Association between job burnout and depressive symptoms in rural primary healthcare workers: The indirect role of sleep quality

doi:10.5498/wjp.122230

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Oct 19, 2026; 16(10): 122230
Published online Oct 19, 2026. doi: 10.5498/wjp.122230

Table 1 Sociodemographic characteristics of the participants

Variables	n (%)	Job burnout¹		Depressive symptoms²		Sleep quality³
Variables	n (%)	Median (IQR)	P value	Median (IQR)	P value	Median (IQR)	P value
Total	421 (100)	22.0 (12.0-35.0)		33.0 (29.0-40.0)		5.0 (3.0-7.0)
Gender
Male	163 (38.7)	22.0 (12.0-34.0)	0.637	32.0 (29.0-39.0)	0.227	4.0 (3.0-6.0)	0.050
Female	258 (61.3)	22.5 (12.0-35.0)		34.0 (29.0-41.0)		5.0 (3.0-8.0)
Age, years
≤ 30	134 (31.8)	26.0 (16.8-36.0)	0.001^b	35.0 (30.8-41.0)	0.021^a	5.0 (3.0-8.0)	0.667
31-40	127 (30.2)	23.0 (14.0-35.0)		34.0 (29.0-40.0)		5.0 (3.0-7.0)
41-50	113 (26.8)	17.0 (8.0-30.0)		32.0 (28.0-38.0)		4.0 (3.0-7.0)
51-60	47 (11.2)	20.0 (9.0-38.0)		34.0 (30.0-42.0)		5.0 (3.0-8.0)
Marital status
Single	80 (19.0)	27.5 (15.3-39.8)	0.036^a	35.0 (29.3-40.8)	0.216	5.0 (3.0-8.0)	0.283
Married	327 (77.7)	21.0 (10.0-33.0)		33.0 (29.0-39.0)		5.0 (3.0-7.0)
Divorced	10 (2.4)	17.0 (10.8-70.3)		34.0 (27.8-50.3)		5.0 (2.8-8.3)
Widowed	4 (1.0)	34.5 (19.3-37.8)		41.0 (34.8-46.5)		7.0 (7.0-8.5)
Education
Junior high school	9 (2.1)	31.0 (9.5-36.0)	0.038^a	43.0 (28.0-46.5)		3.0 (2.5-5.5)	0.005^a
Highschool	72 (17.1)	17.0 (7.3-30.0)		33.0 (29.0-39.8)		4.0 (2.0-6.0)
Bachelor’s degree	306 (72.7)	24.0 (13.0-35.0)		33.5 (29.0-40.0)		5.0 (3.0-8.0)
Master’s degree or above	34 (8.0)	20.0 (11.8-40.3)		35.0 (30.5-40.3)		4.0 (3.0-8.0)
Working years
≤ 5	103 (24.5)	23.0 (16.0-36.0)	0.001^b	33.0 (30.0-39.0)	0.105	5.0 (3.0-7.0)	0.914
6-10	77 (18.3)	29.0 (16.0-37.0)		37.0 (30.0-42.0)		5.0 (3.0-8.0)
11-20	94 (22.3)	20.0 (12.0-32.5)		33.0 (29.0-40.0)		5.0 (3.0-7.3)
> 20	147 (34.9)	18.0 (9.0-32.0)		33.0 (28.0-38.0)		5.0 (3.0-7.0)
Monthly income, CNY
< 2000	23 (5.5)	33.0 (19.0-37.0)	0.120	38.0 (32.0-45.0)	0.003^b	5.0 (3.0-7.0)	0.171
2000-3000	97 (23.0)	21.0 (11.5-32.0)		33.0 (30.0-37.5)		4.0 (2.5-7.0)
3001-5000	218 (51.8)	23.5 (12.0-36.0)		34.0 (29.0-41.0)		5.0 (3.0-8.0)
> 5000	83 (19.7)	18.0 (10.0-32.0)		31.0 (27.0-37.0)		5.0 (3.0-7.0)

¹Job burnout is represented by the total burnout score.

²Depressive symptoms are represented by the Self-Rating Depression Scale.

³Sleep quality is represented by the Pittsburgh Sleep Quality Index.

^aP < 0.05.

^bP < 0.01.

Exchange rate: 1 USD = 7.27 CNY (as of April 2025). IQR: Interquartile range.

Full Size Table

Citation: Nan L, Wang Y, Wareesawetsuwan N, Sanan M, Zhao XF, Yang L, Zhu WL. Association between job burnout and depressive symptoms in rural primary healthcare workers: The indirect role of sleep quality. World J Psychiatry 2026; 16(10): 122230
URL: https://www.wjgnet.com/2220-3206/full/v16/i10/122230.htm
DOI: https://dx.doi.org/10.5498/wjp.122230

Nan L, Wang Y, Wareesawetsuwan N, Sanan M, Zhao XF, Yang L, Zhu WL. Association between job burnout and depressive symptoms in rural primary healthcare workers: The indirect role of sleep quality. World J Psychiatry 2026; 16(10): 122230 [DOI: 10.5498/wjp.122230]

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