FACTORS RELATED TO BURNOUT AMONG NURSES IN

NAKURU TEACHING AND REFERRAL HOSPITAL

BY

CHEROTICH BELINDA: NUR/MG/1931/09/19

MAUREEN MOGITI: NUR/MG/1949/09/19

VIOLA CHERUIYOT: NUR/MG/1773/05/18

LECTURER:

CHARLES AYWAK

A PROPOSAL SUBMITTED IN PARTIAL FULFILMENT OF THE

REQUIREMENT FOR BACHELOR OF SCIENCE IN NURSING SCHOOL OF
MEDICINE AND HEALTH SCIENCE,

KABARAK UNIVERSITY,

PRIVATE BAG,

KABARAK.

©JAN-APRIL 2023
 DECLARATION

We declare that this proposal on FACTORS RELATED TO BURNOUT AMONG NURSES IN

NAKURU LEVEL 5 HOSPITAL is our own work and all the sources that we have or quoted

have been indicated and acknowledged by means of complete references.

SIGNATURE………… …………………………… DATE…08-05-2023

NAME……CHEROTICH BELINDA

SIGNATURE…… ………………………………. DATE……08-05-2023

NAME…VIOLA CHERUIYOT

SIGNATURE……… …………………………… DATE …08-05-2023

NAME…MAUREEN MOGITI

SUPERVISOR: …………..DATE: 09-05-2023

1
 DEDICATION

To our parents and siblings who gave us strength and support during the whole process of

writing our research proposal.

To all healthcare workers who are at the front line workers in promoting life, preventing illness

and disability.

2
 ACKNOWLEDGEMENT

We wish to express our sincere thanks to the Almighty God who helped us throughout the whole

process of writing our research proposal.

We would also like to our gratitude to our supervisor Mr. Charles O. Aywak for the support and

guidance during the whole process of writing the proposal. We also like to pass our gratitude to

all the lecturers for the support towards the completion of this research proposal.

We owe special thanks to the university reference librarian for their valuable support. Unending

appreciation to our families for their great support and encouragement throughout the whole

process. Thanks to all our classmates and friends for their support and encouragements

throughout the process.

 ABSTRACT
Burnout is defined as high degrees of emotional tiredness, depersonalization and diminished
sense of personal success. WHO (2019) found 11.3% overall prevalence of burnout among
nurses but significant differences have been noted between geographical regions and specialties
within nursing practice. A review conducted in sub Saharan Africa showed a prevalence of 33%
(Owour,Mutungi & Mwita 2020). In rural Kenyan Counties, nurses have significant levels of
burnout (Afulani, Ongeri, Kinyua etal., 2020), and 96% of all maternity care nurses experienced
moderate to severe degrees of burnout. Understanding the factors related to burnout among
nurses will help identify interventions to curb burnout among nurses.
OBJECTIVES: The purpose of the study was to determine the factors related to burnout among
bedside nurses in Nakuru Level-5 Hospital.
METHODOLOGY: The study adopted a cross-sectional descriptive study design. The target
population was nurses working in Nakuru Level-5 Hospital. Cluster sampling technique was
used to select a total of 78 participants and used a self-administered questionnaire to collect data.
The data collected was edited and coded for accuracy and completeness. The statistical Package
of Social Sciences SPSS version 26 aided the data analysis and descriptive statistics. Approval
from the Kabarak University Research Ethics Committee (KUREC) of Kabarak University was
sought before the data collection process, and all the ethical procedures were addressed.
FINDINGS: The study was conducted with an overall purpose of seeking to identify the factors
contributing to stress and burnout among nurses. A total of 78 respondents participated in the
study and out of this, 53.8% (42), were between the age of 21-30 years, 33.3%(26) were between
the age of 31-40years, 9% (7) between the age of 41-50 years and 3.9% (3) were between the
age of 51-60 years; 51.3% were single, 35.9% married, 7.7% divorced/separated, 5.1% widowed.
While 52.6% of the respondents were male and 47.4% were female; 53.8% of 78 respondents
had a work experience of 0-5 years, 25.6% 5-10 years, 10.3% 10-15 years, 10.3% ≥ 15years.
Among the 78 respondents who participated, 16.7% were dissatisfied, 48.7% were ambivalent
and 34.6% reported satisfaction with their job.
Levels of burnout were: 35.9% of the respondents reported low levels of emotional exhaustion,
25.6 % moderate levels, while 38.5% had high levels of emotional exhaustion, and 32.1%
reported low levels of depersonalization, 20.5% reported moderate levels, while 47.4 reported
high levels of depersonalization. Regarding personal accomplishment, 46.2% reported low levels
of, 20.5% moderate, while 33.3 high levels of personal accomplishment.
Table of Content

DECLARATION.............................................................................................................................1
ABSTRACT.....................................................................................................................................4
LIST OF ABBREVIATION.....................................................................................................3
Variables and operational definition.........................................................................................4
CHAPTER ONE: INTRODUCTION..............................................................................................1
1.1 Introduction.........................................................................................................................1
1.2 Statement of the problem....................................................................................................3
1.3 Justification of the Study....................................................................................................4
1.4 Research objectives.............................................................................................................5
1.4.1 General objective......................................................................................................5
1.6 Hypothesis...........................................................................................................................5
1.7 Conceptual Framework.......................................................................................................6
CHAPTER TWO: LITERATURE REVIEW..................................................................................8
2.1 INTRODUCTION..............................................................................................................8
2.2 Socio-demographic factors.................................................................................................8
2.3 JOB SATISFACTION......................................................................................................10
2.4 LEVELS OF BURNOUT.................................................................................................11
CHAPTER THREE: METHODOLOGY......................................................................................13
3.1: Introduction......................................................................................................................13
3.2: Research design...............................................................................................................14
3.3 Study Area........................................................................................................................14
3.4. Target Population.............................................................................................................15
3.4.1 Sampling Framework..............................................................................................15
3.5 Sample Size.......................................................................................................................15
3.5.3 Sampling Technique...............................................................................................16
3.6 Selection criteria...............................................................................................................16
3.6.1 Inclusion criteria.....................................................................................................16
3.6.2 Exclusion criteria....................................................................................................17
3.6.3 Data collection tools...............................................................................................17
3.6.4 Validity of the questionnaire...................................................................................17
3.6.5 Reliability of the questionnaire...............................................................................18
3.7 Data Collection and Analysis............................................................................................18
3.8 Ethical considerations.......................................................................................................18
3.9 Limitations of the Study....................................................................................................20
CHAPTER FOUR..........................................................................................................................21
DATA ANALYSIS, PRESENTATION AND INTERPRETATION OF FINDINGS..........21
4.1 Introduction.......................................................................................................................21
4.2. Response rate...................................................................................................................21
4.3. Socio-demographic data...................................................................................................21
4.3.1. Age................................................................................................................................22
4.3.2. Marital status.................................................................................................................23
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 4.3.3 Gender............................................................................................................................24
4.3.4 Working experience.......................................................................................................25
4.4 Job satisfaction..................................................................................................................26
4.5. Levels of burnout.............................................................................................................27
CHAPTER FIVE....................................................................................................................39
SUMMARY, DISCUSSION AND CONCLUSIONS............................................................39
5.1. Introduction......................................................................................................................39
5.2 Summary of the study.......................................................................................................40
CONCLUSION.......................................................................................................................42
RECOMMENDATIONS........................................................................................................42
References......................................................................................................................................43
APPENDICES...............................................................................................................................48
APPENDIX 1A.......................................................................................................................48
APPENDIX 1B.......................................................................................................................49
APPENDIX 2A.......................................................................................................................50
SECTION A SOCIO DEMOGRAPHIC INFORMATION...................................................51
SECTION B JOB SATISFACTION......................................................................................53
SECTION C BURNOUT ASSESSMENT.............................................................................60
APPENDIX 2 B......................................................................................................................65

