Assessment Of Burnout and Quality of Life Among Nursing Professionals in The Ashanti Region of Ghana

Assessment Of Burnout and Quality of Life Among Nursing Professionals in The Ashanti Region of Ghana | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessment Of Burnout and Quality of Life Among Nursing Professionals in The Ashanti Region of Ghana George Wireko Brobby Bonsu, Oscar Vetsi, Francis Atsu Kuadzi, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4224223/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction: Burnout among nursing professionals is problematic for the nursing workforce, considering its effect on their Quality of Life (QoL) and the global shortage of nurses. There is a dearth of literature on the effect of burnout on the QoL of the practice of nursing in Ghana. Hence, this study sought to estimate the prevalence of burnout and its effect on the QoL of nursing professionals in two district hospitals in Ghana. Methods An analytical cross-sectional study was conducted among three hundred and forty-three nursing professionals in two district hospitals in the Ashanti Region, Ghana. Data on participants' socio-demographic characteristics, work-related factors, burnout, and QoL were collected using a pretested structured questionnaire. The Maslach Burnout Inventory (MBI) and the World Health Organization Quality of Life (WHOQOL) questionnaire were used to assess burnout levels and QOL among study participants, respectively. Linear regression analysis was conducted to examine the burnout and the relationship between the dimensions of burnout and participants’ QoL. Result Out of the 343 participants, the prevalence of burnout was 2.9%. The mean age of study participants was 29.6 (± 5.4) years. About 20.7%, 83.6%, and 61.5% of the participants presented with high emotional exhaustion, depersonalization, and personal accomplishment, respectively. The study revealed that night shift (β: 6.06, 95%CI: 1.52, 11.60, p = 0.032) was associated with emotional exhaustion, while full day shift (β: -7.69, 95%CI: -13.48, -1.89, p = 0.010) and rank of nursing/midwifery officer (β:3.57, 95%CI: 1.71, 6.43, p = 0.015) were associated with depersonalization. The personal accomplishment dimension was predicted by casual employment (β: 5.72, 95%CI: 1.13, 11.31, p = 0.045). The mean score of the overall QoL score of study participants was 78.1 (± 8.6). A significant association was observed between moderate burnout for emotional exhaustion (β: − 4.59, 95%CI: -4.59, -0.46, p = 0.017), high burnout for personal accomplishment (β: -6.28, 95%CI: -8.65, -3.91, p < 0.001), and QoL of nursing professionals. Conclusion The total prevalence of burnout among nurse practitioners was low which is influenced by a multiplicity of factors: participants’ rank, type of shift, and type of employment. Burnout has a negative effect on the QoL of nursing professionals. Interventions to reduce the incidence of burnout can target reducing the number of night shifts and instituting incentives for casual/contract nurses. Burnout Quality of Life Nursing Professionals Healthcare Work Stress Introduction Burnout has gained attention in recent years due to its impact on the professional and quality of service provision in the healthcare setting. Globally, up to 58.0% of healthcare workers experience burnout [ 1 ]. The World Health Organization (WHO) defines burnout as ‘‘a syndrome thought to be caused by ongoing workplace stress that has not been effectively controlled’’ [ 2 ]. Burnout is characterized by three dimensions: emotional exhaustion, depersonalization, and personal accomplishment [ 3 ]. This can result in the exhaustion of energy, neglecting one’s self from his or her core responsibilities at the workplace, and loss of confidence and inability to complete a task [ 2 ]. Due to its public health interest, the WHO has now classified it as an occupational disease in the International Classification of Diseases (ICD-11) [ 2 ]. Several studies have shown a high prevalence of burnout among health workers in both high and low-income countries, with a higher prevalence among nurses and midwives than among other healthcare workers [ 4 ], [ 5 ], [ 6 ]. A systematic review and meta-analysis [ 7 ] reported a pooled burnout prevalence of 11.23% among nurses across the globe. In Singapore, a study found that about 39.0%, 40.0%, and 59.0% of nurses working in a tertiary hospital had high emotional exhaustion, depersonalization, and low personal accomplishment, respectively [ 8 ]. In Ethiopia, an overall pooled-prevalence of burnout has reportedly occurred among 39.0% of nurses [ 9 ]. In Uganda, research reported that about 40.0% of healthcare workers experienced high burnout [ 10 ]. Similarly, a study in Malawi reported that approximately 55.0%, 31.0%, and 46.0% of healthcare workers experienced average emotional exhaustion, depersonalization, and low reduced personal accomplishment, respectively [ 11 ]. In Nigeria, according to reports, nurses at tertiary hospitals experienced high emotional exhaustion (42.9%), depersonalization (47.6%), and reduced personal accomplishment (53.8%) [ 12 ]. Another study in Nigeria reported that about 69.0% of healthcare workers experienced burnout [ 13 ]. In Ghana, [ 14 ] found that about 9.90% of healthcare workers in the Greater Accra Region experienced burnout. In the Ashanti Region of Ghana, [ 15 ] found that about 2.1% of nurses working in a tertiary hospital experienced burnout at the workplace. Nursing professionals constitute the majority of the healthcare workforce and are primarily responsible for aiding patients to prevent diseases and improve their health [ 16 ]. The success of Sustainable Development Goal (SDG) three (3), which is good health and well-being for all [ 17 ], is largely dependent on the quality of services provided by nursing professionals globally. Assessing burnout for nursing professionals is key to the progress of the healthcare sector, because burnout does not only negatively affect the health professional, but also the health and safety of the patients [ 18 ]. Burnout among nursing professionals is problematic for the nursing workforce, considering its effect on the quality of life (QoL) of the professional [ 19 ] and the global shortage of nurses [ 20 ]. Quality of life is one of the significant aspects of nursing professionals that should not be overlooked. Quality of life defines the overall well-being of a person, and it encompasses his or her goals, targets, standards as well as living conditions. This usually reflects the issues or things that they cherish so much. It affects the psychological, social, and physical capabilities of a person [ 21 ]. It has been reported that the hospital environment can have a significant influence on the QoL of nursing professionals [ 22 ]. The QoL of a nurse can also be influenced by factors such as age, gender, management support, educational level, and income level [ 23 ], [ 24 ], [ 25 ], [ 26 ]. The QoL of nursing professionals can have a direct impact on the quality of service provided, organizational commitment, and job satisfaction [ 27 ], [ 28 ], [ 29 ]. Nursing professionals are heavily involved in the provision of quality healthcare to patients at the workplace [ 16 ]. Hence, they are mostly exposed to several workplace hazards, such as high workload, stress, and violence, which may increase their burnout levels at the workplace [ 22 ], [ 30 ], [ 31 ]. There is a need to protect the nursing workforce, considering their significance in the provision of quality healthcare delivery. Again, the QoL of nursing professionals may be affected by experiencing burnout at the workplace [ 19 ]. Several studies have reported that exposure to stressors at the workplace increases nurses' risk of burnout and this can subsequently hurt their quality of life and social health [ 33 , 34 ]. In Ghana, some studies have been conducted to determine the prevalence of burnout among nurses and other healthcare professionals [ 14 , 35 – 37 ]. [ 37 ] indicated that healthcare workers' unpreparedness towards Coronavirus disease 2019 (COVID-19) had an increased risk of burnout, [ 38 ] reported the effect of family-to-work-conflict on burnout and [ 14 ] also reported the adverse effect of burnout on the desire to leave the nursing and midwifery professions. However, these studies failed to consider the effects of burnout on QoL among nursing professionals. This study, therefore, sought to address this literature gap among nursing professionals in Ghana, and provide data that will help policy direction, especially among nursing professionals thereby helping to achieve the Sustainable Development Goals. The study aimed to determine the burnout and its association with QoL among nursing professionals in the Mampong and Agona Municipalities in Ashanti region, Ghana. Methods Study design and setting An institutional-based analytical cross-sectional study was conducted among the 343 nursing professionals to ascertain the burnout and its association with QoL. The Mampong Government Hospital (MGH) and Seventh Day Adventist Hospital, Asamang (SDAH) in the Mampong Municipality and Atwima Nwabiagya Districts, respectively in the Ashanti Region of Ghana were the study settings. The Mampong Municipality and Atwima Nwabiagya District constitute the forty-three municipal districts in the Ashanti Region. The two districts have over fifteen (15) health facilities, including hospitals, maternity homes, health centres, private facilities, and clinics. These health facilities provide a wide range of medical services to their inhabitants. Mampong Government Hospital is a district-level hospital that provides 24-hour service to the communities in the municipality. It provides a wide range of medical services and also serves as a referral centre for other health centres and private facilities nearby. The Seventh Day Adventist Hospital, Asamang is located at Asamang in the Atwima Nwabiagya District of the Ashanti Region. The hospital is widely known for the provision of healthcare in the district. It runs a 24-hour service. The facility also serves as a major referral point for other facilities within the district. These facilities were selected because they are among the health facilities residents in these districts mostly visit for health care services and they are the referral facilities in these districts. Study population All registered nurses and midwives working in the Mampong Government and Seventh Day Adventist hospitals were the study population. Nursing practitioners are those certified or licensed as nurses or midwives and are offering patient care. Inclusion and exclusion criteria All certified/registered nurses and midwives who had practiced for at least a year were included in the study. All registered nurses and midwives who were on annual leave during the period of data collection were excluded. Additionally, nursing professionals who declined to participate or failed to consent were excluded from the study. Sample size estimation The Charan and Biswas formula ( \(sample size= (Z^2 (P\left)\right(1-P\left)\right)/E^2)\) was used to estimate the sample size for the study [ 39 ]. At a 95% confidence interval (Z), 5% allowable margin of error (E), 20.0% of an estimated proportion of healthcare workers that experienced high burnout in Ghana [ 37 ] (P), a design effect of 1.3 and a non-response rate of 10%, a total of 350 nursing professionals were recruited participants for the study. Using a non-response rate of 10.0% and a design effect of 1.3, a sample size of 350 was estimated for this study. The design effect was estimated to account for the difference in the size of the two study sites. Sampling technique This study employed simple random sampling to select study participantsy. This was done by proportional allocation of study participants based on the number of nursing professionals in the two facilities. At each facility, the list of nursing professionals was retrieved from the Deputy Director of Nursing Services. The names of the nurses and midwives were assigned codes and entered into balloting. An independent person conducted the balloting. On a piece of paper, codes were written, folded and then placed in an A3 envelope. To make sure they were evenly blended, the envelope was shaken. The paper was drawn from the envelope one after the other until the estimated sample size for each facility was obtained. The names of the nursing professionals corresponding to a code drawn were contacted and screened for the study before recruitment. Data collection instrument Data were collected using a pre-tested structured questionnaire. The questionnaire was used to gather data on socio-demographic characteristics (such as age, sex, educational level, and income level), workplace environment (such as years of practice, management support, hours of work, shift type, and leadership style), burnout and QOL. The Maslach Burnout Inventory (MBI) was used to assess burnout among study populations [ 3 ]. The MBI tool is an internationally validated tool for assessing burnout, and it has been used in numerous studies [ 40 ], [ 41 ], [ 42 ]. MBI tool measures burnout in three dimensions: emotional exhaustion, depersonalization, and personal accomplishment level of the person. A 7-point Likert scale was used to rate each sub-item (0–6). Each study participant's overall score for each burnout dimension was estimated. Overall burnout was defined as high burnout for both emotional exhaustion and depersonalization and low burnout for personal accomplishment [ 3 ]. The rating of each burnout dimension has been presented in Table 1.1 . Table 1.1 Ratings for the dimensions of burnout Dimensions Items Low burnout Moderate burnout High burnout Emotional exhaustion 7 ≤ 17 18–29 ≥ 30 Depersonalization 7 < 6 6–11 ≥ 12 Personal accomplishment 8 ≥ 40 34–39 ≤ 33 A questionnaire from the World Health Organization on quality of life was used to measure the QoL of study participants [ 21 ]. The WHO QoL questionnaire is an approved tool that has been employed in numerous studies to measure the quality of life of nurses [ 21 ], [ 43 ]. This tool has 24 items that assess QoL in four domains: physical health (7 items), psychological health (6 items), social relationship (3 items), and environment (8 items) using a 5-point Likert scale [ 21 ]. To determine the domain score for each of the four domains, the mean scores of the different components in each domain were used. Each domain score was expressed as a percentage with a range of 0 to 100. The overall score of QoL was computed by adding the scores of each domain and expressed as a percentage. The QoL of the study participants increased as the QoL score increased. The questionnaire was pretested among ten nurses in different districts. Corrections were made to the questionnaire after the pretest before sending it to the field for data collection. Data analysis Data were analyzed using Stata statistical software version 16. Descriptive computations were conducted to describe the sampled general characteristics. Univariate and multivariate linear regression analysis was used to predict the factors associated with burnout dimensions and the effect of burnout dimensions on QOL. Covariates that were independently significant at the univariate analysis (p-value < 0.05), together with non-significant covariates at a p-value of < 0.2, were included in the multivariate linear regression analysis using a backward stepwise approach. For the effect of burnout dimensions on nurses' QOL, variables such as age, gender, and years of work, together with all the burnout dimensions, were fitted in the multivariate linear regression using a backward stepwise approach to the model to predict the effect of burnout dimensions on QOL. In all analyses, the significance level was maintained at p < 0.05 at a 95% confidence interval. Ethical consideration Ethical clearance was sought from the Committee on Human Research, Publications and Ethics, of the Kwame Nkrumah University of Science and Technology, Kumasi with reference number (CHRPE/AP/013/23), which served as ethical backing for the study. Moreover, permission was sought from the management of these health facilities and was granted. Before obtaining informed consent from patients, the study objectives, procedures and duration, and right to participation or withdrawal, including possible risks and benefits of the study were explained to participants. Participants were made to understand that their participation will not inflict harm on them, they can choose to withdraw at any point in time, if they desire and that, participation is voluntary. Following that, informed and verbal consent was sought from respondents before data collection. RESULTS Demographic characteristics of study participants The demographic characteristics of participants are presented in Table 1.2 . Out of a total of 350 nursing professionals that were recruited, 343 of them returned their questionnaires, yielding response rate of 98.0%. Nearly half of the participants (49.9%) were between the ages of 20 to 29 years, with a mean age (S.D) of 29.6 (± 5.4) years and a range of 20 to 54 years. A little over two-thirds (67.1%) of