title: Patient satisfaction, stress and burnout in nursing personnel in emergency departments: A cross-sectional study.
abstract: BACKGROUND
  Patient satisfaction is considered a measure of the status of the interaction between health- care professionals and service users. The level of this measure indicates the quality of the care received. Burnout is a common phenomenon in nursing professionals and it is a response to the chronic occupational stress. Different studies have shown a link between patient satisfaction and stress and burnout syndrome experienced by nursing personnel in various hospital units.
  
  
  OBJECTIVE
  The main objective of this study was to analyze the associations between patients' satisfaction with emergency services and perception of work stress and burnout by the nursing professionals who looked after these patients at a group level.
  
  
  METHODS
  The study followed a descriptive and cross-sectional design; the data were collected by means of questionnaires.
  
  
  METHODS
  Emergency services at two general hospitals in Murcia (Spain).
  
  
  METHODS
  Two samples, one formed of emergency service nursing professionals (n=148) and the other formed by patients (n=390), who were grouped in 48 units of analysis.
  
  
  METHODS
  To evaluate perception of stress and burnout of the nursing personnel, we used the Spanish adaptation of the Nursing Stress Scale for hospital emergency nursing personnel, and the Spanish adaptation of the Maslach Burnout Inventory, respectively. A Spanish adaptation of the La Mónica-Obsert Patient Satisfaction Scale was used to define the patients' feelings about their nursing care. Moreover, some socio-demographic variables and the length of stay in the emergency unit were included in the protocol. Before statistical analysis, the data were collated at a group level. The intraclass correlation coefficients and the Average Deviation Index support the aggregation of these data at a unit level.
  
  
  RESULTS
  Neither perception of stress nor the various elements of burnout experienced by nursing staff were related to patients' levels of satisfaction. We observed a significant and positive association between stress perception among the nurses and two of the burnout dimensions, namely emotional exhaustion and cynicism. The length of stay of the patients in the emergency department was negatively related to the frequency of nurses experiencing perceived stress as well as the burnout dimension of cynicism.
  
  
  CONCLUSIONS
  No significant association was observed between experiences of stress and burnout dimensions by nursing professionals and the satisfaction with care received reported by their patients. These findings could be explained by the professional and organizational characteristics of the unit. Finally, the limitations and implications of the study are discussed, as well as future research questions related to research of the associations between occupational stress, burnout and patient satisfaction.
authors.affiliation: University of Murcia, University Hospital Morales Meseguer, Marqués de los Vélez, 30008 Murcia, Spain. Electronic address: mi.rios@um.es.
authors.forename: M Isabel
authors.initials: MI
authors.lastname: Ríos-Risquez
authors.affiliation: Department of Psychiatry and Social Psychology, Faculty of Psychology, University of Murcia, ENAE Business School, Campus Universitario de Espinardo, 30100 Espinardo, Murcia, Spain. Electronic address: mgarciai@um.es.
authors.forename: Mariano
authors.initials: M
authors.lastname: García-Izquierdo
mesh_terms: D002055:Burnout, Professional; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D009741:Nursing Staff, Hospital / Q000523:psychology*; D017060:Patient Satisfaction; D013315:Stress, Psychological; D000078329:Workforce
keywords: Burnout, professional; Emergency nursing; Observational study; Patient satisfaction; Stress, psychological