High Burnout Research Articles

Burnout profiles among esports players: Associations with mental toughness and resilience

ABSTRACT The present study investigated burnout among esports players and its association with mental toughness and resilience. Esports players (N = 453; Mage = 23.0, SD = 4.18; in the top 40% of in-game rank) from seven team-based esports completed the Athlete Burnout Scale (ABO-S), Mental Toughness Questionnaire 18 (MTQ-18), and the Connor-Davidson Resilience Scale (CD-RISC-10). Latent profile analysis identified three distinct burnout profiles: “low burnout risk” (LBR; 33.8%), “medium burnout risk” (MBR; 28.0%), and “high burnout risk” (HBR; 38.3%). Low burnout profiles were associated with higher mental toughness and resilience. The LBR profile was characterized by low levels of reduced accomplishment (RA), physical exhaustion (PE), and negative feelings (NF), while [MBR and HBR reported similar PE and NF scores but] differed in RA, with HBR showing the highest RA and total burnout. This study is the first to show distinct burnout profiles among esports players, indicating a significant prevalence of burnout symptoms. This should be monitored by both players and support staff (e.g. club managers, programme managers, and high-performance support staff). Additionally, mental toughness and resilience appear to play a protective role against burnout.

Burnout and Quality of Life: A Cross-Sectional Study of Dental Clinic Employees at Dent Smile Jakarta

Quality of life is an individual's assessment of their life, which can be influenced by burnout. Burnout is a work-related stress syndrome characterized by emotional exhaustion, a sense of low achievement, and depersonalization. This condition can negatively impact the quality of service, performance, and overall health of clinic employees. The objective of this study is to examine the relationship between burnout and quality of life among employees at the Dent Smile Dental Clinic in Jakarta. The research design employed is a descriptive correlational method with a cross-sectional approach. The sampling technique utilized is purposive sampling. The study's findings indicate that among the 60 employees at the Dent Smile Dental Clinic in Jakarta, 19 employees (31.7%) exhibited low levels of burnout, 17 employees (28.3%) displayed moderate burnout, 10 employees (16.7%) experienced relatively high burnout, and 14 employees (23.3%) were categorized as having high burnout. Meanwhile, 38 employees (63.3%) were found to have a moderate quality of life, 10 employees (16.7%) had a high quality of life, and 12 employees (20%) had a very high quality of life. Data analysis using the Chi-square test revealed no significant relationship between burnout and quality of life among employees at the Dent Smile Dental Clinic in Jakarta (p = 0.633). It is recommended that future research explore other factors influencing burnout, such as length of service, age, and gender.

Exploring how starting work during COVID-19 impacted post-foundation career decisions of new doctors: a mixed methods study

ObjectivesThis study addressed two research questions: What factors do doctors in training describe as influencing their choices to apply (or not apply) for specialty training during their Foundation Year 2?...

Burnout experience among healthcare workers post third COVID-19 wave in India; findings of a cross-sectional study

Background The pandemic exacerbated burnout experienced by healthcare personnel, whose mental health had long been a public health concern before COVID-19. This study used the Copenhagen burnout inventory (CBI) tool to assess burnout and identify predictors among Indian healthcare workers managing COVID-19. Methods A cross-sectional study was conducted from June to December 2022, after the third pandemic wave. A web-based, fillable Google form was used to recruit COVID-19 management professionals from multiple Jaipur district hospitals. Healthcare professionals provided socio-demographic, work-related, and CBI scores. Multiple linear regression was used to control for model covariant independent variables. Results We evaluated the responses of a total of 578 participants with a mean age of 36.59 ± 9.1 years. Based on the CBI cut-off score of 50, 68.1% reported burnout. A total of 67.5%, 56.4%, and 48.6% of healthcare workers reported work-related, personal, and patient-related burnout, respectively. High burnout scores were significantly associated with the nursing profession (β = 7.89, 95% CI; 3.66, 12.11, p < 0.0001). The p-value indicates the probability of observing the data if the null hypothesis is true, and the confidence interval shows the range within which we can be 95% confident that the true effect lies. An independent relationship exists between male gender and higher personal-related burnout scores (β = 4.45, 95% CI 1.9–6.9). Conclusion This study identified key indicators that need further emphasis and the need for organizational and individual-level burnout monitoring in healthcare delivery sectors. Health workers continue to experience burnout due to a combination of personal, professional, and patient-related factors. This underscores the need for targeted organizational and individual interventions. The findings also suggest that the CBI tool could identify healthcare worker burnout risk groups.

