Burnout is a state of emotional exhaustion, depersonalization, and reduced sense of accomplishment that can affect people who work closely with others [1, 2]. Burnout arises from prolonged exposure to chronic emotional stressors at work, leading to mood disturbances, mental health issues, physical ailments, and a negative outlook on professional responsibilities. It can also result in poor communication with patients and various complications in both social and organizational aspects of life [3, 4].

Burnout is a concept that individuals may interpret in various ways. Before Maslach provided a standardized definition, people used the term to describe different experiences. In 1982, Maslach defined burnout as a condition marked by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment. This state commonly affects individuals who work closely with others, stemming from prolonged exposure to stress associated with human interaction [5, 6]. Healthcare professionals are on the front lines of patient care and report some of the highest rates of burnout syndrome, with roughly 40% of hospital nurses experiencing burnout levels that exceed those of other healthcare workers [3, 7]. Working in an intensive care unit is particularly stressful due to high rates of patient morbidity and mortality, demanding daily routines, and frequent encounters with critical situations [8–11]. Extended exposure to high levels of stress can lead to various health issues, with burnout being the most common and immediate concern. Its prevalence ranges from 20% to 60% among healthcare professionals [12].

Burnout increases clinicians’ risk of negative professional and personal outcomes, including reduced free time, a higher likelihood of work-home conflicts, increased depression, and lower career satisfaction [13]. Burnout is a work-related issue that impacts nearly every area of a healthcare professional’s life. It is linked to physical illness, emotional challenges, higher turnover rates, workplace absenteeism, reduced job performance, and negative attitudes. Together, these issues create a long list of difficulties that ultimately diminish the quality of patient care [14].

The intensive care unit (ICU) is a high-pressure environment within hospitals, providing specialized critical care to patients, which contributes to a heavy workload for healthcare professionals, a key factor in increasing the risk of burnout. The presence of advanced medical equipment, the severity of patients’ conditions, long working hours, and other stressors all contribute to heightened stress levels among staff. Maintaining the wellbeing of healthcare professionals is essential for ensuring quality patient care. A meta-analysis and systematic review showed that within the dimensions of burnout, emotional exhaustion had a significant relationship with depression and personality factors [15]. Another meta-analysis and systematic review which was done in Ethiopia revealed the overall proportion of Burn out syndrome among health professionals is 32.73%. Both sociodemographic factors and working conditions influence the risk of burnout syndrome [16].

While numerous studies on burnout have been conducted in Europe, the US, Australia, parts of Africa, and Asia, there is limited research on this topic, particularly in Ethiopia. Specifically, no study has examined the prevalence of burnout in intensive care units in Ethiopia. Therefore, this study aimed to assess the prevalence of burnout and identify the factors associated with it among healthcare professionals working in ICUs at randomly selected university hospitals in southern Ethiopia.

A multicenter cross-sectional study was conducted to assess the prevalence and associated factors of burnout among health professionals working in intensive care units from 09/11/2023 to 09/05/2024GC in three selected teaching and university hospitals of southern Ethiopia, which includes Dilla University, Hawassa University, and Wolaita Sodo University Hospitals. While all health professionals working in the intensive care unit of the selected hospitals were considered as the study population, our sample population considers only health professionals who are available during the study period. All health professionals with work experience of 6 months and above, and were available during the data collection period and willing to participate in the study were included while those who were on sick, study, or other leaves during the data collection period, those who were on grief in the last 2 months of the data collection period, and those who were providing free services for the hospitals were considered to be in the exclusion criteria. This study was done in line with the World Medical Association Declaration of Helsinki’s Ethical Principles for Medical Research Involving Human Subjects [17]and the work has been reported in line with the STROCSS 2021 criteria [18]. The study was also registered on the research registry with the unique identifying number of researchregistry10827 (https://www.researchregistry.com/browse-the-registry#home/).

In this study, we aimed to determine the prevalence of burnout among healthcare providers in three university hospitals located in the southern region of the country. While numerous studies on burnout have been conducted worldwide, including several in Ethiopia, most of the Ethiopian studies have focused on the central or northern regions. Our research specifically targeted burnout in intensive care units due to the limited literature available in this area. Our findings showed that 38.1% of healthcare professionals exhibited symptoms of burnout syndrome (BOS). This prevalence is notably higher than the 13.7% reported in a study conducted in the northwestern region of Ethiopia [23] and another study done in southwestern Ethiopia which reported a prevalence of 34% [7] but lower than another study conducted in Ethiopia among Nurses which found the prevalence of BOS to be around 42.5% [24]. The prevalence of BOS in this current study is also higher than the findings in studies done in Iran [25] and Brazil [3] which showed a BOS prevalence of 21.9% and 10.1% respectively. The discrepancy among these findings may be due to focusing on a specific group of HCPs, the timing, and the difference in the setup of the healthcare system.

