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The association of Chinese hospital work environment with nurse burnout, job satisfaction, and intention to leave
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The purpose of this study was to describe nurse burnout, job satisfaction, and intention to leave and to explore the relationship of work environment to nursing outcomes in a sample of 9,698 nurses from 181 hospitals in China. Nurses reported moderate levels of emotional exhaustion and depersonalization and high levels of reduced personal accomplishment. Nearly one-fifth of the nurses reported high levels of burnout on all three dimensions. Forty-five percent of the nurses were dissatisfied with their current job; these nurses were most dissatisfied with their salary. Five percent of nurses reported an intention to leave. Nurses reporting mixed and good work environments were less likely to report high burnout, job dissatisfaction, and intention to leave compared with those in poor work environments. The results suggest that high burnout and low job satisfaction are prominent problems for Chinese nurses, and improving work environment might be an effective strategy for better nursing outcomes in Chinese hospitals.
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“only one study concluded there is an association between work environment and all MBI dimensions [95]”
From Burnout in nursing: a theoretical review. (2020) · cites this paper as [95]
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“However, the literature suggests that the relationship between length of service (tenure) and turnover is complex, because of possible confounding factors such as context, work environment, experience, and age (4, 13, 17, 25, 29, 42, 43, 45).”
BackgroundResultDing, X., Yang, Y., Su, D., Zhang, T., Li, L., & Li, H. (2018) · The International Journal of Occupational and Environmental Medicine · doi:10.15171/ijoem.2018.1176 · Cited by 28
“Recent studies have shown that nurses' turnover intention is high.(21) Therefore, “how to enhance nurses' job satisfaction in order to reduce possible turnover” is a big question to focus on.”
BackgroundNurses’ turnover intention in secondary hospitals in China: A structural equation modelling approach
Zhang, Y., Zhang, X., Xu, N., & Eun-Kyoung, Y. (2021) · Journal of Nursing Management · doi:10.1111/jonm.13379 · Cited by 34
“According to Zhang et al. (2014), many experienced Chinese nurses with a high educational background were very dissatisfied with their job, as they reported that their value was not fully reflected and their performance was not properly evaluated, which then led to turnover.”
BackgroundUzuntarla, Y., BAYER, N., Gölbaşı, Z., & Akarsu, K. (2021) · Journal of Clinical Medicine of Kazakhstan · doi:10.23950/jcmk/11347 · Cited by 28
“In a study, it was found that 45% of nurses were not satisfied with their current job because of their salaries [32].”
BackgroundNurse turnover research in China: A bibliometric analysis from 2000 to 2015
Lyu, L., Li, G., Li, J., & Li, M. (2016) · International Journal of Nursing Sciences · doi:10.1016/j.ijnss.2016.04.008 · Cited by 27
Alsufyani, A. M., Almalki, K. E., Alsufyani, Y., Aljuaid, S. M., Almutairi, A. M., Alsufyani, B. O., Alshahrani, A., Baker, O. G., & Aboshaiqah, A. E. (2021) · PeerJ · doi:10.7717/peerj.10949 · Cited by 27
Labor conditions and the meanings of nursing work in Barcelona
Lázaro, A. G., Ribas, J. M. B. I., & Ochoa, P. (2018) · Revista Latino-Americana de Enfermagem · doi:10.1590/1518-8345.2342.2947 · Cited by 27
“The vision provided by the participants is also consistent with what the literature reports regarding the dark side of the characteristics and tendencies of working conditions in general, both for their psychosocial risk factors(16-18) and because of the lack of wellbeing in health care work(5-7,10-12,26-27,30-31).”
ResultYoo, H. J., Suh, E. E., Lee, S. H., Hwang, J. H., & Kwon, J. H. (2018) · Asian Nursing Research · doi:10.1016/j.anr.2018.02.005 · Cited by 26
Cui, N., Wang, R., Song, F., & Jin, J. (2021) · Nurse Education in Practice · doi:10.1016/j.nepr.2021.102996 · Cited by 26
Job satisfaction of the nursing team in intensive care units
Teruya, K. Y., de Souza, A. C., & Guirardello, E. D. B. (2019) · Revista Latino-Americana de Enfermagem · doi:10.1590/1518-8345.3168.3182 · Cited by 25
“Benefits and salary compensations are the factors that most influence the satisfaction of nursing professionals(2), followed by workload, recognition, institutional incentive(3-4), autonomy, and respect of the colleagues(5).”
BackgroundDo preceptorship and clinical supervision programmes support the retention of nurses?
