Perceptions Of Burnout Research Articles

Effects of Physical Activity and Counselling Interventions on Health Outcomes among Working Women in Shanghai.

Working women in Shanghai are a high-risk group of suffering work stress and burnout. Women have been found to be affected by work-family conflicts, which results in lower health-related quality of life (HRQoL), higher job stress, and burnout. This study evaluated the potential physical activity and counselling intervention effects on health outcomes of working women in Shanghai. Participants were randomly recruited from eight communities of Shanghai using the stratified cluster sampling method. A total of 121 female workers took part in this study, who were randomly divided into three groups: a control group and two intervention groups (individual-based and group-based intervention). The first intervention involved a moderate physical activity program and an individual based counselling intervention, while the second included the same physical activity program, but with a group counselling approach. Both interventions lasted 12 weeks. Subjective perceptions of work stress, burnout, and HRQoL were measured before and after the intervention. In the control group, the HRQoL value decreased after the intervention, with the mean value falling from 91.59 to 87.10, while there was no significant difference found between participants for stress (p = 0.752) and burnout (p = 0.622) before and after the intervention. After the intervention, the value of stress and burnout decreased, and the value of HRQoL increased in the two intervention groups. At the intervention's completion, there were significant differences compared between the two intervention groups and the control group separately regarding changes in burnout and HRQoL (all p = 0.000). For stress, the group-based intervention group exhibited a significant difference compared to the control group (p = 0.000), while the individual-based intervention group did not (p = 0.128). A Physical activity and counselling intervention delivered either in a group or individual format could reduce stress, burnout, and improve HRQoL of working women in Shanghai, and the group interventions were potentially more effective than those targeted at individuals.

Effect of Work Stress and Burnout Perceptions of Aviation Sector Employees on Organizational Commitment

Effect of Work Stress and Burnout Perceptions of Aviation Sector Employees on Organizational Commitment

“I Have Nothing Else to Give”: A Qualitative Exploration of Emergency Medicine Residents’ Perceptions of Burnout

Phenomenon: Resident physicians experience high degrees of burnout. Medical educators are tasked with implementing burnout interventions, however they possess an incomplete understanding of residents’ lived experiences with this phenomenon. Attempts to understand burnout using quantitative methods may insufficiently capture the complexities of resident burnout and limit our ability to implement meaningful specialty-specific interventions. Qualitative studies examining how residents conceptualize burnout have been briefly examined in other specialties, however the specific stressors that characterize emergency medicine training may lead residents to experience burnout differently. This study used qualitative methodology to explore emergency medicine trainees’ perceptions of the complex phenomenon of burnout during their residency training years. Approach: In order to evaluate a novel wellness intervention at their emergency medicine residency program, the authors conducted four semi-structured focus groups with residents and recent alumni from May 2018 to August 2018. After the focus groups concluded, the authors noted that they lacked an insightful understanding of their residents’ own experiences with physician burnout. Thus, they performed a secondary analysis of data initially gathered for the curricular evaluation. They followed a reflexive thematic analysis approach, analyzing all focus group transcripts in an iterative manner, discussing and refining codes, and developing thematic categories. Findings: Residents described individual-level manifestations of burnout in their day-to-day lives, a calloused view of patient suffering in the clinical environment, and a fatalistic view toward burnout during their training. They experienced a pervasive negativity, emotional fragility, and neglect of self that bled into their social environments. Clinically, burnout contributed to the erosion of the therapeutic physician-patient relationship. Residents perceived burnout as an inevitable and necessary element of their residency training years. Insights: Residents’ lived experiences with burnout include nonclinical manifestations that challenge existing frameworks suggesting that burnout is restricted to the work domain. Burnout interventions in emergency medicine training programs may be more effective if educators inculcate habitual practices of self-monitoring in trainees and explicitly set resident expectations of patient acuity in the clinical environment. Supplemental data for this article is available online at https://doi.org/10.1080/10401334.2021.1875833.

Residents' Perceptions of Faculty Behaviors and Resident Burnout: a Cross-Sectional Survey Study Across a Large Health Care Organization.

