Professional nurses play a key role in the care of sick neonates and provide quality care to the patients and their families. Nurses working in low resource settings are stressed by heavy workload and limited resources to render holistic care to babies admitted to the Neonatal Intensive Care Unit (NICU). The study explored work-related burnout and nursing care experiences of professional nurses working in a NICU of a municipal hospital in the Bono East Region of Ghana. The study applied qualitative explorative descriptive design which was guided by the job-demand and resource theory. Data saturation was attained with fifteen participants who were purposively recruited for the study. A semi structured interview guide and participants’ observations were used to gather information from participants. Interviews were audio-taped and transcribed verbatim then analyzed using Thematic Content Analysis. The study revealed that nurses had both positive and negative work experiences, with a predominance of negative job demand experience and burnout. Burnout in the NICU usually presents in the form of emotional exhaustion and depersonalization. Positive experiences in team work and job satisfaction were gained from caring for sick newborns. The study revealed personal resource like intrinsic motivation, coping style, selfefficacy and resilience motivated nurses. However, the nurses expressed poor coping in management of burnout associated with work. The JD-R theory facilitated gaining responses from the participants that highlighted various coping strategies when overwhelmed with work or burnout. Participants strategies to manage burnout included team support, supportive unit leadership and family support. Nurses identified organizational policies, heavy workload, lack of extrinsic motivation, equipment and emotional engagement as factors contributing to their job demand and burnout experience. The study proposes broad interventions encompassing both individual and organizational strategies to curtail nurses’ burnout. The study concluded that nurses working in acute care settings need to be trained in self-care and health promotion initiative that will improve their wellbeing.
Cite this paper
Adu-Assiamah, S. and Kwapong, P. A. A. (2025). Exploring Nurses’ Burnout in the Neonatal Intensive Care Unit of a Municipal Hospital: Application of the Job Demand and Resource Theory. Open Access Library Journal, 12, e3450. doi: http://dx.doi.org/10.4236/oalib.1113450.
Boateng, Y.A., Osei, S.A., Aboh, I.K. and Druye, A.A. (2021) Causes of Burnout Syndrome and Coping Strategies among High Dependency Unit Nurses of an Institution in the Greater Accra Region of Ghana. Nursing Open, 8, 3334-3339. https://doi.org/10.1002/nop2.1052
Dolan, E.D., Mohr, D., Lem-pa, M., Joos, S., Fihn, S.D., Nelson, K.M., et al. (2015) Using a Single Item to Measure Burnout in Primary Care Staff: A Psychometric Evaluation. Journal of General Inter-nal Medicine, 30, 582-587. https://doi.org/10.1007/s11606-014-3112-6
Roomaney, R., Steenkamp, J. and Kagee, A. (2017) Predictors of Burnout among HIV Nurses in the Western Cape. Curationis, 40, 1-9. https://doi.org/10.4102/curationis.v40i1.1695
Tekindal, B., Tekindal, M.A., Pinar, G., Ozturk, F. and Alan, S. (2012) Nurses’ Burnout and Unmet Nursing Care Needs of Patients’ Relatives in a Turkish State Hospital. International Journal of Nursing Practice, 18, 68-76. https://doi.org/10.1111/j.1440-172x.2011.01989.x
Dyrbye, L.N. (2011) Re-lationship between Work-Home Conflicts and Burnout among American Surgeons: A Comparison by Sex. Archives of Surgery, 146, 211-217. https://doi.org/10.1001/archsurg.2010.310
Bakker, A.B. and Demerouti, E. (2007) The Job Demands‐Resources Model: State of the Art. Journal of Managerial Psychology, 22, 309-328. https://doi.org/10.1108/02683940710733115
Cimiotti, J.P., Aiken, L.H., Sloane, D.M. and Wu, E.S. (2012) Nurse Staffing, Burnout, and Health Care-Associated Infection. American Journal of Infection Control, 40, 486-490. https://doi.org/10.1016/j.ajic.2012.02.029
Butcher, E., Morrison, R., Balogan, O., Duncan, H., St Loius, K., Webb, S. and Shaw, R. (2023) Burnout and Coping Strategies in Paediatric and Nonatal Intensive Care Staff. Clinical Practice in Pediatric Psychology, 12, 16-30.
