Association between adverse childhood experiences and burnout among Chinese female nurses

Burnout is a public health issue. Adverse childhood experiences (ACEs) have been linked to mental health problems, but their impact on burnout is unclear. This study explores the association between ACEs and burnout among Chinese female nurses.

A cross-sectional study was conducted using convenience sampling across seven hospitals in Zhejiang Province, China. ACEs were self-reported and categorized by number, type, and context. Burnout was measured using the Maslach Burnout Inventory-Human Services Survey, including status, severity, and dimensions such as emotional exhaustion, depersonalization, low personal accomplishment. Logistic regression analyses were conducted to examine the association between ACEs and burnout, presented as odds ratios (ORs) and 95% confidence intervals (CIs).

Among the 1966 nurses, 50.15% had at least one ACE, and 70.95% reported experiencing burnout. Participants with a higher ACE score were more likely to experience burnout (OR: 1.30, 95% CI [1.19, 1.42] per unit increase). Specific ACE types, such as abuse (OR: 2.08, 95% CI [1.47, 2.93]), neglect (OR: 1.97, 95% CI [1.52, 2.56]), and adverse community environment (OR: 2.66, 95% CI [1.82, 3.89]), were associated with the risk of burnout. Each additional ACE was associated with an increase in the odds of overall burnout by 30%, emotional exhaustion by 35%, depersonalization by 25%, and low personal accomplishment by 10%.

This study highlights the significant association between ACEs and burnout among nurses. Interventions targeting early-life stressors and supporting nurses with ACEs histories are crucial for mitigating burnout and promoting mental well-being. (PsycInfo Database Record (c) 2026 APA, all rights reserved).