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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