Workplace environment and burnout among hemodialysis healthcare professionals: a pilot study

Abstract This pilot study investigated burnout among healthcare professionals (HCPs) working in center-based and satellite hemodialysis units and examined its association with patient clinical complexity. A cross-sectional study was conducted among 39 HCPs in Pécs, Hungary. Burnout was assessed primarily using the Maslach Burnout Inventory–Human Services Survey (MBI-HSS), with the Mini Oldenburg Burnout Inventory (MOLBI) used as a complementary measure of exhaustion and disengagement. MBI dimensions were analyzed separately, with Emotional Exhaustion (MBI-EE) prespecified as the primary burnout-related outcome for multivariable analysis. Patient clinical complexity was assessed using the Charlson Comorbidity Index (CCI) and Karnofsky Performance Scale (KPS). Exploratory multivariable linear regression was performed with a parsimonious set of prespecified predictors. Patients treated in the center-based dialysis unit had a significantly higher comorbidity burden (CCI: 6.62 vs. 5.55, p = 0.003) and poorer functional status (KPS: 67.9 vs. 85.7, p < 0.001) than those treated in the satellite unit. Healthcare professionals working in the center-based dialysis unit had significantly higher Emotional Exhaustion scores than those working in the satellite unit (29.2 ± 7.2 vs. 22.2 ± 7.1, p = 0.002). MOLBI-measured exhaustion was positively correlated with patient CCI (r = 0.426, p = 0.028). In exploratory multivariable analysis, center-based dialysis unit employment remained associated with higher Emotional Exhaustion after adjustment for age category and marital status (B = 5.587, SE = 2.196, standardized β = 0.351, p = 0.016). Greater patient clinical complexity and functional dependency in the center-based dialysis setting were accompanied by higher Emotional Exhaustion among healthcare professionals. Because dialysis setting and patient case mix were closely related, the observed association should not be interpreted as a causal organizational effect. Larger multicentre longitudinal studies incorporating objective workload measures are warranted.