Cross-Cultural Comparison of Burnout, Insomnia and Turnover Intention Among Nurses in Eastern and Western Cultures During the COVID-19 Pandemic: Protective and Risk Factors

Overview

Journal Nurs Rep

Publisher MDPI

Specialty Nursing

Date 2025 Feb 25

PMID 39997788

Authors

Eveline Frey

Yuen-Yu Chong

Wai-Tong Chien

Andrew T Gloster

Affiliations

Soon will be listed here.

Abstract

: The COVID-19 pandemic has adversely impacted the mental health of nurses worldwide. Nurse burnout results from chronic workplace stress and is characterized by exhaustion, negative or cynical feelings about work, and a diminished sense of accomplishment. This can lead to turnover intention. Therefore, psychological capacities, such as psychological flexibility, that could help nurses regulate and minimize the impact should be studied. This study aimed to compare burnout, insomnia and turnover intention among nurses from an Eastern and Western cultural context and to investigate the role of psychological flexibility as a protective factor against mental health and related problems such as insomnia and turnover intention. : Nurses from Hong Kong (n = 158) and Switzerland (n = 294) involved in patient care during the COVID-19 pandemic participated in an online mental health survey. : We observed high levels of burnout, subthreshold insomnia and turnover intention in nurses from both Switzerland and Hong Kong, with higher burnout rates among Hong Kong nurses and higher turnover intentions among nurses from Switzerland, and that psychological flexibility is a crucial factor that may protect nurses from burnout and insomnia. : The nurses from both regions involved in patient care one year after the onset of the pandemic suffered from poor mental health. Psychological flexibility was identified as a critical factor in improving nurses' mental health. The results of this study should be incorporated into health promotions for nursing professionals and help develop specific and effective interventions for practical nursing application.

References

Frogeli E, Djordjevic A, Rudman A, Livheim F, Gustavsson P . A randomized controlled pilot trial of acceptance and commitment training (ACT) for preventing stress-related ill health among future nurses. Anxiety Stress Coping. 2015; 29(2):202-18. DOI: 10.1080/10615806.2015.1025765. View

Wu F, Lao Y, Feng Y, Zhu J, Zhang Y, Li L . Worldwide prevalence and associated factors of nursing staff turnover: A systematic review and meta-analysis. Nurs Open. 2024; 11(1):e2097. PMC: 10802134. DOI: 10.1002/nop2.2097. View

Lam H, Lau C, Wong C, Lee K, Yip S, Tsang K . A review of epidemiology and public health control measures of COVID-19 variants in Hong Kong, December 2020 to June 2021. IJID Reg. 2022; 2:16-24. PMC: 8590504. DOI: 10.1016/j.ijregi.2021.11.002. View

Fish J, Sharplin G, Wang L, An Y, Fan X, Eckert M . Cross-cultural differences in nurse burnout and the relationship with patient safety: An East-West comparative study. J Adv Nurs. 2021; 78(4):1001-1011. DOI: 10.1111/jan.15024. View

Khajuria A, Tomaszewski W, Liu Z, Chen J, Mehdian R, Fleming S . Workplace factors associated with mental health of healthcare workers during the COVID-19 pandemic: an international cross-sectional study. BMC Health Serv Res. 2021; 21(1):262. PMC: 7981382. DOI: 10.1186/s12913-021-06279-6. View

Gloster A, Lamnisos D, Lubenko J, Presti G, Squatrito V, Constantinou M . Impact of COVID-19 pandemic on mental health: An international study. PLoS One. 2020; 15(12):e0244809. PMC: 7774914. DOI: 10.1371/journal.pone.0244809. View

Luo H, Yao H, Xi Y, Zhang Z, Li J, Li J . Protective and Risk Factors for Medical and Nursing Staff Suffering From Psychological Symptoms During COVID-19. Front Psychol. 2021; 12:603553. PMC: 8086510. DOI: 10.3389/fpsyg.2021.603553. View

Woo T, Ho R, Tang A, Tam W . Global prevalence of burnout symptoms among nurses: A systematic review and meta-analysis. J Psychiatr Res. 2020; 123:9-20. DOI: 10.1016/j.jpsychires.2019.12.015. View

Daryanti Saragih I, Tonapa S, Saragih I, Advani S, Batubara S, Suarilah I . Global prevalence of mental health problems among healthcare workers during the Covid-19 pandemic: A systematic review and meta-analysis. Int J Nurs Stud. 2021; 121:104002. PMC: 9701545. DOI: 10.1016/j.ijnurstu.2021.104002. View

10.

Lee S, Dahinten S, MacPhee M . Psychometric evaluation of the McCloskey/Mueller Satisfaction Scale. Jpn J Nurs Sci. 2016; 13(4):487-495. DOI: 10.1111/jjns.12128. View

11.

Lu H, While A, Barriball K . Job satisfaction among nurses: a literature review. Int J Nurs Stud. 2005; 42(2):211-27. DOI: 10.1016/j.ijnurstu.2004.09.003. View

12.

Leiter M, Maslach C . Nurse turnover: the mediating role of burnout. J Nurs Manag. 2009; 17(3):331-9. DOI: 10.1111/j.1365-2834.2009.01004.x. View

13.

Chong M, Wang W, Hsieh W, Lee C, Chiu N, Yeh W . Psychological impact of severe acute respiratory syndrome on health workers in a tertiary hospital. Br J Psychiatry. 2004; 185:127-33. DOI: 10.1192/bjp.185.2.127. View

14.

Sarabia-Cobo C, Perez V, de Lorena P, Fernandez-Rodriguez A, Gonzalez-Lopez J, Gonzalez-Vaca J . Burnout, Compassion Fatigue and Psychological Flexibility among Geriatric Nurses: A Multicenter Study in Spain. Int J Environ Res Public Health. 2021; 18(14). PMC: 8305508. DOI: 10.3390/ijerph18147560. View

15.

Guo Y, Plummer V, Lam L, Wang Y, Cross W, Zhang J . The effects of resilience and turnover intention on nurses' burnout: Findings from a comparative cross-sectional study. J Clin Nurs. 2018; 28(3-4):499-508. DOI: 10.1111/jocn.14637. View

16.

Chong Y, Chien W, Cheng H, Kassianos A, Gloster A, Karekla M . Can psychological flexibility and prosociality mitigate illness perceptions toward COVID-19 on mental health? A cross-sectional study among Hong Kong adults. Global Health. 2021; 17(1):43. PMC: 8027974. DOI: 10.1186/s12992-021-00692-6. View

17.

Maslach C, Schaufeli W, Leiter M . Job burnout. Annu Rev Psychol. 2001; 52:397-422. DOI: 10.1146/annurev.psych.52.1.397. View

18.

Gloster A, Rinner M, Meyer A . Increasing prosocial behavior and decreasing selfishness in the lab and everyday life. Sci Rep. 2020; 10(1):21220. PMC: 7718232. DOI: 10.1038/s41598-020-78251-z. View

19.

Huang J, Han M, Luo T, Ren A, Zhou X . [Mental health survey of medical staff in a tertiary infectious disease hospital for COVID-19]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2020; 38(3):192-195. DOI: 10.3760/cma.j.cn121094-20200219-00063. View

20.

Lv Q, Zhou W, Kong Y, Chen S, Xu B, Zhu F . Influencing factors of sleep disorders and sleep quality in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Nurs Open. 2023; 10(9):5887-5899. PMC: 10415978. DOI: 10.1002/nop2.1871. View