Factors associated with burnout syndrome: a cross-sectional study among nurse anesthetists in Indonesia 10.55131/jphd/2023/210202

Main Article Content

Parwati P.A
Swarjana I.K
Sastamidhyani N.P.AJ
Adiana I.N


Burnout syndrome is a very common psychological problem experienced by health workers in hospitals, including doctors, anesthesiologists, and nurse anesthetists. Burnout syndrome has a serious impact on health workers' performance and the quality of services provided to patients. This study aims to determine the factors associated with burnout syndrome among nurse anesthetists in Indonesia. A cross-sectional study was conducted in Indonesia involving 405 respondents selected using cluster sampling. A questionnaire was employed for data collection. Univariate analysis (frequency and proportion) was used to measure burnout, and bivariate analysis (chi-square) and multivariate analysis (multiple logistic regression) were used to determine the factors associated with burnout syndrome. This study found that the majority of respondents had experienced low levels of burnout, particularly burnout for emotional exhaustion (EE) at 76.8% and depersonalization (DP) at 64.2%. However, a high level of personal accomplishment (PA) was reported by only 53.1% of subjects. Furthermore, workload factors (AOR: 3.75) and social support (AOR: 0.52) were significantly associated with EE. The factors of workload (AOR: 2.27), social support (AOR: 0.59) and reward (AOR: 1.66) were significantly related to DP. Social support factors (AOR: 2.84) and interpersonal relationships (AOR: 2.28) were significantly associated with PA. This study concludes that the majority of nurse anesthetists reported burnout. Therefore, workplaces need to perform occupational health surveillance for early detection of burnout and health promotion programs to prevent burnout among nurse anesthetists.   

Article Details

How to Cite
Parwati P.A, Swarjana I.K, Sastamidhyani N.P.AJ, Adiana I.N. Factors associated with burnout syndrome: a cross-sectional study among nurse anesthetists in Indonesia: 10.55131/jphd/2023/210202. J Public Hlth Dev [Internet]. 2023 Apr. 4 [cited 2024 Apr. 19];21(2):13-26. Available from: https://he01.tci-thaijo.org/index.php/AIHD-MU/article/view/262773
Original Articles
Author Biographies

Parwati P.A, Diploma IV of Nurse Anesthetist Program, Faculty of Health, Institute of Technology and Health Bali, Bali 80225, Indonesia

Diploma IV of Nurse Anesthetist Program, Faculty of Health, Institute of Technology and Health Bali, Bali 80225, Indonesia

Swarjana I.K, Master of Nursing Program, Faculty of Health, Institute of Technology and Health Bali, Bali 80225, Indonesia

Master of Nursing Program, Faculty of Health, Institute of Technology and Health Bali, Bali 80225, Indonesia

Sastamidhyani N.P.AJ, Bachelor of Nursing Program, Faculty of Health, Institute of Technology and Health Bali, Bali 80225, Indonesia

Bachelor of Nursing Program, Faculty of Health, Institute of Technology and Health Bali, Bali 80225, Indonesia

Adiana I.N, Diploma IV of Nurse Anesthetist Program, Faculty of Health, Institute of Technology and Health Bali, Bali 80225, Indonesia

Diploma IV of Nurse Anesthetist Program, Faculty of Health, Institute of Technology and Health Bali, Bali 80225, Indonesia


Vargas M, Spinelli G, Buonanno P, Iacovazzo C, Servillo G, De Simone S. Burnout Among Anesthesiologists and Intensive Care Physicians: Results From an Italian National Survey. Inquiry. 2020;57:46958020919263. doi: 10.1177/0046958020919263

Rössler W. Stress, burnout, and job dissatisfaction in mental health workers. Eur Arch Psychiatry Clin Neurosci. 2012;262 Suppl 2:S65-9. doi: 10.1007/s00406-012-0353-4

Freudenberger HJ. Staff burn‐out. J Soc Issues. 1974;30(1):159-65.

World Health Organization. Burn-out an "occupational phenomenon": International Classification of Diseases Geneva: World Health Organization [Internet]. 2019 [cited 2022 December 2]. Available from: https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases.

Slezáková Z, Vörösová G, Mičinová G. Burnout syndrome in neurological nursing. Act Nerv Super Rediviva. 2015;57(4):122-7.

Chirico F. The forgotten realm of the new and emerging psychosocial risk factors. J Occup Health. 2017;59(5):433-5.

Yosef B, Woldegerima Berhe Y, Yilkal Fentie D, Belete Getahun A. Occupational Stress among Operation Room Clinicians at Ethiopian University Hospitals. J Environ Public Health. 2022;2022:2077317. doi: 10.1155/2022/2077317

Van der Wal RAB, Wallage J, Bucx MJL. Occupational stress, burnout and personality in anesthesiologists. Curr Opin Anaesthesiol. 2018;31(3):351-6.

