Correlates of burnout among Chinese ICU nurses: a meta-analysis

Burnout is prevalent among nurses, particularly in Intensive Care Units (ICUs), where work is characterized by high intensity, high risk, and heavy workloads. This condition not only directly impairs nurses' physical and mental health and reduces their occupational retention rate but may also threaten the safety of ICU patients due to potential declines in the quality of nursing care. Given these implications, effective alleviation of burnout among ICU nurses is essential for promoting their well-being, stabilizing the nursing workforce, and improving patient satisfaction. Previous studies have explored various variables related to burnout among ICU nurses, such as psychological capital, social support, work-family conflict, and moral distress. However, these findings remain inconsistent and fragmented across studies. To date, a comprehensive quantitative synthesis of the correlations between these variables and burnout among ICU nurses is lacking. Therefore, this study conducted a meta-analysis based on Pearson correlation coefficients to examine the correlates of burnout among ICU nurses, aiming to provide more reliable evidence for the development of targeted intervention strategies for this population.

Databases including CNKI, Wanfang Database, VIP Database, China Biomedical Literature Database (CBM), PubMed, Web of Science, Embase, CINAHL, and Cochrane Library were systematically searched. The search used terms for intensive care units, nurses, burnout, and China in both Chinese and English. The search was conducted from the inception of the database to September 2025. Two researchers with expertise in evidence-based practice performed the literature search, independently screened studies based on the inclusion and exclusion criteria, assessed the quality of the included studies using the Agency for Healthcare Research and Quality (AHRQ)'s quality assessment criteria for observational studies, and extracted relevant data. A meta-analysis was conducted using RevMan 5.4 software, with Pearson correlation coefficients (r values) as the outcome indicator.

A total of 31 studies were included, with a combined sample size of 8,219 participants, and the overall methodological quality of the included studies was moderate. The pooled analysis indicated that burnout was significantly negatively correlated with psychological capital (r = -0.43, 95% CI: -0.53 to -0.33, I ² = 81%), research competence (r = -0.21, 95% CI: -0.30 to -0.11, I ² = 0%), and social support (r = -0.40, 95% CI: -0.49 to -0.28, I ² = 82%) (p < 0.01). Burnout was positively correlated with work-family conflict (r = 0.49, 95% CI: 0.41-0.57, I ² = 69%), presenteeism (r = 0.33, 95% CI: 0.24-0.41, I ² = 0%), moral distress (r = 0.32, 95% CI: 0.16-0.46, I ² = 53%), turnover intention (r = 0.48, 95% CI: 0.24-0.66, I ² = 96%), and alarm fatigue (r = 0.55, 95% CI: 0.26-0.75, I ² = 95%) (p < 0.01). Substantial heterogeneity was observed in several pooled estimates, particularly for turnover intention and alarm fatigue.

This meta-analysis suggests that burnout among ICU nurses is associated with multiple occupational and psychosocial factors, including work-family conflict, turnover intention, presenteeism, social support, and psychological capital. These findings highlight the importance of work-related stressors and psychological resources in relation to burnout among nurses. However, given the heterogeneity across studies and the cross-sectional nature of the included evidence, these associations should be interpreted with caution. The results provide a synthesized overview of the factors related to burnout among ICU nurses and may help inform future research and the development of strategies aimed at supporting nurses' occupational well-being.

This study was registered in the PROSPERO database (registration number: CRD420251146719). The protocol predefined the research objectives, inclusion and exclusion criteria, and main analytical methods. This study was conducted in accordance with the registered protocol. If minor adjustments were made during the study due to data availability, they were clearly described and justified in the Methods section to improve transparency and reproducibility.