职业倦怠及离职意愿与客观护理工作量和护理工作环境的关联：一项针对重症监护护士的横断面研究

Association of Burnout and Intention-To-Leave the Job With Objective Nursing Workload and Nursing Working Environment: A Cross-Sectional Study Among Intensive Care Nurses.

作者信息

Bruyneel Arnaud, Dauvergne Jérôme E, Bouckaert Nicolas, Caillet Anaelle, Sermeus Walter, Poiroux Laurent, Van den Heede Koen

机构信息

Health Economics, Hospital Management and Nursing Research Department, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.

Department of Anaesthesiology and Critical Care, Laënnec Hospital, CHU Nantes, Nantes Université, Nantes, France.

出版信息

J Clin Nurs. 2025 Oct;34(10):4281-4292. doi: 10.1111/jocn.17650. Epub 2025 Jan 14.

DOI:10.1111/jocn.17650

PMID:39809579

Abstract

AIM

The objectives of this study were to determine the prevalence of burnout risk and intention-to-leave among intensive care unit (ICU) nurses and analyse the association of these with workload and work environment.

DESIGN

A cross-sectional survey of nurses working in ICUs was conducted in France between 15 January 2024 and 15 April 2024 alongside a longitudinal assessment of workload during the same period.

METHODS

ICU nurse workload was assessed using the Nursing Activities Score (NAS). The risk of burnout was assessed using the Maslach Burnout Inventory scale and intention-to-leave the hospital was assessed with a binary question. A total of 1271 nurses working in 61 intensive care units completed the questionnaire and 14,134 NAS per patient and 1885 NAS per nurse were included in the study.

RESULTS

The median overall of burnout by hospital site was 64.7% [P25: 53.3-P75: 72.7] for the broad definition and a median of 20.7% [13.3-27.3] of ICU nurses reported an intent-to-leave their job. The median overall NAS score per nurse was 135.9% [121.4-156.9] and the prevalence of NAS scores exceeding 100% per nurse was 73.9% [62.8-80.3]. A significant association was found between nurses working in an ICU with a better work environment and all dimensions of burnout as well as the intention-to-leave the job. A prevalence in the hospital site of NAS scores exceeding 100% per nurse below the median was associated with a lower burnout (OR = 0.69, 95% CI: 0.50-0.88 for broad definition) and intention-to-leave the job (OR = 0.68, 95% CI: 0.50-0.92).

CONCLUSION

This study found significant associations between burnout and the intention to leave the job for nurses in ICUs, mainly due to a better work environment and, to a lesser extent, a lower workload for nurses.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: In an era of nurse shortages and absenteeism, it is crucial for institutions to retain their nursing staff. Our results should encourage hospital managers to take action to improve the ICU work environment and keep ICU workloads manageable to decrease burnout and the intention-to-leave the job among ICU nurses.

REPORTING METHOD

This article follows the STROBE guidelines for the reporting of cross-sectional studies.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

摘要

目的

本研究的目的是确定重症监护病房（ICU）护士职业倦怠风险和离职意愿的患病率，并分析这些因素与工作量和工作环境之间的关联。

设计

2024年1月15日至2024年4月15日期间，在法国对ICU护士进行了横断面调查，并对同期的工作量进行了纵向评估。

方法

使用护理活动评分（NAS）评估ICU护士的工作量。使用马氏职业倦怠量表评估职业倦怠风险，并通过一个二元问题评估离职意愿。共有61个重症监护病房的1271名护士完成了问卷，研究纳入了每位患者14134个NAS和每位护士1885个NAS。

结果

就广义定义而言，各医院站点职业倦怠的总体中位数为64.7%[第25百分位数：53.3 - 第75百分位数：72.7]，20.7%[13.3 - 27.3]的ICU护士报告有离职意愿。每位护士的NAS总体中位数为135.9%[121.4 - 156.9]，每位护士NAS得分超过100%的患病率为73.9%[62.8 - 80.3]。研究发现，工作环境较好的ICU护士与职业倦怠的所有维度以及离职意愿之间存在显著关联。各医院站点中，每位护士NAS得分超过100%且低于中位数的情况与较低的职业倦怠（广义定义下，OR = 0.69，95%置信区间：0.50 - 0.88）和离职意愿（OR = 0.68，95%置信区间：0.50 - 0.92）相关。