Work Stress, Quality of Work Life, and Burnout Among Registered Nurses in Public Hospitals in Samut Songkhram Province, Thailand: An Explanatory Sequential Mixed-Methods Study.

Burnout among nurses is an important occupational and public health concern because it is associated with nurses' well-being, workforce retention, and the quality and safety of patient care. This explanatory sequential mixed-methods study examined levels of work stress, quality of work life, and burnout among registered nurses in public hospitals in Samut Songkhram Province, Thailand, and explored nurses' experiences regarding workplace factors related to burnout. The target quantitative sample was 217 registered nurses, and 186 completed questionnaires were included in the final analysis. Structured questionnaires assessed work stress, quality of work life, and burnout. Multiple regression analysis was used to identify factors associated with burnout. Qualitative data were collected through in-depth interviews with 10 registered nurses and analyzed using content analysis. Most nurses were classified as having high work stress and being at risk of burnout. Work stress and quality of work life jointly explained 35.0% of the variance in burnout. Work-life balance, fair and adequate compensation, professional development, workplace safety, organizational justice, and social integration in the workplace were associated with lower burnout scores. Organizational structure, policy, and climate showed a positive coefficient in relation to burnout and should be interpreted cautiously because the p-value was close to the conventional threshold for statistical significance. Qualitative findings supported the quantitative results and highlighted workload, staffing shortages, limited resources, insufficient recovery time, and workplace support as important workplace concerns.