Burnout and resilience among physical therapy students: a cross-sectional study.

This study aimed to examine the prevalence of burnout, determine burnout-related factors, investigate resilience levels, and assess the relationship between burnout and resilience among physical therapy (PT) students at King Saud University (KSU) in Saudi Arabia. This cross-sectional study involved 153 PT students studying at KSU between January and March 2023. The participants completed an online questionnaire, a Maslach Burnout Inventory, and a Brief Resilience Scale. Low-to-moderate levels of Emotional Exhaustion (EE) were observed in 85% of the participants and high Depersonalization (DP) levels were reported by 34.2%. Female participants reported higher levels of EE and DP, whereas males had a greater prevalence of low Personal Achievement (PA) levels. Approximately 6.5% of the study participants reported high burnout levels (a combination of high DP, high EE, and low PA). Academic stress, followed by sleeping difficulties and changes in the academic year structure, were the most important factors contributing to higher levels of burnout (75.2%, 56.9%, and 43.8%, respectively). Most study participants around (66.0%) reported normal resilience levels. A significant correlation was detected between resilience and 2 domains of burnout (DP and PA), with the correlation being negative and weak for DP and positive and moderate for PA. Overall, low-to-moderate levels of burnout were observed among the PT students who took part. Related factors that contributed to burnout were academic stress, sleeping difficulties, and academic year structure. A normal level of resilience was found to be significantly related to DP and PA but not to EE on the burnout subscales. Higher levels of resilience can be considered to play a protective role against burnout among PT students. Med Pr Work Health Saf. 2024;75(4):343-354.

Less than full-time training, barriers and future needs. A UK-wide online survey of doctors in training.

The the current views of less-than full-time (LTFT) training by both LTFT and full-time (FT) doctors in training, with regards to health and well-being, clinical and non-clinical opportunities, in addition to associated future workforce implications and challenges, are uncertain. We performed a cross-sectional study of UK-based doctors in training via an online questionnaire, designed and piloted by the Royal College of Physicians Edinburgh (RCPE) Trainees and Members Committee. Design was informed by prior investigation into LTFT training undertaken amongst similar populations by RCPE in 2019. The survey was distributed from May to September 2023 via email to trainees across the United Kingdom and was open to all specialties and training grades. The survey focused on lived experience of both LTFT and FT training, as well as perceived challenges for the future workforce. There were 648 responses from doctors in training across the United Kingdom, with an even spread of LTFT and FT trainees. Most responses (53%) were from trainees in medical specialties. Most LTFT trainees plan to train at this pace for more than 5 years. LTFT was commonly linked to improved work-life balance and well-being, with FT training perceived to feature high stress and burnout. Concerns around LTFT relate to administrative errors, reduced training opportunities and colleague prejudice. Trainees are concerned about LTFT leading to rota gaps and incoherent workforce planning around training numbers. With ever-increasing popularity in LTFT training, flexible and robust long-term workforce planning is necessary for the system to adapt to a new normal and improve retention of doctors in training.

How can we measure psychological safety in mental healthcare staff? Developing questionnaire items using a nominal groups technique.

There have been growing concerns about the well-being of staff in inpatient mental health settings, with studies suggesting that they have higher burnout and greater work-related stress levels than staff in other healthcare sectors. When addressing staff well-being, psychological safety can be a useful concept. However, there is no measure of psychological safety that is suitable for use in inpatient mental health settings. Edmondson (1999) is the most commonly used measure of psychological safety, but it was designed for use in general physical healthcare settings. As inpatient mental health settings are unique environments, transferability of knowledge from physical to mental healthcare settings cannot be assumed. We sought to develop questionnaire items that capture psychological safety among healthcare staff working in acute inpatient mental healthcare settings. We used the nominal group technique, a consensus method involving rounds of discussion, idea generation, and item rating/ranking to identify priorities. Twenty-eight stakeholders participated, including 4 who had lived experience of mental health problems, 11 academics and 18 healthcare professionals (8 participants identified with more than 1 category). The study involved a workshop with three parts: (i) an overview of current research and limitations of the Edmondson (1999) measure as outlined above, (ii) discussion on what items should be retained from the Edmondson (1999) measure, and (iii) discussion on what items should be added to the Edmondson (1999) measure. Twenty-one items were generated and retained to capture psychological safety in inpatient mental health settings. These measure professionals' sense of being valued by their team and organization, feeling supported at work, feeling physically safe and protected from physical harm, and knowing they can raise concerns about risk and safety. This is the first study to generate questionnaire items suitable for measuring staff psychological safety in mental health settings. These have been generated via a consensus method to ensure stakeholders' views are reflected. Further research is needed to evaluate factor structure, internal reliability, and convergent validity.

