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Table 1 Summary of studies’ results

From: Burnout in nursing: a theoretical review

  Hypothesised by Maslach’s theory Observed Refuted** Number of studies supporting the relationship
1. Areas of worklife     
 Areas of worklife (high score on Areas of Worklife Scale)   4 out of 4
2. Workload and staffing levels     
 High workload √* (definitive for EE only)   12 out of 13
 Nurse staffing levels (low/inadequate)   √*   12 out of 15
 Time pressure   √* (definitive for EE only)   3 out of 3
3. Job control, reward, values, fairness, community     
 Low control over the job √*   5 out of 7
 Low reward √*   3 out of 3
 Low value congruence √* (definitive for EE and DEP)   7 out of 8
4. Shift work and working patterns     
 Night work    
 Overtime    
 Number of hours worked per week    
 ≥ 12-h shifts   √*(definitive for EE only)   4 out of 4
 Low schedule flexibility   √* (definitive only for EE)   1 out of 1
5. Demands and job complexity     
 Job and psychological demands   √* (definitive for EE only)   8 out of 8
 Low task variety   √*   4 out of 4
 High patient complexity   √*   4 out of 4
 Role conflict   √* (definitive for EE only)   4 out of 4
 Low autonomy   √*   4 out of 6
 Low decision latitude √*   4 out of 4
6. Support factors: working relationships and leadership     
 Negative nurse-physician relationship   √*   10 out of 12
 Low supervisor/leader support   √*   12 out of 12
 Leadership styles that are not authentic and transformational   √* (definitive only for EE)   14 out of 14
 Negative team relationship   √*   14 out of 15
7. Work environment and hospital characteristics     
 Negative work environment (global scale)   √* (definitive for EE only)   11 out of 11
 Low Structural/organisation empowerment   √* (definitive for EE only)   7 out of 7
 Limited Participation in hospital affairs (including policy and research)   √*   2 out of 3
 No development opportunities    
 Low pay    
 High job insecurity   √*   1 out of 1
 Model of nursing care    
 Specialised hospital/ward type    
 Magnet hospital    
8. Staff outcomes and job performance     
 Intention to leave   √*   19 out of 19
 Turnover   
 Low job performance   √*   2 out of 2
 Missed care   √***   3 out of 3
 Sickness absence √*   3 out of 4
 Poor general health √* (definitive for EE only)   4 out of 4
 Mental health issues (including depression)   √*   5 out of 5
 Job dissatisfaction   √***   10 out of 11
9. Patient care and outcomes     
 Poor quality of care   √*   7 out of 8
 Poor patient safety   √*   5 out of 5
 Adverse events   √*   3 out of 3
 Patient negative experience (including dissatisfaction and verbal abuse)   √*   2 out of 2
 Medication errors   √*   2 out of 2
 Infections   √*   3 out of 3
 Pressure ulcers    
 Patient falls   √*   2 out of 2
  1. *Partial evidence (e.g. relationship established with some but not all burnout subscales)
  2. **Refuted when there is consistent evidence that a hypothesised relationship does not exist (e.g. large studies with no confidence intervals shown if no association)
  3. ***Observed in multiple directions