Our recent findings revealed professional stress symptoms, including irritability, fatigue, self-criticism, insomnia, exhaustion, depressive states, social isolation, difficulties with team dynamics, and job dissatisfaction. However, the use of sedatives and analgesics was uncommon among the participants. These results align with those of a similar study conducted in Qatar [26] on primary healthcare physicians which explains that Fatigue (94.6%) was the most common symptom, irritability (81.1%), dissatisfaction with work (69.6%), self-criticism (78%), depressive symptoms (77.9%) and insomnia (77.9%) while considering changing profession and using sedatives were uncommon (14.9% and 16.6% respectively). Unlike our findings in this Qatar study, it was common to use analgesics (89.3%) by physicians. This variability in analgesic usage might be due to local differences in how to handle painful conditions and differences in cultural perspective.

There were different scales used in different studies to determine the prevalence of burnout syndrome. Though we used a list of symptoms (19 items) obtained from Astudillo and Mendinueta [27] to determine the level of BOS, we also compared MBI subscales among HCPs. From the overall study participants, a high level of emotional exhaustion 82 (40.6%) and depersonalization 59 (29.2%) were observed while half of the respondents scored a low level of personal achievement 102 (50.5%). This finding was lower than another study done in Ethiopia [28] and higher than a study done in Spain [29] which showed the estimated prevalence of high levels of emotional exhaustion to be 21%, high levels of depersonalization at 30%, and low levels of personal achievement 44%. Another study in China on ICU nurses also found a relatively low MBI subscale score by detecting high-degree burnout (43.2%) in the emotional exhaustion subscale, followed by 41.2% in the personal accomplishment subscale and 26.1% in the depersonalization subscale [30]. The probable justification for this difference may be due to the difference in study setting, study population and tools, and methodological differences. In our study, we collected data at three University hospitals that are busy and this exposed the health professions to be in a high state of burnout. On the other hand majority of health professionals from developed countries like Spain might have good educational status, job titles, and strong social support, whereas, in our study, there were respondents with low social support, fatigue syndrome, psychological distress, and major sleeping problem which could probably expose for the development of burnout syndrome.

Several significant predictors were identified in this study. Respondents aged 36–45 were found to be 13.2 times more likely to experience burnout syndrome (BOS) compared to those under 30 years old. This may be attributed to increased social and economic challenges as age advances, combined with the demands of a high-pressure work environment. Younger professionals were perceived as more energetic and less susceptible to BOS. However, this finding contrasts with the results of a study conducted in China [30] which showed younger groups were more exposed to burnout. In a study done in Brazil [31] also older age was associated with lower emotional exhaustion and depersonalization scores and with higher professional accomplishment scores. The difference in setup, economic status, and social factors may contribute to this difference.

Other predictors identified in this study included marital status and night shift work. Being married or divorced emerged as a strong predictors of burnout, while working night shifts was found to increase the risk of burnout by 4.15 times. Night shifts disrupt the circadian rhythm, compromise rest and sleep, and disturb physiological balance. These findings are consistent with those of a study conducted in Iran [25]. Fear of patient death and delayed payments were also significant predictors of burnout while having a well-equipped working environment showed an inverse relationship with burnout. Individuals who experienced fear of patient death were more prone to stress and burnout. Additionally, workload was identified as a key factor contributing to burnout, often linked to an imbalance between the healthcare provider-to-patient ratio and the planned standards—a persistent challenge in many developing countries, including Ethiopia. These findings are consistent with results from other studies [7, 32–34]. Health facilities should be adequately equipped, as insufficient resources can lead to frustration among healthcare professionals. Furthermore, with the current global inflation and its particularly severe impact in Ethiopia, delays in timely payment for overtime duties emerged as a strong predictor of burnout. Our finding contrasts with the results of a study conducted in France [35] as we did not find gender and category of profession as predictive variables. Since burnout is an ongoing process that is associated with demographic characteristics and other environmental factors caution should be taken when comparing the results originating from different studies.