Kassa MW, Bedada AG. Job Satisfaction and Its Determinants among Nurse Anesthetists in Clinical Practice: The Botswana Experience. Anesthesiol Res Pract. 2021;2021:5739584.

Sanfilippo F, Noto A, Foresta G, Santonocito C, Palumbo GJ, Arcadipane A, et al. Incidence and Factors Associated with Burnout in Anesthesiology: A Systematic Review. Biomed Res Int. 2017;2017:8648925. doi: 10.1155/2017/8648925

Meeusen VC, Van Dam K, Brown-Mahoney C, Van Zundert AA, Knape HT. Understanding nurse anesthetists' intention to leave their job: how burnout and job satisfaction mediate the impact of personality and workplace characteristics. Health Care Manage Rev. 2011;36(2):155-63. doi: 10.1097/HMR.0b013e3181fb0f41

Eslava-Schmalbach J, Garzón-Orjuela N, Martínez NT, Gonzalez-Gordon L, Rosero E, Gómez-Restrepo C. Prevalence and Factors Associated with Burnout Syndrome in Colombian Anesthesiologists. Int J Prev Med. 2020;11:5. doi: 10.4103/ijpvm.IJPVM_150_18

Abedi-Gilavandi R, Talebi F, Abedi-Taleb E, Nateghi S, Khedmat L, Amini F, et al. Burnout Among Nursing Staff in Ziaeian Hospital. Mater Sociomed. 2019;31(1):10-3. doi: 10.5455/msm.2019.31.10-13

West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med. 2018;283(6):516-29. doi: 10.1111/joim.12752

Chirico F, Leiter M. Tackling stress, burnout, suicide and preventing the “great resignation” phenomenon among healthcare workers (during and after the COVID-19 pandemic) for maintaining the sustainability of healthcare systems and reaching the 2030 sustainable development goals. J Health Soc Sci. 2022:9-13.

Magnavita N, Chirico F, Sacco A. COVID-19: from hospitals to courts. Lancet. 2021;397(10284):1542. doi: 10.1016/S0140-6736(21)00472-4

Chirico F, Magnavita N. Burnout Syndrome and Meta-Analyses: Need for Evidence-Based Research in Occupational Health. Comments on Prevalence of Burnout in Medical and Surgical Residents: A Meta-Analysis. Int J Environ Res Public Health. 2020;17(3). doi: 10.3390/ijerph17030741

Rotenstein LS, Torre M, Ramos MA, Rosales RC, Guille C, Sen S, et al. Prevalence of Burnout Among Physicians: A Systematic Review. JAMA. 2018;320(11):1131-50. doi: 10.1001/jama.2018.12777

Khammar A, Dalvand S, Hashemian AH, Poursadeghiyan M, Yarmohammadi S, Babakhani J, et al. Data for the prevalence of nurses׳ burnout in Iran (a meta-analysis dataset). Data Brief. 2018;20:1779-86. doi: 10.1016/j.dib.2018.09.022

Chirico F, Afolabi AA, Ilesanmi OS, Nucera G, Ferrari G, Sacco A, et al. Prevalence, risk factors and prevention of burnout syndrome among healthcare workers: an umbrella review of systematic reviews and meta-analyses. J Health Soc Sci. 2021;6(4):465-91.

Chirico F, Crescenzo P, Sacco A, Ricco M, Ripa S, Nucera G, et al. Prevalence of burnout syndrome among Italian volunteers of the Red Cross: a cross-sectional study. Ind Health. 2021;59(2):117-27.

Nishimura Y, Miyoshi T, Hagiya H, Kosaki Y, Otsuka F. Burnout of healthcare workers amid the COVID-19 pandemic: A Japanese cross-sectional survey. Int J Environ Res Public Health. 2021;18(5):2434.

Edú-Valsania S, Laguía A, Moriano JA. Burnout: A review of theory and measurement. Int J Environ Res Public Health. 2022;19(3):1780.

Daniel WW, Cross CL. Biostatistics: a foundation for analysis in the health sciences: Wiley; 2018.

Zareei M, Tabanejad Z, Oskouie F, Ebadi A, Mesri M. Job burnout among nurses during COVID-19 pandemic: A systematic review. J Educ Health Promot. 2022;11.

Joshua Lea D, Doherty I, Reede BL, Mahoney CB. Predictors of burnout, job satisfaction, and turnover among CRNAs during COVID-19 surging. AANA journal. 2022;90(2):141.

