Burnout and nursing work environment in public health institutions

cross-sectional study with 745 nurses from 40 public health institutions in São Paulo. Nursing Work Index-Revised (NWI-R) and Maslach Burnout Inventory were used. Similar institutions according to NWI-R were grouped by clustering and the Anova and Bonferroni tests were used in the comparative analyzes.

Results:

there was significant and moderate correlation between emotional exhaustion and autonomy, control over the environment and organizational support; between reduced personal accomplishment, autonomy and organizational support; and between depersonalization and autonomy. The group that presented the worst conditions in the work environment differed on emotional exhaustion from the group with most favorable traits.

Conclusion:

emotional exhaustion was the trait of Burnout that was more consistently related to the group of institutions with more unfavorable working conditions regarding autonomy, organizational support and control over the environment.

Descriptors:
Burnout, Professional; Nursing; Health Facility Environment; Hospitals, Public; Cross-Sectional Studies.

Instrument	Number of items	Cronbach's Alpha
MBI
Emotional exhaustion	9	0.88
Depersonalization	5	0.55
Reduced personal accomplishment	8	0.72
NWI-R
Autonomy	5	0.70
Control over the environment	7	0.79
Physician-nurse relationship	3	0.78
Organizational support	10	0.82

MBI	Autonomy	Control over the environment	Physician-nurse relationship	Organizational support
Emotional exhaustion	0.46 p = 0.003	0.39 p = 0.013	0.24 p = 0.134	0.40 p = 0.010
Depersonalization	0.33 p = 0.039	0.19 p = 0.229	0.13 p = 0.439	0.27 p = 0.087
Reduced personal accomplishment	-0.44 p = 0.004	-0.26 p = 0.104	-0.11 p = 0.516	-0.40 p = 0.011

MBI		NWI - R				p value^* * Teste ANOVA
MBI		Group 1 (n-8)	Group 2 (n=16)	Group 3 (n= 13)	Group 4 (n=3)	p value^* * Teste ANOVA
Emotional exhaustion	Média	21,1	22,4	22,4	25,4	0,035
Emotional exhaustion	DP	1,3	1,5	2,9	0,6	0,035
Depersonalization	Média	8,9	8,4	8,7	10,2	0,028
Depersonalization	DP	0,8	0,9	0,9	0,7	0,028
Reduced personal accomplishment	Média	32,4	31,8	31,7	30,3	0,154
Reduced personal accomplishment	DP	1,1	1,6	1,0	1,7	0,154

Comparisons	Emotional exhaustion (p value^* * Bonferroni Test )	Depersonalization (p value^* * Bonferroni Test )
Group 1 x Group 2	0.981	>0.999
Group 1 x Group 3	>0.999	>0.999
Group 1 x Group 4	0.023	0.293
Group 2 x Group 3	>0.999	>0.999
Group 2 x Group 4	0.149	0.021
Group 3 x Group 4	0.167	0.094

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] CORRESPONDING AUTHOR: Lilia de Souza Nogueira. E-mail: lilianogueira@usp.br

Domain - MBI	Mean	Standard Deviation	Median	Range
Emotional exhaustion	22.4	6.5	22	9-45
Depersonalization	8.9	3.1	9	5-21
Reduced personal accomplishment	31.4	4.3	32	14-40
Subscales - NWI-R	Mean	Standard Deviation	Median	Range
Autonomy	2.0	0.3	2.0	1.4-3.2
Control over the environment	2.4	0.4	2.3	1.5-3.1
Physician-nurse relationship	2.1	0.3	2.1	1.5-2.9
Organizational support	2.1	0.3	2.1	1.5-2.8