A Cross-Sectional Study of Fatigue and Burnout Predictors among Shift-Working Nurses in Saudi Arabia

Abstract

A literature review on shift work's impact on nurses' health linked night shifts, rotating schedules with a high frequency of nights and long hours or overtime with fatigue, burnout, and poor mental health. The review identified significant inconsistencies in the literature regarding which specific shift patterns (e.g., 12-hour vs. 8-hour, rotating vs. fixed nights) had the most critical risk for burnout. It also highlighted a research gap concerning the role of occupational fatigue as a direct mechanism linking shift type to burnout and a scarcity of quantitative data from Saudi Arabia and the larger Middle East and North Africa (MENA) region. This gap provided the rationale for the accompanying journal paper, which aimed to investigate these relationships within a Saudi Arabian context. A cross-sectional quantitative design was employed. Data was collected using an online self-administered questionnaire that was designed to collect social demographic data, fatigue using the Three-Dimensional Work Fatigue Inventory (3D-WFI), and burnout using the Copenhagen Burnout Inventory (CBI). Of the 188 targeted nurses working at King Khalid Hospital in Saudi Arabia who were sent invitation emails, 148 of them returned a fully completed survey questionnaire. The findings showed that night shifts are significantly associated with the highest levels of fatigue, while burnout was linked to the morning and rotating shifts. Fatigue and burnout, as found in this study, are distinct phenomena driven by different mechanisms. Fatigue appears to be a primarily physiological response to circadian disruption inherent in night work. In contrast, burnout is more likely a psychosocial response to the high-demand, high-pressure organisational environment of daytime and rotating shifts. Shift-specific interventions should be tailored to meet each shift's needs, such as mitigating physiological fatigue for night staff and a separate approach to address the organisational stressors that cause burnout among day and rotating shift nurses.