The relationship between job burnout and the perceived organizational climate in nurses working in medical training centers of Iran University of Medical Sciences

Background: Nursing has always been one of the most stressful jobs. Nurses as a key group in the treatment system experience a lot of job stress that can cause fatigue and burnout and thus a negative impact on their mental health. Burnout is an emotionally exhausting state in which a person feels affected and exhausted by their job, in which the person feels unable to meet job expectations, and unable to communicate with others. Burnout leads to absenteeism, leaving the job and the intention to leave, reducing the quality of life, reducing the level of performance and reducing the quality of medical care, as well as reducing the commitment to the organization and it negatively affects the quality of care, client safety and staff performance in the treatment care system. Organizational climate has always been the central cycle of the work environment in the nursing profession and in a hospital environment where the performance of the nurse is recognized as an important component in improving the quality of treatment. Given the importance of burnout and organizational climate, especially in nurses and health care organizations, the researcher did not find a study that focuses on the field of correlation and prediction of burnout and organizational climate on nurses. The aim of this study was to determine the prediction of burnout in nurses based on the organizational climate of nurses working in the internal surgery wards of Iran University of Medical Sciences in 2020. Method: This descriptive cross-sectional correlation study was performed in the medical surgical wards of four selected hospitals of Iran University of Medical Sciences by cluster sampling method. Inclusion criteria were having at least 6 months of clinical experience, no experience of mourning or crisis during the last 6 months, no use of psychiatric drugs in the last 6 months, no acute physical or mental illness and at least a bachelor's degree or higher. To determine the sample size at 95% confidence level and 80% test power, 200 people were estimated. To collect data from the list of demographic information including age, sex, marital status, work experience, employment status, job position, shift work, economic status, Maslach burnout questionnaires (22 items, 3 subscales, 7-point Likert and scope Score 0 to 154) and Halpin and Croft organizational climate questionnaire (32 items, 8 subscales, 5-point Likert scale, and score range 32 to 160) were used. The researcher, after obtaining a letter of introduction from the School of Nursing and Midwifery and obtaining a research license from the Ethics and Research Committee of Iran University of Medical Sciences, referred to the desired educational and medical centers and distributed some questionnaires in person and others online due to the Covid-19 epidemic. Data analysis was performed by SPSS software version 24 using descriptive and inferential statistics.  In the descriptive amart section, frequency distribution tables (for qualitative variables) and mean numerical indices and maximum and minimum standard deviation (for quantitative variables) were used. Results: Among the dimensions of organizational climate, the group spirit dimension (14.2 ± 8.4) is higher than other dimensions, followed by the interest dimension (13.3 ± 9) and the intimacy dimension (13.3 ± 2.2), respectively. In general, the majority of nurses (89%) had a high level of perceived organizational climate. However, burnout in the dimension of depersonalization (63.17 ± 2) was higher than the other two dimensions in the studied nurses. Emotional fatigue had a statistically significant correlation with all perceived dimensions of organizational climate except group spirit and distance, so that it was inversely correlated with the disturbance dimension and was directly correlated with other dimensions. This means that the higher the disturbance score from the organizational climate, the lower the emotional fatigue score, resulting in more emotional fatigue. The results show that burnout in the dimension of emotional fatigue has the highest correlation with the dimension of interest in the organizational climate, so that interest leads to a reduction of emotional fatigue. There was no statistically significant relationship between lack of personal success with harassment, consideration, and emphasis on generating correlation, but there was a statistically significant correlation with other dimensions of organizational climate that the intensity of correlation was higher in terms of interest than other dimensions.  Also, there was a significant inverse correlation between metamorphosis with the dimensions of harassment, distance from the organizational climate, and showed a statistically significant direct correlation with the dimension of interest, but did not show a correlation with other dimensions of organizational climate. The results of analysis of variance showed that the mean dimensions of burnout (P = 0.008) and organizational climate (P = 0.003) had no significant relationship with other demographic characteristics except employment status. Conclusion: Among the dimensions of organizational climate, group morale was higher than other dimensions and 89% of nurses had a high level of perceived organizational climate and burnout in the dimension of depersonalization was higher than the other two dimensions in nurses. The results also showed that emotional fatigue has a statistically significant correlation with all perceived dimensions of organizational climate except group mood and distance. Health workers, especially nurses and managers of different levels of health, seek to design solutions to reduce burnout and improve organizational climate and patient satisfaction according to the existing conditions and facilities. Awareness of health workers, especially nurses and nursing managers can be a basis for deciding whether or not to use these methods, and by preparing training and intervention programs to correct burnout and change the work environment of nurses to take more steps. Also, conducting this research can be the basis for identifying new issues in the clinic and the results of the research can be an effective step to identify issues and problems related to burnout and organizational climate.