Data suggests the learning environment factors influence resident well-being. The authors conducted an assessment of how residents' perceptions of faculty-resident relationships, faculty professional behaviors, and afforded autonomy related to resident burnout. All residents at one organization were surveyed in 2019 using two items from the Maslach Burnout Inventory and the faculty relationship subscale of the Johns Hopkins Learning Environment Scale (JHLES, range 6 to 30). Residents were also asked about faculty professional behaviors (range 0 to 30), and satisfaction with autonomy across various clinical settings. A total of 762/1146 (66.5%) residents responded to the survey. After adjusting for age, gender, postgraduate year, and specialty, lower (less favorable) JHLES-faculty relationship subscale score (parameter estimate, - 3.08, 95% CI - 3.75, - 2.41, p < 0.0001), fewer observed faculty professional behaviors (parameter estimate, - 3.34, 95% CI - 4.02, - 2.67, p < 0.0001), and lower odds of satisfaction with autonomy in the intensive care settings (OR 0.46, 95% CI 0.30, 0.70, p = 0.001), but not other care settings, were reported by residents with burnout in comparison to those without. Similar relationships were observed when emotional exhaustion and depersonalization were analyzed separately as continuous variables. In this cohort, resident perceptions of faculty relationships, faculty professional behaviors, and satisfaction with autonomy in the intensive care unit were associated with resident burnout. Additional longitudinal studies are needed to elucidate the direction of these relationships and determine if faculty development can reduce resident burnout.

Investigation of regulatory role of collective teacher efficacy in the effect of job satisfaction and satisfaction with life on professional burnout

This study examined the effect of job satisfaction and satisfaction with life on perceptions of teachers' professional burnout and the regulatory role of collective teacher efficacy perception by conducting applied research on teachers who work in different educational settings. The measuring tools were "Maslach Burnout Inventory", "Short Form Minnesota Satisfaction Questionnaire", "Satisfaction with Life Scale" and "Collective Teacher Efficacy Scale". The findings of the research showed that: Teachers' perceptions of job satisfaction and satisfaction with life negatively affected their perceptions of professional burnout. Collective teacher efficacy had a regulatory effect on the relationship between satisfaction with life and professional burnout, and on the relationship between job satisfaction and professional burnout.

Outcomes of an Equine Assisted Learning Curriculum to Support Well-Being of Medical Students and Residents.

Objectives of this study were to evaluate an equine assisted learning (EAL) curriculum designed for medical students and resident physicians, and to determine impacts of the curriculum on participant perceptions of burnout and well-being. The EAL curriculum incorporated evidence-based skills and concepts to increase happiness and/or resilience. A pre/post intervention design was used, with 18 EAL participants receiving the curriculum within their month-long community based primary care clerkship elective, and 10 control (CTL) participants who did not receive the curriculum within their clerkship elective. Three waves of surveys tested participant responses before, immediately after, and 3 months after the intervention. Patient Health Questionnaire-4 (PHQ-4) screened for depression and anxiety, and Maslach Burnout Inventory- Human Services Survey for Medical Personnel (MBI) addressed burnout. Analysis of covariance evaluated differences between EAL and CTL groups. EAL participants rated the curriculum highly (9.2 on a 10-point scale). The evaluations were overwhelmingly positive with participants able to identify key concepts that were most helpful, how they would apply those concepts to patient care and interactions with colleagues, and how the horses added value to their learning experience. Significant positive effects of EAL on burnout were identified in terms of improved MBI personal achievement scores, as well as a trend towards improved well-being scores. There was also a trend (P < .08) towards PHQ-4 depression scores to be lower in EAL group at T3. In conclusion, this study is the first to provide AU: quantitative evidence of positive outcomes associated with an EAL curriculum designed to strengthen well-being in medical students and resident physicians.

The effect of patient satisfaction scores on physician job satisfaction and burnout.

Physician burnout is recognized as reversible with the potential to negatively influence quality of care and patient outcomes. The study objective was to evaluate associations between patient satisfaction scores (PSS) and physicians’ perceptions of job satisfaction and burnout via a physician survey. Eighty two out of 107 report PSS are institutionally tracked, with 23/107 and 39/107 reporting PSS utilization in financial compensation or performance review, respectively. Fifty four out of 107, report pressure to emphasize PSS; 63/107, report PSS having negative effect on job satisfaction; 31/107 considered leaving their job or career due to PSS and 84/107 report PSS contribute to burnout. In the cohort of physicians treating patients with spine pain who responded to this survey, PSS are associated with decreased job satisfaction and increased burnout.

Work-Family Conflict, Depression, and Burnout Among Jail Correctional Officers: A 1-Year Prospective Study.

