UTA NURS 4325 - Prevalence of Burnout Syndrome in Emergency Nurses

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www.ccnonline.org CriticalCareNurse Vol 37, No. 5, OCTOBER 2017 e1FeaturePrevalence of Burnout Syndrome in Emergency Nurses: A Meta-AnalysisJose Luis Gómez-Urquiza, PhDEmilia I. De la Fuente-Solana, PhDLuis Albendín-García, RN, PhDCristina Vargas-Pecino, PhDElena M. Ortega-Campos, PhDGuillermo A. Cañadas-De la Fuente, MD, PhDObjective To determine the prevalence of burnout (based on the Maslach Burnout Inventory on the 3 dimensions of high Emotional Exhaustion, high Depersonalization, and low Personal Accomplishment) among emergency nurses.Method A search of the terms “emergency AND nurs* AND burnout” was conducted using the following databases: CINAHL, Cochrane, CUIDEN, IBECS, LILACS, PubMed, ProQuest, PsycINFO, SciELO, and Scopus.Results Thirteen studies were included for the Maslach Burnout Inventory subscales of Emotional Exhaustion and Depersonalization and 11 studies for the subscale of low Personal Accomplishment. The total sample of nurses was 1566. The estimated prevalence of each subscale was 31% (95% CI, 20-44) for Emotional Exhaustion, 36% (95% CI, 23-51) for Depersonalization, and 29% (95% CI, 15-44) for low Personal Accomplishment.Conclusions The prevalence of burnout syndrome in emergency nurses is high; about 30% of the sample was affected with at least 1 of the 3 Maslach Burnout Inventory subscales. Working conditions and personal factors should be taken into account when assessing burnout risk profiles of emergency nurses. (Critical Care Nurse. 2017;37[5]:e1-e9)©2017 American Association of Critical-Care Nurses doi: https://doi.org/10.4037/ccn2017508Burnout syndrome is one of the most important occupational health problems in various pro-fessions that involve working with other people.1 Among susceptible occupations, health care professionals have been identified as the group most likely to experience burnout. Burnout has been studied extensively,1 with Freudenberger2 initiating the study of this syndrome in social services pro-fessionals. Nevertheless, Maslach and Jackson’s3 definition of a 3-dimensional psychological syndrome—in which an individual who provides human services has Emotional Exhaustion, Depersonalization in client attention, and feelings of low Personal Accomplishment—is currently the most accepted and widespread definition. The Maslach Burnout Inventory (MBI) categorizes the intensity of burnout into a low, medium, or high level for each dimension or subscale. Burnout scores are higher when Emotional Exhaustion and Depersonalization subscale scores are higher and Personal Accomplishment scores are lower.3e2 CriticalCareNurse Vol 37, No. 5, OCTOBER 2017 www.ccnonline.orgAuthors Jose Luis Gómez-Urquiza is a nursing lecturer and Guillermo A. Cañadas-De la Fuente is an assistant professor in the Nursing Department, and Emilia I. De la Fuente-Solana is a professor and Elena M. Ortega-Campos is a lecturer in the Methodology of the Behavioural Science Department, University of Granada, Ceuta, Spain.Luis Albendín-García is an emergency and critical care nurse at the Andalusian Health Service, Andalusia, Spain.Cristina Vargas-Pecino is an assistant professor in the Psychology Department, University of Valencia, Valencia, Spain.Corresponding author: Jose L. Gómez-Urquiza, PhD, Nursing Department, University of Granada, Campus Universitario de Ceuta, C/Cortadura del Valle S/N, 51001, Ceuta, Spain (email: [email protected]). To purchase electronic or print reprints, contact the American Association of Critical-Care Nurses, 101 Columbia, Aliso Viejo, CA 92656. Phone, (800) 899-1712 or (949) 362-2050 (ext 532); fax, (949) 362-2049; email, [email protected] health care, nurses have one of the highest rates of burnout.4 This syndrome influences different aspects of nursing health care. A professional with burnout may present with physical weakness, insomnia, hostility, irri-tability, and depression.5 Patients of the individual with burnout are also affected because of a decrease in the quality of nursing care.6,7 Finally, health institutions face burnout-related problems such as increased absenteeism, job rotation, and reduced work performance.8,9 Through educational interventions, mediation, or interventions focused on affected individuals, treatment of burnout among nurses has been studied, although results have been limited.10-12In the last decade, numerous burnout risk factors have been studied among nursing professionals, such as work experience,13 job satisfaction,14 personality, and sociodemographic factors.4 Another important risk fac-tor that has been assessed in recent studies15,16 is the hos-pital unit or spe-cialty in which nurses work. Each specialty cares for patients with certain dis-eases and morbidities, so the daily work of nursing can vary substantially depending on the specific unit. The importance of determining how the specialty influences the development of burnout has been reflected in descrip-tive studies comparing burnout among different spe-cialties, such as internal medicine, palliative care, and hematology,17 or in systematic reviews about burnout in specific units such as oncology,18 critical care,19 and emer-gency departments (EDs).15,16On a daily basis, nurses working in the ED deal with unexpected situations and patients who may be at risk of death because of their pathologies.20 This indirect expo-sure to trauma may generate secondary traumatic stress in emergency nurses.20 In addition, EDs have been iden-tified as one of the medical specialty units where attacks and assaults by patients on health care professionals are most frequent.21 These factors suggest that among nurs-ing professionals, emergency nurses have an increased risk of experiencing burnout. Reviews about burnout among emergency nurses indicate a high prevalence of the syndrome15; however, burnout prevalence rates vary considerably among included studies. For example, reported Emotional Exhaustion prevalence rates range from 9.5%22 to 67%.23 In previous research,15 prevalence rates of and risk factors for burnout were identified in emergency nurses; however, a meta-analysis of these prevalence rates was not done. A meta-analytic study could provide an estimate of the prevalence of burnout among emergency nurses, as has been already done, for example, in oncology professionals.24The aim of this study was to determine the preva-lence of burnout syndrome in emergency nurses, using the MBI manual, which established

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