Job Burnout Among Primary Healthcare Workers in Rural China: A Multilevel Analysis

Abstract

The health workers in rural primary care systems are at the increasing risk of job burnout. To explore the prevalence and associated factors of the job burnout among the primary healthcare worker in rural China, a cross-sectional survey was conducted among 15,627 participants in 459 township hospitals from six provinces. A combination of stratified multi-stage sampling and cluster sampling method, and a self-administrated questionnaire with the Chinese version of the Maslach Burnout Inventory-General Scale (MBI-GS) were used in the investigation. Multilevel regression analyses were used to examine the potential associated factors on both individual and organisational levels. 47.6% of respondents were experiencing moderate burnout, and 3.3% were in severe burnout. Professionals working for over 40 h per week, at young age, with a college degree, and with professional titles at medium or high rank reported a higher degree of job burnout. At the institutional level, the high ratio of performance-based salary was associated with a higher level of depersonalization. Burnout has become prevalent among the primary healthcare workers in rural China, and multiple strategies are needed to reduce the work stress and some high-risk groups’ vulnerability to job burnout.

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“…Overall, serious job burnout of rural PHC workers in China still exists. These findings are similar with the conclusions reported in previous studies about the burnout symptom of PHC workers [8]. With the implementation of the national health coverage strategy, the workload of PHC workers in China is gradually increasing.…”

“…Moreover, job burnout of different professional PHC workers vary. Xu reported that doctors had higher level of burnout than nurses, pharmacists, and other technicians of the PHC network [8].…”

“…Burnout is a global occupational hazard among PHC workers [5]. PHC workers experience burnout due to relatively less work resource, lower wages, and worse career development opportunities compared with health care workers in general organizations [8]. Previous studies also revealed that individual factors (such as age, gender, educational background, work experiences [years], monthly income, and daily work hours) can influence the job burnout of PHC workers [9][10][11].…”

<p>Determinants of Depressive Symptoms Among Rural Health Workers: An Application of Socio-Ecological Framework</p>

“…55 Moreover, the relocated RHWs have to commute a certain distance daily, in addition to the field travel that they have to do as part of their usual work, often without adequate transportation facilities, which may lead to burnout. 56 According to previous studies, 30-40% of healthcare workers may suffer from burnout. [57][58][59] The topic of depression is fairly broad.…”

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“…Job burnout was assessed with the Maslach Burnout Inventory-General Scale (MBI-GS). 36 The Chinese version of MBI-GS composed of 15 items, which is widely used among the Chinese population, 37,38 and it has three dimensions: emotional exhaustion (5 items, such as, "I feel used up at the end of the workday"), depersonalization (4 items, such as, "I have become less enthusiastic about my work"), and personal accomplishment (6 items, such as, "I deal very effectively with the problems of my work"). There are seven selected answers for each item: never, rarely (several times per year), sometimes (once a month), often (several times per month), frequently (once a week), always (several times per week) and every day.…”