BackgroundCorrectional officers (COs) experience elevated rates of mental and physical ill-health as compared with other general industry and public safety occupations. The purpose of this study was to investigate demographic, mental health, job tenure, and work–family characteristics and their prospective association to burnout within and between jail officers during one year of new employment.MethodsIn 2016, newly hired jail officers (N = 144) completed self-reported surveys across four time points in a one-year prospective study at a Midwestern United States urban jail. Linear mixed-effects and growth modeling examined how work–family conflict (W-FC) and depressive symptoms relate to perceptions of burnout over time.ResultsJail officer burnout increased and was related to rises in W-FC and depression symptoms. Within-person variance for W-FC (Bpooled = .52, p < .001) and depression symptoms (Bpooled = .06, p < .01) were significant predictors of burnout. Less time on the job remained a significant predictor of burnout across all analyses (Bpooled = .03, p < .001).ConclusionsResults from this study indicate that burnout increased during the first year of new employment; and increased W-FC, higher depression, and brief tenure were associated with burnout among jail COs. Future study of correctional workplace health is needed to identify tailored, multilevel interventions that address burnout and W-FC prevention and early intervention among COs.

Empowering the Health and Well-Being of the Palliative Care Workforce: Evaluation of a Weekly Self-Care Checklist

BackgroundWorkplace interventions are needed to prevent burnout and support the well-being of the palliative care workforce. MeasuresWe conducted a survey of all palliative care clinical staff to evaluate the usefulness and feasibility of checklist items and the checklist itself. We collected demographics, perceptions of professional satisfaction and burnout, and qualitative feedback aimed at improving the checklist. InterventionWe implemented a 13-item self-care checklist, included in a handbook on palliative care carried in the laboratory coat of all clinical personnel, to remind them to care of their own well-being. OutcomesOf 39 personnel contacted, 32 (82%) responded. Most (20; 62%) found the checklist useful. Exercise was the most highly ranked item, whereas watching visual arts was the lowest ranked item. Conclusions/Lessons LearnedNumerous opportunities were identified to improve the checklist and facilitate achievement of checklist items. Survey data will be used in the next checklist version.

The Relationship Between Residents' Perceptions of Residency Program Leadership Team Behaviors and Resident Burnout and Satisfaction.

To explore the relationship between residents' perceptions of residency program leadership team behaviors and resident burnout and satisfaction. In February 2019, the authors surveyed all residents across the 77 graduate medical education training programs at Mayo Clinic's multiple sites. Survey items measured residents' perceptions of program director and associate program director behaviors (using a composite residency program leadership team score), resident burnout, and resident satisfaction with the program and organization. Multivariable logistic regression was performed to evaluate relationships between these variables at the individual resident (adjusting for age, sex, postgraduate training year, program location, and specialty) and program (including only programs with at least 5 respondents) levels. Of the 1,146 residents surveyed, 762 (66.5%) responded. At the individual resident level, higher composite leadership team scores were associated with lower emotional exhaustion and depersonalization and higher overall satisfaction with the residency program and organization (all P < .001). In adjusted logistic regression models, each 1-point gain in composite leadership team score was associated with 9% lower odds of burnout, 20% higher odds of program satisfaction, and 19% higher odds of satisfaction with the organization (all P < .001). At the residency program level, higher mean composite leadership team scores were associated with a lower rate of burnout (r = -0.35, P = .03) and higher program and organization satisfaction (r = 0.67 and 0.74, respectively, both P < .001). The behaviors of residency program leadership teams influence residents' burnout and satisfaction. Additional studies are needed to determine if leadership training results in improved resident well-being and satisfaction.