Combustion and energy performance of multiple aluminum-based alloy particles

The long ignition delay time, high ignition temperature and agglomeration prevent the aluminum (Al) particles from fully releasing the chemical energy stored within them during combustion. Al-based alloy fuels with high energy density and excellent combustion performance have become a potential candidate for replacement with pure Al. Therefore, understanding the combustion and energy performance of Al-based alloys is beneficial for the development of Al-based energetic materials. Herein, the combustion and energy performance of pure Al and three Al-based alloys were comparatively investigated by means of a thermal analysis system, an ignition and combustion test apparatus, and a variety of physicochemical property characterizations. The results showed that all three Al-based alloys contained at least one intermetallic compound. Al-boron (B) and Al-magnesium (Mg)-B alloys had higher theoretical energy densities than pure Al, while Al-Mg did not. The thermal oxidation properties of all three alloys were significantly better than those of pure Al. Compared with pure Al, the three alloys showed higher burning rate, shorter ignition delays, more vigorous combustion, and higher burnout at room pressure in air. This is still true after adding AP. According to the compositions of the condensed combustion products, the possible chemical reactions during the combustion of the alloys were speculated. Grasping the combustion mechanisms of the alloys is challenging due to the relative lack of thermodynamic data on intermetallic compounds. Finally, a comprehensive comparison of the combustion processes of pure Al and alloys was made. Although the Al-Mg alloy does not have the same theoretical energy density as pure Al, the more outstanding combustion performance and fewer two-phase flow losses may make up for the gap in theoretical energy density.

The childcare director’s role in preventing burnout: a positive-psychological examination of the caregivers’ lived experience

ABSTRACT This study applied a positive-psychological approach to examining childcare directors’ role in maintaining the stability of their staff from the caregivers’ and directors’ points of view. Most of the childcare centers in Israel are characterized by high burnout and turnover of staff members. Nevertheless, some teams stay stable, and turnover is minimal. This study explored the factors using 30 semi-structured interviews with childcare center directors and caregivers regarding their occupational stability. Findings suggested that the sense of belonging to the childcare center was one source of stability. The director acted as a safe haven, maintaining the caregivers’ wellbeing. Other success factors are related mainly to their relations with other staff members, with the director, and with the children, and also to proper management that provides professional training and treats them with respect. The study’s contribution is fourfold. First, it gives voice to a population of women who work under difficult conditions for low pay. Second, it highlights the role of the childcare director in maintaining staff stability. Third, implementing its findings is relevant to creating and improving models of training and supervising early childhood educators. Fourth, studying anti-burnout factors can strengthen teams and provide the children with positive relationships with significant others.

Burnout among Polish paramedics: insights from the Oldenburg Burnout Inventory.

Emergency medical services rely heavily on paramedics who, as frontline responders, face unique stressors that can potentially lead to burnout. This pilot study utilizes the Oldenburg Burnout Inventory (OLBI) to assess burnout levels among Polish paramedics. The aim is to contribute to the understanding of burnout in this specific professional context and identify key factors influencing burnout dimensions. Future research will build on these preliminary findings. A cross-sectional study was conducted from March 01 to April 30, 2023, utilizing an online survey accessible to Polish paramedics. The OLBI, a validated tool, was employed to measure burnout, focusing on two dimensions: exhaustion and withdrawal of involvement. Among the 147 participating paramedics, the majority were male (65.99%). Paramedics exhibited burnout symptoms across both dimensions measured by The Oldenburg Burnout Inventory scale (OLBI), with an average level for lack of commitment recorded at 20.09, an average level for exhaustion at 20.60. The study revealed that 41.5% of paramedics experienced low burnout, 44.9% reported moderate burnout, and 13.6% faced high burnout risks. Analysis showed that women experienced significantly higher levels of exhaustion compared to men (p = 0.01). This pilot study provides valuable initial insights into burnout among Polish paramedics. The OLBI's two-factor structure, evaluating exhaustion and disengagement, proved reliable and valid in this context. The prevalence of burnout, with over 60% of paramedics experiencing moderate to high levels, highlights the urgency of addressing burnout in this profession. Future research will be essential to explore the underlying causes and develop targeted interventions. Understanding the factors contributing to burnout among paramedics is crucial for developing targeted interventions. Strategies should focus on stress management training, organizational support, and well-being initiatives. Addressing gender-specific differences in burnout experiences is essential for tailoring interventions effectively. Proactive psychological support mechanisms and optimized working conditions can enhance paramedics' overall well-being, ensuring their continued effectiveness in providing emergency medical services.