Tawfik, D.S., Sexton, J.B., Kan, P., Sharek, P.J., Nisbet, C.C., Rigdon, J., et al. (2017) Burnout in the Neonatal Intensive Care Unit and Its Re-lation to Healthcare-Associated Infections. Journal of Perinatology, 37, 315-320. https://doi.org/10.1038/jp.2016.211
Afeadie, R.K., Collins, A., Siaw-Marfo, D., Afeadie, Y., Yeboah, J., Tetteh Afeadie, V., et al. (2023) Information and Interaction Opportunities: Experiences of Mothers of Babies at the Neonatal Intensive Care Unit, Accra, Ghana: A Qualitative Study. Journal of Neonatal Nursing, 29, 554-558. https://doi.org/10.1016/j.jnn.2022.11.010
Almeida, A., Moraes, M.S. and Cunha, M.L. (2016) Taking Care of the Newborn Dying and Their Families: Nurses’ Experiences of Neonatal Intensive Care. Revista da Escola de Enfermagem da USP, 50, 122-129. https://doi.org/10.1590/s0080-623420160000300018
Adil, M.S. and Baig, M. (2018) Impact of Job Demands-Resources Model on Burnout and Employee’s Well-Being: Evidence from the Pharmaceutical Organisations of Karachi. IIMB Management Review, 30, 119-133. https://doi.org/10.1016/j.iimb.2018.01.004
Evenstad, S.B.N. (2015) “Be Ex-cellent and Do More with Less”: A Paradox behind Job Burnout Threatening Organi-zational Sustainability. International Journal of Systems and Society, 2, 52-67. https://doi.org/10.4018/ijss.2015070104
Bakker, A.B. and Demerouti, E. (2017) Job Demands-Resources Theory: Taking Stock and Looking Forward. Journal of Occupational Health Psychology, 22, 273-285. https://doi.org/10.1037/ocp0000056
Doulougeri, K., Georganta, K. and Montgomery, A. (2016) “Diagnosing” Burnout among Healthcare Professionals: Can We Find Consensus? Cogent Medicine, 3, 1-10. https://doi.org/10.1080/2331205x.2016.1237605
Kaschka, W.P., Korczak, D. and Broich, K. (2011) Burnout, a Fashionable Diagnosis. Deutsches ärzteblatt Inter-national, 108, 781-787. https://doi.org/10.3238/arztebl.2011.0781
Woo, T., Ho, R., Tang, A. and Tam, W. (2020) Global Prevalence of Burnout Symptoms among Nurses: A Systematic Review and Meta-Analysis. Journal of Psychiatric Research, 123, 9-20. https://doi.org/10.1016/j.jpsychires.2019.12.015
Owuor, R.A., Mutungi, K., Anyango, R. and Mwita, C.C. (2020) Prevalence of Burnout among Nurses in Sub-Saharan Africa: A Systematic Review. JBI Evidence Synthesis, 18, 1189-1207. https://doi.org/10.11124/jbisrir-d-19-00170
Tay, W.Y., Earnest, A., Tan, S.Y. and Ng, M.J.M. (2014) Prevalence of Burnout among Nurses in a Com-munity Hospital in Singapore: A Cross-Sectional Study. Proceedings of Singapore Healthcare, 23, 93-99. https://doi.org/10.1177/201010581402300202
Saeidi, R., Izanloo, A. and Izanloo, S. (2020) A Study of the Relationship between Job Satisfastion and Burnout among Neonatal Intesive Care Unit Staff. IJN, 11, 64-70.