Developing an animal-assisted support program for healthcare employees

BackgroundEmployee burnout and its associated consequences is a significant problem in the healthcare workforce. Workplace animal therapy programs offer a potential strategy for improving employee well-being; however, research on animal therapy programs for healthcare workers is lacking. This study aimed to evaluate the feasibility, acceptability and preliminary impact of an animal-assisted support program to improve healthcare employee well-being.MethodsIn this mixed-methods pilot intervention study, we implemented an animal-assisted support program in a multidisciplinary healthcare clinic at a large VA hospital. The program included 20 sessions over 3 months, each approximately 1-h long. Real-time mood data were collected from participants immediately before and after each session. Participation rates were tracked in real time and self-reported at follow-up. Data on burnout and employee perceptions of the program were collected upon completion via a survey and semi-structured interviews. Differences in mood and burnout pre/post program participation were assessed with t-tests.ResultsParticipation was high; about 51% of clinic employees (n = 39) participated in any given session, averaging participation in 9/20 sessions. Mood (on a scale of 1 = worst to 5 = best mood) significantly improved from immediately before employees interacted with therapy dogs (M = 2.9) to immediately after (M = 4.5) (p = 0.000). Employees reported significantly lower levels of patient-related burnout (e.g., how much exhaustion at work relates to interaction with patients) after (M = 18.0 vs. before, M = 40.0) participating (p = 0.002). Qualitative findings suggested that employees were highly satisfied with the program, noticed an improved clinic atmosphere, and experienced a reduction in stress and boost in mood.ConclusionsEstablishing an animal-assisted support program for employees in a busy healthcare clinic is feasible and acceptable. Our pilot data suggest that animal-assisted programs could be a means to boost mood and decrease facets of burnout among healthcare employees.

Measuring ‘Need for Recovery’ as an indicator of staff well-being in the emergency department: a survey study

BackgroundThe Need for Recovery (NFR) Scale is an 11-item questionnaire that assesses how work affects intershift recovery. Items are summated to form a score with a maximum value of 100....

Associated factors with resilience and burnout: a cross-sectional study in a teaching group in Spain

El profesorado es especialmente vulnerable a desarrollar burnout. La resiliencia es la capacidad de las personas para sobreponerse ante las dificultades de la vida. El objeto del estudio consistió en establecer relaciones entre las percepciones de burnout y resiliencia en el colectivo encuestado. Fue un estudio transversal, descriptivo y correlacional, que respondió a una muestra aleatoria simple de 1268 docentes en el año académico 2017/2018, a través de la participación voluntaria y anónima. Para la evaluación del burnout se empleó la adaptación al castellano del (MBI-GS) de Salanova, Schaufeli, Llorens, Peiró and Grau (2000). La resiliencia se midió mediante el Cuestionario de Evaluación de Resiliencia de Serrano-Martínez (2010). Se hallaron altos puntajes en la dimensión eficacia personal/profesional que sugieren una autoevaluación positiva del trabajo por parte del profesorado, y su influencia como factor protector contra la sensación de estar quemado, solo 2.40% con alto agotamiento y cinismo y bajo puntaje de eficacia. Los resultados mostraron bajo índice de burnout y nivel medio en resiliencia. Se concluyó que la resiliencia disminuye la vulnerabilidad al burnout. Además, las características personales y la resiliencia de los docentes actuaron como variables moduladoras frente al síndrome del burnout.Palabras clave: resiliencia; burnout; estrés laboral; eficacia personal/profesional; inteligencia emocional.

Tükenmişlik ve İşe İlişkin Duygular Arasında İş Stresinin Aracı Rolü: Kamu Çalışanları Örneği

Both stress and burnout among employees are serious workplace problems. Work stress and burnout also affect employees’ feelings towards work and their well-being. Employees’ positive feelings towards work determine their attitude towards general life. For this reason,&nbsp;developing positive feelings towards work can also lead to a decrease in the stress and burnout experienced by the employee. In this study, the relationship between burnout and job-related affective well-being among public sector employees was examined. In addition, this study considers whether job stress has a mediator effect between these two variables. 172 people participated in the study using the questionnaire method. Pearson Correlation Analysis was performed for the relationship between variables. In order to determine the mediator effect analyzes were performed in Structural Equation Modeling. According to the results of the analysis, there is a significant and negative relationship between job related affective well-being and burnout; significant and clear relationship between work stress and burnout. In addition, the stress variable was found to play a partial mediator role in explaining the relationship between job-related affective well-being and burnout. In other words, it is necessary to understand stress in order to explain the relationship between job well-being and perceptions of employees and burnout.

