title: Burnout syndrome in critical care nursing staff.
abstract: BACKGROUND
  Burnout syndrome (BOS) associated with stress has been documented in health care professionals in many specialties. The intensive care unit (ICU) is a highly stressful environment. Little is known about BOS in critical care nursing staff.
  
  
  OBJECTIVE
  To identify determinants of BOS in critical care nurses.
  
  
  METHODS
  We conducted a questionnaire survey in France. Among 278 ICUs contacted for the study, 165 (59.4%) included 2,525 nursing staff members, of whom 2,392 returned questionnaires with complete Maslach Burnout Inventory data.
  
  
  RESULTS
  Of the 2,392 respondents (82% female), 80% were nurses, 15% nursing assistants, and 5% head nurses. Severe BOS-related symptoms were identified in 790 (33%) respondents. By multivariate analysis, four domains were associated with severe BOS: (1) personal characteristics, such as age (odds ratio [OR], 0.97/yr; confidence interval [CI], 0.96-0.99; p=0.0008); (2) organizational factors, such as ability to choose days off (OR, 0.69; CI, 0.52-0.91; p=0.009) or participation in an ICU research group (OR, 0.74; CI, 0.56-0.97; p=0.03); (3) quality of working relations (1-10 scale), such as conflicts with patients (OR, 1.96; CI, 1.16-1.30; p=0.01), relationship with head nurse (OR, 0.92/point; CI, 0.86-0.98; p=0.02) or physicians (OR, 0.81; CI, 0.74-0.87; p=0.0001); and (4) end-of-life related factors, such as caring for a dying patient (OR, 1.39; CI, 1.04-1.85; p=0.02), and number of decisions to forego life-sustaining treatments in the last week (OR, 1.14; CI, 1.01-1.29; p=0.04).
  
  
  CONCLUSIONS
  One-third of ICU nursing staff had severe BOS. Areas for improvement identified in our study include conflict prevention, participation in ICU research groups, and better management of end-of-life care. Interventional studies are needed to investigate these potentially preventive strategies.
authors.affiliation: Medical ICU, Saint-Louis Hospital and Paris 7 University, Assistance Publique, Hôpitaux de Paris, Paris, France.
authors.forename: Marie Cécile
authors.initials: MC
authors.lastname: Poncet
authors.forename: Philippe
authors.initials: P
authors.lastname: Toullic
authors.forename: Laurent
authors.initials: L
authors.lastname: Papazian
authors.forename: Nancy
authors.initials: N
authors.lastname: Kentish-Barnes
authors.forename: Jean-Francçois
authors.initials: JF
authors.lastname: Timsit
authors.forename: Frédéric
authors.initials: F
authors.lastname: Pochard
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chevret
authors.forename: Benoît
authors.initials: B
authors.lastname: Schlemmer
authors.forename: Elie
authors.initials: E
authors.lastname: Azoulay
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000453:epidemiology*; D003422:Critical Care; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D010557:Personnel Administration, Hospital; D015995:Prevalence; D012307:Risk Factors; D013041:Specialties, Nursing; D011795:Surveys and Questionnaires