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Table 3 Factors associated with pediatric nurse burnout

From: What is known about paediatric nurse burnout: a scoping review

Author(s)Number of pediatric nursesFactors associated with burnout
Akman et al. [26]165Higher EE scores associated with working in emergency and surgery, moderate in internal med, PICU, NICU
Low DP scores associated with working in PICU, moderate in all other units
High PA, high all units.
Lower level of burnout associated with a high level of job satisfaction, being married, increased age, and decreased number of assigned patients
Amin et al. [28]129Higher burnout associated with greater perceived stress
Aytekin et al. [29]85Higher EE scores associated with being unhappy with their work environment
Lower EE associated with working at management level in NICU over other NICU nurses
Lower PA scores associated with longer years worked in the NICU
Barr [30]142Core-self evaluations explained 33% variance in burnout
Degree of agreeableness, neuroticism, extraversion, and positive affect contributed to variances in burnout
Positive affect mediated the effect of core self-evaluations on burnout
Barr [31]140Higher burnout associated with high neuroticism and low agreeableness and work stress, controlled for personality traits
Work stress mediated the effect of neuroticism and extraversion on burnout
Berger et al. [32]239Higher burnout and lower compassion satisfaction associated with nurses under 40 years of age, with 6–10 years of experience and/or working in a medical-surgical unit
Bilal et al. [33]113Higher burnout associated with an organizational structure with rules and relations and being a supervisor
Lower burnout and burnout prevention associated with participation in decision-making, instrumental communication, and promotional opportunities
Branch and Klinkenberg [35]179Higher burnout associated with nursing in PICU over other units
Bursch et al. [36]115Higher EE associated with nurses working most frequently in the PICU relative to those working most frequently in the NICU, those who found communication with nurses more stressful, and having a lack of necessary nursing supplies
Lower EE associated with being married or in a domestic partnership relative to respondents who were unmarried and not in a domestic partnership, identifying as Asian/Pacific Islander relative to respondents identifying as White
Higher DP associated with respondents working day shifts relative to those working the night shift or a mix of day and night shifts, nurses working most frequently in the PICU relative to those working most frequently in the NICU, greater endorsement of stress related to communication among nurses, the experience level of colleagues, staffing, and stress associated with the patient population
Lower DP associated with respondents working in the NICU relative to those working frequently in the PICU and respondents who reported being married or in a domestic partnership
Higher PA reported in individuals identifying as White and individuals identifying as Asian/Pacific Islander relative to individuals identifying as others
Lower PA found in nurses who found their own lack of knowledge, skills and/or confidence in themselves stressful and respondents identifying as being of another ethnicity/race relative to respondents identifying as White
Czaja et al. [37]173Lack of burnout or PTSD associated with nurses who generally felt more positively about their work environment, with more confidence in their physician and nurse collogues as well as feeling a part of a team
Davis et al. [38]15Higher PA associated with working in adult oncology over pediatric oncology nurses
Dos Santos Alves et al. [39]267Lower burnout associated with nurses with a perception of having greater autonomy, greater control, good relationships at work, and organizational support, and are more satisfied with the work and the safety climate is assessed as more positive
Duxbury et al. [41]283Higher burnout found in staff nurses who have a head nurse with a leadership style of high structure and low consideration
Estabrooks et al. [43]844Higher EE associated with lower job satisfaction
Favrod et al. [45]91Similar burnout levels in NICU nurses and midwives
NICU nurses more likely to reach the severe threshold of the three subscales of burnout than midwives
NICU nurses reported more traumatic stressors in their working environment
Gallagher and Gormley [46]30Higher EE associated with higher DP and low PA, EE still present despite nurses reporting support systems were in place and felt supported
Lower EE associated with increased years as a BMT nurse
Lower DP associated with increased years as a BMT nurse
Higher PA associated with increased years as a BMT nurse
Gauthier et al. [47]45Lower EE associated with self-compassion at time 1 and time 2, but not at time 3
Lower DP associated with elf-compassion at time 1 and time 2, but not at time 3
Higher PA associated with self-compassion at all three time points
All subscales of burnout were correlated with job satisfaction at time 1, but not at time 2 and time 3
Lower burnout associated with more years of experience, job satisfaction had a significant positive correlation with stress and burnout only at time 1
Holden et al. [51]347Higher burnout associated with unit-level staffing, task-level external mental workload, and job dissatisfaction
Burnout and job dissatisfaction were not significantly associated with the likelihood of medication error
Klein et al. [56]302Nurses rated lack of regular staff meetings, dissatisfaction with the quality of the decision-making process, and providing futile treatment as significantly more stressful than physicians did
Koivula et al. [57]21Higher burnout found in nurses with lower education level relative to those with higher education level