2
LIST OF ABBREVIATION

DSM-5: Diagnostic and Statistical Manual for Mental Disorders fifth edition

ICD: International Classification of Diseases

KUREC: Kabarak University Research Ethics committee

MB: Mindfulness Based

NACOSTI: National Commission for Science Technology and Innovation

SPSS: Statistical Package of Social Sciences

WHO: World Health Organization

3
 Variables and operational definition

CONCEPT DICTIONARY OPERATIONAL VARIABLES

MEANING MEANING
Marital status One of a number of A person's Single

distinct choices for relationship with a

Married
defining a person's significant other of
Divorced/Separated
connection to a the opposite gender

significant other Widowed

Age The number of full The number of years 21-30 years

years, months, days, one has been alive as

31-40 years
hours, etc.., that per one's last
41-50 years
someone, or birthday

something, has been 51-60 years

alive.

Work experience a short unpaid Total number of 0-5 years

period of time at a years one has been

5-10 years
workplace, to gain working
10-15 years
experience of a

working More than 15 years

environment;

Working hours Any hours of a day Number of hours one 6 hours

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 during which work is working per

is done day/shift 8 hours

10 hours

12 hours

14 hours

Leadership Action of leading a Ability to mobilize Satisfied

group of people or and motivate nursing

Neutral
organization staff to work together
Unsatisfied
to achieve their

highest potential

5
 CHAPTER ONE: INTRODUCTION

1.1 Introduction

High degrees of emotional tiredness, depersonalization, and a diminished sense of personal

success are characteristics of the illness known as burnout (Munna, Dupiton, Boutin, & Angus,

2018). Burnout has been found to have an impact on patient care resulting in low-quality service

delivery. Further, burnout also increases the risk of mental illness and musculoskeletal disorders

due to physical exhaustion and different postures employees adopt while on the job. According

to Paulo M., et al., (2017), burnout leads to insomnia, depression and irritability which in turn

lead to absenteeism, low quality of care and high rates of resignation among nurses. Nursing is

emotionally distressing and this contributes to the daily burnout nurses have (Roger W., et al.,

2018). Environmental factors that contribute to the nurse burnout are the uncooperative patients

and family, low institutional commitment to the nursing profession and the relationship with

other healthcare providers (Roger W., et al., 2018). Besides the daily burnout that nurses

encounter during their line of duty, they are also required to develop their nursing career, attend

various training, as well as their part-time education. A study conducted among the nurses in the

US showed that 68.6% left their nursing jobs due to burnout and stressful working environment,

while 59.5% of the working nurses are considering leaving their jobs owing to the same problem

(Megha K., et al., 2021)

There aren't many researches on this in Sub-Saharan Africa, and even fewer in Kenya. The

conditions under which nurses work in Africa predispose them to burnout . These conditions

include a high patient to nurse ratio, which has made nurses to even work up to 12 hours a day. A

study among maternity providers in Uganda and Senegal showed High degrees of emotional

1
tiredness, depersonalization, and a diminished sense of personal success are characteristics of the

illness known as burnout (Munna, Dupiton, Boutin and Angus 2018). Burnout has an impact on

patient care and results in low-quality service delivery. It also increases the risk of mental illness

and musculoskeletal disorders due to physical exhaustion and different postures employees adopt

while on the job. According to Paulo M.et al.,(2017) burnout leads to nurses having insomnia,

depression and irritability which in turn leads to absenteeism, low quality of care and high rates

of resignation. Nursing is emotionally distressing and this contributes to the daily burnout nurses

have (Roger W. et. al., 2018). Environmental factors that contribute to the nurse burnout are the

uncooperative patients and family, low institutional commitment to the nursing profession and

the relationship with other healthcare providers (Roger W. et al., 2018). To add to the daily

burnout nurses, encounter during their line of duty, they are also obliged to develop their nursing

career, attend various training and part-time education. A study conducted among the nurses in

the US showed that 68.6% left their nursing jobs due to burnout and stressful working

environment, while 59.5% of the working nurses are considering leaving their jobs owing to the

same problem (Megha K., et al., 2021)

There aren't many researches on this in Sub-Saharan Africa, and even fewer in Kenya. The

conditions under which nurses work in Africa predisposes high levels of burnout (50%) using

different measures (Afulani, Ongeri , Kinyua et al., 2021). Further, nurses in a maternity hospital

in Kenya were shown to have burnout rates of 88.6%. 20%have shown to have high levels of

burn out and 8 out of 10 maternity providers have moderate levels of burnout which is a cause

for clinical concern.

2
1.2 Statement of the problem

Recent findings from an Italian University hospital revealed that 36% of nurses experienced

moderate to high levels of burnout (Bellanti, Buglio, Capuano et al., 2021). Moreover, nurses

working with COVID-19 patients or in high contagion areas were found to have elevated levels

of burnout, secondary trauma, and depression. Burnout is recognized as an "occupational

phenomenon" by the World Health Organization (WHO), characterized by three dimensions:

feelings of exhaustion or energy depletion, a sense of detachment from one's job, and negative or

cynical attitudes towards work, along with decreased professional efficacy. The 11th version of

the International Classification of Diseases (ICD) identified burnout as a significant global

problem (WHO, 2019). The prevalence of burnout among nurses varies globally, with an overall

rate of 11.23%. However, significant variations have been observed between geographical

regions and nursing specialties. The sub-Saharan African region reported the highest prevalence,

while Europe and Central Asia had the lowest (Woo, Tang & Tam, 2020). A review conducted in

sub-Saharan Africa indicated a 33% prevalence of burnout among nurses (Owuor, Mutungi &

Mwita, 2020). This is supported by the fact that midwives in a rural Kenyan county have

significant levels of burnout that are clinically concerning (Afulani,Ongeri, Kinyua et al., 2020).

According to this survey, 96% of all maternity care professionals experienced moderate to severe

degrees of burnout. This is supported by the fact that midwives in a rural Kenyan county have

significant levels of burnout that are clinically concerning (Afulani,Ongeri, Kinyua et al., 2020).

According to this survey, 96% of all maternity care professionals experienced moderate to severe

degrees of burnout.

3
Interventions to prevent nurse burnout have been developed through studies. A study by Hilcove,

Marceau, Thekdi, et al. from the year 2021 highlighted the value of mindfulness-based (MB)

yoga as a burnout intervention. It also demonstrated the value of self-care in preventing burnout.

Positive statements made by the participants demonstrated this. According to Suleiman N. et al.

(2020), mindfulness has also been shown to reduce emotional exhaustion, depersonalization, and

higher levels of personal achievement. Another study done in the Migori county found out three

ways of coping with burnout which includes addressing burnout individually, seeking help from

others and reaching out to higher powers (Getahun, Oboke,Ogolla et al., 2023).