Perceptions of Burnout, Personal Achievement, and Anxiety Among US Podiatric Medicine and Surgery Residents: A Cross-Sectional Pilot Study

The prevalence of physician burnout among doctors of podiatric medicine (DPM) in the United States remains unknown. The purpose of the present pilot study was to assess perceptions of burnout, personal accomplishment, anxiety, and experiences of shame among DPMs training at Podiatric Medicine and Surgery Residency programs accredited by the Council on Podiatric Medical Education. An anonymous 35-question cross-sectional online survey was developed using the Maslach Burnout Inventory–Human Services Survey (MBI-HSS) and the Hospital Anxiety and Depression Scale–Anxiety (HADS-A). Demographic data (sex, age, marital status, postgraduate year) and experiences of shame were also recorded. On December 31, 2018, the survey was distributed for completion. Univariate and bivariate analyses were conducted to obtain summary measures of the predictors and outcomes. Multinomial logistic regression models were obtained to evaluate the associations, and a 2-sided p < .05 was considered statistically significant. A total of 155 responses were eligible for inclusion. Forty-six percent of respondents reported high burnout, and nearly half (54%) reported low personal achievement and moderate to severe anxiety. Most had experienced ≥1 shame event during residency, which was associated with a greater level of anxiety (p < .001). Overall, lower burnout and higher personal achievement scores using the MBI-HSS were associated with lower anxiety scores using the HADS-A questionnaire (p < .001) and the absence of an experienced shame event (p = .039). Given that a potential relationship appears to exist between anxiety/experiences of shame and burnout/personal achievement in the present pilot study, additional longitudinal studies are warranted to discern any causal relationships.

Group cohesion and relatedness as predictors of self-determined motivation and burnout in adolescent female athletes

ObjectivesAthlete burnout is the result of a maladaptive sport experience that is influenced by the social context. A salient social contextual feature of youth sport is group cohesion. Cohesion may link with burnout through its association with relatedness and self-determined motivation. The current study was designed to test a model in which cohesion associates with burnout by way of relatedness and self-determined motivation. DesignCross-sectional survey-based study. MethodFemale youth soccer athletes (N = 276; M age = 14.9 years, SD = 1.3) completed measures of task and social cohesion, relatedness, self-determined motivation, and burnout. ResultsTask (β = 0.26) and social (β = 0.59) cohesion associated with perceptions of relatedness. In turn, relatedness positively linked with self-determined motivation (β = 0.38), which in turn negatively associated with global burnout (β = −0.79). The indirect effects from task cohesion to burnout (β = −0.08) and from social cohesion to burnout (β = −0.18) by way of relatedness and self-determined motivation were significant. ConclusionsResults support the proposed model whereby greater cohesion associates with an athlete’s feelings of relatedness, which links to more self-determined motivation and, consequently, lower burnout perceptions. Future research is needed to assess support for causality of these links and explore how contextual factors such as the teammate-created motivational climate contributes to group cohesion and relatedness perceptions within this burnout model.

Teamness, burnout, job satisfaction and decision-making in the VA Centers of Excellence in Primary Care Education

Abstract Background/purpose To evaluate teamness perceptions of employees and trainees and associations between teamness and employee perceptions of burnout, satisfaction, and decision-making in the context of a clinical setting with interprofessional trainees. Methods Seven Veterans Health Administration (VA)-funded Centers of Excellence in Primary Care Education (CoEPCE) developed interprofessional ambulatory learning environments. Two hundred forty-eight trainees and 260 employees completed the Assessment for Collaborative Environments (ACE-15) scale, a measure of teamness; VA employees also answered survey questions on burnout, job satisfaction, and decision-making. Means, standard deviations, t-tests, analysis of variance (ANOVA) using Levene's test for homogeneity and Pearson's product-moment correlations were performed. Data were collected in each of two years. Results For employees, higher teamness was correlated with lower burnout, higher satisfaction, and higher decision-making in both years. In Year 1, employee mean ACE-15 score was 46.86 (SD 7.44) and trainee mean was 50.22 (SD 5.81). In year 2, the employee mean was 47.08 (SD 6.16) and trainee mean was 50.47 (SD 6.16) (p Conclusions We found that teamness was significantly higher in trainees than employees in both years, and that the ACE-15 was effective in discriminating between these groups. The ACE-15 is helpful in measuring teamness in a primary care education reform context, and correlates with employee improvements in burnout, satisfaction, and decision-making. This study suggests that, in a context of interprofessional learning, measuring teamness among all care team members can enhance understanding of what influences performance and satisfaction.

The impact of ward climate on staff perceptions of barriers to research-driven service changes on mental health wards: A cross-sectional study.

