Burnout and Its Relationship with Mental Health among Intensive Care Unit (ICU) Staff: A Cross-Sectional Mixed-Methods Study in Saudi Arabia

Abstract

Background: Burnout among Intensive Care Unit (ICU) staff is a critical occupational health issue that significantly affects mental health and patient care outcomes. However, limited research in Saudi Arabia has examined the relationship between burnout and mental health outcomes among ICU professionals using mixed-method approaches. Aim: This study examined the relationship between burnout and mental health outcomes (anxiety, depression, and PTSD) among ICU staff and identified contributing factors and coping strategies. Methods: A cross-sectional mixed-methods study was conducted across five hospitals in Saudi Arabia. A total of 250 ICU healthcare professionals were invited, and 180 completed standardized surveys (72% response rate). Quantitative data were collected using the Maslach Burnout Inventory (MBI) and the Hospital Anxiety and Depression Scale (HADS). Fifty participants volunteered for semi-structured interviews conducted once per participant, lasting approximately 30–45 minutes. Interviews were conducted face-to-face in a private setting and audio-recorded with consent. Quantitative data were analyzed using correlation and regression analysis, while qualitative data were examined through thematic analysis. Results: High workload, emotional exhaustion, staffing shortages, and lack of institutional psychological support were significantly associated with burnout. Burnout demonstrated a strong positive correlation with anxiety (48%), clinically diagnosed anxiety (36%), sleep disturbances (60%), and PTSD symptoms (48%). Qualitative findings supported these results, highlighting emotional strain, exposure to traumatic events, and limited administrative support as major contributors. Participants reported peer support, mindfulness practices, and regular exercise as coping mechanisms. Conclusion: Burnout among ICU staff is significantly associated with adverse mental health outcomes. Institutional strategies including structured mental health programs, workload redistribution, and resilience training are urgently needed to improve staff well-being and patient care sustainability.