the study participants were females, and a little over half (51.0%) were married. Over two-thirds (63.3%) of the study participants were degree holders. Fifty-three (15.5%) of the study participants indicated they take alcohol, while twenty-four (7.0%) of the study participants indicated they smoke. Table 1.2 Demographic characteristics of study participants Variables Frequency (n = 343) Percentage (%) Age group (years) 20–29 171 49.9 30–39 154 44.9 ≥ 40 18 5.2 Mean age (± SD) 29.6 (± 5.4) [ 20 – 54 ] Gender Male 113 32.9 Female 230 67.1 Religion Christian 239 69.7 Muslim 104 30.3 Marital status Never married 168 49.0 Married 175 51.0 Highest level of education Diploma 111 32.4 Degree holders 217 63.3 Post-graduate 15 4.4 Smoke Yes 24 7.0 No 319 93.0 Take alcohol Yes 53 15.5 No 290 84.5 Work-related characteristics of study participants The work-related characteristics of study participants are presented in Table 1.3 . More than half (53.9%) were working at Mampong Government Hospital, over a third (36.2%) of the study participants were on a monthly salary of less than Gh¢2000.00, and almost all (95.9%) the participants were permanent staff. Eighty-eight (25.7%) of the study subjects were in the department of Eye/Dental. Over half (54.8%) of the participants were staff nurses/midwives, and nearly half (48.4%) have less than 5 years of professional experience with a median working experience of 5 (IQR: 4) years, with a range of 1 to 40 years. Almost all the participants (93.9%) perceived the work to be stressful, nearly two-thirds (62.1%) had the majority of their shift in the afternoon, and more than half (56.9%) received adequate support from management. Table 1.3 Work-related characteristics of study participants Variables Frequency (n = 343) Percentage (%) Place of work Agona Government Hospital 158 46.1 Mampong Government Hospital 185 53.9 Monthly salary (Gh¢) < 2000 124 36.2 2000–2999 121 35.3 3000–3999 78 22.7 ≥ 4000 20 5.8 Type of employment Permanent 329 95.9 Contract/casual 14 4.1 Department Male ward 29 8.5 Female ward 13 3.8 Emergency 54 15.7 Maternity 51 14.9 Out-patient department 79 23.0 Eye/Dental 88 25.7 Other* 29 8.5 Rank/position Staff nurse/midwife 188 54.8 Senior Staff Nurse/Midwife 39 11.4 Nursing/Midwifery Officer 72 21.0 Senior Nursing/Midwife Officer 29 8.5 Principal Nursing/Midwifery Officer 15 4.4 Work experience (years) < 5 166 48.4 5–9 143 41.7 10+ 34 9.9 Median work experience (IQR) 5 (4) [ 1 – 40 ] Work is stressful Yes 322 93.9 No 21 6.1 Majority of work shift Morning 87 25.4 Afternoon 213 62.1 Night 18 8.2 Full day 15 4.4 Support from management Adequate 195 56.9 Inadequate 148 43.1 Burnout among study participants Prevalence of burnout among study participants The descriptive statistics of the burnout component are presented in Table 1.4 . The median scores of emotional exhaustion, depersonalization, and personal accomplishment were 15 (IQR: 27), 25 (IQR: 16), and 32 (IQR: 12), respectively, suggesting a low burnout for emotional exhaustion and high burnout for both depersonalization and personal accomplishment. A little over one-fifth (20.7%) experienced high emotional exhaustion, while the majority (83.6%) and over two-thirds of them experienced high depersonalization and high personal accomplishment, respectively. Overall, the prevalence of burnout was 2.9%. Table 1.4 Descriptive statistics of burnout dimensions Dimensions Median IQR Low burnout n (%) Moderate burnout n (%) High burnout n (%) Emotional Exhaustion 15 27 187 (54.5) 85 (24.8) 71 (20.7) Depersonalization 25 16 17 (5.0) 39 (11.4) 287 (83.6) Personal accomplishment 32 12 56 (16.3) 76 (22.2) 211 (61.5) Burnout N % Yes 10 2.9 No 333 97.1 IQR: Interquartile range Factors associated with burnout among study participants Linear regression analysis was performed to identify significant predictors of all the dimensions of burnout. After adjusting for significant variables, emotional exhaustion was predicted by the night shift (adjusted β: 6.06, 95%CI: 1.52, 11.60, p = 0.032) (Table 1.5 ). The depersonalization dimension of burnout was predicted by full day shift (adjusted β: -7.69, 95%CI: -13.48, -1.89, p = 0.010) and rank of nursing/midwifery officer (adjusted β: 3.57, 95%CI: 1.71, 6.43, p = 0.015) (Table 1.6 ). The personal accomplishment dimension was predicted by casual employment (adjusted β: 5.72, 95%CI: 1.13, 11.31, p = 0.045) (Table 1.7 ). Table 1.5 Linear regression analysis of factors associated with emotional exhaustion Variables Model 1 Model 2 β 95%CI p-value Adj. β 95%CI p-value Age (years) -0.25 -0.50, 0.01 0.060 - - - Work experience (years) -0.07 -0.38, 0.24 0.654 - - - Gender Male 1.00 - - - Female 1.32 -1.64, 4.28 0.381 - - - Marital status Never married 1.00 1.00 Married -2.91 -5.68, -0.14 0.039 -2.30 -5.10, 0.49 0.106 Rank/position Staff nurse/midwife 1.00 1.00 Senior Staff Nurse/Midwife 0.96 -3.54, 5.47 0.674 1.05 -3.42, 5.52 0.646 Nursing/Midwifery Officer 2.25 -1.30, 5.80 0.213 2.46 -1.09, 6.02 0.174 Senior Nursing/Midwife Officer -5.64 -10.75, -0.53 0.031 -4.38 -9.51, 0.74 0.093 Principal Nursing/Midwifery Officer 1.42 -5.46, 8.29 0.686 0.52 -6.36, 7.41 0.881 Majority of work shift Morning 1.00 1.00 Afternoon 1.84 -1.43, 5.10 0.269 2.11 -1.14, 5.36 0.203 Night 6.88 1.31, 12.45 0.016 6.06 1.52, 11.60 0.032 Full day 3.43 -3.73, 10.60 0.347 2.28 -4.91, 9.47 0.533 Support from management Adequate 1.00 1.00 Inadequate 3.31 0.52, 6.10 0.020 2.89 0.10, 5.68 0.042 Adjusted R 2 0.033 Prob > F 0.016 Adjusted for significant variables Table 1.6 Linear regression analysis of factors associated with depersonalization Variables Model 1 Model 2 β 95%CI p-value Adj. β 95%CI p-value Age (years) -0.16 -0.37, 0.05 0.128 - - - Work experience (years) 0.03 -0.22, 0.27 0.841 - - - Gender Male 1.00 Female 1.91 -0.47, 4.30 0.116 - - - Relationship status Single 1.00 - - - Married 1.19 -1.06, 3.43 0.299 - - - Rank/position Staff nurse/midwife 1.00 1.00 Senior Staff Nurse/Midwife -1.91 -5.53, 1.72 0.301 -2.06 -5.66, 1.53 0.260 Nursing/Midwifery Officer 3.17 1.32, 6.03 0.029 3.57 1.71, 6.43 0.015 Senior Nursing/Midwife Officer 3.24 -0.87, 7.35 0.122 2.81 -1.28, 6.89 0.178 Principal Nursing/Midwifery Officer 4.20 -1.32, 9.73 0.136 5.00 -0.53, 10.52 0.076 Majority of work shift Morning 1.00 1.00 Afternoon -0.98 -3.61, 1.65 0.465 -0.90 -3.51, 1.71 0.498 Night -4.11 -8.60, 0.38 0.073 -4.04 -8.49, 0.42 0.076 Full day -6.46 -12.24, -0.68 0.029 -7.69 -13.48, -1.89 0.010 Adjusted R 2 0.036 Prob > F 0.007 Table 1.7 Linear regression analysis of factors associated with personal accomplishment Variables Model 1 Model 2 β 95%CI p-value Adj. β 95%CI p-value Age (years) -0.13 -0.33, 0.08 0.228 - - - Work experience (years) -0.12 -0.36, 0.13 0.349 - - - Gender Male 1.00 - - - Female -1.77 -4.12, 0.58 0.140 - - - Marital status Never married 1.00 - - - Married 0.53 -1.68, 2.75 0.637 - - - Type of employment Permanent 1.00 1.00 Contract/casual 5.99 1.42, 11.56 0.035 5.72 1.13, 11.31 0.045 Adjusted R 2 0.013 Prob > F 0.041 Quality of life of study participants The description of the 4 QoL domains and the overall QoL of study participants have been presented in Table 1.8 . The mean score of the overall QoL score of study participants was 78.1 (± 8.6). All the study participants scored more than 50% (mean score) for all the domains of QoL. Comparing the four domains of QoL, the social health domain was the highest with a mean score of 81.2 (± 11.7), followed by the environment domain with a mean score of 79.4 (± 10.6). The physical health domain recorded the lowest score with a mean score of 76.5 (± 11.0). Table 1.8 Descriptive statistics of the 4 quality of life domains and overall quality of life of study participants QOL domains N MIN MAX MEAN SD RC Physical health 343 20 100 76.5 11.0 0.829 Psychological health 343 20 100 76.9 10.8 0.777 Social health 343 40 100 81.2 11.7 0.672 Environment 343 33 100 79.4 10.6 0.841 Overall QOL 343 36 100 78.1 8.6 0.902 Association between burnout and Quality of life of study participants Table 1.9 presents a linear regression analysis of the association between burnout dimensions and QoL. Participants’ QoL was predicted by moderate burnout for emotional exhaustion (β: − 4.59, 95%CI: -4.59, -0.46, p = 0.017) and high burnout for personal accomplishment (β: -6.28, 95%CI: -8.65, -3.91, p < 0.001). Table 1.9 Linear regression analysis of the association between burnout dimensions and QOL Model 1 Model 2 β 95%CI p-value Adj. β 95%CI p-value Emotional exhaustion Low 1.00 1.00 Moderate -3.31 -5.46, -1.17 0.003 -2.53 -4.59, -0.46 0.017 High 2.85 0.56, 5.13 0.015 2.50 0.30, 4.71 0.026 Depersonalization Low 1.00 Moderate 2.88 -2.00, 7.77 0.247 - - - High 3.95 -0.25, 8.15 0.065 - - - Personal accomplishment Low 1.00 1.00 Moderate -1.46 -4.27, 1.34 0.305 -1.62 -4.40, 1.16 0.251 High -6.73 -9.12, -4.34 < 0.001 -6.28 -8.65, -3.91 F < 0.001 Discussion Overall, the prevalence of burnout observed among study participants in the present study was low (2.9%). The findings of this study underpins initial reports that burnout is rife among nursing professionals in sub-Saharan Africa [ 10 ], [ 44 ], [ 45 ]. The overall prevalence of burnout observed in the present study is consistent with the 2.1% reported among nursing professionals in the Kumasi Metropolis [ 15 ]. However, the overall prevalence of burnout observed in the present study is at variance with the prevalence of burnout (68.6%) that was reported among the nurses at a medical tertiary facility in Nigeria [ 46 ]. A possible reason for the disparity between the two studies could be attributed to the variations in the study design, sampling procedure, tools for assessing burnout, and the difference in the healthcare systems in Nigeria and Ghana. The Nigerian study [ 46 ] measured burnout using the Oldenburg Burnout Inventory while the present study used MBI to measure nurses' burnout which could affect the prevalence of burnout. In the present study, a high burnout for both depersonalization (83.6%) was observed as compared to personal accomplishment (61.5%) and emotional exhaustion (54.5%) dimensions. The prevalence of emotional exhaustion observed in the present study affirms initial reports that Ghanaian nurses experience low emotional exhaustion [ 15 ], [ 35 ]. The high level of burnout observed in the present study for both depersonalization and personal accomplishment are similar to higher levels of burnout for depersonalization (71.6%) and personal accomplishment (90.8%) reported among nurses working in a tertiary hospital in Jeddah [ 47 ]. The higher prevalence of burnout for depersonalization is particularly a worry since the depersonalization dimension of burnout is when the employee no longer has an interest in the job and detaches him or herself from her core responsibilities at the workplace. The high depersonalization experienced by nurses in the present study can affect the contribution of nurses to quality healthcare delivery in the healthcare system. It is important to encourage nurses that may be experiencing any form of burnout to seek counselling and possible attention to reduce its incidence at the workplace. The findings of the present study showed that the night shift was associated with the emotional exhaustion dimension while the full-day shift and rank of nursing/midwifery officer were associated with depersonalization. Casual/contract employment was significantly associated with personal accomplishment. In this present study, it was found that night shifts and full-day shifts were significantly associated with emotional exhaustion and personal accomplishment, respectively. In this study, nurses who had most of their shifts to be full day had an expected decrease in high burnout for personal accomplishment compared to those who had the majority of their shifts to be morning. Also, compared to nurses who had the majority of their working shift to be morning shift, those who had most of their shift in the night had an expected increase in emotional exhaustion by six times. A possible explanation for this could be the longer working hours for the night shift compared to the morning shift. Nurses spend a lot of hours at the workplace for night shifts than morning shifts which may increase their stress levels thereby draining them emotionally. A previous study has stressed the need to reduce long working hours to reduce the incidence of burnout at the workplace [ 48 ]. In China, a similar study found a significant influence of long working hours on emotional exhaustion [ 49 ]. In this current study, it was revealed that nursing/midwifery officers had an expected increase in depersonalization levels by three compared with staff nurses/midwives. This may be explained by the high demand for nursing/midwifery officers to deliver quality services that meet the expectation of the patient as they mostly play supervisory roles compared to staff nurses/midwives who are junior officers at the workplace. This makes them overburden themselves with a lot of workloads which can predispose them to experience high burnout for depersonalization. A high workload has also been reported to increase one's risk of burnout in China [ 50 ]. A study in Nigeria also found that senior nurses were at increased risk of high burnout for depersonalization [ 12 ]. The study observed that casual/contract nurses had an expected increase in high burnout for personal accomplishment compared to permanent workers. A possible reason could be that temporary casual/contract nursing workers could be so driven by their desire to land permanent jobs that they accept and complete assignments if they are even tired without taking breaks which can predispose them to high burnout for personal accomplishment. The welfare of every healthcare professional is essential for the delivery of high-quality medical care, based on that, this study assessed the QoL of nursing professionals. Overall, the QoL observed among study participants in the present study was high. Participants reported high QoL in all four domains. However, among the four domains of QoL, participants reported the highest QoL in the social health domain and the least in the physical health domain. The high QoL observed among study participants is important for quality healthcare delivery. This is because nurses play a critical role in the provision of quality healthcare delivery in the healthcare continuum. The high QoL of the social health domain observed in the present study reflects participants’ high level of contentment with social support and peer interaction in their daily lives. This is in agreement with a study in Malaysia which also observed the highest QoL scores in the social health domain among nurses [ 51 ]. In India, a study also reported high QoL scores in the social health domain [ 52 ]. More than half of the nurses in this study were married, and having a supportive partner could be one of the variables that contribute to a good QoL score in terms of social relationships. Again, over half of the study participants indicated they received management support at the workplace which is also a good recipe for good QoL score of the social health domain. The least QoL scores observed in the physical health domain in the present study could be explained by the notion that nurses concurrently perform the responsibilities of woman, mother, wife, and daughter. These can impair physical QoL and cause fatigue and sleep deprivation. In Poland, a similar study reported that of the four domains of the QoL, nurses reported the worst in the physical health domain [ 53 ]. In China, a similar study also observed lower scores of QoL in the physical domain [ 54 ]. However, the physical domain is the worst QoL observed in the present study and is at variance with a study in Australia where nurses performed higher scores in the physical health domain [ 55 ]. The results from the present study underpins initial reports that the occurrence of burnout is negatively associated with the QoL of nursing professionals [ 56 ], [ 57 ], [ 58 ]. It was found out in this present study that participants’ QoL was significantly predicted by high and moderate burnout for personal accomplishment and depersonalization dimensions of burnout respectively. It was found out in this present study that nursing professionals that experienced high burnout for personal accomplishment had an expected decrease in the overall QoL scores compared to those that experienced low burnout. This implies that nursing professionals who experience high levels of burnout for personal accomplishment are greater likelihood of a reduction in their QoL. Nursing professionals assessing themselves as having high burnout for personal accomplishment means that he or she sees themselves as negatively and cannot progress in their professional career. At this stage, the nursing professional may start to doubt his or her capability to progress professionally and this can negatively affect his or her well-being. Findings from this study is in agreement with earlier studies which reported a significantly negative correlation between personal accomplishment and QoL [ 59 ], [ 60 ]. Another significant finding of the present study was that participants that experienced