Assessment of Factors Associated with Burnout Symptoms and Coping Strategies among Intensive Care Unit Nurses in Tertiary Referral Hospitals in Kigali City, Rwanda

Abstract

Background: Burnout is an occupational health concern worldwide, particularly in resource-constrained settings, where increasing healthcare demands, workforce shortages and inadequate resources contribute to work-related stress. Intensive care unit (ICU) nurses care for critically ill patients and may experience exhaustion, mental distress, cognitive impairment and emotional impairment. A 2017 study reported a burnout prevalence of 61.7% among critical care nurses in Rwanda, but evidence concerning associated factors and coping strategies remains limited. Objectives: To determine the prevalence of core burnout symptoms and identify socio-demographic, work-related and coping-strategy factors associated with these symptoms among ICU nurses in three tertiary referral hospitals in Kigali, Rwanda. Methods: This quantitative cross-sectional study included 158 ICU nurses at King Faisal Hospital (KFH), University Teaching Hospital of Kigali (UTHK) and Rwanda Military Hospital (RMH) between 17 April and 16 May 2024. Core burnout symptoms (exhaustion, mental distress, cognitive impairment and emotional impairment) were assessed using items adapted from the Burnout Assessment Tool. Nurses reporting at least one symptom often, always or regularly were classified as having burnout symptoms. Data were analysed using Stata 17, descriptive statistics and binary logistic regression. Results: The 158 ICU nurses were aged 22–63 years (mean age: 35 years), and 52.5% were female. Nearly half were aged 31–40 years. Overall, 117 nurses (74.1%) reported at least one core burnout symptom. Among the socio-demographic variables, age was independently associated with burnout symptoms: nurses aged 41–63 years had higher adjusted odds than those aged 22–30 years (adjusted odds ratio [aOR] = 5.8; 95% confidence interval [CI]: 1.0–32.9). Nurses with 16–29 years of work experience had higher crude odds than those with 1–5 years of experience (crude odds ratio [cOR] = 11.0; 95% CI: 2.3–53.3). Regularly taking 3–4 weeks of annual leave was associated with a lower prevalence of burnout symptoms, although an adjusted estimate could not be obtained. Nurses who rarely or never undertook aerobic exercise for at least 30 minutes had higher adjusted odds of burnout symptoms than regular exercisers (aOR = 2.7; 95% CI: 1.2–6.3). Conclusion: Core burnout symptoms were common among ICU nurses in Kigali tertiary hospitals. Older age and longer work experience were associated with higher odds of burnout symptoms, whereas regular aerobic exercise and annual leave were associated with a lower symptom burden. Causal relationships cannot be established from these cross-sectional findings. Hospitals and the Ministry of Health may consider occupational well-being support, including opportunities for exercise and adequate annual leave, while further research examines these associations.