Evidence map›Paper›PMID 41764522›Full record

ArticleBMC health services research2026

Healthcare workers' perspectives on burnout complaints: exploring underlying dynamics using a complex systems approach.

Ruben Heuven, Saskia van den Berg, Karin Proper, Sandra van Oostrom

Abstract read
In one paragraph

Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Ruben HeuvenCenter for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. ruben.heuven@rivm.nl.ORCID http://orcid.org/0009-0006-1226-9148
Saskia van den BergCenter for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.ORCID http://orcid.org/0000-0002-6842-9781
Karin ProperCenter for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.ORCID http://orcid.org/0000-0001-7016-1625
Sandra van OostromCenter for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.ORCID http://orcid.org/0000-0003-3086-6641

Funding

Rijksinstituut voor Volksgezondheid en Milieu S/133034.
6 · The paper itself

Abstract

backgroundHealthcare workers (HCWs) report burnout complaints more often than the general workforce, leading to reduced quality of life and delivered care, high absenteeism and associated costs. Addressing the complex issue of burnout complaints requires a shift from linear thinking to a systems perspective focused on interaction and feedback. This study explores the dynamics behind burnout complaints by approaching it as a complex system, from the perspective of Dutch HCWs.

methodsThirteen HCWs from eight different professions participated in two Group Model Building sessions to develop a Causal Loop Diagram (CLD). Participants identified contributing factors related to living conditions, working conditions, and societal developments, and mapped their assumed relationships into causal feedback loops.

resultsThe CLD contains 24 factors, 55 assumed causal relationships, and 417 feedback loops. Within these loops, two reinforcing and two balancing key dynamics were identified. The perceived reinforcing dynamics illustrate how burnout complaints and staff shortages amplify each other, and how rising burnout impairs care quality, prompting patient dissatisfaction that further increases burnout complaints. The perceived balancing dynamics reflect how this cycle is partially mitigated by supportive leadership and rising societal awareness, which improves working conditions and employment terms.

conclusionsAccording to HCWs, these dynamics may help explain the rising trend in the prevalence of burnout complaints among HCWs. Understanding these dynamics offers valuable insights for developing more effective strategies to shift the system towards more favorable outcomes.

Indexed as

Attitude of Health PersonnelBurnout, ProfessionalHealth PersonnelAdultFemaleGroup DynamicsHumansJob SatisfactionMaleMiddle AgedNetherlandsWorking Conditions‘Burnout’Causal loop diagram‘Community-based participatory research’Group model buildingHealthcare workers

Identifiers

PMID41764522
PMCPMC13059254

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.