moderate burnout levels for depersonalization had an expected decrease in the QoL scores by four compared to those who had modest degrees of burnout for the depersonalization dimension. This is in line with previous studies that have reported a negative correlation between burnout and QoL [ 19 ], [ 61 ]. A nursing professional experiencing high levels of depersonalization may detach themselves from colleagues and patients which can affect his or her psychological health domain of QoL [ 60 ]. Strengths and limitations of study The study had some strengths and limitations positing that results should be cautiously interpreted. The study’s strength resides in its novelty as the first study to investigate burnout and quality of life among nursing professionals in the study settings. Additionally, the use of appropriate methodology and rigorous analysis is a strength of the study. Despite the strength of the study, it has weaknesses that cannot be overemphasized. The study used a cross-sectional design which provides a snapshot of a particular point in time limiting the ability to establish causality. Additionally, the study is subject to recall bias and social desirability flaws following the design employed This notwithstanding, the rigorous procedures adopted in our study were able to suppress the effects of the weaknesses, thus making the findings viable for decision making. Conclusions This study revealed that the overall prevalence of burnout among nursing professionals was low (2.9%). The prevalence of burnout for depersonalization (83.6%) and personal accomplishment (61.5%) dimensions of burnout were high. Night shift was associated with the emotional exhaustion dimension, full-day shift and rank of nursing/midwifery officer were associated with depersonalization and casual/contract employment was significantly associated with personal accomplishment. Overall, the QoL observed among study participants in the present study was high (mean score: 76.5 (± 11.0) among all the QoL domains. The present study revealed a negative relationship between the dimensions of burnout and the overall QoL. Participants’ QoL was negatively predicted by high and moderate burnout for personal accomplishment and depersonalization dimensions of burnout, respectively. Therefore, Ministry of Health and key health stakeholders should periodically screen nursing professionals for possible burn out and professional guidance and/or counselling where necessary to avert negative repercussions. Implication for practice and research Hospital administrators and nurse managers should encourage nursing professionals experiencing burnout to seek early treatment to avoid any unwanted outcomes, and prioritize reducing the number of night and full-day shifts of nursing professionals within the week and month. This is because this study has highlighted the effect of exposure to a lot of night and full-day shifts on the incidence of burnout among them. The Ministry of Health and appropriate stakeholders should commence processes to permanently engage causal/contract nurses; the hospital administrators can also institute some financial benefits that can cushion them to serve as a source of motivation. Future studies in the future can adopt a qualitative methodology to thoroughly comprehend the dynamics of burnout and its impact on the QoL of nurse practitioners. Also, longitudinal study is recommended to investigate the impact of burnout on quality of healthcare provided to patients. Declarations Ethics approval and consent to participate The Committee for Human Research, Publication, and Ethics of the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana provided ethical clearance for this research with reference number (CHRPE/AP/013/23). Additionally, informed consent was obtained from all participants before data collection. All ethical principles were duly followed throughout the study to conform to the declaration of Helsinki. Consent for publication Not applicable Availability of data and materials The datasets generated and/or analysed in this study are freely available upon making a reasonable request to the corresponding author Competing interests The authors declare that no competing interest exist in the preparation and publication of this paper. Funding The authors had no funding for the study Author’s contributions GWBB conceptualized and developed the concept. GWBB, OV, and FKB conducted the formal analysis and interpreted the results. GWBB, OV, FAK, FKB, KB and DB drafted the manuscript. All authors proofread the manuscript for important intellectual content before submission for publication. Acknowledgments We are most grateful to the cooperative respondents that participated in the study, it was through their cooperation that we are able to contribute to science. We also express our appreciation to the management at Manhyia Government and Seventh Day Adventist Hospitals for allowing us to use their premises for the study. References M. R. Gualano et al. , ‘The burden of burnout among healthcare professionals of intensive care units and emergency departments during the COVID-19 pandemic: a systematic review’, International journal of environmental research and public health , vol. 18, no. 15, p. 8172, 2021. World Health Organization, ‘Burn-out an “occupational phenomenon”: International Classification of Diseases’, International Classification of Disease , no. May 2019. 2019. C. Maslach and S. E. Jackson, ‘The measurement of experienced burnout’, Journal of Organizational Behavior , vol. 2, no. 2, pp. 99–113, 1981, doi: 10.1002/job.4030020205. I. Duarte et al. , ‘Burnout among Portuguese healthcare workers during the COVID-19 pandemic’, BMC Public Health , vol. 20, no. 1, pp. 1–10, 2020, doi: 10.1186/s12889-020-09980-z. M. Elhadi, A. Msherghi, M. Elgzairi, and A. Alhashimi, ‘Burnout Syndrome Among Hospital Healthcare Workers During the COVID-19 Pandemic and Civil War : A Cross-Sectional Study’, Frontiers in psychiatry , vol. 11, pp. 1–11, 2020, doi: 10.3389/fpsyt.2020.579563. S. Adam, A. Mohos, L. Kalabay, and P. Torzsa, ‘Potential correlates of burnout among general practitioners and residents in Hungary: The significant role of gender, age, dependant care and experience’, BMC Family Practice , vol. 19, no. 1, pp. 1–10, 2018, doi: 10.1186/s12875-018-0886-3. T. Woo, R. Ho, A. Tang, and W. Tam, ‘Global prevalence of burnout symptoms among nurses: A systematic review and meta-analysis’, Journal of Psychiatric Research , vol. 123, no. December 2019, pp. 9–20, 2020, doi: 10.1016/j.jpsychires.2019.12.015. S. Y. Ang et al. , ‘Demographics and personality factors associated with burnout among nurses in a Singapore tertiary hospital’, BioMed Research International , vol. 2016, 2016, doi: 10.1155/2016/6960184. A. Hailay, W. Aberhe, G. Mebrahtom, K. Zereabruk, G. Gebreayezgi, and T. Haile, ‘Burnout among nurses working in Ethiopia’, Behavorial Neurology , vol. 2020, 2020. A. Kabunga and P. Okalo, ‘Prevalence and predictors of burnout 19 : a among nurses during COVID- ­ sectional study in hospitals in central Uganda’, BMJ Open , vol. 11, no. 1, p. :e054284, 2021, doi: 10.1136/bmjopen-2021-054284. M. H. Kim et al. , ‘Burnout and self-reported suboptimal patient care amongst health care workers providing HIV care in Malawi’, PLoS ONE , vol. 13, no. 2, pp. 1–15, 2018. F. E. Okwaraji and E. N. Aguwa, ‘Burnout and psychological distress among nurses in a Nigerian tertiary health institution’, African Health Sciences , vol. 14, no. 1, pp. 237–245, 2014, doi: 10.4314/ahs.v14i1.37. A. D. G. Nwosu, E. Ossai, O. Onwuasoigwe, M. Ezeigweneme, and J. Okpamen, ‘Burnout and presenteeism among healthcare workers in Nigeria : Implications for patient care , occupational health and workforce’, Journal of Public Health Research , vol. 10, no. 11, p. pp.jphr-2021, 2021, doi: 10.4081/jphr.2021.1900. K. Odonkor, S.T. and Frimpong, ‘Burnout among healthcare professionals in Ghana: A critical assessment’, BioMed research international , vol. 2020, 2020, doi: https://doi.org/10.1155/2020/1614968. D. A. Opoku et al. , ‘Attrition of nursing professionals in Ghana: An effect of burnout on intention to quit’, Nursing Research and Practice , vol. 2022, 2022. World Health Organization., ‘Nursing and midwifery; Key facts’, WHO FACTS SHEETS . pp. 1–36, 2017. United Nations, ‘Sustainable Development Goal’, United Nations . 2015. C. D. L. Garcia et al. , ‘Influence of burnout on patient safety: systematic review and meta-analysis’, Medicina , vol. 55, no. 9, pp. 1–13, 2019, doi: 10.3390/medicina55090553. X. Li, T. Jiang, J. Sun, L. Shi, and J. Liu, ‘The relationship between occupational stress, job burnout and quality of life among surgical nurses in Xinjiang, China’, BMC Nursing , vol. 20, no. 1, pp. 1–11, 2021, doi: 10.1186/s12912-021-00703-2. R. H. Mudallal, W. M. Othman, and N. F. Al Hassan, ‘Nurses’ burnout: The influence of leader empowering behaviors, work conditions, and demographic traits’, Inquiry (United States) , vol. 54, 2017, doi: 10.1177/0046958017724944. World Health Organization, ‘The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties’, Social Science and Medicine , vol. 46, no. 12, pp. 1569–1585, 1998, doi: 10.1016/S0277-9536(98)00009-4. P. L. Burtson and J. F. Stichler, ‘Nursing work environment and nurse caring: Relationship among motivational factors’, Journal of Advanced Nursing , vol. 66, no. 8, pp. 1819–1831, 2010, doi: 10.1111/j.1365-2648.2010.05336.x. K. Suleiman, Z. Hijazi, M. Al Kalaldeh, and L. Abu Sharour, ‘Quality of nursing work life and related factors among emergency nurses in Jordan’, Journal of Occupational Health , vol. 61, no. 5, pp. 398–406, 2019, doi: 10.1002/1348-9585.12068. T. Moradi, F. Maghaminejad, and I. Azizi-Fini, ‘Quality of working life of nurses and its related factors’, Nursing and Midwifery Studies , vol. 3, no. 2, 2014, doi: 10.5812/nms.19450. R. Faizin, R. Fitryasari, E. D. Wahyuni, and N. Nursalam, ‘Nurse’s individual factors may predict quality of nursing work life (Qnwl) in clinical setting’, International Journal of Psychosocial Rehabilitation , vol. 24, no. 7, 2020, doi: 10.37200/IJPR/V24I7/PR270894. P. Raeissi, M. R. Rajabi, E. Ahmadizadeh, K. Rajabkhah, and E. Kakemam, ‘Quality of work life and factors associated with it among nurses in public hospitals, Iran’, Journal of the Egyptian Public Health Association , vol. 94, no. 1, 2019, doi: 10.1186/s42506-019-0029-2. S. Javanmardnejad, R. Bandari, M. Heravi-Karimooi, N. Rejeh, H. Sharif Nia, and A. Montazeri, ‘Happiness, quality of working life, and job satisfaction among nurses working in emergency departments in Iran’, Health and Quality of Life Outcomes , vol. 19, no. 1, pp. 1–8, 2021, doi: 10.1186/s12955-021-01755-3. S. Suaib, S. Syahrul, and T. Tahir, ‘Nurses’ Quality of Work Life’, Journal of Health Science and Prevention , vol. 3, no. 3S, pp. 63–66, 2019, doi: 10.29080/jhsp.v3i3s.292. A. Karaaslan and M. Aslan, ‘The Relationship Between the Quality of Work and Organizational Commitment of Prison Nurses’, Journal of Nursing Research , vol. 27, no. 3, pp. 1–10, 2019, doi: 10.1097/jnr.0000000000000286. F. Jiang et al. , ‘Intention to leave and associated factors among psychiatric nurses in China: A nationwide cross-sectional study’, International Journal of Nursing Studies , vol. 94, pp. 159–165, 2019, doi: 10.1016/j.ijnurstu.2019.03.013. Ministry of Health and Ghana Health Service, ‘Occupational Health and Safety Policy and Guidelines for the Health Sector’, 2013. M. D. Dyrbye LN, Shanafelt TD, Sinsky CA, Cipriano PF, Bhatt J, Ommaya A, West CP, ‘Burnout Among Health Care Professionals A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care’, NAM perspectives . 2017. N. E. Clarke, S.P. and Donaldson, ‘Nurse staffing and patient care quality and safety. Patient safety and quality: An evidence-based handbook for nurses’. 2008. S. Adriaenssens, J., De Gucht, V. and Maes, ‘Determinants and prevalence of burnout in emergency nurses : A systematic review of 25 years of research’, International Journal of Nursing Studies , vol. 52, no. 1, pp. 649–661, 2015, doi: 10.1016/j.ijnurstu.2014.11.004. M. Nkyi, A.K. and Blay, ‘Occupational burnout among nurses working in Cape Coast Metropolitan Hospital Ghana’, Indian Journal of Health and Wellbeing , vol. 11, no. 10–12, pp. 459–465, 2020. S. T. Opoku and B. A. Apenteng, ‘Career satisfaction and burnout among Ghanaian physicians’, International Health , vol. 6, no. 1, pp. 54–61, 2014, doi: 10.1093/inthealth/iht038. P. A. Afulani et al. , ‘Inadequate preparedness for response to COVID-19 is associated with stress and burnout among healthcare workers in Ghana’, PLoS ONE , vol. 16, no. 4 April, pp. 1–20, 2021, doi: 10.1371/journal.pone.0250294. E. E. A. Asiedu, F. Annor, K. Amponsah-Tawiah, and K. Dartey-Baah, ‘Juggling family and professional caring: Role demands, work–family conflict and burnout among registered nurses in Ghana’, Nursing Open , vol. 5, no. 4, pp. 611–620, 2018, doi: 10.1002/nop2.178. J. Charan and T. Biswas, ‘How to calculate sample size for different study designs in medical research?’, Indian Journal of Psychological Medicine , vol. 35, no. 2. pp. 121–126, 2013. doi: 10.4103/0253-7176.116232. T. D. Shanafelt et al. , ‘Changes in Burnout and Satisfaction with Work-Life Balance in Physicians and the General US Working Population between 2011 and 2014’, Mayo Clinic Proceedings , vol. 90, no. 12, pp. 1600–1613, 2015, doi: 10.1016/j.mayocp.2015.08.023. E. Lahana, K. Papadopoulou, O. Roumeliotou, A. Tsounis, P. Sarafis, and D. Niakas, ‘Burnout among nurses working in social welfare centers for the disabled’, BMC Nursing , vol. 16, no. 1, pp. 1–10, 2017, doi: 10.1186/s12912-017-0209-3. R. H. Mudallal, W. M. Othman, and N. F. Al Hassan, ‘Nurses’ burnout: the influence of leader empowering behaviors, work conditions, and demographic traits.’, INQUIRY: The Journal of Health Care Organization, Provision, and Financing , vol. 54, p. 0046958017724944., 2017, doi: 10.1177/0046958017724944. H. Khatatbeh, T. Al-Dwaikat, J. Rababah, A. Oláh, and A. Pakai, ‘Paediatric nurses’ burnout, quality of life and perceived patient adverse events during the COVID-19 pandemic: Testing an integrated model using structural equation modelling’, Journal of Clinical Nursing , no. July, pp. 1–10, 2021, doi: 10.1111/jocn.16114. Y. Adomaah, B. Sylvia, A. Osei, I. Korkoi, and A. A. Druye, ‘Causes of burnout syndrome and coping strategies among high dependency unit nurses of an institution in the greater Accra region of Ghana’, Nursing Open , vol. 8, no. 6, pp. 3334–3339, 2021, doi: 10.1002/nop2.1052. T. M. Ashipala, D.O. and Nghole, ‘Factors contributing to burnout among nurses at a district hospital in Namibia: A qualitative perspective of nurses’, Journal of Nursing Management , pp. 1–10, 2022, doi: 10.1111/jonm.13693. A. D. G. Nwosu, E. Ossai, O. Onwuasoigwe, M. Ezeigweneme, and J. Okpamen, ‘Burnout and presenteeism among healthcare workers in Nigeria: Implications for patient care, occupational health and workforce productivity’, Journal of Public Health Research , vol. 10, no. 1, p. jphr-2021, 2021, doi: 10.4081/jphr.2021.1900. J. T. Qedair et al. , ‘Prevalence and factors associated with burnout among nurses in Jeddah: a single ‑ institution cross ‑ sectional study’, BMC Nursing , vol. 21, no. 1, pp. 1–8, 2022, doi: 10.1186/s12912-022-01070-2. N. Hu, J. Chen, and T. Cheng, ‘The associations between long working hours, physical inactivity, and burnout’, Journal of Occupational and Environmental Medicine , vol. 58, no. 5, pp. 514–518, 2016, doi: 10.1097/JOM.0000000000000715. B. Wang, Z., Xie, Z., Dai, J., Zhang, L., Huang, Y. and Chen, ‘Physician burnout and its associated factors: a cross-sectional study in Shanghai’, Journal of Occupational Health , p. pp.13-0108, 2014. L. Meng, Y. Liu, H. Liu, Y. Hu, J. Yang, and J. Liu, ‘Relationships among structural empowerment, psychological empowerment, intent to stay and burnout in nursing field in mainland China-based on a cross-sectional questionnaire research’, International Journal of Nursing Practice , vol. 21, no. 3, pp. 303–312, 2015, doi: 10.1111/ijn.12279. K. Y. Lee, ‘Quality of life among nurses in primary healthcare clinics in the health district of Petaling, Selangor’, International Journal of Public Health and Clinical SCiences , vol. 5, no. 5, pp. 2289–7577, 2018, doi: 10.32827/ijphcs.5.5.57. P. N. R. Jathanna and J. D. Silva, ‘Quality of life among nurses working in different health care setting in the state of Karnataka , India’, CHRISMED Journal of Health and Research , vol. 1, no. 4, pp. 241–244, 2014, doi: 10.4103/2348-3334.142986. N. Orszulak, K. Kubiak, A. Kowal, and M. Czapla, ‘Nurses ’ Quality of Life and Healthy Behaviors’, International Journal of Environmental Research and Public Health , vol. 19, no. 19, p. p.12927, 2022. J. O. Asante, M. J. Li, J. Liao, and Y. X. Huang, ‘The relationship between psychosocial risk factors , burnout and quality of life among primary healthcare workers in rural Guangdong province : a cross-sectional study’, BMC Health Services Research , vol. 19, no. 1, pp. 1–10, 2019. L. Perry, X. Xu, C. Duffield, R. Gallagher, R. Nicholls, and D. Sibbritt, ‘Health , workforce characteristics , quality of life and intention to leave : The “ Fit for the Future ” survey of Australian nurses and midwives’, Journal of Advance Nursing , vol. 73, no. 11, pp. 2745–2756, 2017, doi: 10.1111/jan.13347. Z. Omidi, S. Khanjari, T. Salehi, and S. Haghani, ‘Association between burnout and nurses’ quality of life in neonatal intensive care units: During the COVID-19 pandemic’, Journal of Neonatal Nursing , 2022. M. Aranđelović, M. Nikolić, and S. Stamenković, ‘Relationship between Burnout, quality of life, and work ability index — directions in prevention’, The Scientific World Journal , vol. 10, no. 1, pp. 766–777, 2010, doi: 10.1100/tsw.2010.83. S. Naz, A. M. Hashmi, and A. Asif, ‘Burnout and quality of life in nurses of a tertiary care hospital in Pakistan’, vol. 11, pp. 532–536, 2013. H. Farsi, Z., Rajai, N. and Habibi, ‘The relationship between burnout and quality of working life in nurses of AJA hospitals in Tehran’, Military Caring Sciences , vol. 1, no. 2, 2015. L. Colby et al. , ‘The association between the levels of burnout and quality of life among fourth-year medical students at the University of the Free State’, South African Journal of Psychiatry , vol. 24, pp. 1–6, 2018. M. A. Alotni and S. E. Elgazzar, ‘Investigation of burnout, its associated factors and its effect on the quality of life of critical care nurses working in Buraydah Central Hospital at Qassim Region, Saudi Arabia’, The Open Nursing Journal , vol. 14, no. 1, pp. 190–202, 2020, doi: 10.2174/1874434602014010190. