Burnout and anxiety among Chinese nurses: The mediating roles of positive coping strategies and interpersonal relationship problems: A cross-sectional study

Ya Wang^1,2Nan Li³Xia Huang⁴JingJun Wang²Junqiang Huang⁵Yalin Huang⁴Yan Feng⁶Liu Qin⁷Huang Hao^1*

• ¹West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
• ²West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
• ³West China Tianfu Hospital, Sichuan University, Chengdu, Sichuan Province, China
• ⁴Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
• ⁵Chengdushi Dekang Hospital, Chengdu, Sichuan Province, China
• ⁶Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, Shanghai Municipality, China
• ⁷Nanchong Hospital Affiliated to Beijing Anzhen Hospital, Nanchong, China

Background: Burnout among nurses is a global problem that results in increased turnover as well as decreased career satisfaction and poor nursing service. Previous researchers have suggested that anxiety is associated with burnout. However, the relationship between anxiety and burnout requires further investigation to clarify. How interpersonal relationships and coping styles influence this relationship remains to be further explored. Furthermore, the question of how the demographic characteristics of nurses predict burnout remains unanswered.Aims: This study aimed to explore the mechanisms by which anxiety affects burnout, to verify the mediating roles of interpersonal relationship problems and positive coping in the relationship between anxiety and burnout, and to explore the factors that can predict burnout among nurses.Methods: A total of 4,856 nurses were enrolled in this study. The ability of anxiety, positive coping, interpersonal relationship problems, and demographic factors to predict burnout were explored via linear regression models. The relationships among anxiety, positive coping, interpersonal relationship problems, and burnout were also explored by developing a parallel mediation model with the assistance of SPSS PROCESS 3.3 software.The following factors can predict burnout among nurses: internal medicine ward (β=0.075 p<0.01), surgery ward (β=0.054 p<0.01), operating room (β=0.022 p=0.037), a number of night shifts worked per month higher than 10 (β=0.046 p<0.01), and possession of a master's degree or higher level of education (β=0.03 p<0.01). Positive coping (β=0.029, 95% CI: 0.022 to 0.036) and interpersonal relationship problems (β=0.134, 95% CI: 0.118 to 0.151) mediate the relationship between anxiety and burnout.The results of this study reveal that nurses' department, level of education, and number of night shifts worked per month are effective predictors of burnout. Positive coping and interpersonal relationships problems mediate the relationship between anxiety and burnout.