Despite having all the above measures to curb burnout, nurses still experience moderate to high

levels of burnout. This study therefore, aims to study the factors related to burnout among nurses.

1.3 Justification of the Study

In Kenya, few studies have been done on burnout yet it has been recognized as a global crisis

and more acute in the sub Saharan Africa. The well-being and the proper functioning of nurses is

important and is a foundation for an effective health care system. High levels of burnout

jeopardize the nurse's mental health and affects the quality of service they deliver. Findings in a

Teaching and Referral Hospital in Nakuru County showed 47.6% of nurses experienced

moderate to high levels of burnout (Aywak and Rotich 2020).

4
1.4 Research objectives

1.4.1 General objective

The primary objective of this study was to identify the factors associated with burnout among

bedside nurses at Nakuru Level 5 Hospital.

1.4.2 Specific objectives

1. To examine socio-demographic characteristics of the nurses in Nakuru Teaching and

Referral hospita.

2. To assess the levels of job satisfaction among nurses in Nakuru Teaching and Referral

hospital.

3. To assess the levels of burnout among nurses in Nakuru Teaching and Referral hospital.

1.5 Research questions

1. What are the socio-demographic characteristics of the Nurses in Nakuru Teaching and

Referral hospital?

2. What are the levels of job satisfaction among nurses in Nakuru Teaching and Referral

hospital?

3. What are the levels of burnout experienced by nurses at Nakuru Teaching and Referral

hospital?

5
1.6 Hypothesis

H0: Burnout was not associated with socio-demographic factors and job dissatisfaction among

nurses in Nakuru Level 5 Hospital.

Ha: Burnout was associated with socio-demographic factors and job dissatisfaction among

nurses in Nakuru Level 5 Hospital

6
1.7 Conceptual Framework

7
 CHAPTER TWO: LITERATURE REVIEW

2.1 INTRODUCTION

This chapter focuses on the previous studies conducted on the factors contributing to burnout in

nurses. The chapter is structured as follows: Section 2.2 explores the demographic factors

influencing the levels of stress and burnout among nurses, Section 2.3 investigates the personal

factors impacting nurses' levels of stress and burnout, Section 2.4 focuses on the situational

factors affecting nurses' levels of stress and burnout, and Section 2.5 provides a conclusion to the

chapter.

2.2 Socio-demographic factors

Being married have been proved to have an increased risk of developing burnout. This is due to

the fact that marriage comes with a lot of responsibilities and may produce conflicts between job

and home(Bum-Sung Choi et al., 2018). Nonetheless, it has been hypothesized that having a

supportive spouse or partner can help with burnout management, hence minimizing

burnout(Vahid R., Mohammad R. and Masoud G. 2014.) Several researches have demonstrated

that having a spouse or other long-term companion does not increase the risk of burnout (Vahid

R., Mohammad R. and Masoud G. 2014.). According to a study done with 101 female nurses,

work interfered with families more than families interfered with work(Bonnie M. Jennings,.

2020). Current studies have found an association between the female gender and a higher risk of

burnout(Heidari Jamebozorgi et al., 2021). Based on literature and previous studies female

nurses have been found to have a tendency of being susceptible to experiencing signs of stress.

Moreover, the findings of this study indicated a negative relationship between the level of

education and the experience of burnout. This can be attributed to the more effective utilization
8
of social resources by individuals with higher education levels. As nurses attain higher levels of

education, they develop a greater awareness of the importance of social support, acquire the

skills to access resources, and improve their utilization (Heidari Jamebozorgi et al., 2021).

Another study conducted by Zarei et al. (2021) revealed elevated levels of burnout among

younger nurses. According to Maslach, this syndrome is more prevalent among young

professionals working in high-risk areas, including healthcare settings. As individuals age, the

prevalence of burnout tends to decrease, which may be due to older employees acquiring

strategies to manage occupational stress, adapt to challenges, and develop resilience (Maslach, as

cited in Zarei et al., 2021).

Conflicts with patients, families and other healthcare workers can lead to increased levels of

burnout. A study done by Poncet, Toullic, Papazian et al... (2019), said that emotional exhaustion

is a direct result of conflicts and later leads to poor personal and professional accomplishment

and depersonalization. This study also suggested that poor relationship with patients and other

healthcare workers is a risk factor of increased levels of and burnout. A study done by,

Rodriguez-Rey et al., (2018), further showed that having conflicts with families or patients or

even colleagues in the past few days or weeks had an increased level of burnout. Hayes, Douglas

and Bonner (2015), Ojekou and Odetola (2015) and Garossa, Moremo-jimenez, Kiang and

Gonzales (2018), found out that the older the nurse and the longer the time he or she has worked

in the dialysis unit, the lower the levels of burnout levels. A study by Rodriguez-Rey et al.

(2018) showed that gender, age, and desire to have children had no effect on the incidence of

burnout.

9
2.3 JOB SATISFACTION

As stated by Lephoko, Bezuidenhout, and Roos (2019), job satisfaction refers to a state of

pleasurable or positive emotions that arises from an individual's assessment of their job, work

experience, or work environment.On the other hand, dissatisfaction at work means lack of

satisfaction. This is caused by factors within the workplace or work environment that negatively

affect the employee. Job dissatisfaction leads to dysfunctional outcomes such as increased

turnover and absenteeism.

Staffing issues are some of the factors that contribute significantly to nurse burnout. A study by

Michaela, Stephen, Tony et al. (2020) showed that lack of adequate staffing led to unmanageable

patient-to-caregiver ratios, negatively impacting patients and staff.

These challenges lead to a hindrance in providing optimal care, causing caregivers to feel despair

and frustration. Such obstacles strain the healthcare system even during normal circumstances.

However, these systems face tremendous strain during unprecedented situations like the recent

Covid-19 outbreak. Soud and Ogembo (2019) discovered that workload, long working hours,

and insufficient wages were the primary factors causing job dissatisfaction among caregivers in

Africa. These factors have been shown to negatively impact nurses' job satisfaction (Oldenburg,

2016) and even influence their intention to leave their positions. A study focusing on psychiatric

nurses revealed extremely high levels of burnout (95%) and significant levels of job satisfaction

(82%).

There is a significant positive correlation between authentic leadership, job satisfaction, and team

engagement. The findings of this study demonstrate that perceiving authentic leadership

positively is associated with individual job satisfaction and team engagement. They further
10
suggest that authentic leadership significantly influences job satisfaction and performance

through its positive effects.The study showed self-esteem as the only factor among business

leaders' true leadership level factors, which showed a statistically significant effect on job

satisfaction. This is where genuine leadership directly influences employee attitudes and

behavior. Authentic leadership cannot directly affect job satisfaction, but it is assumed to have no

direct effect because it requires mediating effects and variables (Francica, Dewian, Dhaniel., et

al. 2020). A recent study done found out that shift duration has an impact on the development of

burnout (Batayneh, Shaukat and Nashwan 2019).

Workplace dissatisfaction leads to nurse burnout, resulting in poor patient service. At this point

the nurse leaves her job to do something else that is not her specialty.

2.4 LEVELS OF BURNOUT

According to (Patel, et.al, 2018), burnout is one of the greatest pandemics of the twenty-first

century and a common occurrence. It can have an impact on one’s health, wellbeing, and job

satisfaction at work, and in extreme circumstances, it can cause burnout episodes. Consists of

diminished personal productivity, depersonalization, and emotional weariness. Chronic

workplace stress results in burnout.