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4224223","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":292065675,"identity":"2c1d2ebc-a643-4d34-9939-8f8f0cb6a7ff","order_by":0,"name":"George Wireko Brobby Bonsu","email":"","orcid":"","institution":"Directorate of University Health Services, Akenten Appiah-Menkah University of Skills Training and Entrepreneurial Development, Kumasi","correspondingAuthor":false,"prefix":"","firstName":"George","middleName":"Wireko Brobby","lastName":"Bonsu","suffix":""},{"id":292065677,"identity":"48f8693b-27bd-4701-acf0-cfe9ac414807","order_by":1,"name":"Oscar Vetsi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3UlEQVRIiWNgGAWjYFADZuYDQFJChmgNEgzMbAkgmocELQw8BiAGYS38/Icffq5ss6mTb+f5/OpGjQUPA/vhoxvwaZGckWYsebYtTcLgMO8265xjQIfxpKXdwKfF4AYPg2TDmcMSBsy824xz2IBaJHjM8Gs5f4b5Z8OZ/xLyzTzPjHP+EaPlQA6bZEPFAQmGwzzMj3PbiNAC9IuZZUNFsuSGw2xmzLl9EjxshPwCDLHHNxsM7Pjl+w8//pzzrU6On/3wMbxakAGbBJgkVjkIMH8gRfUoGAWjYBSMHAAABn9ALLPWHTYAAAAASUVORK5CYII=","orcid":"","institution":"Department of Public Health, Ada West District Health Directorate, Disease Control Unit, Sege","correspondingAuthor":true,"prefix":"","firstName":"Oscar","middleName":"","lastName":"Vetsi","suffix":""},{"id":292065679,"identity":"0fddb51a-1c23-40d3-b4d3-d5c1e58413eb","order_by":2,"name":"Francis Atsu Kuadzi","email":"","orcid":"","institution":"Winneba COLANGE Clinic, University of Education, Winneba","correspondingAuthor":false,"prefix":"","firstName":"Francis","middleName":"Atsu","lastName":"Kuadzi","suffix":""},{"id":292065680,"identity":"dafe5c67-f58c-4f9f-8c69-4b271a5092fc","order_by":3,"name":"Francis Kwantwi-Barima","email":"","orcid":"","institution":"Directorate of University Health Services. 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College of Languages Education, Ajumako","correspondingAuthor":false,"prefix":"","firstName":"Francis","middleName":"","lastName":"Kwantwi-Barima","suffix":""},{"id":292065682,"identity":"ea912713-f61d-4812-83ea-014a017643ab","order_by":4,"name":"Kingsley Boakye","email":"","orcid":"","institution":"Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi","correspondingAuthor":false,"prefix":"","firstName":"Kingsley","middleName":"","lastName":"Boakye","suffix":""},{"id":292065686,"identity":"18115d65-dc38-44d4-9c08-2d564331d91a","order_by":5,"name":"Daniel Boateng","email":"","orcid":"","institution":"Department of Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht","correspondingAuthor":false,"prefix":"","firstName":"Daniel","middleName":"","lastName":"Boateng","suffix":""}],"badges":[],"createdAt":"2024-04-05 17:05:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4224223/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4224223/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":57697421,"identity":"d6cfe1b9-3137-43ea-b862-3e533a7a43c6","added_by":"auto","created_at":"2024-06-04 13:01:52","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1329776,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4224223/v1/0ed48cac-f508-4c3a-9de3-ebacf49a8d70.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessment Of Burnout and Quality of Life Among Nursing Professionals in The Ashanti Region of Ghana","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBurnout has gained attention in recent years due to its impact on the professional and quality of service provision in the healthcare setting. Globally, up to 58.0% of healthcare workers experience burnout [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The World Health Organization (WHO) defines burnout as \u0026lsquo;\u0026lsquo;a syndrome thought to be caused by ongoing workplace stress that has not been effectively controlled\u0026rsquo;\u0026rsquo; [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Burnout is characterized by three dimensions: emotional exhaustion, depersonalization, and personal accomplishment [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. This can result in the exhaustion of energy, neglecting one\u0026rsquo;s self from his or her core responsibilities at the workplace, and loss of confidence and inability to complete a task [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Due to its public health interest, the WHO has now classified it as an occupational disease in the International Classification of Diseases (ICD-11) [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSeveral studies have shown a high prevalence of burnout among health workers in both high and low-income countries, with a higher prevalence among nurses and midwives than among other healthcare workers [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e], [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. A systematic review and meta-analysis [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] reported a pooled burnout prevalence of 11.23% among nurses across the globe. In Singapore, a study found that about 39.0%, 40.0%, and 59.0% of nurses working in a tertiary hospital had high emotional exhaustion, depersonalization, and low personal accomplishment, respectively [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. In Ethiopia, an overall pooled-prevalence of burnout has reportedly occurred among 39.0% of nurses [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. In Uganda, research reported that about 40.0% of healthcare workers experienced high burnout [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Similarly, a study in Malawi reported that approximately 55.0%, 31.0%, and 46.0% of healthcare workers experienced average emotional exhaustion, depersonalization, and low reduced personal accomplishment, respectively [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. In Nigeria, according to reports, nurses at tertiary hospitals experienced high emotional exhaustion (42.9%), depersonalization (47.6%), and reduced personal accomplishment (53.8%) [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Another study in Nigeria reported that about 69.0% of healthcare workers experienced burnout [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. In Ghana, [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] found that about 9.90% of healthcare workers in the Greater Accra Region experienced burnout. In the Ashanti Region of Ghana, [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] found that about 2.1% of nurses working in a tertiary hospital experienced burnout at the workplace.\u003c/p\u003e \u003cp\u003eNursing professionals constitute the majority of the healthcare workforce and are primarily responsible for aiding patients to prevent diseases and improve their health [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. The success of Sustainable Development Goal (SDG) three (3), which is good health and well-being for all [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], is largely dependent on the quality of services provided by nursing professionals globally. Assessing burnout for nursing professionals is key to the progress of the healthcare sector, because burnout does not only negatively affect the health professional, but also the health and safety of the patients [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Burnout among nursing professionals is problematic for the nursing workforce, considering its effect on the quality of life (QoL) of the professional [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] and the global shortage of nurses [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Quality of life is one of the significant aspects of nursing professionals that should not be overlooked. Quality of life defines the overall well-being of a person, and it encompasses his or her goals, targets, standards as well as living conditions. This usually reflects the issues or things that they cherish so much. It affects the psychological, social, and physical capabilities of a person [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. It has been reported that the hospital environment can have a significant influence on the QoL of nursing professionals [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. The QoL of a nurse can also be influenced by factors such as age, gender, management support, educational level, and income level [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. The QoL of nursing professionals can have a direct impact on the quality of service provided, organizational commitment, and job satisfaction [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eNursing professionals are heavily involved in the provision of quality healthcare to patients at the workplace [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Hence, they are mostly exposed to several workplace hazards, such as high workload, stress, and violence, which may increase their burnout levels at the workplace [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e], [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. There is a need to protect the nursing workforce, considering their significance in the provision of quality healthcare delivery. Again, the QoL of nursing professionals may be affected by experiencing burnout at the workplace [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Several studies have reported that exposure to stressors at the workplace increases nurses' risk of burnout and this can subsequently hurt their quality of life and social health [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. In Ghana, some studies have been conducted to determine the prevalence of burnout among nurses and other healthcare professionals [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan additionalcitationids=\"CR36\" citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e] indicated that healthcare workers' unpreparedness towards Coronavirus disease 2019 (COVID-19) had an increased risk of burnout, [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e] reported the effect of family-to-work-conflict on burnout and [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] also reported the adverse effect of burnout on the desire to leave the nursing and midwifery professions. However, these studies failed to consider the effects of burnout on QoL among nursing professionals. This study, therefore, sought to address this literature gap among nursing professionals in Ghana, and provide data that will help policy direction, especially among nursing professionals thereby helping to achieve the Sustainable Development Goals. The study aimed to determine the burnout and its association with QoL among nursing professionals in the Mampong and Agona Municipalities in Ashanti region, Ghana.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and setting\u003c/h2\u003e \u003cp\u003eAn institutional-based analytical cross-sectional study was conducted among the 343 nursing professionals to ascertain the burnout and its association with QoL.\u003c/p\u003e \u003cp\u003eThe Mampong Government Hospital (MGH) and Seventh Day Adventist Hospital, Asamang (SDAH) in the Mampong Municipality and Atwima Nwabiagya Districts, respectively in the Ashanti Region of Ghana were the study settings. The Mampong Municipality and Atwima Nwabiagya District constitute the forty-three municipal districts in the Ashanti Region. The two districts have over fifteen (15) health facilities, including hospitals, maternity homes, health centres, private facilities, and clinics. These health facilities provide a wide range of medical services to their inhabitants. Mampong Government Hospital is a district-level hospital that provides 24-hour service to the communities in the municipality. It provides a wide range of medical services and also serves as a referral centre for other health centres and private facilities nearby. The Seventh Day Adventist Hospital, Asamang is located at Asamang in the Atwima Nwabiagya District of the Ashanti Region. The hospital is widely known for the provision of healthcare in the district. It runs a 24-hour service. The facility also serves as a major referral point for other facilities within the district. These facilities were selected because they are among the health facilities residents in these districts mostly visit for health care services and they are the referral facilities in these districts.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStudy population\u003c/h2\u003e \u003cp\u003eAll registered nurses and midwives working in the Mampong Government and Seventh Day Adventist hospitals were the study population. Nursing practitioners are those certified or licensed as nurses or midwives and are offering patient care.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eInclusion and exclusion criteria\u003c/h2\u003e \u003cp\u003eAll certified/registered nurses and midwives who had practiced for at least a year were included in the study. All registered nurses and midwives who were on annual leave during the period of data collection were excluded. Additionally, nursing professionals who declined to participate or failed to consent were excluded from the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSample size estimation\u003c/h2\u003e \u003cp\u003eThe Charan and Biswas formula (\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(sample size= (Z^2 (P\\left)\\right(1-P\\left)\\right)/E^2)\\)\u003c/span\u003e\u003c/span\u003e was used to estimate the sample size for the study [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. At a 95% confidence interval (Z), 5% allowable margin of error (E), 20.0% of an estimated proportion of healthcare workers that experienced high burnout in Ghana [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e] (P), a design effect of 1.3 and a non-response rate of 10%, a total of 350 nursing professionals were recruited participants for the study.\u003c/p\u003e \n\u003cp\u003e\u003cimg 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OQwq+XVQMK996mFydyBZ+FIIhPwXSCck9//xBNf6H1hU8iPnsNG8DoFbDpgLQBEXJyIQ8k8E81mm6iO8X1fyO/HlD08AOgwkSx8EQv53qAEIqUfwrt+6K0Na/66vO3lnB72O/J3sHcLOFidHIOQ/cYK4q+/dseudH33I7o1rP0B8LuN1EQj5T5p7SO3f83GzXiOr5Ne/8EOuef+z4U9h/hEE3t7eQv4TlgEk7x7rRWh3uZKfOR0AsuH6GQcBIRDyC4n0QWAxBEL+xRKecIOAEAj5hUT6ILAYAiH/YglPuEFACIT8QiJ9EFgMgZB/sYQn3CAgBEJ+IZE+CCyGQMi/WMITbhAQAiG/kEgfBBZDIORfLOEJNwgIgZBfSKQPAoshEPIvlvCEGwSEQMgvJNIHgcUQCPkXS3jCDQJCIOQXEumDwGIIhPyLJTzhBgEhEPILifRBYDEE/gNvZDvrNn3ReQAAAABJRU5ErkJggg==\" width=\"255\" height=\"139\"\u003e\u003c/p\u003e\u003cp\u003eUsing a non-response rate of 10.0% and a design effect of 1.3, a sample size of 350 was estimated for this study. The design effect was estimated to account for the difference in the size of the two study sites.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eSampling technique\u003c/h2\u003e \u003cp\u003eThis study employed simple random sampling to select study participantsy. This was done by proportional allocation of study participants based on the number of nursing professionals in the two facilities. At each facility, the list of nursing professionals was retrieved from the Deputy Director of Nursing Services. The names of the nurses and midwives were assigned codes and entered into balloting. An independent person conducted the balloting. On a piece of paper, codes were written, folded and then placed in an A3 envelope. To make sure they were evenly blended, the envelope was shaken. The paper was drawn from the envelope one after the other until the estimated sample size for each facility was obtained. The names of the nursing professionals corresponding to a code drawn were contacted and screened for the study before recruitment.