Assessing Depression, Anxiety, Perceived Stress, and Job Burnout in Hospital Medical Staff During COVID-19: A Cross-sectional Study in Hamedan, Iran, 2019

Background: The medical staff who fought on the front line against the COVID- 19 pandemic were more affected by its physical and psychological dangers than others. Objective: This study aimed to investigate the level of depression, stress, anxiety, and job burnout of the medical staff in the COVID-19 wards of Hamedan Hospitals. Methods: In this cross-sectional study, the study population consisted of all medical staff working in educational and treatment centers affiliated with Hamedan University of Medical Sciences in 2019, of which 173 were medical staff in COVID-19 wards, and 173 were medical staff included by systematic random sampling from other wards. Data were collected using a demographic information checklist, Beck Depression Inventory, Beck Anxiety Inventory, perceived stress scale, and Maslach Burnout Inventory. The data were analyzed with chi-square coefficient tests and one-way analysis of variance (ANOVA) with SPSS-22 software. Results: About 26.9% of medical staff in COVID-19 wards had high job burnout, significantly different from those in non-COVID-19 wards (p < 0.05). The incidence of depression was 67.5% among the medical staff in COVID-19 wards, including twenty-nine people (18.5%) with mild depression, forty-two (26.7%) with moderate depression, and thirtyfive (22.3%) with severe depression. Thirty people (19.1%) had mild anxiety, forty-three (27.4%) had moderate anxiety, and three (3.3%) had severe anxiety. In addition, the prevalence of perceived stress was 94.3%. A statistically significant difference was observed between depression, anxiety, perceived stress, and job burnout in the medical staff of COVID-19 wards and other wards (p < 0.05). Conclusions: Stress, anxiety, depression, and job burnout among staff working in COVID- 19 wards differ significantly from other hospital wards employees. In similar circumstances to this pandemic, paying extra attention to medical staff is essential due to their role and the effect of their health on society’s health.

Numerical analysis of NOx reduction in large-scale MSW grate furnace through in-bed combustion optimization using multi-section fuel bed model with thermally thick treatment

This study focuses on reducing NOx emissions in large-scale municipal solid waste (MSW) grate furnaces through in-bed combustion control. A multi-section fuel bed model with thermally thick treatment is developed to accommodate the configurations of large-scale MSW grate furnaces. The model incorporates detailed sub-grid models to simulate the intraparticle gradient, and the stochastic mixing is accounted to deal with the multi-section fuel beds with vertical drop-offs. The influences of primary air distribution and average grate velocity on combustion status and NOx emissions are investigated numerically and validated in a 600 t/d MSW grate boiler. The results indicate that combining a relatively low primary air ratio with a thickened fuel bed ensures both reduced NOx emissions and high burnout efficiency. By reducing the excess air ratio of primary air from 1.2 to 0.9 and distributing it through a rear-enhanced air mode, the overall NOx emission decreased from 398.50 mg/Nm3 to 215.05 mg/Nm3, although at the expense of an increased unburned carbon content from 1.995 wt% to 3.063 wt%. Further lowering the grate velocity to thicken the fuel bed allowed for leveraging the heterogeneous reduction effect of the char layer, reducing the NOx emissions to 184.95 mg/Nm3. Additionally, the unburned carbon content was also remarkably reduced to 1.560 wt%. The proposed strategies of delaying the primary air supply and thickening the fuel bed offer a cost-effective alternative to post-combustion measures, with which the MSW grate boilers can achieve lower NOx emissions while maintaining efficient and stable combustion.

The Mental Health of Healthcare Workers: Navigating the New Normal.

Increased workloads, fear of illness, social disconnection and high burnout rates during the COVID-19 pandemic caused significant trauma throughout the medical community. Using evidence-based insights from Mental Health Research Canada's quantitative and qualitative data, this article explores how the healthcare community was impacted by the COVID-19 pandemic. Recent trends in national mental health indicators support a theory of a new normal, but some Canadians continue to fall behind. Overall, these insights highlight the need for sustained efforts from leaders, policy makers and researchers that are crucial to supporting the rebuilding of the healthcare sector in Canada.