Mahoney CB, Lea J, Schumann PL, Jillson IA. Turnover, burnout, and job satisfaction of certified registered nurse anesthetists in the United States: Role of job characteristics and personality. AANA journal. 2020;88(1):39-48.

Chiron B, Michinov E, Olivier-Chiron E, Laffon M, Rusch E. Job satisfaction, life satisfaction and burnout in French anaesthetists. J Health Psychol. 2010;15(6):948-58.

Sillero A, Zabalegui A. Organizational factors and burnout of perioperative nurses. Clin Pract Epidemiol Ment Health. 2018;14:132-42.

Alharbi AA, Dahinten VS, MacPhee M. The relationships between nurses’ work environments and emotional exhaustion, job satisfaction, and intent to leave among nurses in Saudi Arabia. J Adv Nurs. 2020;76(11):3026-38.

Magalhães E, Oliveira ÁCMdS, Govêia CS, Ladeira LCA, Queiroz DM, Vieira CV. Prevalencia del síndrome de burnout entre los anestesistas del Distrito Federal. Rev Bras Anestesiol. 2015;65(2):104-10.

Dall’Ora C, Ball J, Reinius M, Griffiths P. Burnout in nursing: a theoretical review. Hum Resour Health. 2020;18(1):1-17.

Vanchapo AR. Beban kerja dan stres kerja. Jawa Timur: Penerbit Qiara Media; 2020.

Phillips C. Relationships between workload perception, burnout, and intent to leave among medical–surgical nurses. JBI Evidence Implementation. 2020;18(2):265-73.

Lrago T, Asefa F, Yitbarek K. Physicians' burnout and factors in southern Ethiopia affecting it. Ethiop J Health Sci. 2018;28(5):589-98.

Sonpaveerawong J, Limmun W, Chuwichian N. Prevalence of psychological distress and mental health problems among the survivors in the flash floods and landslide in Southern Thailand. Walailak J Sci Technol. 2019;16(4):255-64.

Fernandez A, Black J, Jones M, Wilson L, Salvador-Carulla L, Astell-Burt T, et al. Flooding and mental health: A systematic mapping review. PlOS ONE. 2015;10(4):e0119929.

Chang HE, Cho SH. The influence of social support on the relationship between emotional demands and health of hospital nurses: A cross-sectional study. Healthcare. 2021;9(2):1-13.

Shrestha MV, Manandhar N, Joshi SK. Burnout among healthcare professionals in Nepal: an analytical study. Int J Occup Saf Health. 2021;11(2):89-94.

Sussman D, Paul JE. The impact of transitioning from a 24-hour to a 16-hour call model amongst a cohort of canadian anesthesia residents at McMaster University–a survey study. Adv Medical Educ Pract. 2015;6:501-6.

Fradelos E, Mpelegrinos S, Mparo C, Vassilopoulou C, Argyrou P, Tsironi M, et al. Burnout syndrome impacts on quality of life in nursing professionals: The contribution of perceived social support. Progress in Health Sciences. 2014;4(1):102-9.

Adriaenssens J, De Gucht V, Maes S. Causes and consequences of occupational stress in emergency nurses, a longitudinal study. J Nurs Manag. 2015;23(3):346-58.

Velando‐Soriano A, Ortega‐Campos E, Gómez‐Urquiza JL, Ramírez‐Baena L, De La Fuente EI, Cañadas‐De La Fuente GA. Impact of social support in preventing burnout syndrome in nurses: A systematic review. Jpn J Nurs Sci. 2020;17(1):e12269.

Choowichian N, Thapinta D, Sethabouppha H, Thungjaroenkul P. Factors predicting stress among nurses in the situation of unrest of the four southern border provinces of Thailand. Walailak J Sci Technol. 2020;17(3):269-84.

Roomaney R, Steenkamp J, Kagee A. Predictors of burnout among HIV nurses in the Western Cape. Curationis. 2017;40(1):1-9.

Vania L, Purba SD. Pengaruh job satisfaction terhadap organizational citizenship behavior (OCB) dengan organizational commitment sebagai variabel intervening pada Rumah Sakit Pantai Indah Kapuk di Jakarta. Jurnal Manajemen. 2014;11(2):99-119.

Chirico F, Sacco A, Ferrari G. Total Worker Health” strategy to tackle the COVID-19 pandemic and future challenges in the workplace. J Health Soc Sci. 2021;6(4):452-7.

Acquadro Maran D, Capitanelli I, Cortese CG, Ilesanmi OS, Gianino MM, Chirico F. Animal-Assisted Intervention and Health Care Workers’ Psychological Health: A Systematic Review of the Literature. Animals. 2022;12(3):383.

Chirico F. Spirituality to cope with COVID-19 pandemic, climate change and future global challenges. J Health Soc Sci. 2021;6(2):151-8.