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eData collection instrument\u003c/h2\u003e \u003cp\u003eData were collected using a pre-tested structured questionnaire. The questionnaire was used to gather data on socio-demographic characteristics (such as age, sex, educational level, and income level), workplace environment (such as years of practice, management support, hours of work, shift type, and leadership style), burnout and QOL.\u003c/p\u003e \u003cp\u003eThe Maslach Burnout Inventory (MBI) was used to assess burnout among study populations [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The MBI tool is an internationally validated tool for assessing burnout, and it has been used in numerous studies [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e], [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e], [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. MBI tool measures burnout in three dimensions: emotional exhaustion, depersonalization, and personal accomplishment level of the person. A 7-point Likert scale was used to rate each sub-item (0\u0026ndash;6). Each study participant's overall score for each burnout dimension was estimated. Overall burnout was defined as high burnout for both emotional exhaustion and depersonalization and low burnout for personal accomplishment [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The rating of each burnout dimension has been presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1.1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1.1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRatings for the dimensions of burnout\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDimensions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eItems\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLow burnout\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eModerate burnout\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHigh burnout\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotional exhaustion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepersonalization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6\u0026ndash;11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePersonal accomplishment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eA questionnaire from the World Health Organization on quality of life was used to measure the QoL of study participants [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. The WHO QoL questionnaire is an approved tool that has been employed in numerous studies to measure the quality of life of nurses [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. This tool has 24 items that assess QoL in four domains: physical health (7 items), psychological health (6 items), social relationship (3 items), and environment (8 items) using a 5-point Likert scale [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. To determine the domain score for each of the four domains, the mean scores of the different components in each domain were used. Each domain score was expressed as a percentage with a range of 0 to 100. The overall score of QoL was computed by adding the scores of each domain and expressed as a percentage. The QoL of the study participants increased as the QoL score increased. The questionnaire was pretested among ten nurses in different districts. Corrections were made to the questionnaire after the pretest before sending it to the field for data collection.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eData were analyzed using Stata statistical software version 16. Descriptive computations were conducted to describe the sampled general characteristics. Univariate and multivariate linear regression analysis was used to predict the factors associated with burnout dimensions and the effect of burnout dimensions on QOL. Covariates that were independently significant at the univariate analysis (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05), together with non-significant covariates at a p-value of \u0026lt;\u0026thinsp;0.2, were included in the multivariate linear regression analysis using a backward stepwise approach. For the effect of burnout dimensions on nurses' QOL, variables such as age, gender, and years of work, together with all the burnout dimensions, were fitted in the multivariate linear regression using a backward stepwise approach to the model to predict the effect of burnout dimensions on QOL. In all analyses, the significance level was maintained at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 at a 95% confidence interval.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eEthical consideration\u003c/h2\u003e \u003cp\u003e Ethical clearance was sought from the Committee on Human Research, Publications and Ethics, of the Kwame Nkrumah University of Science and Technology, Kumasi with reference number (CHRPE/AP/013/23), which served as ethical backing for the study. Moreover, permission was sought from the management of these health facilities and was granted. Before obtaining informed consent from patients, the study objectives, procedures and duration, and right to participation or withdrawal, including possible risks and benefits of the study were explained to participants. Participants were made to understand that their participation will not inflict harm on them, they can choose to withdraw at any point in time, if they desire and that, participation is voluntary. Following that, informed and verbal consent was sought from respondents before data collection.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eDemographic characteristics of study participants\u003c/h2\u003e \u003cp\u003eThe demographic characteristics of participants are presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1.2\u003c/span\u003e. Out of a total of 350 nursing professionals that were recruited, 343 of them returned their questionnaires, yielding response rate of 98.0%. Nearly half of the participants (49.9%) were between the ages of 20 to 29 years, with a mean age (S.D) of 29.6 (\u0026plusmn;\u0026thinsp;5.4) years and a range of 20 to 54 years. A little over two-thirds (67.1%) of the study participants were females, and a little over half (51.0%) were married. Over two-thirds (63.3%) of the study participants were degree holders. Fifty-three (15.5%) of the study participants indicated they take alcohol, while twenty-four (7.0%) of the study participants indicated they smoke.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1.2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic characteristics of study participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (n\u0026thinsp;=\u0026thinsp;343)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge group (years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e171\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e154\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean age (\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29.6 (\u0026plusmn;\u0026thinsp;5.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[\u003cspan additionalcitationids=\"CR21 CR22 CR23 CR24 CR25 CR26 CR27 CR28 CR29 CR30 CR31 CR32 CR33 CR34 CR35 CR36 CR37 CR38 CR39 CR40 CR41 CR42 CR43 CR44 CR45 CR46 CR47 CR48 CR49 CR50 CR51 CR52 CR53\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e230\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReligion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChristian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMuslim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e168\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e175\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHighest level of education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDegree holders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e217\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePost-graduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSmoke\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e319\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e93.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTake alcohol\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e290\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e84.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eWork-related characteristics of study participants\u003c/h2\u003e \u003cp\u003eThe work-related characteristics of study participants are presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e1.3\u003c/span\u003e. More than half (53.9%) were working at Mampong Government Hospital, over a third (36.2%) of the study participants were on a monthly salary of less than Gh\u0026cent;2000.00, and almost all (95.9%) the participants were permanent staff. Eighty-eight (25.7%) of the study subjects were in the department of Eye/Dental. Over half (54.8%) of the participants were staff nurses/midwives, and nearly half (48.4%) have less than 5 years of professional experience with a median working experience of 5 (IQR: 4) years, with a range of 1 to 40 years. Almost all the participants (93.9%) perceived the work to be stressful, nearly two-thirds (62.1%) had the majority of their shift in the afternoon, and more than half (56.9%) received adequate support from management.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1.3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eWork-related characteristics of study participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (n\u0026thinsp;=\u0026thinsp;343)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlace of work\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgona Government Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMampong Government Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e185\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMonthly salary\u003c/b\u003e (Gh\u0026cent;)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;2000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2000\u0026ndash;2999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3000\u0026ndash;3999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;4000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eType of employment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePermanent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e329\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eContract/casual\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDepartment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale ward\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale ward\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmergency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaternity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOut-patient department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEye/Dental\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRank/position\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStaff nurse/midwife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e188\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSenior Staff Nurse/Midwife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNursing/Midwifery Officer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSenior Nursing/Midwife Officer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrincipal Nursing/Midwifery Officer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWork experience (years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian work experience (IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[\u003cspan additionalcitationids=\"CR2 CR3 CR4 CR5 CR6 CR7 CR8 CR9 CR10 CR11 CR12 CR13 CR14 CR15 CR16 CR17 CR18 CR19 CR20 CR21 CR22 CR23 CR24 CR25 CR26 CR27 CR28 CR29 CR30 CR31 CR32 CR33 CR34 CR35 CR36 CR37 CR38 CR39\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWork is stressful\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e322\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e93.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMajority of work shift\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMorning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAfternoon\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFull day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSupport from management\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdequate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e195\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInadequate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eBurnout among study participants\u003c/h2\u003e \u003cdiv id=\"Sec18\" class=\"Section3\"\u003e \u003ch2\u003ePrevalence of burnout among study participants\u003c/h2\u003e \u003cp\u003eThe descriptive statistics of the burnout component are presented in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e1.4\u003c/span\u003e. The median scores of emotional exhaustion, depersonalization, and personal accomplishment were 15 (IQR: 27), 25 (IQR: 16), and 32 (IQR: 12), respectively, suggesting a low burnout for emotional exhaustion and high burnout for both depersonalization and personal accomplishment. A little over one-fifth (20.7%) experienced high emotional exhaustion, while the majority (83.6%) and over two-thirds of them experienced high depersonalization and high personal accomplishment, respectively. Overall, the prevalence of burnout was 2.9%.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1.4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescriptive statistics of burnout dimensions\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDimensions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIQR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLow burnout\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eModerate burnout\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eHigh burnout\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotional Exhaustion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e187 (54.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e85 (24.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e71 (20.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepersonalization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e39 (11.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e287 (83.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePersonal accomplishment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e56 (16.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e76 (22.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e211 (61.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBurnout\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eN\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e97.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eIQR: Interquartile range\u003c/h2\u003e \u003cdiv id=\"Sec20\" class=\"Section3\"\u003e \u003ch2\u003eFactors associated with burnout among study participants\u003c/h2\u003e \u003cp\u003eLinear regression analysis was performed to identify significant predictors of all the dimensions of burnout. After adjusting for significant variables, emotional exhaustion was predicted by the night shift (adjusted β: 6.06, 95%CI: 1.52, 11.60, p\u0026thinsp;=\u0026thinsp;0.032) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e1.5\u003c/span\u003e). The depersonalization dimension of burnout was predicted by full day shift (adjusted β: -7.69, 95%CI: -13.48, -1.89, p\u0026thinsp;=\u0026thinsp;0.010) and rank of nursing/midwifery officer (adjusted β: 3.57, 95%CI: 1.71, 6.43, p\u0026thinsp;=\u0026thinsp;0.015) (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e1.6\u003c/span\u003e). The personal accomplishment dimension was predicted by casual employment (adjusted β: 5.72, 95%CI: 1.13, 11.31, p\u0026thinsp;=\u0026thinsp;0.045) (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e1.7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1.5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLinear regression analysis of factors associated with emotional exhaustion\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eModel 1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eModel 2\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95%CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAdj. β\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e95%CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge (years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.50, 0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.060\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWork experience (years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.38, 0.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.654\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-1.64, 4.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.381\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-2.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-5.68, -0.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.039\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-5.10, 0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.106\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRank/position\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStaff nurse/midwife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSenior Staff Nurse/Midwife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-3.54, 5.