Burnout among nursing students: predictors and association with empathy and self-efficacy

Lopes, Adriana Rezende; Nihei, Oscar Kenji

doi:10.1590/0034-7167-2018-0280

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 73 (1) • 2020 • https://doi.org/10.1590/0034-7167-2018-0280 copy

Burnout among nursing students: predictors and association with empathy and self-efficacy

Burnout en estudiantes de enfermería: predictores y asociación con empatía y autoeficacia

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to analyze burnout, its predictors and association with empathy and self-efficacy among nursing students.

Method:

cross-sectional analytical study with 284 students from five state universities in the state of Parana, Brazil. The instruments applied were: social and academic questionnaire, Maslach Burnout Inventory, Interpersonal Reactivity Index and Occupational Self-Efficacy Scale (Short Form). Spearman’s correlation and univariate and multivariate logistic analysis were used.

Results:

6.0% of the students presented high burnout, 36.3% presented high emotional exhaustion, 37.7% presented high depersonalization and 28.2% presented low personal accomplishment. The burnout predictors were: absence of physical activity; weekly workload >24 hours; low empathic concern. There were negative correlations between empathy (empathic concern and perspective taking) and depersonalization; self-efficacy and emotional exhaustion; and positive correlations between personal accomplishment and empathy and self-efficacy.

Conclusion:

Personal factors and an academic variable were burnout predictors among nursing students. The correlations suggest that self-efficacy and empathy can prevent burnout.

Descriptors:
Burnout, Psychological; Empathy; Self Efficacy; Students, Nursing; Education, Nursing

Variable	High burnout						p ^* * Mann-Whitney Test;
	No			Yes
	Mean	SD	Median	Mean	SD	Median
Empathic Concern	27.3	4.4	28	24.1	5.0	25	0.011^§ § p<0.05.
Perspective Taking	26.3	4.5	26	24.2	3.0	24	0.032^§ § p<0.05.
Personal Distress	18.6	4.9	18	20.8	5.5	21	0.032^§ § p<0.05.
Self-efficacy	22.8	4.3	24	20.6	5.2	22	0.092

Variables	EE	DE	PA	EC	Pt	PD	SE
Emotional Exhaustion (EE)	1
Depersonalization (DE)	0.160^* * p<0.05;	1
Personal Accomplishment (PA)	-0.247^§ § p<0.001.	-0.215^§ § p<0.001.	1
Empathic Concern (EC)	0.004	-0.312^§ § p<0.001.	0.178^* * p<0.05;	1
Perspective Taking (PT)	-0.064	-0.218^§ § p<0.001.	0.178^* * p<0.05;	0.336^§ § p<0.001.	1
Personal Distress (PD)	0.195^* * p<0.05;	0.095	-0.270^§ § p<0.001.	0.109	-0.054	1
Self-Efficacy (SE)	-0.214^§ § p<0.001.	-0.105	0.428^§ § p<0.001.	0.003	0.135^* * p<0.05;	-0.441^§ § p<0.001.	1

Variable	Univariate regression		Multivariate regression^* * Pearson 0.817; Hosmer-Lemeshow 0.479; ROC 0.77.
Variable	OR (95%CI)	p	OR (95%CI)	p
Gender¹ 1 male;	0.556 (0.071-4.355)	0.544
Age² 2 >24 years;	0.479 (0.106-2.158)	0.298
Civil status³ 3 Stable union/Married;	0.365 (0.047-2.834)	0.267
Children⁴ 4 Yes;	1.053 (0.230-4.833)	0.947
Family income⁵ 5 >3 minimum wages;	1.170 (0.438-3.126)	0.755
Weekly workload⁶ 6 ≤24 hours;	2.830 (1.015-7.889)	0.041^§ § p<0.20.	2.939 (1.025-8.429)	0.040
Time in the internship⁷ 7 > 3 months.	0.536 (0.068-4.209)	0.518
Employment⁴ 4 Yes;	0.694 (0.193-2.492)	0.562
Physical activity⁴ 4 Yes;	0.245 (0.055-1.096)	0.031^§ § p<0.20.	0.208 (0.045-0.956)	0.018
Leisure activity⁴ 4 Yes;	0.697 (0.249-1.954)	0.500
Empathic concern	0.865 (0.779-0.961)	0.007^§ § p<0.20.	0.866 (0.778-0.965)	0.001
Perspective taking	0.902 (0.808-1.006)	0.063^§ § p<0.20.
Personal distress	1.096 (0.992-1.211)	0.068^§ § p<0.20.
Self-efficacy	0.896 (0.806-0.995)	0.044^§ § p<0.20.

