Burnout among emergency department healthcare workers in Palestine and Türkiye: a cross-sectional comparative study

BACKGROUND: Burnout is a common concern among healthcare workers in hospital emergency departments (EDs). This study examines the level of burnout and associated factors among healthcare workers in EDs of Palestinian and Turkish hospitals. It also assessed the relationship between prevalence of burnout and workplace violence as well as with job turnover in EDs. METHODS: A cross-sectional study was conducted in 14 Palestinian hospital EDs in the West Bank and 3 hospitals in Isparta Province in Türkiye. All ED physicians, nurses, and other staff across the 17 hospitals (≈ 660 workers) were invited to participate in the study. A total of 377 completed the survey (Palestine 227; Türkiye 150). The Maslach Burnout Inventory- Human Services Survey for Medical Personnel was used to assess occupational burnout. Data collection was done between June and November 2024. FINDINGS: A majority (70.0%) of the Palestinian participants experienced burnout associated with emotional exhaustion (score ≥ 27) compared to 48.7% in Türkiye (p < 0.001), 51.4% reported burnout related to depersonalization (score ≥ 10) compared to 43.3% in Türkiye (p = 0.282), and 53.3% reported burnout related to personal accomplishment (score ≤ 33) compared to 62.6% in Türkiye (p = 0.207). Unadjusted odds ratios indicate a significant prevalence of burnout, characterized by having high scores on the emotional exhaustion (≥ 27) and/ or depersonalization (≥ 10), especially among Palestinian compared to Turkish participants (OR 2.581; 95% CI 1.640-4.063; p < 0.001), among physicians (OR 3.718; 95% CI 1.946-7.103; p < 0.001) and nurses (OR 3.248; 95% CI 1.882-5.605; p < 0.001) compared to other ED workers, as well as among those exposed to any type of workplace violence (physical/non-physical) during the past year (OR 4.287; 95% CI 2.666-6.895; p < 0.001). The adjusted odds ratios showed that burnout is significantly associated with the job category, where physicians (OR 2.499; 95% CI 1.244-5.018; p = 0.01) and nurses (OR 2.147; 95% CI 1.135-4.059; p = 0.019) are more likely to experience burnout than other ED workers, as well as with exposure to workplace violence (OR 3.304; 95% CI 1.948-5.606; p < 0.001). The findings showed that burnout syndrome was associated with a higher intention to leave the EDs, with 57.8% of individuals experiencing burnout expressing a desire to quit EDs (p < 0.001). CONCLUSIONS: The study indicates a high prevalence of burnout among ED workers in both countries, particularly among physicians and nurses. Workplace violence is a significant factor associated with burnout and, subsequently, turnover from EDs. To reduce the risk of burnout on health workers and services, it is essential to adopt strategies such as providing counseling, skills development, maintaining adequate staffing, and mitigating violence against ED workers.