The most popular tool for evaluating burnout syndrome is the Maslach Burnout Inventory (Ryan

et al. 2018). More and more occupations are being affected by burnout, with nurses and doctors

being among the most common victims. The start of burnout in nurses and doctors is correlated

with certain internal and external characteristics, including gender, age, marital status, desire for

children, personality features, and workload. Depending on the system or medical condition

being treated, it’s possible that nurses are often assigned to a particular medical sector inside a
11
hospital and separated into units or services. Each service has unique qualities, and these can also

affect how quickly employees burn out.

According to (WHO 2019) Burnout has been characterized by emotions and or are en grained

into all facets of an individual’s life and affect patient care, job retention, and general well-being.

It is defined as a negative response to ongoing emotional stress.

Burnout was added to the International Classification of Diseases (ICD-11) of the World Health

Organization in 2019, despite not being a diagnosable condition in the DSM-5. It is described

there as “a syndrome conceptualized as resulting from chronic workplace stress that has not been

successfully managed and is characterized by three dimensions:1)Increasing mental distance

from one’s employment, or emotions of pessimism or cynicism regarding one’s career; (II)

feelings of energy depletion or tiredness; and (III) decreased professional efficacy. Burnout is

associated to other mental health illnesses like depression, anxiety, physical sickness, increased

absenteeism, poor job retention, and diminished professionalism in research examining its

consequences on health practitioners from many disciplines.

Burnout has been closely linked to declines in treatment quality, decreased patient safety, and

decreased patient satisfaction from the perspective of patient care. Burnout is a risk factor for

workers in many occupations, although it has been observed to be more common in acute care

settings including emergency medical, nursing, and emergency medicine. Regular exposure to

traumatic and emotionally upsetting events, frequently changing dynamic and uncontrolled

environments, an increase in workplace violence, physical schedules that are conducive to

stressors, such as fatigue and injury risk, irregular work, frequently night shifts, unpredictable

and extended shift lengths, and infrequent rest breaks are all features of the professional
12
environment that paramedics work in, while working long hours with a heavy load. Paramedics

are also more susceptible to larger workplace pressures, such as corporate culture, politics, and

working conditions that were previously connected to other occupations in burnouts (WHO

2019).

13
 CHAPTER THREE: METHODOLOGY

3.1: Introduction.

The methodology refers to the specific method or approach employed to locate, select, process,

and analyze data related to a particular topic. This chapter presents a summary of the study area,

the research design, the target population, the sampling strategy, and the ethical considerations

involved in the research.

3.2: Research design

In accordance with Creswell (2015), research is a specialized procedure that involves data

collection, data analysis, and report writing. When aiming to promptly address research

questions, the selection of an appropriate study design becomes vital. In the case of this study,

the objective was to examine the factors influencing stress and burnout among nurses at Nakuru

Level-5 Hospital in Nakuru County. Consequently, a cross-sectional descriptive design was

opted for. Cross-sectional descriptive studies primarily aim to portray the prevalence of a health

outcome within a specific population or at a particular point in time

3.3 Study Area

The research took place at Nakuru County Level-5 Hospital in Kenya. This hospital, located

approximately 4.4 km from Nakuru town, is the fourth-largest government hospital in Kenya and

serves as a referral center for various counties in the South and Central Rift Valley region, as

well as other regions. The choice of this study location was based on several factors: it is a

county hospital in Nakuru that receives referrals, it has a significant population of nurses, and it

provided an opportunity to gain insights into the factors contributing to nursing burnout.

Additionally, the proximity of the hospital to Kabarak University, approximately 21 km away,

14
makes it easily accessible for conducting research. Please refer to APPENDIX 1A for a map of

Kenya showing Nakuru County, APPENDIX 1B for a map of Nakuru County showing Nakuru

Town West Sub-County, and APPENDIX 1C for a map of Nakuru Town West Sub-County

indicating the location of Nakuru Level-5 Hospital.

3.4. Target Population

The target population refers to a subset of the population available for study ( Wolters 2020).

The target population of this study were the nurses working in Nakuru Level 5 hospital because

these are the people who are directly involved in care provision of the patients during day to day

activities and period of hospital stay and are directly exposed to the risk factors of nurses'

burnout.

3.4.1 Sampling Framework

The study adopted cluster sampling, the wards were selected into clusters from the population or

groups from the population. Every person in the cluster selected was used as a study participant

provided they met inclusion criteria and consented to participate in the study.

3.5 Sample Size

The term "sample size" is used to describe the number of individuals included in a research study

in order to provide a representative representation of the population (Kibuacha, 2021). In this

particular study, the sample size was determined using the Naissuma formula (2009) which is ;

n = NC²/{ C² + (N-1) e²}

15
Where:

n = sample size

N = Size of target population (343 nurses from the hospital's website)

C = coefficient of variation (0.5)

e= error margin (0.05)

Substituting these values in the equation, estimated sample size (n) was:

n= {(343×0.5²)} ÷ {0.5²+ (343-1)0.05}

85.75÷1.105

77.60

78 participants

3.5.3 Sampling Technique

Cluster sampling was employed to select the wards for the study. This method involves dividing

the entire population into clusters or groups, and a random selection of clusters is made using the

cluster sampling technique (Singh A and Masuku M. 2014). The sample included all participants

within the selected clusters.

3.6 Selection criteria

3.6.1 Inclusion criteria

All nurses working in the selected clusters were included

16
All nursing interns working in the selected clusters were included

3.6.2 Exclusion criteria

Those who met the inclusion criteria but are unwilling to take part in the research were not

included in the study.

Nurses and interns in the non-selected clusters were excluded.

3.6.3 Data collection tools

Closed ended questionnaires were used to collect data. The purpose of questionnaires was to aid

in data collection. In order to acquire the needed data from nurses, a series of questions were

completed on the questionnaire. Job satisfaction survey tool was also used to assess for nine

dimensions of job satisfaction related to overall satisfaction. Maslach Burnout inventory tool was

used to assess for the levels of burnout, this tool has three sections including emotional

exhaustion, depersonalization, and personal accomplishment.

3.6.4 Validity of the questionnaire

By examining whether the questionnaire can measure the things it was designed to test, the

validity of the questionnaire can be established. Validity of the questionnaire was ensured

through analysis of principal components of the questions as they compare to the specific

objective.

17
3.6.5 Reliability of the questionnaire

Reliability aims to determine if the questionnaire is effectively collecting the intended data and

aligning with the study's objectives. Additionally, it involves evaluating the length of the

questionnaire and the speed at which participants complete it, comparing it to the estimated time.

Test-retest was used to determine the reliability of the questionnaires.

3.7 Data Collection and Analysis

The self-administered questionnaire was the favored instrument for data collection in this study.

Data analysis involves the systematic application of logical and/or statistical methods to

describe, summarize, evaluate, and interpret the data. The collected data was reviewed and

organized through editing and coding to ensure accuracy and completeness. The statistical

software SPSS version 26 was utilized to facilitate data analysis, including the use of descriptive

statistics such as frequency tables and measures of central tendency to present the data. The

interpretation of the data was performed using various tools such as tables, pie charts, bar graphs,

and other available means of interpretation.

