Melampaui Resiliensi Individu: Sebuah Narrative Review tentang Burnout dan Turnover Intention pada Dokter dan Perawat
DOI:
https://doi.org/10.37385/ceej.v7i2.11653Keywords:
Burnout, Turnover Intention, Perawat, Dokter, Job Demands-Resources Model, Retensi Tenaga KesehatanAbstract
Latar Belakang: Burnout pada tenaga kesehatan telah mencapai tingkat krisis global dengan prevalensi 32-47% pada dokter dan perawat rumah sakit. Sindrom ini membawa implikasi mendalam terhadap stabilitas tenaga kerja, keselamatan pasien, dan keberlanjutan sistem kesehatan. Pandemi COVID-19 telah memperburuk tantangan ini secara dramatis. Tujuan: Menyintesis bukti terkini mengenai hubungan antara burnout dan turnover intention pada dokter dan perawat, mengidentifikasi faktor-faktor kunci, serta mengembangkan kerangka kerja berbasis bukti untuk organisasi kesehatan. Metode: Narrative review mengikuti pedoman SANRA. Pencarian literatur terstruktur dilakukan di PubMed, Scopus, Web of Science, CINAHL, dan Embase (Januari 2010 - Maret 2025). Sebanyak 100 artikel peer-review diseleksi untuk sintesis. Model Job Demands-Resources (JD-R) berfungsi sebagai kerangka teoretis utama. Hasil: Lima temuan utama diperoleh: (1) Prevalensi burnout sebesar 32% pada dokter dan 47% pada perawat, dengan angka lebih tinggi di ICU (71,6%) dan UGD (64%); (2) Burnout meningkatkan turnover intention 3-4 kali lipat (OR 3,10-3,79); (3) Prediktor terkuat adalah faktor sistemik, yaitu ketidakcukupan staf (54%), lingkungan kerja buruk (34%), lembur wajib (β=0,395), kekerasan di tempat kerja (74-97%), dan work-life interference (OR 1,72); (4) Tenaga kesehatan memprioritaskan intervensi organisasi dibandingkan program individu; (5) Intervensi efektif meliputi rasio staf wajib, terapi seni kreatif, dan program mentorship. Kesimpulan: Burnout dan turnover intention terutama didorong oleh faktor sistemik, bukan defisit resiliensi individu. Organisasi kesehatan harus beralih dari membangun resiliensi individu menuju penciptaan sistem kesehatan yang resilien melalui reformasi struktural.
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