Subscale: Variable	Univariate regression		Multivariate regression^* * hEE: Pearson 0,359; Hosmer-Lemeshow 0.659; ROC 0.68; hDE: Pearson 0.405; Hosmer-Lemeshow 0.216; ROC 0/70; rPA: Pearson 0.210; Hosmer-Lemeshow 0.453; ROC 0.75.
Subscale: Variable	OR (95%CI)	p	OR (95%CI)	p
hEE: Gender¹ 1 male;	0.816 (0.355-1.877)	0.630
Age² 2 >24 years;	0.467 (0.242-0.901)	0.018^§ § p<0.20.	0.504 (0.253-1.004)	0.046
Civil state³ 3 Married/stable union;	0.721 (0.349-1.487)	0.368
Children⁴ 4 Yes;	0.777 (0.353-1.712)	0.527
Family income⁵ 5 >3 minimum wages;	1.009 (0.618-1.650)	0.970
Weekly workload⁶ 6 ≤24 hours;	1.759 (1.073-2.883)	0.025^§ § p<0.20.	1.777 (1.056-2.988)	0.030
Time in the internship⁷ 7 >3 months.	1.180 (0.524-2.656)	0.691
Employment⁴ 4 Yes;	1.094 (0.619-1.934)	0.756
Physical activity⁴ 4 Yes;	0.535 (0.313-0.915)	0.020^§ § p<0.20.	0.482 (0.273-0.851)	0.010
Leisure activity⁴ 4 Yes;	0.667 (0.391-1.135)	0.137^§ § p<0.20.
Empathic concern	1.018 (0.964-1.075)	0.515
Perspective taking	0.989 (0.938-1.044)	0.703
Personal distress	1.064 (1.012-1.119)	0.014^§ § p<0.20.
Self-efficacy	0.926 (0.875-0.979)	0.007^§ § p<0.20.	0.939 (0.884-0.998)	0.041
hDE: Gender¹ 1 male;	2.057 (0.938-4.511)	0.072^§ § p<0.20.
Age² 2 >24 years;	0.740 (0.402-1.361)	0.328
Civil state³ 3 Married/stable union;	0.585 (0.279-1.226)	0.144^§ § p<0.20.
Children⁴ 4 Yes;	0.992 (0.464-2.120)	0.983
Family income⁵ 5 >3 minimum wages;	0.999 (0.614-1.625)	0.996
Weekly workhours⁶ 6 ≤24 hours;	1.141 (0.698-1.866)	0.598
Time in the internship⁷ 7 >3 months.	0.673 (0.283-1.600)	0.360
Employment⁴ 4 Yes;	0.853 (0.480-1.516)	0.587
Physical activity⁴ 4 Yes;	1.057 (0.637-1.754)	0.830
Leisure activity⁴ 4 Yes;	0.517 (0.304-0.876)	0.014^§ § p<0.20.	0.469 (0.269-0.817)	0.007
Empathic concern	0.883 (0.834-0.935)	0.001^§ § p<0.20.	0.876 (0.826-0.929)	0.0001
Perspective taking	0.947 (0.897-1.000)	0.047^§ § p<0.20.
Personal distress	1.027 (0.978-1.078)	0.279
Self-efficacy	0.963 (0.911-1.018)	0.181^§ § p<0.20.
rPA: Gender¹ 1 male;	0.836 (0.341-2.050)	0.691
Age² 2 >24 years;	0.742 (0.381-1.444)	0.372
Civil status³ 3 Married/stable union;	0.962 (0.455-2.032)	0.919
Kids⁴ 4 Yes;	1.182 (0.533-2.621)	0.684
Family income⁵ 5 >3 minimum wages;	1.094 (0.649-1.843)	0.736
Weekly workload⁶ 6 ≤24 hours;	1.297 (0.764-2.205)	0.337
Time in the internship⁷ 7 >3 months.	0.733 (0.284-1.897)	0.513
Employment⁴ 4 Yes;	0.553 (0.282-1.082)	0.073^§ § p<0.20.
Physical activity⁴ 4 Yes;	0.724 (0.413-1.271	0.256
Leisure actvity⁴ 4 Yes;	1.132 (0.631-2.029	0.677
Empathic concern	0.872 (0.820-0.927	0.001^§ § p<0.20.	0.867 (0.812-0.924)	0.0001
Perspective taking	0.900 (0.847-0.956)	0.001^§ § p<0.20.
Personal distress	1.102 (1.043-1.164)	0.001^§ § p<0.20.
Self-efficacy.	0.838 (0.785-0.894)	0.001^§ § p<0.20.	0.831 (0.775-0.890)	0.0001

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[1] Corresponding Author: Adriana Rezende Lopes E-mail: arlopes11@uol.com.br