3.8 Ethical considerations

These guidelines provide a set of principles and recommendations for the methodology and

design of your research. It is crucial for scientists and researchers to adhere to a rigorous code of

conduct when collecting data. The guidelines established by NACOSTI outline the ethical

standards and best practices that should be followed in the research process. The nursing

departmental committee at Kabarak University listened to the proposal defense presented by the

18
researchers and provided their recommendations and necessary corrections. On completion, the

nursing department at Kabarak University issued the researchers with a letter of approval

indicating that researcher successfully defended the proposal at departmental committee level.

The researchers applied on-line for the research proposal review by sending a copy of the

refined proposal in conjunction with the letter of approval at departmental committee level to the

Kabarak University Research Ethics Committee (KUREC) which upon approving it, shall send

to NACOSTI for reviewing and issuance of the research permit.

The researchers adopted the KUREC informed consent in the study. Regarding the study site, the

researchers wrote a letter to the Nakuru Level-5 Hospital administration explaining what the

study entailed, its significance, time it was carried out and the target population. (NACOSTI ,

2019).

For the research participants who in this study were nurses of Nakuru Level-5 Hospital the

researchers saught an informed consent by explaining what the research is all about, the

significance and purpose of carrying out the study, possible benefits and harms of participating

in the study and assuring the participants that any personal information which they provided in

the study was remain private. Confidentiality was maintained by concealing the identity of the

research participants during data collection, each respondent was facilitated to respond to the

questionnaire in a separate room away from unauthorized persons and the administered

questionnaires was locked in a safe cabinet until when data processing and analysis was done.

Also, the participants received a guarantee that the information gathered was only utilized for

academic and research endeavors. Additionally, the participants were assured that the data

collected was solely used for academic and research purposes.

19
3.9 Limitations of the Study

The main limitation of this study was financial constraints, to cater for travelling cost, purchasing

stationery, internet and other contingencies difficulty getting the standard materials or references

to suit our study knowledge and attitudes. A lot time was required to collect data ,analyze and

process it with respect to a large sample size. The entire process on collected data was at least

three weeks hence better planning was necessary to ensure that all information is gathered

processed and interpreted.

20
 CHAPTER FOUR

DATA ANALYSIS, PRESENTATION AND INTERPRETATION OF FINDINGS

4.1 Introduction
This chapter focuses on the data analysis, presentation and interpretation of the findings on

factors related to burnout among nurses in Nakuru Teaching and Referral hospital.

4.2. Response rate

The researchers conducted the study among nurses and nursing interns working in Nakuru

Teaching and Referral hospital. The response rate was 100%(n=78) from the questionnaires.

4.3. Socio-demographic data

This section presents the age, marital status, gender and the work experience of the respondents.

4.3.1. Age
The respondents were asked to indicate the category in which their ages fell.

Table 4.1 shows the distribution of nurses according to their ages.

Age Frequency Percentage

21-30 42 53.8%

31-40 26 33.3%

41-50 7 9%

51-60 3 3.9%

Total 78 100%

21
 From the above results, majority of the nurses fell into the age bracket of 21-30 years (53.8%)

showing that most of the nurses working in the facility are in their twenties. A small percentage

of nurses (3.9%) were in the age bracket of 51-60 years. This data suggests that nurses working

in the facility are young and below 40 years of age

4.3.2. Marital status

The respondents were asked to indicate the characteristic that best defines them.

Table 4.2 indicates the distribution of the respondents according to their marital status.

Marital status Frequency Percentage

Single 40 51.3

Married 28 35.9

Divorced/separated 6 7.7

Widowed 4 5.1

Total 78 100

The above results shows that majority of the respondents are single(51.3%) and the widowed are

22
 the minority with a percentage of 5.1%. 35.9% of the respondents were married whereas 7.7%

were either divorced or separated.

4.3.3 Gender

The respondents were asked to indicate the gender in which they identify themselves with.

Table 4.3 indicates the distribution of the respondents according to their gender

Gender Frequency Percentage

Male 41 52.6

Female 47 47.4

Total 78 100

The above findings shows that majority of the respondents were male totaling upto 52.6% and

female with 47.4%. This suggests thag majority of the nurses working in the facility are male.

4.3.4 Working experience

The respondents were asked to indicate the category of the years on which they have been

23
 working as a nurse.

Table 4.4 indicates the distribution of nurses according to their working experience

Working experience Frequency Percentage

0-5 42 53.8

5-10 20 25.6

10-15 8 10.3

15+ 8 10.3

Total 78 100

Majority of the respondents (53.8%) had a working experience of less than 5years, followed by

less than 10 years (25.6%) and an equal number of nurses had a working experience of between

10-15 years and above 15 years each with 10.3%

4.4 Job satisfaction

The respondents were asked to indicate their opinion on a series of questions presented to them.

Table 4.5 shows the distribution of nurses according to their job satisfaction

Job satisfaction Frequency Percentage

24
Dissatisfaction 13 16.7

Ambivalent 38 48.7

Satisfaction 27 34.6

Total 78 100

great percentage(48.7%) of the respondents were not decided on either being satisfied or not

satisfaction , followed by those who were satisfied (34.6%) and the minority were not satisfied

with a percentage of 13%.

4.5. Levels of burnout

Respondents were asked to indicate their best opinion on a burnout assessment tool presented to

them.
25
 Table 4.6 indicates the distribution of nurses according to their levels of burnout

Levels of burnout Frequency Percentage

Emotional exhaustion

Low 28 35.9

Moderate 20 25.6

High 30 38.5

Depersonalization

Low 25 32.1

Moderate 16 20.5

High 37 47.4

Decreased personal

accomplishment

Low 36 46.2

Moderate 16 20.5

High 26 33.3

26
Emotional exhaustion

27
Decreased personal accomplishment

From the above findings, a high percentage (38.5%) had a high emotional exhaustion, followed

by low emotional exhaustion (35.9) and 20.5% had moderate emotional exhaustion.

47.7% had a high depersonalization levels, followed by low levels of depersonalization, 32.1%,

low depersonalization levels and 20.5% had moderate depersonalization levels.

Majority of the nurses (46.2%) had low decreased personal accomplishment, whereas 33.3% had

high decreased personal accomplishment. 20.5% of the nurses had moderate decreased personal
28
 accomplishment.

Table 4.7 showing the relationship between socio-demographic chatacteristics and

emotional exhaustion

Low Moderate High

Age

21-30 13(16.7%) 13(16.7%) 16(20.5%)

31-40 10(12.8%) 6(7.7%) 10(12.8%)

41-50 3(3.8%) 1(1.3%) 3(3.8%)

51-60 2(2.6%) 0(0%) 1(1.3%)

Marital status

Single 15(19.2%) 10(12.8%) 15(19.2%)

Married 10(12.8%) 6(7.7%) 12(15.4%)

Divorced/Separated 2(2.6%) 2(2.6%) 2(2.6%)

Widowed 1(1.3%) 2(2.6%) 1(1.3%)

Gender

Male 17(21.8%) 7(9%) 17(21.8%)

Female 11(14.1%) 13(16.7%) 13(16.7%)

Work experience

0-5 13(16.7% ) 13(16.7%) 15(19.2%)

6-10 11(14.1%) 4(5.1%) 6(7.7%)

10-15 2(2.6%) 3(3.8%) 4(5.1%)

29
15+ 2(2.6%) 0(0%) 5(6.4%)

Age:

Among nurses aged 21-30, 16.7% experienced low emotional exhaustion, 16.7% had moderate

emotional exhaustion, and 20.5% had high emotional exhaustion.

