Care-related regret in the intensive care unit and its association with burnout and intention to change profession: A...

Intensive care unit (ICU) healthcare workers (HCWs) face burnout and retention challenges. We hypothesized that care-related regret may contribute. This study aimed to investigate the relationship between care-related regret, burnout, and turnover intention among ICU HCWs, and to identify associated risk and protective factors.

A survey was sent to 360 HCWs in four ICUs to measure regret intensity (Regret Intensity Scale-10), coping strategies (Regret Coping Scale), burnout (Copenhagen Burnout Inventory), and turnover intention. Analyses were stratified by profession, and regression models examined associations between regret, burnout, and turnover intention.

A total of 158 HCWs (92 nurses; 66 physicians; 62 % female) participated. Nurses and physicians reported similar regret events in the last month (median: 3[IQR: 2-5]). Nurses presented higher regret intensity than physicians (32[27-36] vs. 27 [23-33], p < 0.01). The main cause of regret was futility of care (43 % of respondents). Nurses had higher burnout scores than physicians: personal- (67[54-83] vs. 54[38-63]), work- (64[48-79] vs. 46[25-57]), and patient-related (50[33-64] vs. 33[17-46]) burnout (p < 0.01) and considered quitting more frequently (45 % vs. 11 %, p < 0.01). In multivariable analyses, regret intensity was associated with all burnout subdomains. Maladaptive regret coping strategies were associated with both personal- and patient-related burnout. Perceived futility of care was associated with patient-related burnout. Regret intensity tended to be associated with turnover intention, but this was non-significant.

Regret among ICU HCWs is related to futility of care and associated with burnout. Identifying regret may be a valuable strategy to mitigate burnout and improve retention in ICU settings.