Giorgi, F., Mattei, A., Notarnicola, I., Petrucci, C. and Lancia, L. (2017) Can Sleep Quality and Burnout Af-fect the Job Performance of Shift‐Work Nurses? A Hospital Cross‐Sectional Study. Journal of Advanced Nursing, 74, 698-708. https://doi.org/10.1111/jan.13484
Gebregziabher, D., Berhanie, E., Berihu, H., Belstie, A. and Teklay, G. (2020) The Relationship between Job Satisfaction and Turnover Intention among Nurses in Axum Comprehensive and Specialized Hospital Tigray, Ethiopia. BMC Nursing, 19, Article No. 79. https://doi.org/10.1186/s12912-020-00468-0
Lee, K.R. and Kim, J.M. (2016) Effects of Emotional Labor on Burnout in Nurses: Focusing on the Moderating Effects of Social Intelligence and Emotional Intelligence. Journal of Korean Academy of Nursing Administration, 22, 22-32. https://doi.org/10.11111/jkana.2016.22.1.22
You, L., Aiken, L.H., Sloane, D.M., Liu, K., He, G., Hu, Y., et al. (2013) Hospital Nursing, Care Quality, and Patient Satisfaction: Cross-Sectional Surveys of Nurses and Patients in Hospitals in China and Europe. International Jour-nal of Nursing Studies, 50, 154-161. https://doi.org/10.1016/j.ijnurstu.2012.05.003
Li, B., Bruyneel, L., Sermeus, W., Van den Heede, K., Matawie, K., Aiken, L., et al. (2013) Group-Level Impact of Work Environment Dimensions on Burnout Experiences among Nurses: A Multivariate Multilevel Probit Model. International Journal of Nursing Studies, 50, 281-291. https://doi.org/10.1016/j.ijnurstu.2012.07.001
Van der Heijden, B., Brown Mahoney, C. and Xu, Y. (2019) Impact of Job Demands and Resources on Nurses’ Burnout and Occupational Turnover Intention Towards an Age-Moderated Mediation Model for the Nursing Profession. International Journal of Environmental Research and Public Health, 16, Article 2011. https://doi.org/10.3390/ijerph16112011
Dall’Ora, C., Ball, J., Reinius, M. and Griffiths, P. (2020) Burnout in Nursing: A Theoretical Review. Human Resources for Health, 18, Article No. 41. https://doi.org/10.1186/s12960-020-00469-9
Mudallal, R.H., Othman, W.M. and Al Hassan, N.F. (2017) Nurses’ Burnout: The Influence of Leader Empowering Behaviors, Work Conditions, and Demographic Traits. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 54, 1-10. https://doi.org/10.1177/0046958017724944
Aseidu, E.A. (2017) Jugging Family and Professional Caring: Role Demand, Work-Family Conflict and Burnout among Registered Nurses in Ghana. Nursing Open, 5, 611-620. https://doi.org/10.1002/nop2.178
Mao, A., Cheong, P.L., Van, I.K. and Tam, H.L. (2021) “I Am Called Girl, but That Doesn’t Matter” -Perspectives of Male Nurses Regarding Gender-Related Advantages and Disadvantages in Professional Development. BMC Nursing, 20, Article No. 2021. https://doi.org/10.1186/s12912-021-00539-w
Barrett, C., Mathews, M., Poitras, M., Norful, A.A., Mar-tin-Misener, R., Tranmer, J., et al. (2021) Job Titles and Education Requirements of Registered Nurses in Primary Care: An International Document Analysis. Interna-tional Journal of Nursing Studies Advances, 3, Article 100044. https://doi.org/10.1016/j.ijnsa.2021.100044
Akparep, J.Y., Jengre, E. and Mogre, A.A. (2019) The Influence of Leadership Style on Organizational Performance at Tumakavi Development Association, Tamale, Northern Region of Ghana. Open Journal of Leadership, 8, 1-22. https://doi.org/10.4236/ojl.2019.81001
Fetouh, F.M., Fakhry, S.F. and Abd-Elhamid, L.A. (2023) Factors Affecting Decisional Involvement among Staff Nurse. Egyptian Journal of Health Care, 14, 380-391. https://doi.org/10.21608/ejhc.2023.282518
