Temporal shifts in burnout dynamics: A cross-sectional study of protective and risk factors among front-line nurses in China during and post-COVID-19

This cross-sectional multi-center survey aimed to investigate the prevalence and correlates of burnout among front-line nurses in China during and after the COVID-19 epidemic. The study recruited front-line nurses from 27 provinces of China in November to December 2022 and April to July 2023. Assessment measures included demographic questionnaire, Pittsburgh Sleep Quality Index for sleep quality, Self-Rating Anxiety Scale for anxiety, Self-Rating Depression Scale for depression, and Maslach Burnout Inventory-Human Services Survey for burnout. Among 775 nurses during the pandemic and 693 post-pandemic, burnout prevalence was significantly higher during the pandemic (94.7% vs 71.3%, P < .001). Emotional exhaustion prevalence did not differ significantly (33.8% vs 33.3%, P = .848), while depersonalization and reduced personal achievement were higher during the pandemic (P < .001). Scores for SAS, SDS, PSQI, emotional exhaustion, and depersonalization were significantly lower post-pandemic (P < .001), while reduced personal achievement scores were higher (P < .01). Logistic regression revealed high financial stress as a protective factor during the pandemic (OR = 0.443, 95% CI 0.222-0.883), while post-pandemic, frequent exercise (OR = 0.506, 95% CI 0.290-0.880), SDS scores (OR = 1.031, 95% CI 1.002-1.061), and PSQI scores (OR = 1.058, 95% CI 1.034-1.083) were associated with burnout. Receiver operating characteristic analysis showed good predictive value for SDS and PSQI scores. Burnout prevalence among front-line nurses was significantly higher during the COVID-19 pandemic. High financial stress was protective during the pandemic, while frequent exercise post-pandemic was protective against burnout.