title: Perceived Nonbeneficial Treatment of Patients, Burnout, and Intention to Leave the Job Among ICU Nurses and Junior and Senior Physicians.
abstract: OBJECTIVE
  Perceiving nonbeneficial treatment is stressful for ICU staff and may be associated with burnout. We aimed to investigate predictors and consequences of perceived nonbeneficial treatment and to compare nurses and junior and senior physicians.
  
  
  METHODS
  Cross-sectional, multicenter paper-pencil survey on personal and work-related characteristics, perceived nonbeneficial treatment, burnout, and intention to leave the job.
  
  
  METHODS
  Convenience sample of 23 German ICUs.
  
  
  METHODS
  ICU nurses and physicians.
  
  
  METHODS
  None.
  
  
  RESULTS
  A total of 847 questionnaires were returned (51% response); 778 had complete data for final multivariate analyses. Nonbeneficial treatment was in median perceived "sometimes." Adjusted for covariates, it was perceived more often by nurses and junior physicians (both p ≤ 0.001 in comparison to senior physicians), while emotional exhaustion was highest in junior physicians (p ≤ 0.015 in comparison to senior physicians and nurses), who also had a higher intention to leave than nurses (p = 0.024). Nonbeneficial treatment was predicted by high workload and low quality collaboration with other departments (both p ≤ 0.001). Poor nurse-physician collaboration predicted perception of nonbeneficial treatment among junior physicians and nurses (both p ≤ 0.001) but not among senior physicians (p = 0.753). Nonbeneficial treatment was independently associated with the core burnout dimension emotional exhaustion (p ≤ 0.001), which significantly mediated the effect between nonbeneficial treatment and intention to leave (indirect effect: 0.11 [95% CI, 0.06-0.18]).
  
  
  CONCLUSIONS
  Perceiving nonbeneficial treatment is related to burnout and may increase intention to leave. Efforts to reduce perception of nonbeneficial treatment should improve the work environment and should be tailored to the different experiences of nurses and junior and senior physicians.
authors: 1Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany. 2Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany. 3Department of Work and Organizational Psychology, Helmut Schmidt University, Hamburg, Germany.
authors: Daniel
authors: D
authors: Schwarzkopf
authors: Hendrik
authors: H
authors: Rüddel
authors: Daniel O
authors: DO
authors: Thomas-Rüddel
authors: Jörg
authors: J
authors: Felfe
authors: Bernhard
authors: B
authors: Poidinger
authors: Claudia T
authors: CT
authors: Matthäus-Krämer
authors: Christiane S
authors: CS
authors: Hartog
authors: Frank
authors: F
authors: Bloos
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000209:etiology*; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D033182:Intention; D033183:Interdisciplinary Communication; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010465:Perception; D010563:Personnel Turnover; D019555:Physician-Nurse Relations; D011795:Surveys and Questionnaires; D019564:Unnecessary Procedures / Q000523:psychology*; D016526:Workload