Gatbonton, R.R.G. (2019) Deci-sional Involvement on Work Quality of Nurses. Nursing and Palliative care Interna-tional Journal, 2, 21-27. https://doi.org/10.30881/npcij.00011
Sakiru, O.K., D’Silva, J.L., Othman, J., Si-long, A.D. and Busayo, A.T. (2013) Leadership Styles and Job Satisfaction among Employees in Small and Medium Enterprises. International Journal of Business and Management, 8, 34-41. https://doi.org/10.5539/ijbm.v8n13p34
McGrath, S.P., Taenzer, A.H., Karon, N. and Blike, G. (2016) Surveillance Monitoring Manage-ment for General Care Units: Strategy, Design, and Implementation. The Joint Com-mission Journal on Quality and Patient Safety, 42, 293-302. https://doi.org/10.1016/s1553-7250(16)42040-4
Utomo, M.T., Sampurna, M.T.A., Melisa, M., Permana, P.B.D., Angelo Albright, I., Etika, R., et al. (2022) Nurse Workload, Missed Nursing Care, and the Contributing Factors in the Neonatal Inten-sive Care Unit in a Limited Resource Setting: A Case from Indonesia. F1000Research, 11, Article 468. https://doi.org/10.12688/f1000research.109105.1
Tubbs-Cooley, H.L., Mara, C.A., Carle, A.C., Mark, B.A. and Pickler, R.H. (2019) Association of Nurse Workload with Missed Nursing Care in the Neonatal Intensive Care Unit. JAMA Pediatrics, 173, 44-51. https://doi.org/10.1001/jamapediatrics.2018.3619
Lupo, R., Lezzi, A., Conte, L., Santoro, P., Carvello, M., Artioli, G., Carabro, A., Cal-dararo, A., Botti, S. and Carrriero, M.C. (2021) Work Environment and Related Burnout Levels: Survey among Healthcare Workers in Two Hospitals of Southern Italy. PubMed, 92, e2021009.
Lang, G.M., Pfister, E.A. and Siemens, M.J. (2010) Nursing Burnout: Cross-Sectional Study at a Large Army Hospital. Military Medicine, 175, 435-441. https://doi.org/10.7205/milmed-d-09-00284
Leineweber, C., Westerlund, H., Chungkham, H.S., Lindqvist, R., Runesdotter, S. and Tishelman, C. (2014) Nurses’ Practice Environment and Work-Family Conflict in Relation to Burn Out: A Multilevel Modelling Approach. PLOS ONE, 9, e96991. https://doi.org/10.1371/journal.pone.0096991
Obeidat, H.M., Bond, E.A. and Callister, L.C. (2009) The Parental Experience of Having an Infant in the Newborn Intensive Care Unit. Journal of Perinatal Education, 18, 23-29.
Ncube, R.K., Barlow, H. and Mayers, P.M. (2016) A Life Uncertain—My Baby’s Vulnerability: Mothers’ Lived Experience of Connection with Their Preterm Infants in a Botswana Neonatal Intensive Care Unit. Curationis, 39, a1575. https://doi.org/10.4102/curationis.v39i1.1575
Adu-Assiamah, S. (2022) Ex-ploring Psychosocial Experiences of Parents with Children Undergoing Cancer Treatment at Korle-Bu Teaching Hospital. OALib, 9, e8429. https://doi.org/10.4236/oalib.1108429
Melo, E.M., Ferreira, P.L., Lima, R.A. and Mello, D.F. (2014) The Involvement of Parents in the Healthcare Provided to Hospitalzed Children. Revista Latino-Americana de Enfermagem, 22, 432-439. https://doi.org/10.1590/0104-1169.3308.2434
Eskandari Kootahi, Z., Yazdani, N., Parsa, H., Erami, A. and Bahrami, R. (2023) Professional Values and Job Satisfaction Neonatal Intensive Care Unit Nurses and Influencing Factors: A Descrip-tive Correlational Study. International Journal of Africa Nursing Sciences, 18, Article 100512. https://doi.org/10.1016/j.ijans.2022.100512
Sodeify, R., Vanaki, Z. and Mohammadi, E. (2013) Nurses’Experiences of Perceived Support and Their Contributing Factors: A Qualitative Content Analysis. Iranian Journal of Nursing and Midwifery Research, 18, 191-197.
