Job stress and burnout among hospital administrative staff: a cross-sectional study

Abstract

Although job stress and burnout have been widely studied among physicians and nurses, hospital administrative staff, who play a critical role in healthcare delivery, have received comparatively less attention. This study aims to assess job stress, burnout, and their association among hospital administrative staff. This cross-sectional study targeted hospital administrative staff from a teaching hospital in central Taiwan. A questionnaire was conducted from October to December 2023, covering the Chinese version of the Copenhagen Burnout Inventory, the Chinese version of the Job Content Questionnaire, and sociodemographic information. Multiple linear regression analysis was employed to examine the relationship between job stress and burnout. A total of 117 hospital administrative staff participated in the study, with a mean age of 38.56 years, and the majority (79.5%) were female. Based on responses to the Job Content Questionnaire, participants reported moderate levels of job control, high psychological job demands, moderate physical job demands, and high social support. The Copenhagen Burnout Inventory indicated that they experienced moderate levels of both personal and work-related burnout, while client-related burnout was relatively low. After adjusting for potential confounders, multiple linear regression analysis revealed that physical job demands (B = 7.43, p = 0.01) and social support (B = -1.24, p = 0.03) were significant predictors of personal burnout. Similarly, work-related burnout was significantly associated with being aged 40–49 (B = -11.40, p = 0.03), aged 50 or above (B = -13.81, p = 0.03), higher physical job demands (B = 7.22, p = 0.02), and lower social support (B = -1.28, p = 0.04). No significant factors were identified for client-related burnout. This study reveals that among hospital administrative staff, job demands and social support are key factors of burnout. These findings suggest that interventions should prioritize reducing physical job demands and strengthening workplace social support. Future research should explore the mechanisms linking these factors to burnout and evaluate targeted interventions across diverse healthcare settings.

Introduction

Burnout, a psychological phenomenon, emerges when employees face a stressful occupational environment characterized by high job demands and limited resources^1,2. First described by Freudenberger in 1974, this concept has since spurred extensive research into its characteristics and prevalence³. Burnout is identified as an occupational phenomenon commonly observed in people-oriented professions, including those within the healthcare facilities⁴. Burnout can manifest in distinct but related forms within distinct professional contexts, depending on its sources⁵. Distinguishing between personal, work-related, and client-related burnout is important for understanding how various stressors affect employees differently and for developing tailored interventions. For example, personal burnout reflects an individual’s general state of exhaustion, regardless of context; work-related burnout captures strain arising specifically from job demands and organizational factors; and client-related burnout pertains to the emotional burden of working closely with service recipients. To capture these distinctions, this study used the Copenhagen Burnout Inventory (CBI), which was developed to measure these three domains separately⁵. This approach allows for a more nuanced assessment of burnout and supports the development of interventions that target the most relevant stressors in a given occupational context, such as healthcare administration.

In healthcare settings, hospital administrative staff, who are neither doctors nor nurses, play a crucial role in supporting patient care. Administrative workers represent a significant portion of hospital staff. For example, in the United States, administrative roles account for approximately 23.4% of the hospital workforce in private sector hospitals and 19.8% in Veterans Health Administration hospitals⁶. Their duties encompass scheduling appointments, arranging diagnostic services, managing medical records, handling billing and insurance forms, and providing assistance to physicians, nurses, and medical technicians. This diverse and demanding workload, combined with the need to coordinate services across multiple departments, can lead to significant job stress, which in turn contributes to burnout⁷.