Aparício, C., & Nicholson, J. (2020) · British Journal of Nursing · doi:10.12968/bjon.2020.29.20.1192 · Cited by 26
Impact of satisfactions with psychological reward and pay on Chinese nurses' work attitudes
Chen, F., Yang, M., Gao, W., Liu, Y., & Gieter, S. D. (2015) · Applied Nursing Research · doi:10.1016/j.apnr.2015.03.002 · Cited by 24
Zhang, C., Hu, L., Ma, J., Wu, S., Guo, J., & Liu, Y. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-023756 · Cited by 24
Perng, S., Sung, H., Chen, C., Lee, T.-Y., & Koo, M. (2019) · Nurse Education Today · doi:10.1016/j.nedt.2019.104241 · Cited by 23
Exploring Global Research Trends in Burnout among Nursing Professionals: A Bibliometric Analysis
de Oliveira, D. G., Reis, A. D. C., Franco, I. D. M., & Braga, A. L. (2021) · Healthcare · doi:10.3390/healthcare9121680 · Cited by 31
Zhu, Y., Zhang, Y., Wong, F. K. Y., Kuo, S., Cheung, K., Lam, M. C. H., Sophia Huey-Lan, H. U., Fang, Z., & Zhang, Y. (2022) · Journal of Nursing Management · doi:10.1111/jonm.13801 · Cited by 22
Validation of Psychometric Properties of the Nursing Work Index—Revised Scale in Portugal
Anunciada, S., Benito, P., Gaspar, F., & Lucas, P. R. M. B. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19094933 · Cited by 23
Kiptulon, E. K., Elmadani, M., Szőllősi, A., Zrínyi, M., & Siket, A. U. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-13365-6 · Cited by 30
Li, Y., Yumeng, C., Chunfen, Z., & Jinbo, F. (2020) · Workplace Health & Safety · doi:10.1177/2165079919900796 · Cited by 22
Registered nurses’ role experiences of caring for older stroke patients: a qualitative study
Cheng, W., Tu, J., & Shen, X. (2021) · BMC Nursing · doi:10.1186/s12912-021-00626-y · Cited by 21
Creating positive practice environments in a primary health care setting
Rabie, T., Klopper, H. C., & Coetzee, S. K. (2017) · International Journal of Nursing Practice · doi:10.1111/ijn.12555 · Cited by 21
Trigo, T. R., Freitas, C. C. S. D., Wang, Y.-P., Ribeiro, F. G., de Lucia, M. C. S., Siqueira, J. O., Iosifescu, D. V., Hallak, J. E. C., & Fraguas, R. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00695 · Cited by 21
Ebrahimzade, N., Mooghali, A., Lankarani, K. B., & Sadati, A. K. (2015) · Shiraz E-Medical Journal · doi:10.17795/semj27070 · Cited by 20
“This result is compatible with previous findings (37, 38).”
Acosta-Ramos, S., Ramírez-Martínez, F. R., Manríquez, I. R., Galindo-Odilon, M., Estrada-Esparza, S. Y., Trejo-Franco, J., & Flores-Padilla, L. (2021) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2021.07.002 · Cited by 21
Psychosocial factors associated with career success among nurses: A latent profile analysis.
Zhang, Y.-L., An, Y., Wang, L., Zhao, Q.-G., Li, H.-Y., & Fan, X.-Z. (2022) · Journal of Advanced Nursing · doi:10.1111/jan.15524 · Cited by 18
Metadata
- Authors
- Zhang, L.-F., You, L.-M., Liu, K., Zheng, J., Fang, J.-B., Lu, M.-M., Lv, A.-L., Ma, W.-G., Wang, J., Wang, S.-H., Wu, X., Zhu, X.-W., & Bu, X.-Q.
- Affiliations
- Sun Yat-sen University (CN)
- China Medical University (CN)
- Peking University (CN)
- Venue
- Nursing Outlook
- Publisher
- Elsevier BV
- Published
- 2014-03
- Volume
- 62
- Issue
- 2
- Pages
- 128-137
- ISSN
- 0029-6554 (ISSN-L)
- PMC
- PMC3959248
- OpenAlex
- W2086028708
- Cited by
- 228
- References
- 35
- Citations by year
- 2026: 6 · 2025: 13 · 2024: 11 · 2023: 15 · 2022: 17 · 2021: 34 · 2020: 31 · 2019: 29 · 2018: 18 · 2017: 20 · 2016: 13 · 2015: 17 · 2014: 4
- FWCI
- 33.42
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Nursing Outlook (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- China Medical Board (R01NR004513)
- European Commission
- National Institute of Nursing Research (R01NR004513)
- Topics
- Health Sciences › Nursing › Research and Theory › Nursing education and management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Burnout
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Keywords
- nurse burnout, job satisfaction, turnover intention, work environment, emotional exhaustion, depersonalization, personal accomplishment, salary dissatisfaction, Chinese nurses, hospital nursing workforce
- MeSH terms
- Adolescent, Adult, Burnout, Professional, China, Female, Humans, Job Satisfaction, Male, Middle Aged, Nursing Staff, Hospital, Personnel Turnover, Retrospective Studies, Salaries and Fringe Benefits, Stress, Psychological, Workplace, Young Adult
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