Beyond the classroom: a qualitative study of the lived experiences of special needs education teachers in the Philippines

Teachers of Special Education (SNED) help students with a wide range of emotional, physical, mental, and academic needs. However, they also face various other issues, such as managing behaviour, inclusion, and differentiation. The study employed a qualitative approach, particularly the phenomenological method, to gain insights into the lived experiences of these educators. Five participants are regular teachers with over five years of service residing in Sta. Cruz Davao del Sur, Philippines, was purposively selected for the study. The primary challenges identified by the participants include the need for more training and resources. These challenges often lead to high stress levels and burnout among SNED teachers. However, these educators employ adaptive strategies to cope with these challenges, including modifying their teaching methods, collaborating with colleagues, and engaging parents in learning. The insights gained from the study highlight the importance of teacher growth and student development. The participants noted improvements in their students' abilities as a significant reward for their hard work. Moreover, teacher's dedication and commitment to individualized instruction significantly contribute to these students' overall academic and social development.

ACADEMIC BURNOUT CONDITIONS IN INDONESIAN STUDENTS: PHYSICAL, MENTAL, AND EMOTIONAL

The unclear end of the Covid-19 pandemic has had an impact on learning in schools. Students as an affected community cause the online learning process with various limitations, even though students have begun to get used to online learning. Conditions related to online learning pose a new problem about academic burnout. This study aims to develop an academic burnout scale and describe the condition of student academic burnout. The research method uses a mix-method with academic burnout variables and the target is students. The results found three aspects of academic burnout from physical fatigue, mental exhaustion, and emotional exhaustion. The burnout scale is validly tested with reliability in the very high category. The measurement of student academic burnout found that the average student has a high burnout category as a result of online learning. The effects of burnout conditions are self-confidence, motivation, achievement, self-control or depression in students. Immediate intervention for the prevention, reduction, or alleviation of burnout by school counselors or in collaboration with psychologists or universities.

Satisfaction and wellbeing of general surgery trainees in the Saudi Arabian residency educational environment: A mixed-methods study

BackgroundSurgical residency training is prominently demanding and stressful. This can affect the residents' wellbeing, work-life balance and increase the rates of burnout. We aimed to assess rates of satisfaction and burn-out among GS residents in the national training programs and provide a subsequent in-depth analysis of the potential reasons. MethodA sequential explanatory mixed-methods study was conducted using an online survey and virtual interviews. The validated abbreviated Maslach Burnout Inventory (aMBI) was used to assess burnout while satisfaction was assessed via 5-points Likert scale. ResultsAfter excluding incomplete responses from the total 74 received, 53 were analyzed. The average participant age was 27.4 ± 2 years, with females comprising 52 % of the sample. Junior residents made up 58.5 %, and nearly half −45 %- considered quitting GS training. Moderate to high burnout rates were noted on each aMBI subscale, ranging from 41.7 % to 62.5 %. The majority of residents expressed dissatisfaction with the level of research engagement (81.1 %), supervision, and mentorship. However, operative exposure was a source of satisfaction. Dissatisfaction rates with intra-operative learning, academia, teaching, and clinical exposure were 62.3 %, 52.8 %, 50.9 %, and 35.8 %, respectively. Interviews revealed surgical case flow and a friendly work environment as major satisfaction sources. Conversely, lack of academic supervision and suboptimal hands-on training were major dissatisfaction sources. ConclusionDissatisfaction and burn-out is prevalent among national GS training programs. Sub-optimal educational delivery and low-quality hands-on operative exposure -rather than lack of exposure to cases- seem to be the culprit.

How School Burnout Affects Depression Symptoms Among Chinese Adolescents: Evidence from Individual and Peer Clique Level.

The impact of peer clique school burnout norms on adolescents' emotional adaptation is becoming increasingly prominent, but its underlying mechanisms remain unclear, especially in China where academic achievement is highly valued. The present study examined how clique burnout norms impact the relationship between school burnout, negative cognitive bias, and depressive symptoms. A total of 904 Chinese adolescents (57% boys; Mage = 12.73, SD = 0.43) participated in a two-wave longitudinal study (initiated in 2015, with approximately a 2-year interval). The results of multilevel models indicated that only in low clique burnout norms, adolescents with high school burnout at T1 would exhibit more negative cognitive bias and suffer from more depressive symptoms at T2, whereas the moderating effect was only observed in all-boys cliques. These findings reflect that a decrease in the overall level of burnout within a peer clique does not necessarily benefit every student, and the adaptation issues of students experiencing burnout still require attention even in a relatively healthy context.

