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护士职业倦怠的全球患病率及影响因素:系统评价与荟萃分析的伞状综述

Global prevalence and contributing factors of nurse burnout: an umbrella review of systematic review and meta-analysis.

作者信息

Getie Addisu, Ayenew Temesgen, Amlak Baye Tsegaye, Gedfew Mihretie, Edmealem Afework, Kebede Worku Misganaw

机构信息

Department of Nursing, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

出版信息

BMC Nurs. 2025 May 26;24(1):596. doi: 10.1186/s12912-025-03266-8.

Abstract

INTRODUCTION

Nurse burnout negatively impacts patient care quality, safety, and outcomes, while harming nurses' mental health, job satisfaction, and retention. It also imposes financial burdens on healthcare organizations through absenteeism, reduced productivity, and higher turnover costs, highlighting the need for research to address these challenges. The umbrella review methodology was selected to integrate evidence from multiple systematic reviews and meta-analyses, offering a broad and in-depth summary of existing research to guide practice and policy. This approach equips stakeholders with a holistic understanding of the multifaceted impacts of nurse burnout, facilitating the design of effective interventions that support nurses, enhance healthcare delivery, and optimize patient outcomes. Consequently, this umbrella review aims to evaluate the global prevalence and contributing factors of nurse burnout.

METHODS

This umbrella review included 14 systematic reviews and meta-analyses identified from various databases. The quality of each study was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR II). Data were extracted using Microsoft Excel and analyzed with STATA 17.0. Heterogeneity was measured using Higgin's I Statistics, and summary prevalence estimates were calculated with the Der Simonian-Laird random-effects model. Meta-regression and subgroup analyses were conducted to identify the source of high heterogeneity. Publication bias was assessed using funnel plots and Egger's regression test, with the former providing a visual assessment of bias and the latter offering a statistical method to detect asymmetry.

RESULTS

The global prevalence of nurse burnout was evaluated in three areas: emotional exhaustion (33.45%, 95% CI 27.31-39.59), depersonalization (25.0%, 95% CI 17.17-33.00), and low personal accomplishment (33.49%, 95% CI 28.43-38.55). Emotional exhaustion was most common among nurses working during the COVID-19 pandemic (39.23%, 95% CI 16.22-94.68). Oncology nurses experienced the highest rate of depersonalization (42%, 95% CI 16.71-77.30), while nurses in intensive care units reported the highest rate of low personal accomplishment (46.02%, 95% CI 43.83-48.28).

CONCLUSIONS

Nurse burnout is prevalent worldwide, often marked by a sense of low personal accomplishment. Several factors contribute to this issue, including role conflict, negative emotions, family problems, moral distress, stress, commuting distance, predictability of work tasks, and workplace advancement.

摘要

引言

护士职业倦怠会对患者护理质量、安全和结果产生负面影响,同时损害护士的心理健康、工作满意度和留职率。它还会因旷工、生产力下降和更高的人员更替成本给医疗机构带来经济负担,凸显了开展研究以应对这些挑战的必要性。本研究选择采用伞状综述方法,整合来自多项系统评价和荟萃分析的证据,对现有研究进行广泛而深入的总结,以指导实践和政策制定。这种方法使利益相关者能够全面了解护士职业倦怠的多方面影响,有助于设计有效的干预措施,以支持护士、改善医疗服务提供并优化患者结局。因此,本伞状综述旨在评估护士职业倦怠的全球患病率及其影响因素。

方法

本伞状综述纳入了从多个数据库中识别出的14项系统评价和荟萃分析。使用《多种系统评价评估》(AMSTAR II)对每项研究的质量进行评估。数据通过Microsoft Excel提取,并使用STATA 17.0进行分析。使用希金斯I统计量测量异质性,并使用Der Simonian-Laird随机效应模型计算汇总患病率估计值。进行元回归和亚组分析以确定高异质性的来源。使用漏斗图和埃格回归检验评估发表偏倚,前者提供偏倚的直观评估,后者提供检测不对称性的统计方法。

结果

从三个方面评估了护士职业倦怠的全球患病率:情感耗竭(33.45%,95%置信区间27.31 - 39.59)、去个性化(25.0%,95%置信区间17.17 - 33.00)和个人成就感低落(33.49%,95%置信区间28.43 - 38.55)。情感耗竭在COVID-19大流行期间工作的护士中最为常见(39.23%,95%置信区间16.22 - 94.68)。肿瘤科室护士的去个性化发生率最高(42%,95%置信区间16.71 - 77.30),而重症监护病房护士的个人成就感低落发生率最高(46.02%,95%置信区间43.83 - 48.28)。

结论

护士职业倦怠在全球范围内普遍存在,常表现为个人成就感低落。导致这一问题的因素有多个,包括角色冲突、负面情绪、家庭问题、道德困扰、压力、通勤距离、工作任务的可预测性以及职场晋升等。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7203/12108038/0dad55f63488/12912_2025_3266_Fig1_HTML.jpg

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