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The association of Chinese hospital work environment with nurse burnout, job satisfaction, and intention to leave
Open accessAbstract
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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“Following the aggregation method used in similar studies (Aiken et al., 2008; Liu et al., 2012; Nantsupawat et al., 2011), we analyzed the work environment at the hospital level.”
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Wang, Q., Zhu, J., & Wu, B. (2025) · Nursing Outlook · doi:10.1016/j.outlook.2025.102390 · Cited by 2
Zaidan, J. L., de Aquino, J. M., Lima, A. D. G. T., Barros, A. C., & Silva, E. (2022) · Revista de Enfermagem Referência · doi:10.12707/rvi22017 · Cited by 2
“Neste sentido, outros estudos apontam que tanto os benefícios quanto a remu-neração são os fatores que mais influenciam a satisfação dos profissionais de enfermagem (Brayer et al., 2017; Zhang et al., 2014).”
BackgroundJaślan, D., Różańska, A., Siewierski, T., & Nowacka, A. L. (2024) · Problemy Pielęgniarstwa · doi:10.5114/ppiel.2024.139129 · Cited by 2
“…analysis conducted for the purposes of this study, an attempt was made to qualitatively assess the selected articles in terms of the following questions: For the purposes of this article, the results of occupational burnout research conducted with the use of MBI were presented (Table 1) [36-46].”
Shao, Q. (2024) · Social Science Computer Review · doi:10.1177/08944393241263825 · Cited by 2
“Existing studies show that Chinese employees in hospitals with Bianzhi usually have higher levels of job satisfaction (Shang et al., 2014; Zhang et al., 2014), and we examine this relationship in a broader occupational sphere.”
Yuliadi, H., Sumiyati, S., & Purnama, R. (2018) · Journal of Business Management Education (JBME) · doi:10.17509/jbme.v3i3.14298 · Cited by 2
Fadiga no trabalho em enfermeiras/os da estratégia saúde da família
de Almeida, L. M. W. S. (2014) · doi:10.11606/t.83.2014.tde-20022015-161019 · Cited by 2
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“53% in personnel younger than 30 years of age (7).”
BackgroundMaster's Degree Nurses: A Mixed‐Methods Study on Supply, Demand, and Utilisation
Zhuang, Z., Nong, H., Zhang, M., Guo, X., Ji, L., Deng, W., & Zhang, L. (2025) · Journal of Advanced Nursing · doi:10.1111/jan.70254 · Cited by 1
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Psychometric properties of the Granada Burnout Questionnaire applied to nurses
Sierra, J. C., la Fuente, E. D., García, J. G., Cañadas, G. A., Costas, C. S. L., Cañadas, G. R., Aguayo‐Estremera, R., de la Fuente, L., & Vargas, C. (2015) · Cited by 1
Nuraevindah, N., Sabilu, Y., & Irma, I. (2023) · Endemis Journal · doi:10.37887/ej.v3i4.37302 · Cited by 1
Utlu, N., Akar, D., Altan, H. A., Arslan, H. Ç., & Kuloğlu, E. (2024) · Sağlık Akademisi Kastamonu · doi:10.25279/sak.1102301 · Cited by 1
Pengaruh Worklife Balance Dan Kepuasan Kerja Terhadap Turnover Intention Karyawan Generasi Milenial
Sandi, H. H., & Erlin, N. A. (2023) · Journal of Comprehensive Science (JCS) · doi:10.59188/jcs.v2i3.482 · Cited by 1
Kiptulon, E. K., Szőllősi, A., Miklós, Z., & Siket, A. U. (2025) · Nursing Open · doi:10.1002/nop2.70298 · Cited by 1
“…and George 2020; Aloisio et al. 2021; Al-Surimi et al. 2022; Bellou 2010; Choi et al. 2014; Choi et al. 2013; Hayes et al. 2009; Hulkova et al. 2024; Hwang 2019; Labrague et al. 2017; Labrague et al. 2017; Park and Kim 2009; Roza et al. 2022; Tsai 2011; Widodo et al. 2021; Zhang et al. 2014).”
Body mass index and depressive symptoms among Chinese nurses: A cross-sectional study
Wang, Y., Cui, X., Lu, Y., & Fu, C. (2025) · Medicine · doi:10.1097/md.0000000000045886 · Cited by 1
“[62,63] The possible explanations for this research result may involve multiple factors, and the specific causes require further investigation to determine.”
Toling, W., Lacap, J. P., Biag, G., Cosina, M. J., Españo, L. J., Evangelista, M. I., Garcia, F. J., & Osial, R. (2021) · PREO Journal of Business and Management · doi:10.67730/467bfz84 · Cited by 1
Prevalence of Burnout Syndrome in Nursing: A Systematic Review
Andarini, E., Stefanus, S., & Kusumaningrum, T. (2018) · Cited by 1
Study and Comparison of Elderly Care System in Germany and China
Li, J. (2019) · Cited by 1
Hori, H., Orita, M., Taira, Y., Matsunaga, H., Kudo, T., & Takamura, N. (2020) · PLoS ONE · doi:10.1371/journal.pone.0236997 · Cited by 1
Nursing satisfaction in county hospitals at the closing of health system reform round
Kachie, A. D. T., & Lulin, Z. (2020) · International Journal of Scientific and Research Publications · doi:10.29322/ijsrp.10.12.2020.p10802 · Cited by 1
“However, many studies have focused on examining the extrinsic (environmental, physical, and social) factors that can influence job satisfaction (Hayes, Douglas, & Bonner, 2015; L.F. Zhang et al., 2014).”
Backgroundjanighorabn, M., & Dadkhahtehrani, T. (2021) · Nursing and Midwifery Journal · doi:10.52547/unmf.19.8.643 · Cited by 1
Professional burnout in Staff of Mental Units: The Role of Working Conditions
Papathanasiou, I. V., Tsaras, K., Christodoulou, E., Daglas, A., Κourakos, M., Kleisiaris, C. F., & Fradelos, Ε. C. (2017) · Likarska sprava · doi:10.31640/ls-2017(7)08 · Cited by 1
“These findings appear to be confirmed over time since more recent studies have come to similar results [14, 27].”
ResultEfeitos da satisfação no trabalho na qualidade de vida da equipe de enfermagem na atenção primária
Lima, R. P. (2017) · doi:10.14393/ufu.di.2017.424 · Cited by 1
Zhou, X., Chen, M., Wang, Y., Li, Q., Huang, X., & Deng, H. (2024) · Research Square · doi:10.21203/rs.3.rs-3848184/v1 · Cited by 1
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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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