The percentage of high emotional exhaustion appears to decrease with age, as it is lowest (1.3%)

among individuals aged 51-60.

Marital Status:

Married individuals had the highest percentage of low emotional exhaustion (19.2%), followed

by single individuals (15.4%).

Divorced/separated and widowed nurses generally had lower percentages of low emotional

exhaustion but varied for moderate and high exhaustion levels.

Gender:

Males had a slightly higher percentage of low emotional exhaustion (21.8%) compared to

females (14.1%).

Females had a higher percentage of moderate emotional exhaustion (16.7%) compared to males

(9%).

Work Experience:

Nurses with 0-5 years of work experience had the highest percentage of low emotional

exhaustion (16.7%).

Emotional exhaustion seems to decrease as work experience increases, with the lowest

percentage of high emotional exhaustion (2.6%) among those with 10-15 years of experience.

30
 Table 4.8 showing the relationship between socio-demographic characteristics and

depersonalization

Low Moderate High

Age

21-30 12(15.4%) 11(14.1%) 19(24.4%)

31-40 9(11.5%) 4(5.1%) 13(16.7%)

41-50 3(3.8%) 0(0%) 4(5.1%)

51-60 1(1.3%) 0(0%) 2(2.6%)

Marital status

Single 15(19.2%) 9(11.5%) 6((7.7%)

Married 9(11.5%) 5(6.4%) 14(17.9%)

Divorced/Separated 0(0%) 1(1.3%) 5(6.4%)

Widowed 1(1.3%) 1(1.3%) 2(2.6%)

Gender

Male 14(17.9%) 7(9%) 20(25.6%)

Female 11(14.1%) 9(11.5%) 17(21.8%)

Working experience

0-5 14(17.9%) 5(6.4%) 23(29.5%)

5-10 7(9%) 5(6.4%) 8(10.3%)

10-15 2(2.6%) 2(2.6%) 4(5.1%)

15+ 2(2.6%) 4(5.1%) 2(2.6%)

31
Age:

Among participants aged 21-30, 15.4% experienced Low depersonalization, 14.1% had

Moderate, and 24.4% had High depersonalization.

As age increased, depersonalization tended to decrease. For instance, in the 51-60 age group,

only 1.3% reported High depersonalization.

Marital Status:

Single individuals had the highest percentage (19.2%) reporting Low depersonalization, while

married individuals had 11.5% in the Low category.

Widowed participants had 1.3% in the High depersonalization category, indicating a lower

prevalence.

Gender:

Males had slightly higher percentages in the Low and High depersonalization categories

compared to females.

Females showed a slightly higher percentage in the Moderate category.

Working Experience:

Participants with 0-5 years of experience had 17.9% in the Low category.

As working experience increased, the percentage of Low depersonalization tended to decrease.

Those with 10-15 years of experience had the highest percentage (29.5%) in the High

depersonalization category.

Table 4.9 showing the relationship between socio-demographic characteristics and

personal accomplishment

32
 Low Moderate High

Age

21-30 18(23.1%) 9(11.5%) 15(19.2%)

31-40 12(15.4%) 6(7.7%) 8(10.3%)

41-50 4(5.1%) 0(0%) 3(3.8%)

51-60 2(2.6%) 1(1.3%) 0(0%)

Marital status

Single 16(20.5%) 11(14.1%) 13(16.7%)

Married 13(16.7%) 3(3.8%) 12(15.4%)

Divorced 5(6.4%) 0(0%) 1(1.3%)

Widowed 2(2.6% 2(2.6%) 0(0%)

Gender

Male 20(25.6%) 10(12.8%) 11(12.8%)

Female 16(20.5%) 6(7.7) 15(19.2%)

Working experience

0-5 18(23.1%) 8(10.3%) 16(20.5%)

5-10 10(12.8%) 3(3.8%) 7(9%)

10-15 4(5.1%) 1(1.3%) 3(3.8%)

15+ 4(5.1%) 4(5.1%) 0(0%)

Age:

33
 Nurses aged 21-30 have the highest percentage (23.1%) in the Low personal accomplishment

category, while those aged 51-60 have the lowest percentage (2.6%).

As age increases, the percentage of individuals reporting Low personal accomplishment tends to

decrease.

Marital Status:

Single individuals have the highest percentage (20.5%) in the Low category, followed by

married individuals (16.7%).

Divorced and widowed participants have lower percentages in the Low category.

Gender:

Males have a higher percentage (25.6%) in the Low personal accomplishment category

compared to females (20.5%).

Females have a higher percentage (19.2%) in the High category compared to males (12.8%).

Working Experience:

Participants with 0-5 years of experience have the highest percentage (23.1%) in the Low

personal accomplishment category.

Those with 10-15 years of experience have the highest percentage (20.5%) in the High personal

accomplishment category.

Table 4.10 showing the relationship between job satisfaction and burnout
Dissatisfaction Ambivalent Satisfaction
Emotional exhaustion

34
Low 3(3.8%) 8(10.3%) 14(17.9%)

Moderate 6(7.7%) 13(16.7%) 3(3.8%)

High 4(5.1%) 17(21.8%) 10(12.8%)

Depersonalization

Low 1(1.3%) 6(7.7%) 27((34.6)

Moderate 5(6.4%) 8(10.3%) 0(0%)

High 7(9%) 24(30.8%) 0(0%)

Decreased personal

accomplishment
3(3.8%) 24(30.8%) 8(10.3%)
Low
2(2.6%) 10(12.8%) 19(24.4%)
Moderate
8(10.3%) 4(5.1%) 0(0%)
High

Emotional Exhaustion:

Among those with low job satisfaction, 3.8% reported low emotional exhaustion, 7.7% had

moderate emotional exhaustion, and 5.1% had high emotional exhaustion.

For those with ambivalent job satisfaction, 10.3% reported low emotional exhaustion, 16.7% had

moderate emotional exhaustion, and 21.8% had high emotional exhaustion.

Among those with high job satisfaction, 17.9% reported low emotional exhaustion, 3.8% had

moderate emotional exhaustion, and 12.8% had high emotional exhaustion.

Depersonalization:
35
In the low job satisfaction group, 1.3% reported low depersonalization, 6.4% had moderate

depersonalization, and 9% had high depersonalization.

For those with ambivalent job satisfaction, 7.7% reported low depersonalization, 10.3% had

moderate depersonalization, and a significant 30.8% had high depersonalization.

In the high job satisfaction group, 34.6% reported high depersonalization, and there were no

responses for low or moderate depersonalization.

Decreased Personal Accomplishment:

Among those with low job satisfaction, 3.8% reported low decreased personal accomplishment,

2.6% had moderate levels, and 10.3% had high levels.

For those with ambivalent job satisfaction, 30.8% reported low decreased personal

accomplishment, 12.8% had moderate levels, and 5.1% had high levels.

In the high job satisfaction group, 10.3% reported low decreased personal accomplishment,

24.4% had moderate levels, and there were no responses for high decreased personal

accomplishment.

