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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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Citations
Cites
Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction
Aiken, L. H. (2002) · JAMA · doi:10.1001/jama.288.16.1987 · Cited by 5,226
Champion, D. F., & Westbrook, B. W. (1984) · Measurement and Evaluation in Counseling and Development · doi:10.1080/07481756.1984.12022754 · Cited by 2,389
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Development of the practice environment scale of the nursing work index†‡
Lake, E. T. (2002) · Research in Nursing & Health · doi:10.1002/nur.10032 · Cited by 1,769 · cited 1×
“Higher scores indicate agreement that the item is present in the environment, which means a better work environment, and the mean subscale scores are derived by averaging item means for each subscale (Lake, 2002).”
MethodNurses’ Reports On Hospital Care In Five Countries
Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J. A., Busse, R., Clarke, H. F., Giovannetti, P., Hunt, J., Rafferty, A. M., & Shamian, J. (2001) · Health Affairs · doi:10.1377/hlthaff.20.3.43 · Cited by 1,623 · cited 2×
“In this study, 5.1% of nurses expressed an intention to leave their present job in the next 12 months, which was much lower than the findings in Western countries (Aiken et al., 2001) although contract nurses were more likely to report an intention to leave compared with bianzhi nurses.”
BackgroundResultInfluentialEffects of Hospital Care Environment on Patient Mortality and Nurse Outcomes
Aiken, L. H., Clarke, S. P., Sloane, D. M., Lake, E. T., & Cheney, T. (2008) · JONA: The Journal of Nursing Administration · doi:10.1097/01.nna.0000312773.42352.d7 · Cited by 860 · cited 3×
“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.”
BackgroundMethodEffects of Hospital Care Environment on Patient Mortality and Nurse Outcomes
Aiken, L. H., Clarke, S. P., Sloane, D. M., Lake, E. T., & Cheney, T. (2009) · JONA The Journal of Nursing Administration · doi:10.1097/nna.0b013e3181aeb4cf · Cited by 799
McHugh, M. D., Kutney-Lee, A. M., Cimiotti, J. P., Sloane, D. M., & Aiken, L. H. (2011) · Health Affairs · doi:10.1377/hlthaff.2010.0100 · Cited by 772 · cited 1×
“…with salary and benefits, more than one half of the nurses reported dissatisfaction with their professional status, which was much higher than the reports in the United States, where only 17% of bedside nurses in hospitals indicated dissatisfaction with professional status (McHugh et al., 2011).”
ResultNurse burnout and quality of care: Cross‐national investigation in six countries
Poghosyan, L., Clarke, S. P., Finlayson, M., & Aiken, L. H. (2010) · Research in Nursing & Health · doi:10.1002/nur.20383 · Cited by 574
Importance of work environments on hospital outcomes in nine countries
Aiken, L. H., Sloane, D. M., Clarke, S. P., Poghosyan, L., Cho, E., You, L., Finlayson, C. M., Kanai‐Pak, M., & Aungsuroch, Y. (2011) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzr022 · Cited by 465 · cited 16×
“In this study, work environment was positively related to nursing outcomes, which is consistent with the studies in other countries (Aiken et al., 2011; Van Bogaert et al., 2010).”
BackgroundResultInfluentialSelf-citation
Research works printed but not linked: 2
- Gu, 2011, The human resource crisis in the field of Chinese medicine (in Chinese), Journal of China National School of Administration, 6, 17
- Xun, 2011, A Study on the nurse work environment and intention to leave (in Chinese), Chinese Journal of Practical Nursing, 27, 64
Cited by
Sorted by citations
Burnout in nursing: a theoretical review.
Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020) · Human Resources for Health · doi:10.1186/s12960-020-00469-9 · Cited by 1,181
Job satisfaction among hospital nurses: A literature review
Lu, H. S., Zhao, Y., & While, A. (2019) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2019.01.011 · Cited by 681
Lake, E. T., Sanders, J., Duan, R., Riman, K. A., Schoenauer, K. M., & Chen, Y. (2019) · Medical Care · doi:10.1097/mlr.0000000000001109 · Cited by 424
Ramírez-Elvira, S., Romero-Béjar, J. L., Suleiman-Martos, N., Gómez-Urquiza, J. L., Monsalve-Reyes, C., Cañadas-De la Fuente, G. A., & Albendín-García, L. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182111432 · Cited by 267
“Other authors also found that an improvement in salary [48] leads to improved motivation [49]; as a consequence, job satisfaction increases, and professionals are less prone to suffer burnout syndrome [50].”
BackgroundWang, H., Jin, Y., Wang, D., Zhao, S., Sang, X., & Yuan, B. (2020) · BMC Family Practice · doi:10.1186/s12875-020-1083-8 · Cited by 208
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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