Despite the essential role of administrative staff in hospitals, research on burnout among this population is limited compared to the extensive studies on physicians and nurses. A systematic review reported that the prevalence of burnout among physicians ranges from 0 to 80.5%, highlighting substantial variability across studies⁸. Another study analyzing data from 43,026 healthcare workers found overall burnout rates of 49.9%, with 47.3% in physicians, 56.0% in nurses, 54.1% in other clinical staff, and 45.6% in non-clinical staff⁹. Although few studies have examined burnout across different healthcare professions separately, those that have suggest that administrative staff may experience burnout at levels comparable to, or even higher than, physicians and medical technicians^10,11. For instance, a study conducted in Taiwan reported that physicians, medical technicians and administrative staff had similar personal and work-related burnout conditions¹⁰. In addition, a study in Greece found higher prevalence rates of personal and work-related burnout in administrative staffs than among physicians and nurses¹¹. Although some studies have reported on burnout among administrative staff, they primarily provide prevalence estimates and comparisons with clinical roles^10,11, with limited focus on job stress as a contributing factor. This gap underscores the need for studies that examine burnout in this group within a theoretical framework that accounts for occupational stressors.

Psychosocial risks at work are widely recognized as key contributors to burnout^12–15. One of the most influential frameworks in this area is Karasek’s Job Demand-Control (JDC) model, introduced in 1979¹⁴, which posits that job strain arises from the combination of high job demands and low decision-making control. In 1988, Johnson and Hall expanded this model to include workplace social support, resulting in the Job Demand-Control-Support (JDCS) model^15,16. This expanded framework suggests that low social support can further exacerbate the negative effects of job strain. According to the JDCS framework, burnout tends to increase when job demands are high, job control is limited, and social support is lacking¹⁷. Among healthcare workers, factors such as age, education, marital status, job title, years of experience, overtime work, shift work, job strain, social support, and over-commitment have all been linked to increased burnout^10,18–21. Burnout not only affects healthcare workers’ well-being but also negatively impacts service delivery, increases the likelihood of medical errors, and reduces the quality of patient care^22,23.

Despite increasing research on job stress and burnout among physicians and nurses, there remains a limited body of literature focusing on hospital administrative staff. Although some research has noted burnout prevalence among hospital administrative staff, few have explored how key psychosocial factors, such as job demands, autonomy, and workplace support, specifically influence burnout in this group. Additionally, existing studies often categorize administrative personnel with broader non-clinical roles, making it difficult to isolate stressors unique to their work. This lack of targeted analysis limits the development of effective, role-specific interventions. To address this gap, the present study investigated job stress and burnout among hospital administrative staff and evaluated their association.

Methods

Participants and study design

This cross-sectional study was conducted at a teaching hospital in Taichung, Taiwan. The hospital has a capacity of approximately 633 beds and manages an annual patient turnover of approximately 100,000 outpatient visits and 26,017 inpatient admissions. The institution employs a diverse workforce, including approximately 166 administrative staff, whose responsibilities include scheduling patient appointments, managing medical records, coordinating interdepartmental services, processing billing and insurance claims, and assisting clinical staff. Given its size, service capacity, and workforce composition, this hospital provides a representative setting for investigating job stress and burnout among administrative staff. Its administrative structure, job roles, and workload patterns are consistent with those of other tertiary hospitals in Taiwan, making the findings relevant to similar institutional contexts despite the single-site design.

We used a total population sampling technique, inviting all 166 eligible administrative staff employed at the time of the study to participate. Participants were recruited based on the following inclusion criteria: (a) full-time employment as hospital administrative staff at the time of the study and (b) age between 20 and 65 years. Exclusion criteria included: (a) part-time staff and (b) those on extended leave (e.g., maternity, sick, or sabbatical leave). Exclusion criteria included: (a) part-time employees and (b) those currently on extended leave (e.g., maternity, sick, or sabbatical leave). To ensure adequate statistical power, we conducted a sample size calculation using G*Power software (version 3.1). Assuming a medium effect size (f² = 0.22), power of 0.80, alpha level of 0.05, and inclusion of up to 13 predictors in a multiple regression analysis, the minimum required sample size was estimated to be 93 participants. This study was approved by the Institutional Review Board (IRB) of Cheng Ching General Hospital, which waived the requirement for written informed consent due to the anonymous nature of the survey (IRB No. HP230018). All methods were performed in accordance with relevant guidelines and regulations. Data collection took place between October 1 and December 31, 2023. Prior to participation, eligible administrative staff were approached in person by trained research personnel, who provided a verbal explanation of the study’s purpose, procedures, voluntary nature, and confidentiality protections. Each questionnaire was accompanied by a cover letter reiterating this information and stating that completion and return of the questionnaire would be considered as implied consent to participate. No personal identifiers were collected, and all responses were treated confidentially and analyzed in aggregate. This process ensured participant anonymity and was conducted in accordance with institutional guidelines and the principles outlined in the Declaration of Helsinki.