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.674\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-3.42, 5.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.646\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNursing/Midwifery Officer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-1.30, 5.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-1.09, 6.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.174\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSenior Nursing/Midwife Officer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-5.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-10.75, -0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.031\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-4.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-9.51, 0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.093\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrincipal Nursing/Midwifery Officer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-5.46, 8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.686\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-6.36, 7.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.881\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMajority of work shift\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMorning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAfternoon\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-1.43, 5.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.269\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-1.14, 5.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.203\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.31, 12.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.52, 11.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.032\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFull day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-3.73, 10.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.347\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-4.91, 9.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.533\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSupport from management\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdequate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInadequate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.52, 6.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.10, 5.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.042\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdjusted R\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.033\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProb\u0026thinsp;\u0026gt;\u0026thinsp;F\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003cp\u003eAdjusted for significant variables\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1.6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLinear regression analysis of factors associated with depersonalization\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eModel 1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eModel 2\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95%CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAdj. β\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e95%CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.37, 0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.128\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWork experience (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.22, 0.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.841\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.47, 4.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.116\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRelationship status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-1.06, 3.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRank/position\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStaff nurse/midwife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSenior Staff Nurse/Midwife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-5.53, 1.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.301\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-5.66, 1.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.260\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNursing/Midwifery Officer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.32, 6.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.71, 6.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.015\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSenior Nursing/Midwife Officer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.87, 7.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-1.28, 6.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.178\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrincipal Nursing/Midwifery Officer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-1.32, 9.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.53, 10.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.076\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMajority of work shift\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMorning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAfternoon\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-3.61, 1.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.465\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-3.51, 1.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.498\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-4.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-8.60, 0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-4.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-8.49, 0.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.076\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFull day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-6.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-12.24, -0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-7.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-13.48, -1.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.010\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdjusted R\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.036\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProb\u0026thinsp;\u0026gt;\u0026thinsp;F\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1.7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLinear regression analysis of factors associated with personal accomplishment\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eModel 1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eModel 2\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95%CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAdj. β\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e95%CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.33, 0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.228\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWork experience (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.36, 0.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.349\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-4.12, 0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.140\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-1.68, 2.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.637\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eType of employment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePermanent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eContract/casual\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.42, 11.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.13, 11.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.045\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdjusted R\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProb\u0026thinsp;\u0026gt;\u0026thinsp;F\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.041\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eQuality of life of study participants\u003c/h2\u003e \u003cp\u003eThe description of the 4 QoL domains and the overall QoL of study participants have been presented in Table\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e1.8\u003c/span\u003e. The mean score of the overall QoL score of study participants was 78.1 (\u0026plusmn;\u0026thinsp;8.6). All the study participants scored more than 50% (mean score) for all the domains of QoL. Comparing the four domains of QoL, the social health domain was the highest with a mean score of 81.2 (\u0026plusmn;\u0026thinsp;11.7), followed by the environment domain with a mean score of 79.4 (\u0026plusmn;\u0026thinsp;10.6). The physical health domain recorded the lowest score with a mean score of 76.5 (\u0026plusmn;\u0026thinsp;11.0).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1.8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescriptive statistics of the 4 quality of life domains and overall quality of life of study participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQOL domains\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMIN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMAX\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMEAN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eRC\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e343\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e76.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e11.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.829\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsychological health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e343\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e76.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e10.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.777\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e343\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e81.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e11.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.672\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnvironment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e343\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e79.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e10.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.841\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall QOL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e343\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e78.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e8.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.902\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eAssociation between burnout and Quality of life of study participants\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab9\" class=\"InternalRef\"\u003e1.9\u003c/span\u003e presents a linear regression analysis of the association between burnout dimensions and QoL. Participants\u0026rsquo; QoL was predicted by moderate burnout for emotional exhaustion (β: \u0026minus;\u0026thinsp;4.59, 95%CI: -4.59, -0.46, p\u0026thinsp;=\u0026thinsp;0.017) and high burnout for personal accomplishment (β: -6.28, 95%CI: -8.65, -3.91, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab9\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1.9\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLinear regression analysis of the association between burnout dimensions and QOL\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eModel 1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eModel 2\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95%CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAdj. β\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e95%CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotional exhaustion\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-3.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-5.46, -1.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-4.59, -0.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.56, 5.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.30, 4.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDepersonalization\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-2.00, 7.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.247\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.25, 8.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePersonal accomplishment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-4.27, 1.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.305\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-1.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-4.40, 1.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.251\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-6.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-9.12, -4.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-6.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-8.65, -3.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdjusted R\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProb\u0026thinsp;\u0026gt;\u0026thinsp;F\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eOverall, the prevalence of burnout observed among study participants in the present study was low (2.9%). The findings of this study underpins initial reports that burnout is rife among nursing professionals in sub-Saharan Africa [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e], [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. The overall prevalence of burnout observed in the present study is consistent with the 2.1% reported among nursing professionals in the Kumasi Metropolis [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. However, the overall prevalence of burnout observed in the present study is at variance with the prevalence of burnout (68.6%) that was reported among the nurses at a medical tertiary facility in Nigeria [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. A possible reason for the disparity between the two studies could be attributed to the variations in the study design, sampling procedure, tools for assessing burnout, and the difference in the healthcare systems in Nigeria and Ghana. The Nigerian study [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e] measured burnout using the Oldenburg Burnout Inventory while the present study used MBI to measure nurses' burnout which could affect the prevalence of burnout.\u003c/p\u003e \u003cp\u003eIn the present study, a high burnout for both depersonalization (83.6%) was observed as compared to personal accomplishment (61.5%) and emotional exhaustion (54.5%) dimensions. The prevalence of emotional exhaustion observed in the present study affirms initial reports that Ghanaian nurses experience low emotional exhaustion [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e], [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. The high level of burnout observed in the present study for both depersonalization and personal accomplishment are similar to higher levels of burnout for depersonalization (71.6%) and personal accomplishment (90.8%) reported among nurses working in a tertiary hospital in Jeddah [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. The higher prevalence of burnout for depersonalization is particularly a worry since the depersonalization dimension of burnout is when the employee no longer has an interest in the job and detaches him or herself from her core responsibilities at the workplace. The high depersonalization experienced by nurses in the present study can affect the contribution of nurses to quality healthcare delivery in the healthcare system. It is important to encourage nurses that may be experiencing any form of burnout to seek counselling and possible attention to reduce its incidence at the workplace.\u003c/p\u003e \u003cp\u003eThe findings of the present study showed that the night shift was associated with the emotional exhaustion dimension while the full-day shift and rank of nursing/midwifery officer were associated with depersonalization. Casual/contract employment was significantly associated with personal accomplishment.