title: Underlying spirituality and mental health: the role of burnout.
abstract: OBJECTIVE
  This study investigated the effects of burnout on the relationship between spirituality and mental health among healthcare workers in Hong Kong.
  
  
  METHODS
  Using a cross-sectional design, 312 healthcare workers (mean age=38.6, SD=9.9; 77.7% females) in a mental rehabilitation institution completed a self-administered questionnaire on anxiety, depression, burnout, and daily spiritual experiences. Multivariate regressions were used to test the effects of burnout on the relationships between daily spiritual experiences and anxiety and depression.
  
  
  RESULTS
  After adjusting for age, education level, marital status, and staff ranking, higher levels of daily spiritual experience were associated with lower levels of burnout (β=-0.22, p<0.01), depression (β=-0.68, p<0.01), and anxiety (β=-0.05, p<0.01). Burnout was found to have a significant partial mediating effect on the relationship between daily spiritual experiences and depression (z=-2.99, p<0.01), accounting for 37.8% of the variation in depression. Burnout also completely mediated the relationship between daily spiritual experiences and anxiety (z=-3.06, p<0.01), accounting for 73.9% of the variation in anxiety.
  
  
  CONCLUSIONS
  The results suggested that the association between spirituality and mental health is influenced by the level of burnout, thereby supporting the role of burnout as a potential mediator. Moreover, day-to-day spiritual practice was found to be potentially protective against burnout and mental health problems. Future interventions could incorporate spirituality training to reduce burnout so as to improve the well-being of healthcare workers.
authors.affiliation: Centre on Behavioral Health, The University of Hong Kong.
authors.forename: Rainbow Tin Hung
authors.initials: RT
authors.lastname: Ho
authors.forename: Cheuk Yan
authors.initials: CY
authors.lastname: Sing
authors.forename: Ted Chun Tat
authors.initials: TC
authors.lastname: Fong
authors.forename: Friendly So Wah
authors.initials: FS
authors.lastname: Au-Yeung
authors.forename: Kit Ying
authors.initials: KY
authors.lastname: Law
authors.forename: Lai Fan
authors.initials: LF
authors.lastname: Lee
authors.forename: Siu Man
authors.initials: SM
authors.lastname: Ng
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D002055:Burnout, Professional / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006723:Hong Kong; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009784:Occupational Diseases / Q000523:psychology; D029181:Spirituality; D011795:Surveys and Questionnaires