Work Demands, Burnout, and Withdrawal Behaviors Among Healthcare Workers: A Systematic Review and Meta-Analysis

This study aimed to determine whether work demands-specifically work overload and mental workload-are associated with burnout and withdrawal behaviors among healthcare workers, and to estimate the magnitude of these associations.

A systematic review with meta-analysis and exploratory structural meta-analytic modeling was conducted, following the PRISMA 2020 guidelines. The search covered Web of Science, Scopus, and PubMed/MEDLINE with no restrictions on publication year, yielding 34 studies. Of these, five studies providing six independent samples with comparable data were included in three bivariate random-effects meta-analyses using REML and Fisher's z-transformation, as well as a two-stage TSSEM to explore the statistical indirect association involving burnout.

This review identified heterogeneity in the constructs and instruments used, as well as consistent associations between the variables of interest. The meta-analyses showed positive associations between work overload and burnout, work overload and turnover intention, and burnout and turnover intention. Work overload showed comparatively more homogeneous associations with both burnout and turnover intention, whereas the burnout-turnover intention association showed greater between-study heterogeneity. The exploratory TSSEM showed an indirect association between work overload and turnover intention through burnout, alongside an association between work overload and turnover intention conditional on burnout.

Work demands are associated with burnout and withdrawal behaviors. The findings suggest that work overload shows comparatively more consistent associations with burnout and turnover intention, whereas the burnout-turnover intention association appears more sensitive to contextual and measurement-related factors. Burnout may be a relevant correlate within the association between work overload and turnover intention, although longitudinal evidence is needed to establish temporal relationships.