| Objectives1)To explore the prevalence of nurse burnout in the tertiary hospitals among a large sample;2)To identify latent profiles of nurse burnout using Latent Profile Analysis;3)To analyze the relationships between latent profiles of nurse burnout and nurse work performance/patient safety.MethodsThis is a cross-sectional research design.We recruited qualified nurses from 4 tertiary hospitals in Shandong Province through a multi-stage stratified cluster random sampling method from October to December 2020.With the help of an online questionnaire survey platform(Wenjuanxing),the valid sample size in this study is 1877.The tools used in the survey included self-compiled general information questionnaires(including general demographic information such as age,gender,marital status,education level,average monthly income,etc.,and work-related characteristics such as working years,employment methods,work titles,and the number of night shifts per month,etc.),Maslach Burnout Inventory-Human Service Survey,Work Performance Scale,Patient Safety Scale.LPA was used to analyze the latent profiles of nurse burnout,with model fitting indexes,such as AIC,BIC,entropy index,BLRT and LMR.Other statistical analysis methods include:descriptive analysis,one-way analysis of variance,chi-square test,binary logistic regression,multiple logistic regression,etc.SPSS26.0 and Mplus7.0 were used for data analysis.Results1.The burnout score was 41.00±20.40,and the prevalence was 65.7%.The Emotional Exhaustion dimension score was 16.81±12.26,and the prevalence was 21.8%;the Depersonalization dimension score was 5.54±6.09,and the prevalence was 23.4%;the Diminished Personal Accomplishment dimension score was 18.64±13.17,and the prevalence was 55.6%.2.Through LPA,the research subjects in terms of nurse burnout can be divided into 4 latent profiles:the "Low Burnout Group" accounted for 54.9%,the "Emotional Exhaustion/Depersonalization Group" accounted for 6.2%,and the "Low Accomplishment Group" accounted for 13.5%,the "Moderate Burnout Group"accounted for 25.5%.3.One-way analysis of variance showed that the nurses of different latent profiles of burnout were statistically significant in age(F=6.408,P<0.001),marital status(χ2=12.241,P=0.007),education level(χ=9.695,P=0.021),working years(χ2=27.478,P=0.001),and the number of night shifts per month(χ2=36.289,P<0.001).4.The overall work performance score(F=80.24,P<0.001),task performance score(F=70.61,P<0.001),and peripheral performance score(F=77.988,P<0.001)were statistically significant in nurses of different latent profiles of burnout.The post hoc tests showed that the task performance score,peripheral performance score and overall work performance scores of the "Low Burnout Group" were significantly higher than the other three latent profiles of nurses.The peripheral performance scores and overall work performance scores of the "Low Accomplishment Group"were significantly lower than that of the "Low Burnout Group"and "Emotional Exhaustion/Depersonalization Group".5.The general linear regression analysis indicated that after controlling for age,gender,marital status,education level,working years and the number of night shifts per month,taking the "Low Burnout Group" for reference,the work performance scores of "Emotional Exhaustion/Depersonalization Group" "Low Accomplishment Group" and "Moderate Burnout Group" decreased by 3.814 units(P<0.001),6.735 units(P<0.001)and 5.449 units(P<0.001)respectively.6.Chi-square test showed that the profiles of burnout is significantly associated with perceived patient safety level(χ2=127.169,P<0.001)and the occurrence of adverse events in the past year(χ2=12.785,P=0.005).The percentage of nurses with perceived "excellent" patient safety level was the highest among "Low Accomplishment Group",which was significantly higher than that of the other three latent profiles;while the percentage of nurses with perceived "normal or lower’patient safety level was the highest among "Emotional Exhaustion/Depersonalization Group" and "Moderate Burnout Group",which was significantly higher than that of"Low Burnout Group" and "Low Accomplishment Group".The percentage of nurses who had adverse events in the past year was the highest among "Emotional Exhaustion/Depersonalization Group" nurses,which was significantly higher than that of "Low Burnout Group" and "Low Accomplishment Group".7.Multiple logistic regression analysis showed that:after controlling for age,gender,marital status,education level,working years and the number of night shifts per month,compared with "Low Burnout Group" nurses,taking the perceived"excellent" patient safety level as reference,being a member of "Low Accomplishment Group" reduced the risk of patient safety being "good" by 51.3%(OR=0.487,95%CI=0.362-0.654),while the risk of patient safety being "good" was increased by 76.4%(OR=1.764,95%CI=1.347-2.310)in "Moderate Burnout Group";nurses in the "Emotional Exhaustion/Depersonalization Group" had a 4.055-fold increase in the risk of patient safety being "normal or lower"(OR=5.055,95%CI=2.749-9.296),and nurses in the "Moderate Burnout Group" had a 3.915-fold increase in the risk of patient safety being "normal or lower"(OR=4.915,95%CI=3.319-7.278).8.The binary logistic regression showed that after controlling for age,gender,marital status,education level,working years and the number of night shifts per month,compared with "Low Burnout Group" nurses,the risk of adverse events of"Emotional Exhaustion/Depersonalization Group" increased by 72.7%(OR=1.727,95%CI=1.076-2.772).Conclusions1.The prevalence of nurse burnout in tertiary hospitals was high and serious,which is worthy of attention.2.The nurse burnout in the tertiary hospitals can be divided into 4 latent profiles,named"Low Burnout Group" "Emotional Exhaustion/Depersonalization Group""Low Accomplishment Group" and "Moderate Burnout Group".Among them,"Low Burnout Group" nurses have the highest proportion,and "Emotional Exhaustion/Depersonalization Group" nurses have the lowest proportion.3.The "Low Burnout Group" nurses had the best work performance,while the"Low Accomplishment Group" nurses had the worst work performance.The "Low Accomplishment Group" nurses perceived the best level of patient safety,while the"Emotional Exhaustion/Depersonalization Group" nurses and "Moderate Burnout Group" nurses perceived the worst level of patient safety."Emotional Exhaustion/Depersonalization Group" nurses had the highest probability of adverse events.4.Managers should comprehensively analyze the different characteristics of nurse burnout,identify the latent profiles of nurse burnout,and screen out the latent profiles with poor work performance and adverse effects on patient safety as early as possible.At the same time,specific intervention measures to improve nurse work performance and ensure patient safety. |
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