Rich Club Reorganization in Nurses Before and After the Onset of Occupational Burnout: A Longitudinal MRI Study

Abstract

BackgroundStudies on potential disruptions in rich club structure in nursing staff with occupational burnout are lacking. Moreover, existing studies on nurses with burnout are limited by their cross‐sectional design.PurposeTo investigate rich club reorganization in nursing staff before and after the onset of burnout and the underlying impact of anatomical distance on such reconfiguration.Study TypeProspective, longitudinal.PopulationThirty‐nine hospital nurses ( years old at baseline, years old at a follow‐up within 1.5 years, 38 female).Field Strength/SequenceMagnetization‐prepared rapid gradient‐echo and gradient‐echo echo‐planar imaging sequences at 3.0 T.AssessmentThe Maslach Burnout Inventory and Symptom Check‐List 90 testing were acquired at each MRI scan. Rich club structure was assessed at baseline and follow‐up to determine whether longitudinal changes were related to burnout and to changes in connectivities with different anatomical distances (short‐, mid‐, and long range).Statistical TestsChi‐square, paired‐samples t, two‐sample t, Mann–Whitney U tests, network‐based statistic, Spearman correlation analysis, and partial least squares regression analysis. Significance level: Bonferroni‐corrected .ResultsIn nurses who developed burnout: 1) Strengths of rich club, feeder, local, short‐, mid‐, and long‐range connectivities were significantly decreased at follow‐up compared with baseline. 2) At follow‐up, strengths of above connectivities and that between A5m.R and dlPu.L were significantly correlated with emotional exhaustion (r ranges from −0.57 to −0.73) and anxiety scores (r = −0.56), respectively. 3) Longitudinal change (follow‐up minus baseline) in connectivity strength between A5m.R and dlPu.L reflected change in emotional exhaustion score (r = 0.87). Longitudinal changes in strength of connectivities mainly involving parietal lobe were significantly decreased in nurses who developed burnout compared with those who did not.Data ConclusionIn nurses after the onset of burnout, rich club reorganization corresponded to significant reductions in strength of connectivities with different anatomical distances.Level of Evidence1Technical EfficacyStage 2