Questionnaire

The questionnaire comprised 50 questions, including 9 on sociodemographic characteristics, 25 on job stress, and 16 on burnout. Sociodemographic characteristics covered gender, age, educational level, marital status, years of administrative work, job title, shift work, weekly working hours, and daily round-trip commuting time.

The Chinese version of the Job Content Questionnaire (C-JCQ), based on Karasek’s job demand-control-support model, was used to evaluate job stress^15,24,25. The C-JCQ comprises 25 items, which are distributed across four dimensions: job control (9 items), psychological job demands (7 items), physical job demands (1 item), and social support (8 items). Responses to the items are rated on a four-point Likert scale, ranging from 1 (strongly disagree) to 4 (strongly agree). In line with standard practice in JDCS-based research²⁶and to preserve statistical power, we analyzed each dimension as a continuous variable. Higher scores indicate greater levels of job control, job demands, or social support, depending on the specific dimension assessed. In this study, the internal consistency of the scales was assessed using Cronbach’s alpha. The coefficients were 0.77 for job demand, 0.75 for job control, and 0.90 for social support. The overall C-JCQ scale showed acceptable internal consistency, with a Cronbach’s alpha of 0.80.

The Chinese version of the Copenhagen Burnout Inventory (C-CBI) was used to assess burnout^27,28. The C-CBI consists of 16 items distributed across three subscales: personal burnout (5 items), work-related burnout (5 items), and client-related burnout (6 items). Each item is assessed using a 5-point Likert scale, with response options scored as follows: 0 (never), 1 (seldom), 2 (sometimes), 3 (often), and 4 (always). Burnout levels were assessed by computing the average score for each subscale. This was achieved by summing the scores of the respective items, dividing by the total number of items within that subscale, and multiplying by 25 to convert the scores to a standardized 0-100 metric. Each subscale score ranges from 0 to 100, with higher scores indicating greater levels of burnout. In the current study, the reliability of the subscales was strong, with Cronbach’s alpha values of 0.88 for personal burnout, 0.92 for work-related burnout, and 0.92 for client-related burnout. The overall C-CBI demonstrated excellent internal consistency, with an alpha coefficient of 0.94.

Statistical analysis

Descriptive statistics were used to summarize participant characteristics and scale scores. Continuous variables (e.g., age, working hours per week, scores from the C-JCQ and C-CBI) were reported as means with standard deviations (SD), while categorical variables (e.g., gender, marital status, shift work) were summarized as frequencies and percentages. The Kolmogorov-Smirnov test was used to assess the normality of distribution for the dependent variable, burnout scores. Pearson’s correlation analysis was performed to explore the relationships between continuous variables, including the dimensions of the C-JCQ (job control, psychological and physical demands, and social support) and the C-CBI (personal, work-related, and client-related burnout). Pearson’s correlation coefficient can range from − 1 to + 1, with values closer to −1 or + 1 indicating stronger relationships, and values closer to 0 indicating weaker or no relationship. A positive coefficient indicates that as one variable increases, the other variable tends to increase, while a negative coefficient indicates that as one variable increases, the other tends to decrease. To identify potential factors associated with burnout, simple linear regression analyses were initially conducted, considering independent variables such as gender, age, educational level, marital status, years of administrative work experience, job title, shift work, working hours, round-trip commuting time, job control, psychological job demands, physical job demands, and social support. We then conducted multiple linear regression analyses to examine how job stress was related to burnout, controlling for possible confounding factors such as age, gender, and other variables that showed statistical significance (p < 0.05) in the initial simple linear regression analyses. The explanatory power of the regression models was indicated by adjusted R-squared values. All statistical analyses were performed using SPSS Version 21.0 software (IBM Corp., Armonk, NY, USA), with significance determined at a threshold of p < 0.05.

