, emotional exhaustion, measured using the validated Dutch version of the Maslach Burnout Inventory. Organizational culture was assessed using the Culture of Care Barometer, which measures five aspects of organizational culture. Moral distress and work-life balance were measured with validated questionnaires.
696 ICU professionals (39.7 %) responded. All aspects of the CoCB were negatively associated with the emotional exhaustion component of burnout, both in univariable and multivariable models. Four aspects of organizational culture were significantly associated to the serial association between moral distress, work-to-home spillovers, and emotional exhaustion. For these aspects, the total indirect association was equal or larger than the total direct association.
Multiple aspects of organizational culture reduce burnout among ICU professionals in a largely indirect manner, via moral distress and work-life balance. Improving organizational culture can mitigate burnout symptoms among ICU clinicians.
组织文化被认为是重症监护室（ICU）专业人员职业倦怠的一个保护因素。本研究的目的是探讨组织文化作为先前发现的职业倦怠中介风险因素（即工作与生活平衡和道德困扰）的潜在前因之间的关联。
在荷兰的11个ICU进行多中心横断面研究。主要结局指标是职业倦怠的核心症状——情感耗竭，使用经过验证的荷兰版马氏职业倦怠量表进行测量。使用护理文化晴雨表评估组织文化，该量表测量组织文化的五个方面。使用经过验证的问卷测量道德困扰和工作与生活平衡。
696名ICU专业人员（39.7%）做出了回应。在单变量和多变量模型中，护理文化晴雨表的所有方面均与职业倦怠的情感耗竭成分呈负相关。组织文化的四个方面与道德困扰、工作对家庭的溢出效应和情感耗竭之间的序列关联显著相关。对于这些方面，总间接关联等于或大于总直接关联。
组织文化的多个方面主要通过道德困扰和工作与生活平衡，以间接方式减少ICU专业人员的职业倦怠。改善组织文化可以减轻ICU临床医生的职业倦怠症状。
