title: Burnout mediates the association between depression and patient safety perceptions: a cross-sectional study in hospital nurses.
abstract: OBJECTIVE
  The aim of this study was to investigate the relationships between depressive symptoms, burnout and perceptions of patient safety. A mediation model was proposed whereby the association between symptoms of depression and patient safety perceptions was mediated by burnout.
  
  
  BACKGROUND
  There is growing interest in the relationships between depressive symptoms and burnout in healthcare staff and the safety of patient care. Depressive symptoms are higher in healthcare staff than the general population and overlap conceptually with burnout. However, minimal research has investigated these variables in nurses. Given the conceptual overlap between depressive symptoms and burnout, there is also a need for an explanatory model outlining the relative contributions of these factors to patient safety.
  
  
  METHODS
  A cross-sectional questionnaire was distributed at three acute NHS Trusts.
  
  
  METHODS
  Three-hundred and twenty-three hospital nursing staff completed measures of depressive symptoms, burnout and patient safety perceptions (including measures at the level of the individual and the work area/unit) between December 2015 - February 2016.
  
  
  RESULTS
  When tested in separate analyses, depressive symptoms and burnout facets were each associated with both patient safety measures. Furthermore, the proposed mediation model was supported, with associations between depressive symptoms and patient safety perceptions fully mediated by burnout.
  
  
  CONCLUSIONS
  These results suggest that symptoms of depression and burnout in hospital nurses may have implications for patient safety. However, interventions to improve patient safety may be best targeted at improving burnout in particular, with burnout interventions known to be most effective when focused at both the individual and the organisational level.
authors.affiliation: School of Psychology, University of Leeds, UK.|Bradford Institute for Health Research, Bradford Royal Infirmary, UK.
authors.forename: Judith
authors.identifier: http://orcid.org/0000-0003-0431-013X
authors.initials: J
authors.lastname: Johnson
authors.affiliation: Bradford Institute for Health Research, Bradford Royal Infirmary, UK.
authors.forename: Gemma
authors.initials: G
authors.lastname: Louch
authors.affiliation: School of Psychology, University of Leeds, UK.
authors.forename: Alice
authors.initials: A
authors.lastname: Dunning
authors.affiliation: School of Psychology, University of Leeds, UK.
authors.forename: Olivia
authors.initials: O
authors.lastname: Johnson
authors.affiliation: Bradford Institute for Health Research, Bradford Royal Infirmary, UK.
authors.forename: Angela
authors.initials: A
authors.lastname: Grange
authors.affiliation: Bradford Institute for Health Research, Bradford Royal Infirmary, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Reynolds
authors.affiliation: School of Psychology, University of Leeds, UK.|Bradford Institute for Health Research, Bradford Royal Infirmary, UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Hall
authors.affiliation: Bradford Institute for Health Research, Bradford Royal Infirmary, UK.|Leeds Institute of Medical Education, University of Leeds, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: O'Hara
mesh_terms: D002055:Burnout, Professional; D003430:Cross-Sectional Studies; D006801:Humans; D009741:Nursing Staff, Hospital / Q000523:psychology*; D061214:Patient Safety; D006113:United Kingdom
keywords: burnout; health care; nursing; patient safety; workforce issues