Background Sustained attention to the prevalence and associated factors of burnout in China is important for the health care service quality and related reform. In this study, we investigated the prevalence of job burnout among medical staff in Liaoning province, China; performed a survey of subjective perception ranking for the main stressors among respondents; estimated the effect of stresses from work tasks and the relationship with patients on job burnout in order to provide improved strategy and suggestion for hospital administrators. Methods The respondents were from 8 hospitals in 3 cities in Liaoning province, China. Data were collected and analyzed including the following sections: (1) demographic characteristics; (2) work situations; (3) ranking of six stressors; (4) job burnout scale; (5) effort-reward imbalance scale; (6) work violence scale; (7) fear of malpractice scale. A total of 1056 individuals became the study objects. A statistical analysis and hierarchical linear regression analysis were performed to explore the prevalence of burnout and the effects of stressors. Results The prevalence of job burnout was 20.5, and 72.9% of all respondents reported a least one symptom of burnout. The respondents who were male, 30–39 years old, had a master’s degree or high and working hours > 60 h per week, came from obstetrics and gynecology or pediatrics profession prone to job burnout. The relationship with patients and work tasks are the top two ranking stressors in the subjective perception survey. Regression analysis showed that the relationship with patients explained 19.2, 16.8 and 2.0% of variance in burnout subscales EE, DP and PA, respectively and work tasks explained 23.5, 16.0 and 5.24% of variance in burnout subscales EE, DP and PA, respectively. Conclusion The Chinese medical staff had high prevalence of job burnout. Some factors of demographic and work situations were associated with job burnout. The medical staff considered the relationship with patients and work tasks are the two major stressors. These two stressors are also the major indicators associated with job burnout. The hospital administrators should be aware of the risk of burnout. Efforts should be made to ameliorate the status of job burnout.

Background As a major reason for defensive medicine, the status and effect of “fear of malpractice” among Chinese medical staff is an important topic that needs to be studied. Our study investigated fear of malpractice among Chinese medical workers, assessed its association with burnout, and explored the mediating role of legal consciousness between these factors. Design A quantitative, cross-sectional study. Setting All respondents were investigated using a self-report questionnaire. Demographic characteristics and measurements including a fear of malpractice scale, and a burnout and legal consciousness scale were employed. The effect of fear of malpractice on burnout was examined by carrying out a binary regression analysis. A mediation model was used to test the mediating role of legal consciousness. Participants The study sample included 1031 doctors and nurses (297 male and 734 female; age = 36.3 ± 8.98). Results The average score of fear of malpractice was 20.97 ± 5.34. Respondents with higher levels of fear of malpractice were more prone to burnout ([OR] = 2.865; 95% CI 1.942–4.226). Legal consciousness partially and negatively mediated the effect of fear of malpractice on burnout. Conclusion High levels of fear of malpractice were found among Chinese medical workers, and this fear had a significant effect on burnout. Legal consciousness may be a resource that can alleviate burnout.

Background Rapidly increasing health care costs are a widespread problem in the world. The cost-consciousness among Chinese medical staff is an important topic that needs further investigation. Our study aimed to focus on the cost-consciousness of Chinese medical staff and explore the factors related to their cost-consciousness. Differences regarding cost-consciousness between doctors and nurses were also reported. Methods Eight hospitals in Liaoning Province, China, were surveyed using a self-reporting questionnaire. A total of 1043 respondents, including 635 doctors and 408 nurses, participated in the study. A revised Chinese Cost-consciousness Scale was used to estimate cost-consciousness. Results The mean score of the Cost-consciousness Scale was 27.60 and 28.18 among doctors and nurses, respectively, and there were no significant differences in any personal characteristics. Most Chinese medical staff were aware of the treatment costs and considered cost control as their responsibility. Chinese doctors disliked adhering to guidelines more and preferred to remain independent in making or denying a treatment decision; thus, they like autonomously balancing the treatment and cost. Chinese nurses have similar attitudes, but nurses tended to deny costly services and interventions and were more sensitive to the health care costs by rationing decisions and uncertainty in their medical practice. Conclusion We reveal the attitudes regarding cost-consciousness among Chinese medical staff. Chinese medical staff was aware of their responsibility in health cost control. Chinese doctors and nurses had different tendencies with regard to health care cost containment. Our study highlights the importance of education and professional training on cost-consciousness.