Chih-Hsuan Huang, Hsin-Hung Wu, Yii-Ching Lee, Li Li
Objectives: – Emotional exhaustion among ICU professionals poses a significant threat to both health care quality and staff well-being. While patient safety culture (PSC) is recognized as a potential buffer, its longitudinal impact on emotional exhaustion remains underexplored, particularly within high-intensity clinical environments like ICUs. This study investigates how ICU professionals’ perceptions of PSC influence the progression of emotional exhaustion over a 5-year period, highlighting shifts in organizational and psychological predictors. Methods: – A 5-year longitudinal survey (2020-2024) was conducted in a regional teaching hospital in Taiwan. A total of 1213 valid responses were collected from ICU physicians and nurses using the Chinese version of the Safety Attitudes Questionnaire (CSAQ), which includes 6 PSC dimensions and an emotional exhaustion scale. Stepwise multiple regression was used annually to identify significant predictors of emotional exhaustion. Results: – Findings revealed a temporal shift in the predictors of emotional exhaustion. In 2020, organizational support factors—job satisfaction (β=−0.523, p<0.001) and perceptions of management (β=−0.443, p<0.001)—were significant negative predictors, while safety climate showed a counterintuitive positive association (β=0.264, p=0.004). From 2021 to 2024, stress recognition emerged as the most consistent protective factor (β range=−0.366 to −0.537, p<0.001). Interestingly, teamwork climate, often considered beneficial, was positively associated with emotional exhaustion in later years, suggesting added interpersonal burdens in collaborative ICU settings. Conclusions: – Emotional exhaustion in ICU professionals is shaped by dynamic interactions between organizational structures and individual-level coping resources. Early burnout prevention should focus on institutional support, while long-term strategies should promote stress awareness and carefully manage team-based expectations. These findings provide health care leaders with actionable insights to design adaptive, stage-specific interventions to sustain psychological resilience in high-stress clinical environments. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved.
Hubei Enterprise Culture Research Center, Hubei University of Economics, Wuhan, China; Business School, Hubei University of Economics, Wuhan, China; Department of Business Administration, National Changhua University of Education, Changhua, Taiwan; Faculty of Education, State University of Malang, East Java, Malang, Indonesia; Department of Health Business Administration, Hungkuang University, Taichung, Taiwan; International College, Guangzhou College of Commerce, Guangzhou, China