\u003c/p\u003e \u003cp\u003eIn this present study, it was found that night shifts and full-day shifts were significantly associated with emotional exhaustion and personal accomplishment, respectively. In this study, nurses who had most of their shifts to be full day had an expected decrease in high burnout for personal accomplishment compared to those who had the majority of their shifts to be morning. Also, compared to nurses who had the majority of their working shift to be morning shift, those who had most of their shift in the night had an expected increase in emotional exhaustion by six times. A possible explanation for this could be the longer working hours for the night shift compared to the morning shift. Nurses spend a lot of hours at the workplace for night shifts than morning shifts which may increase their stress levels thereby draining them emotionally. A previous study has stressed the need to reduce long working hours to reduce the incidence of burnout at the workplace [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. In China, a similar study found a significant influence of long working hours on emotional exhaustion [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn this current study, it was revealed that nursing/midwifery officers had an expected increase in depersonalization levels by three compared with staff nurses/midwives. This may be explained by the high demand for nursing/midwifery officers to deliver quality services that meet the expectation of the patient as they mostly play supervisory roles compared to staff nurses/midwives who are junior officers at the workplace. This makes them overburden themselves with a lot of workloads which can predispose them to experience high burnout for depersonalization. A high workload has also been reported to increase one's risk of burnout in China [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. A study in Nigeria also found that senior nurses were at increased risk of high burnout for depersonalization [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe study observed that casual/contract nurses had an expected increase in high burnout for personal accomplishment compared to permanent workers. A possible reason could be that temporary casual/contract nursing workers could be so driven by their desire to land permanent jobs that they accept and complete assignments if they are even tired without taking breaks which can predispose them to high burnout for personal accomplishment.\u003c/p\u003e \u003cp\u003eThe welfare of every healthcare professional is essential for the delivery of high-quality medical care, based on that, this study assessed the QoL of nursing professionals. Overall, the QoL observed among study participants in the present study was high. Participants reported high QoL in all four domains. However, among the four domains of QoL, participants reported the highest QoL in the social health domain and the least in the physical health domain. The high QoL observed among study participants is important for quality healthcare delivery. This is because nurses play a critical role in the provision of quality healthcare delivery in the healthcare continuum.\u003c/p\u003e \u003cp\u003eThe high QoL of the social health domain observed in the present study reflects participants\u0026rsquo; high level of contentment with social support and peer interaction in their daily lives. This is in agreement with a study in Malaysia which also observed the highest QoL scores in the social health domain among nurses [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. In India, a study also reported high QoL scores in the social health domain [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. More than half of the nurses in this study were married, and having a supportive partner could be one of the variables that contribute to a good QoL score in terms of social relationships. Again, over half of the study participants indicated they received management support at the workplace which is also a good recipe for good QoL score of the social health domain.\u003c/p\u003e \u003cp\u003eThe least QoL scores observed in the physical health domain in the present study could be explained by the notion that nurses concurrently perform the responsibilities of woman, mother, wife, and daughter. These can impair physical QoL and cause fatigue and sleep deprivation. In Poland, a similar study reported that of the four domains of the QoL, nurses reported the worst in the physical health domain [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e]. In China, a similar study also observed lower scores of QoL in the physical domain [\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e]. However, the physical domain is the worst QoL observed in the present study and is at variance with a study in Australia where nurses performed higher scores in the physical health domain [\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe results from the present study underpins initial reports that the occurrence of burnout is negatively associated with the QoL of nursing professionals [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e], [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e], [\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e]. It was found out in this present study that participants\u0026rsquo; QoL was significantly predicted by high and moderate burnout for personal accomplishment and depersonalization dimensions of burnout respectively.\u003c/p\u003e \u003cp\u003eIt was found out in this present study that nursing professionals that experienced high burnout for personal accomplishment had an expected decrease in the overall QoL scores compared to those that experienced low burnout. This implies that nursing professionals who experience high levels of burnout for personal accomplishment are greater likelihood of a reduction in their QoL. Nursing professionals assessing themselves as having high burnout for personal accomplishment means that he or she sees themselves as negatively and cannot progress in their professional career. At this stage, the nursing professional may start to doubt his or her capability to progress professionally and this can negatively affect his or her well-being. Findings from this study is in agreement with earlier studies which reported a significantly negative correlation between personal accomplishment and QoL [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e], [\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAnother significant finding of the present study was that participants that experienced moderate burnout levels for depersonalization had an expected decrease in the QoL scores by four compared to those who had modest degrees of burnout for the depersonalization dimension. This is in line with previous studies that have reported a negative correlation between burnout and QoL [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], [\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e]. A nursing professional experiencing high levels of depersonalization may detach themselves from colleagues and patients which can affect his or her psychological health domain of QoL [\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec25\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and limitations of study\u003c/h2\u003e \u003cp\u003eThe study had some strengths and limitations positing that results should be cautiously interpreted. The study\u0026rsquo;s strength resides in its novelty as the first study to investigate burnout and quality of life among nursing professionals in the study settings. Additionally, the use of appropriate methodology and rigorous analysis is a strength of the study. Despite the strength of the study, it has weaknesses that cannot be overemphasized. The study used a cross-sectional design which provides a snapshot of a particular point in time limiting the ability to establish causality. Additionally, the study is subject to recall bias and social desirability flaws following the design employed This notwithstanding, the rigorous procedures adopted in our study were able to suppress the effects of the weaknesses, thus making the findings viable for decision making.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study revealed that the overall prevalence of burnout among nursing professionals was low (2.9%). The prevalence of burnout for depersonalization (83.6%) and personal accomplishment (61.5%) dimensions of burnout were high. Night shift was associated with the emotional exhaustion dimension, full-day shift and rank of nursing/midwifery officer were associated with depersonalization and casual/contract employment was significantly associated with personal accomplishment. Overall, the QoL observed among study participants in the present study was high (mean score: 76.5 (\u0026plusmn;\u0026thinsp;11.0) among all the QoL domains. The present study revealed a negative relationship between the dimensions of burnout and the overall QoL. Participants\u0026rsquo; QoL was negatively predicted by high and moderate burnout for personal accomplishment and depersonalization dimensions of burnout, respectively. Therefore, Ministry of Health and key health stakeholders should periodically screen nursing professionals for possible burn out and professional guidance and/or counselling where necessary to avert negative repercussions.\u003c/p\u003e \u003cdiv id=\"Sec27\" class=\"Section2\"\u003e \u003ch2\u003eImplication for practice and research\u003c/h2\u003e \u003cp\u003eHospital administrators and nurse managers should encourage nursing professionals experiencing burnout to seek early treatment to avoid any unwanted outcomes, and prioritize reducing the number of night and full-day shifts of nursing professionals within the week and month. This is because this study has highlighted the effect of exposure to a lot of night and full-day shifts on the incidence of burnout among them. The Ministry of Health and appropriate stakeholders should commence processes to permanently engage causal/contract nurses; the hospital administrators can also institute some financial benefits that can cushion them to serve as a source of motivation. Future studies in the future can adopt a qualitative methodology to thoroughly comprehend the dynamics of burnout and its impact on the QoL of nurse practitioners. Also, longitudinal study is recommended to investigate the impact of burnout on quality of healthcare provided to patients.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Committee for Human Research, Publication, and Ethics of the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana provided ethical clearance for this research\u0026nbsp;with reference number (CHRPE/AP/013/23).\u0026nbsp;Additionally, informed consent was obtained from all participants before data collection. All ethical principles were duly followed throughout the study to conform to the declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analysed in this study\u0026nbsp;are freely available upon making a reasonable request to the corresponding author\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that no competing interest exist in the preparation and publication of this paper.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors had no funding for the study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor’s contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGWBB conceptualized and developed the concept. GWBB, OV, and FKB conducted the formal analysis and interpreted the results. GWBB, OV, FAK, FKB, KB and DB drafted the manuscript. All authors proofread the manuscript for important intellectual content before submission for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe are most grateful to the cooperative respondents that participated in the study, it was through their cooperation that we are able to contribute to science. We also express our appreciation to the management at Manhyia Government and Seventh Day Adventist Hospitals for allowing us to use their premises for the study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eM. R. Gualano \u003cem\u003eet al.\u003c/em\u003e, \u0026lsquo;The burden of burnout among healthcare professionals of intensive care units and emergency departments during the COVID-19 pandemic: a systematic review\u0026rsquo;, \u003cem\u003eInternational journal of environmental research and public health\u003c/em\u003e, vol. 18, no. 15, p. 8172, 2021.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization, \u0026lsquo;Burn-out an \u0026ldquo;occupational phenomenon\u0026rdquo;: International Classification of Diseases\u0026rsquo;, \u003cem\u003eInternational Classification of Disease\u003c/em\u003e, no. May 2019. 2019.\u003c/li\u003e\n\u003cli\u003eC. Maslach and S. E. Jackson, \u0026lsquo;The measurement of experienced burnout\u0026rsquo;, \u003cem\u003eJournal of Organizational Behavior\u003c/em\u003e, vol. 2, no. 2, pp. 99\u0026ndash;113, 1981, doi: 10.1002/job.4030020205.\u003c/li\u003e\n\u003cli\u003eI. Duarte \u003cem\u003eet al.\u003c/em\u003e, \u0026lsquo;Burnout among Portuguese healthcare workers during the COVID-19 pandemic\u0026rsquo;, \u003cem\u003eBMC Public Health\u003c/em\u003e, vol. 20, no. 1, pp. 1\u0026ndash;10, 2020, doi: 10.1186/s12889-020-09980-z.\u003c/li\u003e\n\u003cli\u003eM. Elhadi, A. Msherghi, M. Elgzairi, and A. Alhashimi, \u0026lsquo;Burnout Syndrome Among Hospital Healthcare Workers During the COVID-19 Pandemic and Civil War : A Cross-Sectional Study\u0026rsquo;, \u003cem\u003eFrontiers in psychiatry\u003c/em\u003e, vol. 11, pp. 1\u0026ndash;11, 2020, doi: 10.3389/fpsyt.2020.579563.\u003c/li\u003e\n\u003cli\u003eS. Adam, A. Mohos, L. Kalabay, and P. Torzsa, \u0026lsquo;Potential correlates of burnout among general practitioners and residents in Hungary: The significant role of gender, age, dependant care and experience\u0026rsquo;, \u003cem\u003eBMC Family Practice\u003c/em\u003e, vol. 19, no. 1, pp. 1\u0026ndash;10, 2018, doi: 10.1186/s12875-018-0886-3.\u003c/li\u003e\n\u003cli\u003eT. Woo, R. Ho, A. Tang, and W. Tam, \u0026lsquo;Global prevalence of burnout symptoms among nurses: A systematic review and meta-analysis\u0026rsquo;, \u003cem\u003eJournal of Psychiatric Research\u003c/em\u003e, vol. 123, no. December 2019, pp. 9\u0026ndash;20, 2020, doi: 10.1016/j.jpsychires.2019.12.015.\u003c/li\u003e\n\u003cli\u003eS. Y. Ang \u003cem\u003eet al.\u003c/em\u003e, \u0026lsquo;Demographics and personality factors associated with burnout among nurses in a Singapore tertiary hospital\u0026rsquo;, \u003cem\u003eBioMed Research International\u003c/em\u003e, vol. 2016, 2016, doi: 10.1155/2016/6960184.\u003c/li\u003e\n\u003cli\u003eA. Hailay, W. Aberhe, G. Mebrahtom, K. Zereabruk, G. Gebreayezgi, and T. Haile, \u0026lsquo;Burnout among nurses working in Ethiopia\u0026rsquo;, \u003cem\u003eBehavorial Neurology\u003c/em\u003e, vol. 2020, 2020.\u003c/li\u003e\n\u003cli\u003eA. Kabunga and P. Okalo, \u0026lsquo;Prevalence and predictors of burnout 19 : a among nurses during COVID- \u0026shy; sectional study in hospitals in central Uganda\u0026rsquo;, \u003cem\u003eBMJ Open\u003c/em\u003e, vol. 11, no. 1, p. :e054284, 2021, doi: 10.1136/bmjopen-2021-054284.\u003c/li\u003e\n\u003cli\u003eM. H. Kim \u003cem\u003eet al.\u003c/em\u003e, \u0026lsquo;Burnout and self-reported suboptimal patient care amongst health care workers providing HIV care in Malawi\u0026rsquo;, \u003cem\u003ePLoS ONE\u003c/em\u003e, vol. 13, no. 2, pp. 1\u0026ndash;15, 2018.\u003c/li\u003e\n\u003cli\u003eF. E. Okwaraji and E. N. Aguwa, \u0026lsquo;Burnout and psychological distress among nurses in a Nigerian tertiary health institution\u0026rsquo;, \u003cem\u003eAfrican Health Sciences\u003c/em\u003e, vol. 14, no. 1, pp. 237\u0026ndash;245, 2014, doi: 10.4314/ahs.v14i1.37.\u003c/li\u003e\n\u003cli\u003eA. D. G. Nwosu, E. Ossai, O. Onwuasoigwe, M. Ezeigweneme, and J. Okpamen, \u0026lsquo;Burnout and presenteeism among healthcare workers in Nigeria : Implications for patient care , occupational health and workforce\u0026rsquo;, \u003cem\u003eJournal of Public Health Research\u003c/em\u003e, vol. 10, no. 11, p. pp.jphr-2021, 2021, doi: 10.4081/jphr.2021.1900.\u003c/li\u003e\n\u003cli\u003eK. Odonkor, S.T. and Frimpong, \u0026lsquo;Burnout among healthcare professionals in Ghana: A critical assessment\u0026rsquo;, \u003cem\u003eBioMed research international\u003c/em\u003e, vol. 2020, 2020, doi: https://doi.org/10.1155/2020/1614968.\u003c/li\u003e\n\u003cli\u003eD. A. Opoku \u003cem\u003eet al.\u003c/em\u003e, \u0026lsquo;Attrition of nursing professionals in Ghana: An effect of burnout on intention to quit\u0026rsquo;, \u003cem\u003eNursing Research and Practice\u003c/em\u003e, vol. 2022, 2022.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization., \u0026lsquo;Nursing and midwifery; Key facts\u0026rsquo;, \u003cem\u003eWHO FACTS SHEETS\u003c/em\u003e. pp. 1\u0026ndash;36, 2017.\u003c/li\u003e\n\u003cli\u003eUnited Nations, \u0026lsquo;Sustainable Development Goal\u0026rsquo;, \u003cem\u003eUnited Nations\u003c/em\u003e. 2015.\u003c/li\u003e\n\u003cli\u003eC. D. L. Garcia \u003cem\u003eet al.\u003c/em\u003e, \u0026lsquo;Influence of burnout on patient safety: systematic review and meta-analysis\u0026rsquo;, \u003cem\u003eMedicina\u003c/em\u003e, vol. 55, no. 9, pp. 1\u0026ndash;13, 2019, doi: 10.3390/medicina55090553.\u003c/li\u003e\n\u003cli\u003eX. Li, T. Jiang, J. Sun, L. Shi, and J. Liu, \u0026lsquo;The relationship between occupational stress, job burnout and quality of life among surgical nurses in Xinjiang, China\u0026rsquo;, \u003cem\u003eBMC Nursing\u003c/em\u003e, vol. 20, no. 1, pp. 1\u0026ndash;11, 2021, doi: 10.1186/s12912-021-00703-2.\u003c/li\u003e\n\u003cli\u003eR. H. Mudallal, W. M. Othman, and N. F. Al Hassan, \u0026lsquo;Nurses\u0026rsquo; burnout: The influence of leader empowering behaviors, work conditions, and demographic traits\u0026rsquo;, \u003cem\u003eInquiry (United States)\u003c/em\u003e, vol. 54, 2017, doi: 10.1177/0046958017724944.