Intensive Care Medicine

, Volume 44, Issue 12, pp 2079–2090 | Cite as

Professional burnout among physicians and nurses in Asian intensive care units: a multinational survey

  • Kay Choong SeeEmail author
  • Ming Yan Zhao
  • Emiko Nakataki
  • Kaweesak Chittawatanarat
  • Wen-Feng Fang
  • Mohammad Omar Faruq
  • Bambang Wahjuprajitno
  • Yaseen M. Arabi
  • Wai Tat Wong
  • Jigeeshu V. Divatia
  • Jose Emmanuel Palo
  • Babu Raja Shrestha
  • Khalid M. K. Nafees
  • Nguyen Gia Binh
  • Hussain Nasser Al Rahma
  • Khamsay Detleuxay
  • Venetia Ong
  • Jason Phua
  • SABA Study Investigators and the Asian Critical Care Clinical Trials Group



Professional burnout is a multidimensional syndrome comprising emotional exhaustion, depersonalization, and diminished sense of personal accomplishment, and is associated with poor staff health and decreased quality of medical care. We investigated burnout prevalence and its associated risk factors among Asian intensive care unit (ICU) physicians and nurses.


We conducted a cross-sectional survey of 159 ICUs in 16 Asian countries and regions. The main outcome measure was burnout as assessed by the Maslach Burnout Inventory-Human Services Survey. Multivariate random effects logistic regression analyses of predictors for physician and nurse burnout were performed.


A total of 992 ICU physicians (response rate 76.5%) and 3100 ICU nurses (response rate 63.3%) were studied. Both physicians and nurses had high levels of burnout (50.3% versus 52.0%, P = 0.362). Among countries or regions, burnout rates ranged from 34.6 to 61.5%. Among physicians, religiosity (i.e. having a religious background or belief), years of working in the current department, shift work (versus no shift work) and number of stay-home night calls had a protective effect (negative association) against burnout, while work days per month had a harmful effect (positive association). Among nurses, religiosity and better work-life balance had a protective effect against burnout, while having a bachelor’s degree (compared to having a non-degree qualification) had a harmful effect.


A large proportion of Asian ICU physicians and nurses experience professional burnout. Our study results suggest that individual-level interventions could include religious/spiritual practice, and organizational-level interventions could include employing shift-based coverage, stay-home night calls, and regulating the number of work days per month.


Critical care Intensive care units Nurses Physicians Professional burnout 



The authors are grateful for the many ICU physicians and nurses, who generously took time off their busy schedules to complete the survey.

Compliance with ethical standards

Human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards

Ethical approval

Ethical approval was obtained for the overall study in Singapore (NHG-DSRB 2014/01032), and by institutional review boards according to local regulations in each participating centre and country.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

All authors do not have any conflicts of interests to declare. Survey instruments and software were purchased using the authors’ personal funds.

Supplementary material

134_2018_5432_MOESM1_ESM.docx (829 kb)
Supplementary material 1 (DOCX 829 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature and ESICM 2018

Authors and Affiliations

  • Kay Choong See
    • 1
    Email author
  • Ming Yan Zhao
    • 2
  • Emiko Nakataki
    • 3
  • Kaweesak Chittawatanarat
    • 4
    • 18
  • Wen-Feng Fang
    • 5
  • Mohammad Omar Faruq
    • 6
  • Bambang Wahjuprajitno
    • 7
  • Yaseen M. Arabi
    • 8
  • Wai Tat Wong
    • 9
  • Jigeeshu V. Divatia
    • 10
  • Jose Emmanuel Palo
    • 11
  • Babu Raja Shrestha
    • 12
  • Khalid M. K. Nafees
    • 13
  • Nguyen Gia Binh
    • 14
  • Hussain Nasser Al Rahma
    • 15
  • Khamsay Detleuxay
    • 16
  • Venetia Ong
    • 17
  • Jason Phua
    • 1
  • SABA Study Investigators and the Asian Critical Care Clinical Trials Group
  1. 1.Division of Respiratory and Critical Care MedicineUniversity Medicine Cluster, National University Hospital, National University Health SystemSingaporeSingapore
  2. 2.Department of Critical Care MedicineHarbin Medical University 1st HospitalHarbinChina
  3. 3.Department of Emergency and Critical Care MedicineTokushima University HospitalTokushimaJapan
  4. 4.Department of Surgery, Faculty of MedicineChiang Mai UniversityChiang MaiThailand
  5. 5.Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial HospitalChang Gung University College of Medicine, and Chang Gung University of Science and TechnologyKaohsiungTaiwan
  6. 6.Department of Critical Care MedicineBIRDEM General HospitalDhakaBangladesh
  7. 7.Department of Anesthesiology and ReanimationUniversity of AirlanggaSurabayaIndonesia
  8. 8.Intensive Care DepartmentKing Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research CenterRiyadhSaudi Arabia
  9. 9.Department of Anesthesia and Intensive CareThe Chinese University of Hong KongHong KongChina
  10. 10.Department of Anaesthesia, Critical Care and PainTata Memorial HospitalMumbaiIndia
  11. 11.Department of MedicineThe Medical CityPasigPhilippines
  12. 12.Department of Anaesthesiology and Intensive CareKathmandu Medical College Teaching HospitalKathmanduNepal
  13. 13.Department of Critical Care MedicineRIPAS HospitalBandar Seri BegawanBrunei
  14. 14.Department of Intensive CareBach Mai HospitalHanoiVietnam
  15. 15.Department of Intensive CareDubai HospitalDubaiUnited Arab Emirates
  16. 16.Department of Intensive CareMahosot HospitalVientianeLaos
  17. 17.Medical Affairs-EducationNational University HospitalSingaporeSingapore
  18. 18.The Thai Society of Critical Care MedicineBangkokThailand

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