The table suggests a clear relationship between job satisfaction and burnout levels. In general, as

job satisfaction increases, emotional exhaustion and depersonalization tend to decrease, while

personal accomplishment tends to increase.

High job satisfaction appears to be associated with lower emotional exhaustion and

depersonalization, as well as higher levels of personal accomplishment.

Conversely, low job satisfaction is associated with higher emotional exhaustion and

depersonalization, and lower personal accomplishment

36
 CHAPTER FIVE

SUMMARY, DISCUSSION AND CONCLUSIONS

5.1. Introduction

This chapter provides the summary of the study findings with reference to the study objectives,

gives the study conclusion as well as recommendations.

5.2 Summary of the study

The study was conducted with an overall purpose of seeking to identify the factors affecting

stress an burnout among nurses and also determine the levels of burnout among nurses. A total of

78 respondents participated in the study and out of this, 53.8% (42), were between the age of 21-

30 years, 33.3%(26) were between the age of 31-40years, 9% (7) between the age of 41-50 years

and 3.9% (3) were between the age of 51-60 years. On marital status, 51.3% were single, 35.9%

married, 7.7% divorced/separated, 5.1% widowed. On gender. 52.6% of the respondents were

male while 47.4% were female. On work experience, 53.8% of 78 respondents had a work

experience of 0-5 years, 25.6% 5-10 years, 10.3% 10-15 years , 10.3% more that 15years.

On job satisfaction survey, among the 78 respondents who participated, 16.7% were dissatisfied,

48.7% were ambivalent and 34.6% reported satisfaction.

37
The results showing levels of burnout were also analysed. 35.9% of the respondents reported low

levels of emotional exhaustion, 25.6 % reported moderate levels, while 38.5% reported high

levels of emotional exhaustion. On depersonalization, 32.1% reported low levels of

depersonalization, 20.5% reported moderate levels while 47.4 reported high levels of

depersonalization. On personal accomplishment, 46.2% reported low levels personal

accomplishment, 20.5% moderate personal accomplishment while 33.3 high levels of personal

accomplishment.

A comparison of the results showed that those between the age of 21-30 years experienced

higher levels of emotional exhaustion n-16(20.5%), high depersonalization n-19(24.4%) and low

personal accomplishment n-18(23.1%). In the age group of 31-40 years emotional exhaustion

was moderate n-10(12.8%), high depersonalization n-13(16.7%), and low personal

accomplishment n-12 (15.4 %). In the age group of 51-60, emotional exhaustion was low n-2

(2.6%), high depersonalization n-2 (2.6%) and low personal accomplishment n-2(2.6%). This

indicates that emotional exhaustion decreased with age, depersonalization increased with age

while sense of personal accomplishment grew less with age. Emotional exhaustion scores were

higher in younger nurses and that the scores for a lack of personal accomplishment were also

higher. This finding is consistent with the literature review, which mentioned that burnout tends

to decrease with age, possibly because older employees develop better strategies to manage

occupational stress and adapt to challenges.

The results for gender were also examined. . 52.6% of the respondents were male while 47.4%

were female. The was no significant difference in emotional exhaustion between the genders.

There was high depersonalization in both, female n-17 (21.8%) and male n-20 (25.6 %). Both

genders had low personal accomplishment, male n-20(25.6%), while female n- 16(20.5%). From
38
the results, there is no significant difference between males and females in their levels of

burnout.

All 78 respondents provided information on their marital status. n-40 (51.3%) were single, n-28

(35.9%) were married n-6 (7.7%) were separated/divorced, n-4 ( 5.1%) were widowed. The

single reported low levels of emotional exhaustion n-15 (19.2%), low levels of depersonalization

n-15(19.2%) and low levels of personal accomplishment n-16(20.5%). Those married 15.4%

reported higher levels of emotional exhaustion, high depersonalization and low personal

accomplishment. The divorced/separated reported moderate levels of emotional exhaustion,

higher levels of depersonalization n-5 (6.4%) and low personal accomplishment n-5 (6.4%) and

low personal accomplishment . The widowed reported moderate emotional exhaustion n-

2(2.6%), high depersonalization n-2 (2.6%), and moderate personal accomplishment. This shows

that their higher emotional exhaustion and depersonalization among married people than singles.

Hence married nurses suffer higher levels of burnout than singles. This finding aligns with the

literature review, which mentioned conflicting evidence regarding the impact of marriage on

burnout. Some studies suggested that conflicts between job and home could contribute to burnout

among married individuals, while others indicated that having a supportive spouse can mitigate

burnout.

On work experience, 53.8% of 78 respondents had a work experience of 0-5 years, 25.6% 5-10

years, 10.3% 10-15 years, and 10.3% more than 15years. Those with work experience of 0-5

years experienced higher levels of emotional exhaustion n-15(19.2%) higher levels of

depersonalization n-23(29.5%) and low personal accomplishment n-18(23.1%). Those in the

category of 5-10 years experienced lower emotional exhaustion n-11(14.1%), low

depersonalization n-10(12.8%) and low personal accomplishment. This shows that nurses with
39
less than 5 years of experience experienced higher levels of burnout than those with 5 years and

above. This corresponds with the literature review, which mentioned that older nurses and those

with longer work experience tend to have lower burnout levels. This may be attributed to the

development of coping strategies and increased resilience over time.

A comparison between job satisfaction and burnout levels was done and was as shown in the

summary and the table above. On emotional exhaustion the table suggests that there is a

correlation between job satisfaction and emotional exhaustion. As job satisfaction increases,

emotional exhaustion tends to decrease. This aligns with the literature review, which highlights

factors such as workload, long working hours, and insufficient wages as contributors to job

dissatisfaction among caregivers. High emotional exhaustion often results from job

dissatisfaction. The results for depersonalization we're also analysed and the data in the table

show a similar pattern, whereas job satisfaction increases, depersonalization tends to decrease.

This is consistent with the literature, which mentions how factors within the workplace

environment, like staffing issues, can lead to job dissatisfaction and subsequently contribute to

depersonalization. Lastly the results for decreased personal accomplishment were also analysed

and recorded and the table indicates that higher job satisfaction is associated with increased

personal accomplishment, while lower job satisfaction is linked to decreased personal

accomplishment. This finding aligns with the concept that job satisfaction has a positive impact

on an individual's sense of accomplishment, as mentioned in the literature.

CONCLUSION

In conclusion, the research showed a significant prevalence of burnout among nurses. This

conclusion was arrived at by noting 38.5% out of 78 nurses who answered the questionnaire had
40
high levels of emotional exhaustion, 25.6% moderate and 35.9%low.

It also shows that nurses are suffering from high levels of depersonalization 47.4% and a

diminished sense of personal accomplishment. It is therefore imperative for the hospital as an

organisation to mitigate and forestall the occurrence of burnout in nurses by taking active steps

to deal with the factors that were identified as causes of burnout and to implement those

measures that have been noted as contributing towards the prevention of burnout in nurses.

RECOMMENDATIONS

Comparative research should be conducted to determine the differences in the incidence of

burnout among nurses in both private and public hospitals.

Research should be carried out to identify the negative consequences of burnout for individual

nurses, for their private and professional interpersonal relationships, and for the organisation (the

hospital) as a functioning whole.

