Abstract
BACKGROUND: Burnout is a prevalent occupational phenomenon among healthcare workers. To evaluate the current evidence on nurses' burnout and the impact of turnover intention during the pandemic is imperative. OBJECTIVE: We aimed to comprehensively synthesize and quantify the impact of health emergencies caused by the COVID-19 pandemic outbreak on nurses' burnout and identify factors associated with the negative impact. METHODS: Systematic searches were conducted in PubMed, Web of Science, EBSCO (ASP), Cochrane Library, and supplemented by a manual search, for publications from December 2019 to February 2023. RESULTS: A total of 176 articles involving 110,316 nurses were identified. The overall pooled estimate of the prevalence of burnout was 48% (95% confidence interval [CI] 42-55%). The mean score for overall burnout on the 22-item (7-point) Maslach Burnout Inventory (MBI) was 59.83 (95% CI 49.33 to 70.34). In the work environment, nurses who were exposed to COVID-19 (SMD 0.19, 95% CI 0.04 to 0.33) or worked in emergency departments and ICUs (SMD 0.10, 95% CI 0.06 to 0.14) scored higher for burnout compared to those in general wards. In the presence of increased burnout, overall burnout in nurses was associated with a sevenfold increase in depression (OR 7.40, 95% CI 3.82 to 14.35), a fourfold increase in anxiety (OR 4.14, 95% CI 2.15 to 7.98) and stress (OR 4.60, 95% CI 2.31 to 9.17), and a fourfold increase in low resilience (OR 4.06, 95% CI 2.13 to 7.76) in mental health outcomes. As burnout increased, turnover intention was nearly four times as likely compared with retention (OR 3.55, 95% CI 1.73 to 7.28), and it was related to the quality of care. CONCLUSION: The results of this meta-analysis indicate that half of the nurses experienced burnout during the COVID-19. Nurses' burnout is associated with the sustainability of healthcare organizations. Healthcare organizations and societies should invest more time and effort in implementing evidence-based strategies to mitigate nurses' burnout across specialties, especially in emergency medicine and for younger nurses in specialized departments, to better prepare for future public health emergencies.