Factors Associated with Burnout Among Nurses: The Roles of Shift Work Characteristics, Work–Life Balance Satisfaction, and Chronic Disease

Abstract

Highlights What are the main findings? Work–life balance satisfaction showed the strongest association with burnout among the variables examined. Chronic disease showed a borderline association with higher burnout, whereas shift duration was not independently associated after adjustment, although the very limited variation in shift patterns restricts what can be concluded from this. The final hierarchical regression model explained 43.9% of the variance in burnout scores. Moderate-to-severe burnout affected 70% of the participating nurses. What are the implications of the main findings? Work–life balance deserves attention in burnout prevention alongside shift scheduling, not in place of it. Organizational strategies including predictable scheduling, adequate recovery time, and supportive staffing policies may reduce nurse burnout. Early screening and occupational health support should be considered for nurses living with chronic diseases. Future longitudinal multicenter studies are needed to confirm causal relationships and evaluate intervention effectiveness. Abstract Background: Burnout is a major challenge to the ongoing viability of the nursing workforce. However, only a limited number of studies have integrated work shift characteristics, satisfaction with work–life balance, and chronic illness into the same model. Aim: To examine whether shift work patterns, satisfaction with work–life balance, and chronic illness are independently associated with burnout among nurses. Methods: Between March and May of 2025, an analytical cross-sectional study was conducted on 100 nurses in two Egyptian military hospitals. Burnout was measured with the 20-item Burnout Syndrome Assessment Scale (BOSAS; Cronbach’s α = 0.832 in the present sample). Unadjusted associations were examined using univariable linear regression with HC3 robust standard errors, and hierarchical multiple linear regression was used to identify factors independently associated with the total burnout score. Results: The reported prevalence of burnout was 30.0% mild, 57.0% moderate, and 13.0% severe. The mean total burnout score was 46.72 ± 11.55. The final model of the regression explained 43.9% of the variance in burnout. Work–life balance satisfaction showed the strongest association with burnout among the variables in the model (standardized β = −0.479, p < 0.001), with each one-category increase in satisfaction corresponding, on average, to a 4.49-point lower burnout score. Chronic illness showed a borderline association with higher burnout (B = 4.40, p = 0.0499). In addition, nurses aged 36–45 years had lower scores than those aged 18–25 years. Shift duration, gender, and physical activity were not independently associated with burnout, although the near-uniform shift patterns in this sample limited the ability to detect an effect of shift length. Conclusions: In this sample, greater work–life balance satisfaction was associated with lower burnout, while the near-uniformity of shift exposure limited what could be concluded about shift duration. The cross-sectional design precludes causal inference and the direction of these relationships cannot be established. Preventive measures that protect work–life balance, such as predictable rosters, sufficient recovery time, and staffing that eases competing work and family demands, warrant evaluation, as does early support for nurses living with chronic disease.