Analyzing the Impact of Practice Environment on Nurse Burnout Using Conventional and Multilevel Logistic Regression Models

Abstract

Background: Most of the previous studies on nursing practice environment and job burnout employed conventional analyses ignoring the impact of unit-level data clusters. This study addressed this gap by examining the effects of the nursing practice environments on dimensions of occupational burnout among a sample of Chinese nurses using multilevel logistic regression models and demonstrating the superiority of employing multilevel models over conventional models within this context. Methods: A proportionate stratified sampling method was applied in this cross-sectional study that invited 1,300 registered nurses (RNs) from nine clinical units of a large, academic hospital in urban China to complete the questionnaire. Nurse-reported information was obtained using the Practice Environment Scale of the Nursing Work Index (PES-NWI) and the Maslach Burnout Inventory (MBI). Findings: A total of 1,178 valid questionnaires were returned for a response rate of 90.62%. RNs generally perceived their nursing practice environment as favorable as measured by the PES-NWI. Approximately 40% of the respondents reported experiencing emotional exhaustion and depersonalization. The multivariate models indicated that nurse burnout was significantly associated with nurse participation in hospital affairs, nursing foundations for quality of care, and adequate staffing. In addition, our results illustrated the advantage of multilevel modeling over the conventional modeling for handling hierarchical data in terms of the accuracy of the estimates and the goodness-of-fit of the model. Conclusions/Application to Practice: These findings underscore the importance of measures aimed at enhancing nursing practice environments to prevent RNs from experiencing feelings of burnout and of considering multilevel analysis in future nursing research.

A cross-sectional study on burnout and its individual and environmental correlates among hepatological surgery nurses in Hunan Province, China

“…Substantial previous evidence has documented that the lack of support from leadership, lack of collaboration among colleagues, and lack of patient trust and respect were leading factors that contribute to nursing burnout [ 21 , 29 ]. Our findings add further support to the previous studies and suggest improvements in the working environment to reduce nurse burnout, which has already been may significantly decrease nurse burnout, which may significantly minimize the negative impacts of nurse burnout on patient outcomes as well as improve patient satisfaction [ 19 , 34 , 45 , 46 ].…”

Taking our pulse

“…Even prior to the global pandemic, direct care nursing teams were reporting higher than average rates of depression, anxiety, and burnout; and in 2014, nurses were at greater risk for suicide than other professions. 1,4,6,7 The research points to prevalent themes related to nurses' distress, includ-ing burnout, institutional distrust, posttraumatic stress syndrome (PTSS)/posttraumatic stress disorder (PTSD), and moral injury. 1,[8][9][10][11] Following the pandemic, nurses are experiencing symptoms of PTSS and PTSD and further sustained trauma as they continue to face the global and system issues that are causing rampant burnout.…”

“…1 It's important to note that nurses' health and wellness has a dramatic impact on the health of their patients, the profession, and the healthcare system, which ultimately affects the community and nation. [2][3][4] Although nurses are talented at assessing others and advocating for the correct interventions to support others' health, they often can't translate these skills to selfcare. 5 This study aimed to explore the sustained needs of direct care nursing teams, the perceived approachability of available interventions, and which interventions these nurses have pursued to identify and remove the barriers preventing nurses from achieving wellness.…”

“…Nurses are notably experiencing physical and psychological symptoms from the sustained stresses of the profession, making their health and wellness more elusive 1. It's important to note that nurses' health and wellness has a dramatic impact on the health of their patients, the profession, and the healthcare system, which ultimately affects the community and nation 2-4…”

Predicting medical-surgical nurses' work satisfaction and intent to stay

“…12 Nurse-patient ratios Nurse-patient ratios are often attributed to decreased work satisfaction. 1,3,4,[13][14][15] In a cross-sectional study of 1,209 hospital nurses, staffing resource adequacy was the greatest predictor of workplace satisfaction. 15 Although the number of patient assignments is important, this number is relative based on the acuity of the assign-ment.…”