A longitudinal study to investigate the relationship between burnout and palliative measures to

prevent burnout in nurses would provide valuable information about the effect and usefulness of

such measures over a period of time.

A questionnaire could be developed from the results obtained from phase 2 of this study for the

use of future research into burnout in nurses.

The hospital should take responsibility for implementing the measures identified by the nurses

for creating a working environment that would be conducive to improvements in the professional

life as well as the mental, physical and emotional health of the nurses.

The hospital should commit itself to obtaining an adequate number of staff for all its wards. This

41
would enable the hospital to allocate manageable and fair workloads to its staff. This factor is

vitally important because of the fact that unmanageable workloads were identified by the nurses

in the study as one of the main causes of burnout

Work shifts should be arranged in such a way that they are not too long. They should also be

organised in such a way that nurses are given adequate breaks.

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46
 APPENDICES

APPENDIX 1A

Map of Kenya Showing Nakuru County

47
APPENDIX 1B

Map of Nakuru Town Showing Location of Nakuru Level-5 Hospital

48
.

APPENDIX 2A

QUESTIONNAIRE

Dear respondents,

We are, Cherotich Belinda, Maureen Mogiti and Viola Cheruiyot, Bachelor of Science Nursing

students at Kabarak University. We are carrying out research on FACTORS RELATED TO

BURNOUT AMONG NURSES IN NAKURU LEVEL 5 HOSPITAL. Kindly spare your time to

complete the attached questionnaire. The responses you provide will be used only for the study

and not anywhere else. Be assured that your responses will be treated confidentially and in order

to ensure this, ensure this, DO NOT write your name anywhere in this questionnaire. What is

required of you is simply to provide honest and adequate answers according to instructions given

in the questionnaire.

49
SECTION A SOCIO DEMOGRAPHIC INFORMATION

1. Age (years)

a) 21-30

b) 31-40

c) 41-50

d) 51-60

2. Gender

a) Male

b) Female

3. Marital status

a) Single

b) Married

c) Divorced or Separated

d) Widowed

50
 4. Working experience[years]

a) 0-5

b) 5-10

c) 10-15

d) 15 and above

SECTION B JOB SATISFACTION

PLEASE CIRCLE THE ONE NUMBER FOR EACH QUESTION THAT COMES CLOSEST

TO REFLECTING YOUR OPINION ABOUT IT.

Disagree Disagree Disagree Agree Agree Agree

very much moderately slightly slightly moderately very

much

I feel I am being 1 2 3 4 5 6

paid a fair amount

for the work I do.

There is really too 1 2 3 4 5 6

little chance for

51
promotion on my

job.

My supervisor is 1 2 3 4 5 6

quite competent in

doing his/her job.

I am not satisfied 1 2 3 4 5 6

with the benefits I

receive

When I do a good 1 2 3 4 5 6

job, I receive the

recognition for it

that I should

receive.

Many of our rules 1 2 3 4 5 6

and procedures

make doing a

good job difficult.

I like the people I 1 2 3 4 5 6

work with.

I sometimes feel 1 2 3 4 5 6

my job is

52
meaningless

Communications 1 2 3 4 5 6

seem good within

this organization.

Raises are too few 1 2 3 4 5 6

and far between

Those who do 1 2 3 4 5 6

well on the job

stand a fair chance

of being promoted

My supervisor is 1 2 3 4 5 6

unfair to me

The benefits we 1 2 3 4 5 6

receive are as

good as most other

organizations

offer.

I do not feel that 1 2 3 4 5 6

the work I do is

appreciated.

My efforts to do a 1 2 3 4 5 6
53
good job are

seldom blocked by

red tape.

I find I have to 1 2 3 4 5 6

work harder at my

job because of the

incompetence of

people I work

with.

I like doing the 1 2 3 4 5 6

things I do at

work.

The goals of this 1 2 3 4 5 6

organization are

not clear to me.

I feel 1 2 3 4 5 6

unappreciated by

the organization

when I think about

what they pay

54
me.

People get ahead 1 2 3 4 5 6

as fast here as they

do in other places.

My supervisor 1 2 3 4 5 6

shows too little

interest in the

feelings of

subordinates.

The benefit 1 2 3 4 5 6

package we have

is equitable.

There are few 1 2 3 4 5 6

rewards for those

who work here.

I have too much to 1 2 3 4 5 6

do at work.

I enjoy my 1 2 3 4 5 6

coworkers.

I often feel that I 1 2 3 4 5 6

do not know what

55
is going on with

the organization.

I feel a sense of 1 2 3 4 5 6

pride in doing my

job

I feel satisfied 1 2 3 4 5 6

with my chances

for salary

increases.

There are benefits 1 2 3 4 5 6

we do not have

which we should

have.

I like my 1 2 3 4 5 6

supervisor.

I have too much 1 2 3 4 5 6

paperwork

I don't feel my 1 2 3 4 5 6

efforts are

rewarded the way

56
they should be.

I am satisfied with 1 2 3 4 5 6

my chances for

promotion.

There is too much 1 2 3 4 5 6

bickering and

fighting at work

My job is 1 2 3 4 5 6

enjoyable.

Work assignments 1 2 3 4 5 6

are not fully

explained.

SECTION C BURNOUT ASSESSMENT

Questions Never A few Once a A few Once a A few Ever

times a month times week times y day

year per per

57
 month week

Section A 0 1 2 3 4 5 6

I feel emotionally

drained by my work

Working with people all

day require a great deal

of efforts

I feel like my work is

breaking me down

I feel frustrated by my

work

I feel I work too hard at

my job

It stresses me too much

to work in direct contact

with people

I feel like am at the end

of my rope

TOTAL SCORE-

SECTION A

58
Questions Never A few Once a A few Once a A few Every

times month times week times day

per per per

year month week

Section B 0 1 2 3 4 5 6

I feel I look after

certain patients

impersonally, as if

they are object

I feel tired when I get

up in the morning and

have to face another

day at work

I have the impression

that my patients make

me responsible for

some of their

problems

59
 I am the end of my

patience at the end of

my work day

I really don’t care

about what happen to

some of my patients

I have become more

insensitive to people

since I have been

working

I am afraid that this

job is making me

uncaring

TOTAL SCORE-

SECTION B

Questions Never A few Once a A few Once a A few Ever

times month times week times y day

60
 per per per

year month week

Section C 0 1 2 3 4 5 6

I accomplish many

worthwhile things in

this job

I feel full of energy

I am easily able to

understand what my

patients feel

I look after my patients’

problems very

effectively

In my work, I handle

emotional problems

very calmly

Through my work I feel

that I have a positive

influence on people

I am easily able to

create a relaxed
61
atmosphere with my

patient

I feel refreshed when I

have been closed to my

patients at work

TOTAL SCORE-

SECTION C

APPENDIX 2 B

BUDGET

ITEM QUANTITY TOTAL COST

STATIONERY 600*3 1800

PHOTOCOPY AND 60*30 1800

BINDING

TRANSPORT 400*3 1200

62
INTERNET 2GB 1000

KUREC 1500

NACOSTI 1500

DATA ANALYSIS 2000

CONTINGENCIES 500

TOTAL 11300

WORK PLAN (TIME)

ITEM JAN 2023 April 2023 May 2023

Proposal

development

Data

collection

63
Data analysis

and

interpretation

64