Beyond the Immediate Impact: Burnout, Psychological Distress, and Workforce Retention Among Healthcare Workers One...

Background/Objectives: This study aimed to evaluate burnout, psychological distress, and intention to quit among healthcare workers one year after the 6 February 2023 earthquakes, and to examine the relative contributions of disaster-related exposures and organizational factors using a hierarchical analytical approach. Methods: This cross-sectional study included 640 healthcare workers from a tertiary referral hospital in one of the provinces most severely affected by the earthquakes. Data were collected using validated instruments, including the Maslach Burnout Inventory, Hospital Anxiety and Depression Scale, Impact of Event Scale-Revised, and Intention to Quit Scale. Hierarchical multiple linear regression analyses were performed to evaluate factors associated with burnout dimensions, psychiatric symptoms, and intention to quit. Results: Clinically significant anxiety symptoms were observed in 32.5% of participants, depressive symptoms in 55.8%, and PTSD risk in 54.1%. Low personal accomplishment was the most prevalent burnout dimension (69.1%), while high emotional exhaustion and depersonalization were observed in 43.0% and 18.9% of participants, respectively. Workplace climate variables accounted for the largest increment in explained variance across all seven models. Low job satisfaction was the strongest and most consistent factor associated with adverse outcomes, with standardized coefficients ranging from β = +0.27 to +0.61. Non-close colleague relations were independently associated with higher burnout, anxiety, depression, and intention to quit scores, as well as lower personal accomplishment. Despite the high prevalence of psychological symptoms, post-earthquake psychiatric help-seeking was reported by only 6.2% of participants. Conclusions: One year after the earthquakes, healthcare workers continued to experience a substantial psychological burden. Although disaster-related exposures were associated with several adverse outcomes, organizational factors appeared to demonstrate more consistent associations with mental health indicators. These findings highlight the potential importance of improving modifiable workplace conditions to support psychological well-being and workforce sustainability in post-disaster healthcare systems.