Job burnout and anxiety among medical staff: A latent profile and moderated mediation analysis

BackgroundDue to work pressure, work intensity, and the impact of emergencies such as the epidemic, job burnout and mental health problems among medical staff have become increasingly prominent. ObjectivesOur study aims to characterize the patterns of burnout in Chinese medical staff, explore the profile differences on anxiety and self-esteem, examine whether the differences in these profiles on anxiety were mediated by self-esteem, and investigate whether this mediating process was moderated by positive coping styles among medical staff. MethodsData were collected from 602 medical staff in China by a convenient sampling method. A latent profile and moderated mediation analysis were performed. ResultsLatent profile analysis on three burnout dimensions [emotional exhaustion, cynicism, and professional efficacy] indicated two burnout profiles: low burnout (82.47% of the sample) and high burnout (17.53%). Medical staff with a low burnout profile had lower levels of emotional exhaustion and cynicism than those with a high burnout profile. It was also determined that self-esteem mediates burnout and anxiety in both high- and low-burnout medical staff. The moderating role of positive coping styles was also identified (β = 0.30, 95%CI: 0.058–0.550). ConclusionsThe identification of two distinct burnout patterns (low burnout and high burnout) provides clinical administrators with clear goals for individualizing support and interventions for medical staff with different levels of burnout. Furthermore, attention should be given to self-esteem and positive coping styles, as they act as potential mediators and moderators of medical staff's mental health problems.

Psychological and Physiological Changes in Firefighters Based on Roadside Flowerscape Models and Plant Colors

Background and objective: This study was conducted to examine the psychological and physiological changes in firefighters according to roadside flowerscape (RFS) models and color stimulation.Methods: EEG and ECG measurement was taken and a survey was conducted on a total of 30 firefighters with a mean age of 35.3 ± 9.4 years in Jeonju.Results: For the violet RFS among the four colors (white, yellow, pink, and violet) of the RFSs, RST(radio of SMR to theta), RSMT(ratio to mid beta to theta), RMT(ratio of mid beta to theta), RMB(relative mid beta power spectrum), and ASEF(spectral edge frequency of 50% alpha spectrum band), which is a comfort indicator, were the highest in all lobes, including the prefrontal lobe, a finding which was statistically significant. The radio of alpha to high beta (RAHB), an indicator of calm and relaxation, was the highest for the white flowerscape. As for the level of gardening activity, the higher the age, the higher the average monthly income and rank, and the longer work experience, the higher the average value. The stress level of firefighters was 46.7%, indicating the need for expert help. Among the four colors (white, yellow, pink, and violet) of the RFSs, the preference for the yellow flowerscape was the highest, and "pleasant" was also the most common emotion, a finding which was statistically significant. As for the correlation between loyalty to the RFSs and key variables, a positive correlation was found between loyalty and gardening activity level, while a negative correlation was found between loyalty and job burnout. By examining the effects of key variables, as well as demographic variables such as gardening activity level and job burnout on respondents' loyalty, a sense of calm was found to be the most influential variable.Conclusion: Based on these findings, it is expected that supporting the development of RFS models and improving a sense of calm and the level of gardening activities, which affect the loyalty of firefighters, who are high-risk workers, will reduce high stress levels and job burnout, and increase interest in plants and psychological and physiological relaxation effects.

Psychological safety is associated with better work environment and lower levels of clinician burnout.

Burnout is attributed to negative work environments and threatens patient and clinician safety. Psychological safety is the perception that the work environment is safe for interpersonal risk-taking and may offer insight into the relationship between the work environment and burnout. In this cross-sectional analysis of survey data from 621 nurse practitioners in California, we found that one-third (34%) experienced high burnout. Four factors in the work environment were negatively associated with burnout and positively associated with psychological safety. Significant mediation effects of psychological safety were observed on the relationships between each work environment factor and both emotional exhaustion and depersonalization. The largest mediation effects were observed on the total effects of Nurse Practitioner-Physician Relations and Practice Visibility on Emotional Exhaustion (37% and 32%, respectively) and Independent Practice and Support and NP-Administration Relations on Depersonalization (32% and 29%, respectively). We found, overall, that psychological safety decreased the strength of the negative relationship between work environment and burnout. We argue that research, practice, and policy efforts to mitigate burnout and improve the work environment should consider psychological safety as a metric for system-level well-being.