2012 Sep;44(3):274-83. doi: 10.1111/j.1547-5069.2012.01462.x. Epub 2012 Aug 7.

Comparison of nurse burnout across army hospital practice environments.


Colonel, U.S. Army, 1st Medical Brigade, Task Force Medical-Afghanistan, Bagram, Afganistan  Colonel (Retired), U.S. Army, Associate Professor and Banton Endowed Professor, The University of Alabama at Birmingham School of Nursing, Birmingham, AL, USA  Lieutenant Colonel, U.S. Army, Chief, Center for Nurse Science and Clinical Inquiry, Womack Army Medical Center, Fort Bragg, NC, USA.


Purpose: The primary purpose of this study was to examine the nursing practice environment and burnout of nursing personnel assigned to a deployed combat support hospital (CSH). A secondary aim was to compare differences in the level of burnout between the deployed Army nursing personnel and Army nursing personnel assigned to an Army hospital in the United States that served as the U.S. military's primary referral center for American combat casualties evacuated from Iraq. Design: A nonexperimental cross-sectional design was used for this study. Methods: The Maslach Burnout Inventory and the Practice Environment Scale were administered to 105 personnel who deployed with a CSH to Iraq. Data from this study were linked to data obtained from 152 nursing personnel who participated in an earlier burnout study at a large Army hospital in the United States. The linked datasets yielded a final sample of 257 Army nursing personnel. Analysis of variance and linear regression analysis were used to analyze these data. Findings: Emotional exhaustion was common across groups. For the deployed nursing personnel, emotional exhaustion was related to a perceived lack of support from management, foundations for quality of care, collegial relationships, and extended work schedules. The U.S.-based Army hospital group scored significantly higher emotional exhaustion, but it was related to the additional responsibilities associated with being an Army nurse, working extended schedules, and working with combat casualties for extended periods of time. The U.S.-based group perceived more personal accomplishment from the work they do. Conclusions: Burnout was common across Army hospital settings. Emotional exhaustion was most problematic in the U.S.-based Army hospital; however, there was less cynicism toward patients and a greater perception of personal accomplishment associated with work. Clinical Relevance: This study supports the importance of a professional practice environment for Army nursing personnel both during deployment and in U.S.-based Army hospitals. Journal of Nursing Scholarship, 2011; XX:X, XXX-XXX.

©2011 Sigma Theta Tau International.

No claim to original US government works.


Link to PubMed

UAB School of Health Professions and School of Nursing Professor Patrick McNees, PhD, FAAN (MPI) and School of Nursing Professor Karen Meneses, PhD, RN, FAAN received a $1.3 million R01 award from the National Institute of Nursing Research for their 3 year (2009-2012) study titled, “Cost-Effectiveness Analysis into Factors Affecting Quality of Life Health Related Research” (1R01NR011885-01).

The overall goal of the newly funded project is to determine the cost-effectiveness of the telephone-supported Rural Breast Cancer Survivors (RBCS) Intervention Package, a psychoeducational support intervention designed for rural dwelling breast cancer survivors.

The project was submitted in response to the NIH’s RFA-NR-09-005, Incorporating cost-effectiveness analysis into factors affecting quality of life (QOL) health related research.

Currently the US standard of care for post treatment breast cancer survivors equals very little care.  The deficit of care is reduced further for those individuals who live in rural settings.  What care is available is often times not covered by conventional insurance and not affordable for most survivors.  According to McNees “Women who are survivors of breast cancer are often times lost in the transition between treatment and survivorship; this transition can have a huge impact on QOL”.

The RBCS project has sought to create a conduit where care is accessible (financially and geographically) to those living in rural areas. Drs. McNees and Meneses hope to further develop the RBCS intervention with the aim to maximize breast cancer survivor’s QOL at the lowest reasonable cost with the best outcomes, making the opportunities for competent, effective, and informed care.

Ideally, the results of this study will not only allow better determinations of the costs of maintaining the intervention package as a service and the specific effects on breast cancer survivors, but also will provide cost-effectiveness data to effectively educate and inform consumers and healthcare providers.

As a means to facilitate and expand collaborations across disciplines, Drs. McNees and Meneses have been awarded these funds using the multiple principal investigator (MPI) model.  This award will strengthen the ties and research opportunities between the School of Nursing (SON) and the School of Health Professions (SHP).