Long working hours and burnout in health care workers: Non‐linear dose‐response relationship and the effect mediated by sleeping hours—A cross‐sectional study

• Published in: Journal of occupational health Vol. 63; no. 1; pp. e12228 - n/a
• Main Authors: Lin, Ro‐Ting, Lin, Yu‐Ting, Hsia, Ying‐Fang, Kuo, Chin‐Chi
• Format: Journal Article
• Language: English
• Published: Australia John Wiley & Sons, Inc 01-01-2021; John Wiley and Sons Inc
• Subjects: Burnout; Coronaviruses; COVID-19; Cross-sectional studies; Health care; Health care facilities; health care workers; mediation analysis; Medical personnel; Nurses; Occupational health; Original; Pandemics; Personal health; Physicians; Questionnaires; Sleep deprivation; sleeping hours; Statistical analysis; Subgroups; Technicians; Variables; Working conditions; Working hours; United States > US; Taiwan; mediation analysis; sleeping hours; health care workers; burnout; working hours
• ISSN: 1348-9585; 1341-9145; 1348-9585
• DOI: 10.1002/1348-9585.12228

Objectives
Burnout among health care workers is highly prevalent and has profound impact on quality of care. Hospital on‐duty schedules lead to long working hours and short sleeping hours; both are common factors associated with burnout. We examined the dose‐response relationship and the potential mediating role of sleeping hours on the association between working hours and burnout among health care workers.
Methods
We collected data on the burnout status, using the Mandarin version of the Copenhagen Burnout Inventory (subscales measure work‐related and personal burnouts), working hours, sleeping hours, and relevant measures for 2081 health care personnel who underwent a routine health examination in a medical center in Taiwan during 2016‐2017. Four subgroups were compared: physicians (n = 369), nurses (n = 973), technicians (n = 391), and administrators (n = 348).
Results
Average weekly working hours are associated with burnout scores in a non‐linear dose‐response manner. Compared with a work week of 40 hours, the odds ratio of work‐related burnout doubled when hours exceeded 60, tripled when hours exceeded 74, and quadrupled when hours exceeded 84. Physicians’ burnout is less susceptible to incremental increases in working hours, compared to the situations in other health care workers. The proportions eliminated by reducing sleeping hours were 25%‐73% for physicians and 7%‐29% for nurses respectively.
Conclusions
Our findings suggest that working hours are associated with burnout, and the association was partially mediated by sleeping hours.