Occupational injury and job esteem in relation to burnout dimensions among nurses in Beijing: a cross-sectional study

Burnout threatens nurses' well-being and the sustainability of healthcare delivery. Occupational injury may contribute to burnout, whereas job esteem may provide an important professional resource; however, their associations with specific burnout dimensions remain unclear. This study examined the associations of occupational injury and job esteem with emotional exhaustion, depersonalization, and personal accomplishment among nurses.

A cross-sectional survey was conducted from January 2023 to September 2024 among 3,654 nurses from 14 hospitals in Beijing. Burnout was assessed using the Maslach Burnout Inventory, job esteem using the Job Esteem Scale, and occupational injuries and exposures using a study-specific questionnaire. Three multivariable binary logistic regression models were fitted to examine factors independently associated with high emotional exhaustion, high depersonalization, and high personal accomplishment. Results are reported as adjusted odds ratios (aORs) with 95% confidence intervals (CIs).

Overall, 89.2% of participants had ever experienced an occupational injury or exposure, and 71.4% reported at least one event during the preceding 12 months. After adjustment, professional self-awareness (aOR = 0.580, 95% CI: 0.461-0.729; p < 0.001) and organizational respect and recognition (aOR = 0.659, 95% CI: 0.493-0.881; p = 0.005) were associated with lower odds of high emotional exhaustion, whereas social trust and respect was associated with higher odds (aOR = 1.332, 95% CI: 1.049-1.691; p = 0.019). All five job-esteem dimensions were associated with lower odds of high depersonalization (aORs = 0.488-0.793; all p ≤ 0.037). Organizational respect and recognition (aOR = 2.353, 95% CI: 1.499-3.695; p < 0.001), professional authority and future value (aOR = 2.892, 95% CI: 2.041-4.097; p < 0.001), and professional competence (aOR = 2.486, 95% CI: 1.398-4.420; p = 0.002) were associated with higher odds of high personal accomplishment. Psychological harm was associated with higher odds of high emotional exhaustion (aOR = 1.527, 95% CI: 1.261-1.847; p < 0.001) and high depersonalization (aOR = 1.410, 95% CI: 1.210-1.644; p < 0.001), and with lower odds of high personal accomplishment (aOR = 0.666, 95% CI: 0.492-0.900; p = 0.008). Increasing occupational injury or exposure frequency was primarily associated with higher odds of high emotional exhaustion.

Occupational injuries and exposures and job esteem showed distinct associations with emotional exhaustion, depersonalization, and personal accomplishment among nurses. The findings highlight occupational safety, post-incident support, professional competence, and organizational recognition as relevant considerations in dimension-specific burnout management. Given the cross-sectional design, these associations should not be interpreted as causal.