Kousar, S., Hussain, M., Afzal, M., Gilani, A. and Azhar, M. (2018) Impact of Job Satisfaction on Nurses’ Performance. Saudi Journal of Nursing and Health Care, 1, 49-55.
Piquette, D., Reeves, S. and Le-blanc, V.R. (2009) Interprofessional Intensive Care Unit Team Interactions and Med-ical Crises: A Qualitative Study. Journal of Interprofessional Care, 23, 273-285. https://doi.org/10.1080/13561820802697818
Tang, C.J., Zhou, W.T., Chan, S.W.-C. and Liaw, S.Y. (2017) Interprofessional Collaboration between Junior Doctors and Nurses in the General Ward Setting: A Qualitative Exploratory Study. Journal of Nursing Management, 26, 11-18. https://doi.org/10.1111/jonm.12503
Spence Laschinger, H.K. and Havens, D.S. (1997) The Effect of Workplace Empowerment on Staff Nurs-es’ Occupational Mental Health and Work Effectiveness. The Journal of Nursing Ad-ministration, 27, 42-50. https://doi.org/10.1097/00005110-199706000-00012
Nasiripour, A.A., Raeisi, P. and Hedayati, S.P. (2009) The Relationship between Organizational Cul-tures and Employees Productivity. Journal of Health Administration, 12, 17-24.
Poku, C.A., Donkor, E. and Naab, F. (2020) Determinants of Emotional Exhaustion among Nursing Workforce in Urban Ghana: A Cross-Sectional Study. BMC Nursing, 19, Article No. 116. https://doi.org/10.1186/s12912-020-00512-z
Boland, L.L., Mink, P.J., Kamrud, J.W., Jeruzal, J.N. and Stevens, A.C. (2019) Social Support Outside the Workplace, Coping Styles, and Burnout in a Cohort of EMS Providers from Minnesota. Workplace Health & Safety, 67, 414-422. https://doi.org/10.1177/2165079919829154
Odonkor, S.T. and Frimpong, K. (2020) Burnout among Healthcare Professionals in Ghana: A Critical Assessment. BioMed Research International, 2020, Article 1614968. https://doi.org/10.1155/2020/1614968
Kaburi, B.B., Bio, F.Y., Kubio, C., Ameme, D.K., Kanu, E., Sackey, S.O. and Afari, E.A. (2016) Psychological Working Conditions and Predictors of Occupational Stress among Nurses, Salaga Government Hospital, Ghana, 2016. Pan African Medical Journal, 33, 1-15.
Aryankhesal, A., Mohammadibakhsh, R., Hamidi, Y., Alidoost, S., Behzadifar, M., Sohrabi, R., et al. (2019) Interventions on Reducing Burnout in Physicians and Nurses: A Systematic Review. Medical Journal of The Islamic Republic of Iran, 33, 467-474. https://doi.org/10.47176/mjiri.33.77
Yildirim, N., Yesilbas, H. and Kantek, F. (2023) Interventions to Reduce Nurses’ Burnout: A Systematic Review and Meta‐Analysis. Japan Journal of Nursing Science, 20, e12542. https://doi.org/10.1111/jjns.12542