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization, \u0026lsquo;The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties\u0026rsquo;, \u003cem\u003eSocial Science and Medicine\u003c/em\u003e, vol. 46, no. 12, pp. 1569\u0026ndash;1585, 1998, doi: 10.1016/S0277-9536(98)00009-4.\u003c/li\u003e\n\u003cli\u003eP. L. Burtson and J. F. Stichler, \u0026lsquo;Nursing work environment and nurse caring: Relationship among motivational factors\u0026rsquo;, \u003cem\u003eJournal of Advanced Nursing\u003c/em\u003e, vol. 66, no. 8, pp. 1819\u0026ndash;1831, 2010, doi: 10.1111/j.1365-2648.2010.05336.x.\u003c/li\u003e\n\u003cli\u003eK. Suleiman, Z. Hijazi, M. Al Kalaldeh, and L. Abu Sharour, \u0026lsquo;Quality of nursing work life and related factors among emergency nurses in Jordan\u0026rsquo;, \u003cem\u003eJournal of Occupational Health\u003c/em\u003e, vol. 61, no. 5, pp. 398\u0026ndash;406, 2019, doi: 10.1002/1348-9585.12068.\u003c/li\u003e\n\u003cli\u003eT. Moradi, F. Maghaminejad, and I. Azizi-Fini, \u0026lsquo;Quality of working life of nurses and its related factors\u0026rsquo;, \u003cem\u003eNursing and Midwifery Studies\u003c/em\u003e, vol. 3, no. 2, 2014, doi: 10.5812/nms.19450.\u003c/li\u003e\n\u003cli\u003eR. Faizin, R. Fitryasari, E. D. Wahyuni, and N. Nursalam, \u0026lsquo;Nurse\u0026rsquo;s individual factors may predict quality of nursing work life (Qnwl) in clinical setting\u0026rsquo;, \u003cem\u003eInternational Journal of Psychosocial Rehabilitation\u003c/em\u003e, vol. 24, no. 7, 2020, doi: 10.37200/IJPR/V24I7/PR270894.\u003c/li\u003e\n\u003cli\u003eP. Raeissi, M. R. Rajabi, E. Ahmadizadeh, K. Rajabkhah, and E. Kakemam, \u0026lsquo;Quality of work life and factors associated with it among nurses in public hospitals, Iran\u0026rsquo;, \u003cem\u003eJournal of the Egyptian Public Health Association\u003c/em\u003e, vol. 94, no. 1, 2019, doi: 10.1186/s42506-019-0029-2.\u003c/li\u003e\n\u003cli\u003eS. Javanmardnejad, R. Bandari, M. Heravi-Karimooi, N. Rejeh, H. Sharif Nia, and A. Montazeri, \u0026lsquo;Happiness, quality of working life, and job satisfaction among nurses working in emergency departments in Iran\u0026rsquo;, \u003cem\u003eHealth and Quality of Life Outcomes\u003c/em\u003e, vol. 19, no. 1, pp. 1\u0026ndash;8, 2021, doi: 10.1186/s12955-021-01755-3.\u003c/li\u003e\n\u003cli\u003eS. Suaib, S. Syahrul, and T. Tahir, \u0026lsquo;Nurses\u0026rsquo; Quality of Work Life\u0026rsquo;, \u003cem\u003eJournal of Health Science and Prevention\u003c/em\u003e, vol. 3, no. 3S, pp. 63\u0026ndash;66, 2019, doi: 10.29080/jhsp.v3i3s.292.\u003c/li\u003e\n\u003cli\u003eA. Karaaslan and M. Aslan, \u0026lsquo;The Relationship Between the Quality of Work and Organizational Commitment of Prison Nurses\u0026rsquo;, \u003cem\u003eJournal of Nursing Research\u003c/em\u003e, vol. 27, no. 3, pp. 1\u0026ndash;10, 2019, doi: 10.1097/jnr.0000000000000286.\u003c/li\u003e\n\u003cli\u003eF. Jiang \u003cem\u003eet al.\u003c/em\u003e, \u0026lsquo;Intention to leave and associated factors among psychiatric nurses in China: A nationwide cross-sectional study\u0026rsquo;, \u003cem\u003eInternational Journal of Nursing Studies\u003c/em\u003e, vol. 94, pp. 159\u0026ndash;165, 2019, doi: 10.1016/j.ijnurstu.2019.03.013.\u003c/li\u003e\n\u003cli\u003eMinistry of Health and Ghana Health Service, \u0026lsquo;Occupational Health and Safety Policy and Guidelines for the Health Sector\u0026rsquo;, 2013.\u003c/li\u003e\n\u003cli\u003eM. D. Dyrbye LN, Shanafelt TD, Sinsky CA, Cipriano PF, Bhatt J, Ommaya A, West CP, \u0026lsquo;Burnout Among Health Care Professionals A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care\u0026rsquo;, \u003cem\u003eNAM perspectives\u003c/em\u003e. 2017.\u003c/li\u003e\n\u003cli\u003eN. E. Clarke, S.P. and Donaldson, \u0026lsquo;Nurse staffing and patient care quality and safety. Patient safety and quality: An evidence-based handbook for nurses\u0026rsquo;. 2008.\u003c/li\u003e\n\u003cli\u003eS. Adriaenssens, J., De Gucht, V. and Maes, \u0026lsquo;Determinants and prevalence of burnout in emergency nurses : A systematic review of 25 years of research\u0026rsquo;, \u003cem\u003eInternational Journal of Nursing Studies\u003c/em\u003e, vol. 52, no. 1, pp. 649\u0026ndash;661, 2015, doi: 10.1016/j.ijnurstu.2014.11.004.\u003c/li\u003e\n\u003cli\u003eM. Nkyi, A.K. and Blay, \u0026lsquo;Occupational burnout among nurses working in Cape Coast Metropolitan Hospital Ghana\u0026rsquo;, \u003cem\u003eIndian Journal of Health and Wellbeing\u003c/em\u003e, vol. 11, no. 10\u0026ndash;12, pp. 459\u0026ndash;465, 2020.\u003c/li\u003e\n\u003cli\u003eS. T. Opoku and B. A. Apenteng, \u0026lsquo;Career satisfaction and burnout among Ghanaian physicians\u0026rsquo;, \u003cem\u003eInternational Health\u003c/em\u003e, vol. 6, no. 1, pp. 54\u0026ndash;61, 2014, doi: 10.1093/inthealth/iht038.\u003c/li\u003e\n\u003cli\u003eP. A. Afulani \u003cem\u003eet al.\u003c/em\u003e, \u0026lsquo;Inadequate preparedness for response to COVID-19 is associated with stress and burnout among healthcare workers in Ghana\u0026rsquo;, \u003cem\u003ePLoS ONE\u003c/em\u003e, vol. 16, no. 4 April, pp. 1\u0026ndash;20, 2021, doi: 10.1371/journal.pone.0250294.\u003c/li\u003e\n\u003cli\u003eE. E. A. Asiedu, F. Annor, K. Amponsah-Tawiah, and K. Dartey-Baah, \u0026lsquo;Juggling family and professional caring: Role demands, work\u0026ndash;family conflict and burnout among registered nurses in Ghana\u0026rsquo;, \u003cem\u003eNursing Open\u003c/em\u003e, vol. 5, no. 4, pp. 611\u0026ndash;620, 2018, doi: 10.1002/nop2.178.\u003c/li\u003e\n\u003cli\u003eJ. Charan and T. Biswas, \u0026lsquo;How to calculate sample size for different study designs in medical research?\u0026rsquo;, \u003cem\u003eIndian Journal of Psychological Medicine\u003c/em\u003e, vol. 35, no. 2. pp. 121\u0026ndash;126, 2013. doi: 10.4103/0253-7176.116232.\u003c/li\u003e\n\u003cli\u003eT. D. Shanafelt \u003cem\u003eet al.\u003c/em\u003e, \u0026lsquo;Changes in Burnout and Satisfaction with Work-Life Balance in Physicians and the General US Working Population between 2011 and 2014\u0026rsquo;, \u003cem\u003eMayo Clinic Proceedings\u003c/em\u003e, vol. 90, no. 12, pp. 1600\u0026ndash;1613, 2015, doi: 10.1016/j.mayocp.2015.08.023.\u003c/li\u003e\n\u003cli\u003eE. Lahana, K. Papadopoulou, O. Roumeliotou, A. Tsounis, P. Sarafis, and D. Niakas, \u0026lsquo;Burnout among nurses working in social welfare centers for the disabled\u0026rsquo;, \u003cem\u003eBMC Nursing\u003c/em\u003e, vol. 16, no. 1, pp. 1\u0026ndash;10, 2017, doi: 10.1186/s12912-017-0209-3.\u003c/li\u003e\n\u003cli\u003eR. H. Mudallal, W. M. Othman, and N. F. Al Hassan, \u0026lsquo;Nurses\u0026rsquo; burnout: the influence of leader empowering behaviors, work conditions, and demographic traits.\u0026rsquo;, \u003cem\u003eINQUIRY: The Journal of Health Care Organization, Provision, and Financing\u003c/em\u003e, vol. 54, p. 0046958017724944., 2017, doi: 10.1177/0046958017724944.\u003c/li\u003e\n\u003cli\u003eH. Khatatbeh, T. Al-Dwaikat, J. Rababah, A. Ol\u0026aacute;h, and A. Pakai, \u0026lsquo;Paediatric nurses\u0026rsquo; burnout, quality of life and perceived patient adverse events during the COVID-19 pandemic: Testing an integrated model using structural equation modelling\u0026rsquo;, \u003cem\u003eJournal of Clinical Nursing\u003c/em\u003e, no. July, pp. 1\u0026ndash;10, 2021, doi: 10.1111/jocn.16114.\u003c/li\u003e\n\u003cli\u003eY. Adomaah, B. Sylvia, A. Osei, I. Korkoi, and A. A. Druye, \u0026lsquo;Causes of burnout syndrome and coping strategies among high dependency unit nurses of an institution in the greater Accra region of Ghana\u0026rsquo;, \u003cem\u003eNursing Open\u003c/em\u003e, vol. 8, no. 6, pp. 3334\u0026ndash;3339, 2021, doi: 10.1002/nop2.1052.\u003c/li\u003e\n\u003cli\u003eT. M. Ashipala, D.O. and Nghole, \u0026lsquo;Factors contributing to burnout among nurses at a district hospital in Namibia: A qualitative perspective of nurses\u0026rsquo;, \u003cem\u003eJournal of Nursing Management\u003c/em\u003e, pp. 1\u0026ndash;10, 2022, doi: 10.1111/jonm.13693.\u003c/li\u003e\n\u003cli\u003eA. D. G. Nwosu, E. Ossai, O. Onwuasoigwe, M. Ezeigweneme, and J. Okpamen, \u0026lsquo;Burnout and presenteeism among healthcare workers in Nigeria: Implications for patient care, occupational health and workforce productivity\u0026rsquo;, \u003cem\u003eJournal of Public Health Research\u003c/em\u003e, vol. 10, no. 1, p. jphr-2021, 2021, doi: 10.4081/jphr.2021.1900.\u003c/li\u003e\n\u003cli\u003eJ. T. Qedair \u003cem\u003eet al.\u003c/em\u003e, \u0026lsquo;Prevalence and factors associated with burnout among nurses in Jeddah: a single ‑ institution cross ‑ sectional study\u0026rsquo;, \u003cem\u003eBMC Nursing\u003c/em\u003e, vol. 21, no. 1, pp. 1\u0026ndash;8, 2022, doi: 10.1186/s12912-022-01070-2.\u003c/li\u003e\n\u003cli\u003eN. Hu, J. Chen, and T. Cheng, \u0026lsquo;The associations between long working hours, physical inactivity, and burnout\u0026rsquo;, \u003cem\u003eJournal of Occupational and Environmental Medicine\u003c/em\u003e, vol. 58, no. 5, pp. 514\u0026ndash;518, 2016, doi: 10.1097/JOM.0000000000000715.\u003c/li\u003e\n\u003cli\u003eB. Wang, Z., Xie, Z., Dai, J., Zhang, L., Huang, Y. and Chen, \u0026lsquo;Physician burnout and its associated factors: a cross-sectional study in Shanghai\u0026rsquo;, \u003cem\u003eJournal of Occupational Health\u003c/em\u003e, p. pp.13-0108, 2014.\u003c/li\u003e\n\u003cli\u003eL. Meng, Y. Liu, H. Liu, Y. Hu, J. Yang, and J. Liu, \u0026lsquo;Relationships among structural empowerment, psychological empowerment, intent to stay and burnout in nursing field in mainland China-based on a cross-sectional questionnaire research\u0026rsquo;, \u003cem\u003eInternational Journal of Nursing Practice\u003c/em\u003e, vol. 21, no. 3, pp. 303\u0026ndash;312, 2015, doi: 10.1111/ijn.12279.\u003c/li\u003e\n\u003cli\u003eK. Y. Lee, \u0026lsquo;Quality of life among nurses in primary healthcare clinics in the health district of Petaling, Selangor\u0026rsquo;, \u003cem\u003eInternational Journal of Public Health and Clinical SCiences\u003c/em\u003e, vol. 5, no. 5, pp. 2289\u0026ndash;7577, 2018, doi: 10.32827/ijphcs.5.5.57.\u003c/li\u003e\n\u003cli\u003eP. N. R. Jathanna and J. D. Silva, \u0026lsquo;Quality of life among nurses working in different health care setting in the state of Karnataka , India\u0026rsquo;, \u003cem\u003eCHRISMED Journal of Health and Research\u003c/em\u003e, vol. 1, no. 4, pp. 241\u0026ndash;244, 2014, doi: 10.4103/2348-3334.142986.\u003c/li\u003e\n\u003cli\u003eN. Orszulak, K. Kubiak, A. Kowal, and M. Czapla, \u0026lsquo;Nurses \u0026rsquo; Quality of Life and Healthy Behaviors\u0026rsquo;, \u003cem\u003eInternational Journal of Environmental Research and Public Health\u003c/em\u003e, vol. 19, no. 19, p. p.12927, 2022.\u003c/li\u003e\n\u003cli\u003eJ. O. Asante, M. J. Li, J. Liao, and Y. X. Huang, \u0026lsquo;The relationship between psychosocial risk factors , burnout and quality of life among primary healthcare workers in rural Guangdong province : a cross-sectional study\u0026rsquo;, \u003cem\u003eBMC Health Services Research\u003c/em\u003e, vol. 19, no. 1, pp. 1\u0026ndash;10, 2019.\u003c/li\u003e\n\u003cli\u003eL. Perry, X. Xu, C. Duffield, R. Gallagher, R. Nicholls, and D. Sibbritt, \u0026lsquo;Health , workforce characteristics , quality of life and intention to leave : The \u0026ldquo; Fit for the Future \u0026rdquo; survey of Australian nurses and midwives\u0026rsquo;, \u003cem\u003eJournal of Advance Nursing\u003c/em\u003e, vol. 73, no. 11, pp. 2745\u0026ndash;2756, 2017, doi: 10.1111/jan.13347.\u003c/li\u003e\n\u003cli\u003eZ. Omidi, S. Khanjari, T. Salehi, and S. Haghani, \u0026lsquo;Association between burnout and nurses\u0026rsquo; quality of life in neonatal intensive care units: During the COVID-19 pandemic\u0026rsquo;, \u003cem\u003eJournal of Neonatal Nursing\u003c/em\u003e, 2022.\u003c/li\u003e\n\u003cli\u003eM. Aranđelović, M. Nikolić, and S. Stamenković, \u0026lsquo;Relationship between Burnout, quality of life, and work ability index \u0026mdash; directions in prevention\u0026rsquo;, \u003cem\u003eThe Scientific World Journal\u003c/em\u003e, vol. 10, no. 1, pp. 766\u0026ndash;777, 2010, doi: 10.1100/tsw.2010.83.\u003c/li\u003e\n\u003cli\u003eS. Naz, A. M. Hashmi, and A. Asif, \u0026lsquo;Burnout and quality of life in nurses of a tertiary care hospital in Pakistan\u0026rsquo;, vol. 11, pp. 532\u0026ndash;536, 2013.\u003c/li\u003e\n\u003cli\u003eH. Farsi, Z., Rajai, N. and Habibi, \u0026lsquo;The relationship between burnout and quality of working life in nurses of AJA hospitals in Tehran\u0026rsquo;, \u003cem\u003eMilitary Caring Sciences\u003c/em\u003e, vol. 1, no. 2, 2015.\u003c/li\u003e\n\u003cli\u003eL. Colby \u003cem\u003eet al.\u003c/em\u003e, \u0026lsquo;The association between the levels of burnout and quality of life among fourth-year medical students at the University of the Free State\u0026rsquo;, \u003cem\u003eSouth African Journal of Psychiatry\u003c/em\u003e, vol. 24, pp. 1\u0026ndash;6, 2018.\u003c/li\u003e\n\u003cli\u003eM. A. Alotni and S. E. Elgazzar, \u0026lsquo;Investigation of burnout, its associated factors and its effect on the quality of life of critical care nurses working in Buraydah Central Hospital at Qassim Region, Saudi Arabia\u0026rsquo;, \u003cem\u003eThe Open Nursing Journal\u003c/em\u003e, vol. 14, no. 1, pp. 190\u0026ndash;202, 2020, doi: 10.2174/1874434602014010190.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Burnout, Quality of Life, Nursing Professionals, Healthcare, Work Stress","lastPublishedDoi":"10.21203/rs.3.rs-4224223/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4224223/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction:\u003c/h2\u003e \u003cp\u003eBurnout among nursing professionals is problematic for the nursing workforce, considering its effect on their Quality of Life (QoL) and the global shortage of nurses. There is a dearth of literature on the effect of burnout on the QoL of the practice of nursing in Ghana. Hence, this study sought to estimate the prevalence of burnout and its effect on the QoL of nursing professionals in two district hospitals in Ghana.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eAn analytical cross-sectional study was conducted among three hundred and forty-three nursing professionals in two district hospitals in the Ashanti Region, Ghana. Data on participants' socio-demographic characteristics, work-related factors, burnout, and QoL were collected using a pretested structured questionnaire. The Maslach Burnout Inventory (MBI) and the World Health Organization Quality of Life (WHOQOL) questionnaire were used to assess burnout levels and QOL among study participants, respectively. Linear regression analysis was conducted to examine the burnout and the relationship between the dimensions of burnout and participants\u0026rsquo; QoL.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e \u003cp\u003eOut of the 343 participants, the prevalence of burnout was 2.9%. The mean age of study participants was 29.6 (\u0026plusmn;\u0026thinsp;5.4) years. About 20.7%, 83.6%, and 61.5% of the participants presented with high emotional exhaustion, depersonalization, and personal accomplishment, respectively. The study revealed that night shift (β: 6.06, 95%CI: 1.52, 11.60, p\u0026thinsp;=\u0026thinsp;0.032) was associated with emotional exhaustion, while full day shift (β: -7.69, 95%CI: -13.48, -1.89, p\u0026thinsp;=\u0026thinsp;0.010) and rank of nursing/midwifery officer (β:3.57, 95%CI: 1.71, 6.43, p\u0026thinsp;=\u0026thinsp;0.015) were associated with depersonalization. The personal accomplishment dimension was predicted by casual employment (β: 5.72, 95%CI: 1.13, 11.31, p\u0026thinsp;=\u0026thinsp;0.045). The mean score of the overall QoL score of study participants was 78.1 (\u0026plusmn;\u0026thinsp;8.6). A significant association was observed between moderate burnout for emotional exhaustion (β: \u0026minus;\u0026thinsp;4.59, 95%CI: -4.59, -0.46, p\u0026thinsp;=\u0026thinsp;0.017), high burnout for personal accomplishment (β: -6.28, 95%CI: -8.65, -3.91, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and QoL of nursing professionals.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe total prevalence of burnout among nurse practitioners was low which is influenced by a multiplicity of factors: participants\u0026rsquo; rank, type of shift, and type of employment. Burnout has a negative effect on the QoL of nursing professionals. Interventions to reduce the incidence of burnout can target reducing the number of night shifts and instituting incentives for casual/contract nurses.\u003c/p\u003e","manuscriptTitle":"Assessment Of Burnout and Quality of Life Among Nursing Professionals in The Ashanti Region of Ghana","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-19 14:37:23","doi":"10.21203/rs.3.rs-4224223/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"de002e64-553b-4252-b29e-87f174dc58a3","owner":[],"postedDate":"April 19th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-06-04T12:53:44+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-19 14:37:23","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4224223","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4224223","identity":"rs-4224223","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}