{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:30:41Z","timestamp":1793053841265,"version":"4.5.0"},"reference-count":32,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,3,27]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine burnout prevalence, associated factors and coping strategies used by nursing professionals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional analytical study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Public and private healthcare institutions in Kerala, India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Nursing professionals in Kerala (n=349).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Burnout levels (assessed with the Burnout Assessment Tool (BAT)) and coping strategies. Log-binomial regression was performed to identify factors associated with burnout.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>High burnout was reported by 36.1% of participants (126\/349; 95%\u2009CI 31.1 to 41.4). Burnout prevalence was higher among nurses with an MSc (Master of Science) or higher educational qualification (adjusted prevalence ratio (APR)=1.46; 95%\u2009CI 1.04 to 2.03); those working in urban settings (APR=1.41; 95%\u2009CI 1.04 to 1.90); those who were single, divorced or separated (APR=1.58; 95%\u2009CI 1.18 to 2.12); those with travel time \u226530\u2009min (APR=1.36; 95%\u2009CI 1.03 to 1.79); and those engaged in clinical\/direct patient care duties (APR=1.75; 95%\u2009CI 1.18 to 2.59). Commonly reported coping strategies included active coping (59.6%), seeking instrumental social support (58.7%) and venting (54.4%), whereas negative strategies, such as substance use, were less frequent (22.9%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Over one-third of the nurses in our study reported high burnout. Efforts to reduce burnout should focus on nurses with higher qualifications, those working in urban settings, those with higher travel time, those who are single\/divorced\/separated and those involved in clinical duties to enhance healthcare quality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-113120","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T16:40:49Z","timestamp":1776271249000},"page":"e113120","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Burnout, associated factors and coping strategies among nursing professionals in Kerala, India: a cross-sectional study"],"prefix":"10.1136","volume":"16","author":[{"given":"Jithesh Krishnan","family":"Ambujam","sequence":"first","affiliation":[{"name":"Department of Public Health, Amrita Institute of Medical Sciences, Amrita School of Medicine, Amrita Vishwa Vidyapeetham, Kochi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul T","family":"Francis","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Amrita Institute of Medical Sciences, Amrita School of Medicine, Amrita Vishwa Vidyapeetham, Kochi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0298-5363","authenticated-orcid":false,"given":"Jeby Jose","family":"Olickal","sequence":"additional","affiliation":[{"name":"Department of Public Health, Amrita Institute of Medical Sciences, Amrita School of Medicine, Amrita Vishwa Vidyapeetham, Kochi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3236-4215","authenticated-orcid":false,"given":"P Sankara","family":"Sarma","sequence":"additional","affiliation":[{"name":"Department of Public Health, Amrita Institute of Medical Sciences, Amrita School of Medicine, Amrita Vishwa Vidyapeetham, Kochi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4536-2684","authenticated-orcid":false,"given":"Kavumpurathu Raman","family":"Thankappan","sequence":"additional","affiliation":[{"name":"Department of Public Health, Amrita Institute of Medical Sciences, Amrita School of Medicine, Amrita Vishwa Vidyapeetham, Kochi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"2026041509402725000_16.4.e113120.1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.52.1.397"},{"key":"2026041509402725000_16.4.e113120.2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2012.3199"},{"key":"2026041509402725000_16.4.e113120.3","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12752"},{"key":"2026041509402725000_16.4.e113120.4","unstructured":"World Health Organization . 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