WHAT IS KNOWN ON THE SUBJECT?: To date, improvements on U.K. acute mental health wards have been difficult to sustain. The barriers to change may be context dependent. Mental health wards are volatile workplaces with service user violence/aggression, frequent staff and patient changes, and ongoing service improvements. The evidence suggests that burnout affects staff perceptions of barriers to change, and ward climate affects burnout. As two potentially important, independent predictors of staff perceptions of barriers to change, the impact of ward climate and burnout on how staff regard changes should be considered. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Elements of ward climate such as high numbers of incidents and temporary staff independently worsened mental health staff perceptions of barriers to change, in addition to negative impacts from burnout and occupational status. How staff perceived ward climate was also linked their perceptions of barriers to change; however, burnout was no longer a significant consideration with these variables. Staff with low job satisfaction and high interaction anxiety also had low confidence regarding changes. Staff with low job satisfaction were also demotivated towards changes. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Ward climate is clearly an important factor in how nurses view organizational changes. In this study, nurses' perceptions of barriers to change were worse if they viewed ward climate negatively, or if temporary staff and incident numbers were high. Staff perceptions of ward climate and barriers to change should be assessed, ahead of service changes. Developing change strategies based on such information is likely to produce better implementation outcomes. Specifically, targeting staff confidence and motivation (which are barriers to change) may improve how staff regard their ward climate. Abstract Introduction To create successful change programmes for mental health wards, it is necessary to understand which aspects of ward climate prevent change. Question Does ward climate influence mental health nurse's perceptions of barriers to change? Method Random-effects models were used to test whether the following ward climate variables influenced the outcome measure "staff perceptions of barriers to change" (VOCALISE) and its subscales (powerlessness/confidence/demotivation): (a) Perceptions of ward climate (VOTE: subscales included work intensity/job satisfaction/interaction anxiety). (b) Ward climate indicators (incidents/detention under the Mental Health Act (2007)/staffing/bed pressure). As known predictors of VOCALISE, burnout (Maslach Burnout Inventory) and occupational status were included in the models. Results Perceptions of ward climate (VOTE), incidents, temporary staff, occupational status and burnout significantly and negatively affected perceptions of barriers to change (VOCALISE). Staff with low job satisfaction (VOTE) and high interaction anxiety (VOTE) also had low confidence (VOCALISE). Staff with low job satisfaction (VOTE) were also demotivated (VOCALISE). Discussion Ward climate is an important predictor of how staff regard service changes in mental health wards. Implications for practice Staff perceptions of ward climate and barriers to change should be assessed ahead of service changes to identify pressures that impede progress and lower morale.

Time to recover: The moderating role of psychological detachment in the link between perceptions of high-involvement work practices and burnout

This study investigated the impact of employee perceptions of high-involvement work practices (HIWPs) on employee burnout. It further tested the proposition that the recovery experience of psychological detachment would moderate the HIWPs – burnout link. The proposed model was tested among a sample of nurses and midwives (N = 1,135) in Ireland. The results showed that, as hypothesized, employees’ perceptions of HIWPs were associated with lower levels of burnout. Furthermore, psychological detachment moderated the relationship between HIWPs and burnout such that the negative HIWPs-burnout relationship was more pronounced for participants with high compared to low levels of psychological detachment. This study contributes to the HRM and occupational health psychology literature by taking a contingency perspective to understand when the positive effects of HIWPs can be enhanced or undermined.

Nursing Work Environment, Turnover Intention, Job Burnout, and Quality of Care: The Moderating Role of Job Satisfaction.

The purpose of this study was twofold: (a) to assess predictors of the turnover intention, burnout, and perceived quality of care among nurses working in Oman, and (b) to examine the potential moderating role of job satisfaction on the relationship between work environment and nurse turnover intention. A cross-sectional design was used to collect data from a sample of 207 nurses working in a public hospital in Muscat, Oman. An electronic survey was used to assess nurses' perceptions of work environment, burnout, job satisfaction, turnover intention, and quality of care. Participation in hospital affairs, a foundation for quality of care, and staffing adequacy were predictors of burnout among nurses and perceived quality of care. Logistic regression analysis revealed that working in a favorable environment was associated with less turnover intention, but only when job satisfaction was high. Improving nurse job satisfaction is a mechanism through which future interventions could enhance working conditions and promote better nurse retention. Organizational strategies are needed to increase nurse job satisfaction by empowering nurses to take more active roles in hospital affairs as a strategy to reduce turnover intention and enhance the quality of patient care.