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January 21, 2026Medicine1 citationsOpen Access

Temporal shifts in burnout dynamics: A cross-sectional study of protective and risk factors among front-line nurses in China during and post-COVID-19

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JZJianan ZhouKZKe ZhangHDHaochen Ding

Key Points

  • The aim is to investigate burnout prevalence and factors among front-line nurses in China during and after COVID-19.
  • Conducted a cross-sectional multi-center survey across 27 provinces.
  • Assessed nurses using various scales for sleep quality, anxiety, depression, and burnout.
  • Compared burnout levels and related factors during and post-pandemic.
  • Burnout prevalence was significantly higher during the pandemic (94.7%) than post-pandemic (71.3%).
  • Emotional exhaustion levels were similar during both periods, while depersonalization increased during the pandemic.
  • Post-pandemic, frequent exercise and lower scores on anxiety and depression scales correlated with reduced burnout.

Abstract

This cross-sectional multi-center survey aimed to investigate the prevalence and correlates of burnout among front-line nurses in China during and after the COVID-19 epidemic. The study recruited front-line nurses from 27 provinces of China in November to December 2022 and April to July 2023. Assessment measures included demographic questionnaire, Pittsburgh Sleep Quality Index for sleep quality, Self-Rating Anxiety Scale for anxiety, Self-Rating Depression Scale for depression, and Maslach Burnout Inventory-Human Services Survey for burnout. Among 775 nurses during the pandemic and 693 post-pandemic, burnout prevalence was significantly higher during the pandemic (94.7% vs 71.3%, P < .001). Emotional exhaustion prevalence did not differ significantly (33.8% vs 33.3%, P = .848), while depersonalization and reduced personal achievement were higher during the pandemic ( P < .001). Scores for SAS, SDS, PSQI, emotional exhaustion, and depersonalization were significantly lower post-pandemic ( P < .001), while reduced personal achievement scores were higher ( P < .01). Logistic regression revealed high financial stress as a protective factor during the pandemic (OR = 0.443, 95% CI 0.222–0.883), while post-pandemic, frequent exercise (OR = 0.506, 95% CI 0.290–0.880), SDS scores (OR = 1.031, 95% CI 1.002–1.061), and PSQI scores (OR = 1.058, 95% CI 1.034–1.083) were associated with burnout. Receiver operating characteristic analysis showed good predictive value for SDS and PSQI scores. Burnout prevalence among front-line nurses was significantly higher during the COVID-19 pandemic. High financial stress was protective during the pandemic, while frequent exercise post-pandemic was protective against burnout.

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Cite This Study

Zhou et al. (2026) studied this question.

synapsesocial.com/papers/69706d13b6488063ad5c1e2ehttps://doi.org/10.1097/md.0000000000047030
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