Latimer et al. [58]27Higher burnout associated with nurses with less experience
Lewiston et al. [59]38Higher EE associated with cystic fibrosis caregivers compared to controls
Higher DP associated with cystic fibrosis caregivers compared to controls
Equal PA from the job in cystic fibrosis caregivers and the control group
Lin et al. [63]144Higher burnout associated with higher work stress (after controlling for the demographics) and depression
Occupational burnout had a mediating effect on the relationship between work stress and depression levels
Maytum et al. [65]20Factors associated with triggering burnout: seeing too many painful procedures done to children, seeing too much sadness, seeing too much death, angry, yelling families, and non-compliant patients/families
Systems triggers: unreasonable policies, staffing shortages, insurance frustrations, paperwork, need to justify their position, and general healthcare system dysfunction
Role-specific triggers: lack of support, feeling you are on your own, less respondents cited unclear expectations, change in role and lack of challenge
Work overload: excessive demands of work
Personal triggers becoming overly involved or crossing professional boundaries
Factors associated with coping with burnout: short-term—self-care (exercise, meditation, journaling), fun/humor, non-work relationships; long-term personal coping strategies—developing a personal philosophy and faith and engaging in self-analysis
Short-term work-related coping strategies: developing supportive and honest professional relationships, need for their work to be congruent with their professional philosophy and interest
Messmer et al. [67]33Higher burnout associated with lower satisfaction and position
Lower burnout associated with nurses who would recommend their career to others relative to those who would recommend their career with reservation
Meyer et al. [16]251Higher burnout predicated by current stress exposure after controlling for pre-existing stress exposure
Morrison Wylde et al. [70]95Lower burnout associated with “acting with awareness” at time 2
Moussa and Mahmood [71]55Higher EE associated with lack of access to work information
Lower EE associated with nurses increased age, length of professional experience, and experience on the unit
Lower DP associated with nurses increased age, length of professional experience, and experience on the unit
Higher PA associated with nurses increased age, length of professional experience, and experience on the unit
Murphy-Oikonen et al. [73]14Higher burnout and frustration when caring for infants with neonatal abstinence syndrome
Neumann et al. [74]238Lower EE associated with caring for both pediatric and adult patients had lower relative to those who just cared for adults only
Oehler and Davidson [76]121Higher and more frequent burnout found in acute pediatric nurses relative to non-acute pediatric nurses
Higher burnout associated with increased job stress, workload, conflict with physicians, and uncertainty regarding treatment
Oehler et al. [77]49Higher EE predicted by job stress, trait anxiety, and experience on the current unit and explained 55% of the variance
Higher DP predicted by job stress and total work experience
Lower PA predicted by level of supervisor support and state anxiety
Ohue et al. [78]27Higher PA found in nurses in the pediatrics and outpatient departments relative to those of the nurses in the obstetrics and gynecology departments
Pagel and Wittmann [79]74Higher burnout related to higher reporting of the variable “percentage of children on a unit with social of behavioral problems”
Rochefort and Clarke [83]339Lower EE associated with higher ratings of nurse staffing and resource adequacy
Rodrigues et al. [85]73Higher EE associated with greater time on the unit (moderate effect), nurses concern that current standards of care inhibit optimal pain management, negative views of the hospital environment (large effect), barriers to optimal pain management (moderate effect), lower self-efficacy (moderate effect), and moral distress (moderate effect)
Burnout associated with expressions of exhaustion, frustration, overburden of their workload, and the hopelessness in working with chronically ill pediatric patients, issues about self-efficacy regarding patient outcomes
Sekol and Kim [88]240Higher burnout found in those with 5–9 years of experience working on the surgical unit
Lower burnout associated with working on the hematolgy/oncology unit, nursing experience of > 20 years, and all levels of experience if working on the hematolgy/oncology unit
Soroush et al. [90]86Higher burnout associated with low clinical competency
Squires et al. [91]735Higher DP associated with lower application of research information in the work context
Stimpfel et al. [92]3 710Higher burnout associated with nurses who worked the longest shifts relative to those working shorter, 8-h shifts
Sun et al. [94]277Higher burnout in nurses who worked in obstetrics and gynecology units relative to nurses who worked in the surgery and pediatric units, in that order
Tawfik et al. [95]1 374Higher burnout associated with an average number of daily admissions of the NICU
Tawfik et al. [96]1 464Higher burnout in understaffed units
Vicentic et al. [97]60Higher EE associated with higher anxiety and depression variables and higher risk of EE for those who care for children with CP than those who care for children without CP
Zanatta and Lucca [101]57Higher EE associated with being married and having health problems related to work
  1. EE Emotional Exhaustion, a subscale of the Maslach Burnout Inventory; DP Depersonalization, a subscale of the Maslach Burnout Inventory; PA Personal Accomplishment, a subscale of the Maslach Burnout Inventory; NICU neonatal intensive care unit; PICU pediatric intensive care unit; STS secondary traumatic stress; PTSD post-traumatic stress disorder; CP cerebral palsy