Results

A total of 117 hospital administrative staff met the inclusion criteria and completed the questionnaire, with a response rate of 70.5%. The mean age of participants was 38.56 years, with the majority being female (79.5%) and single (50.4%). Most respondents held a college/university or below degree (85.5%) and were entry-level staff (88.0%) with an average work experience of 114.35 months. Additionally, 66.7% did not engage in shift work, and participants reported working an average of 44.53 h per week with a round-trip commuting time of 52.74 min (Table 1).

Table 1.

Sociodemographic and occupational characteristics of hospital administrative staff. (n = 117).

Variables	N	%	Mean	SD
Gender
Male	24	20.5
Female	93	79.5
Age, year			38.56	11.65
<30	34	29.1
30–39	28	23.9
40–49	34	29.1
≧50	21	17.9
Educational level
College/University or below	100	85.5
Graduate school	17	14.5
Marital status
Single	59	50.4
Married	58	49.6
Years of administrative staff work, month			114.35	109.17
Job title
Entry-level roles	103	88.0
Manager-level roles or above	14	12.0
Shift work
Yes	39	33.3
No	78	66.7
Working hours per week, hour			44.53	6.79
Round-trip commuting time per day, minute			52.74	31.29

SD, Standard deviation.

Table 2 presents the mean (SD) scores for each subscale of the C-JCQ and C-CBI. Participants reported a moderate level of job control (64.22 ± 6.80, range: 24–96) and relatively high psychological job demands (20.42 ± 1.94, range: 7–28). Physical job demands scored 2.62 ± 0.66 on a 1–4 scale, indicating moderate physical exertion. Social support was perceived as relatively high (24.87 ± 3.46, range: 8–32). In terms of burnout, the mean personal burnout score was 43.38 ± 19.85, work-related burnout was 40.68 ± 21.59, and client-related burnout was 35.43 ± 21.39, all measured on a scale of 0-100. These findings suggest moderate burnout levels, with personal and work-related burnout scoring higher than client-related burnout.

Table 2.

Distribution of scores on the Chinese version of the job content questionnaire dimensions (C-JCQ) and Chinese version of Copenhagen burnout inventory (C-CBI) among hospital administrative staff.

C-JCQ subscales	Minimum	Maximum	Mean	SD
Job control (range 24–96)	50	88	64.22	6.80
Psychological job demands (range 7–28)	15	26	20.42	1.94
Physical job demands (range 1–4)	1	4	2.62	0.66
Social support (range 8–32)	18	32	24.87	3.46
C-CBI subscales
Personal burnout (range 0-100)	0	90	43.38	19.85
Work-related burnout (range 0-100)	0	100	40.68	21.59
Client-related burnout (range 0-100)	0	87.5	35.43	21.39

C-JCQ, Chinese version of the Job Content Questionnaire; C-CBI, Chinese Version of Copenhagen Burnout Inventory; SD, Standard deviation.

Table 3 presents the Pearson correlation coefficients among the scales of the C-JCQ and C-CBI. A significant positive correlation was found between psychological job demands and job control (r = 0.211), indicating that as psychological job demands increase, job control also tends to increase. Similarly, a positive correlation was observed between physical job demands and psychological job demands (r = 0.365), suggesting that higher physical job demands are associated with greater psychological job demands. However, no significant correlation was identified between social support and any other domains of the C-JCQ. With regard to the C-CBI, a strong positive correlation was observed between work-related burnout and personal burnout (r = 0.787), implying that higher levels of work-related burnout are associated with higher personal burnout. Furthermore, personal burnout demonstrated a positive correlation with client-related burnout (r = 0.472), indicating that greater personal burnout is linked to increased client-related burnout. Work-related burnout also showed a positive correlation with client-related burnout (r = 0.638). In terms of the relationship between job stress and burnout, a positive correlation was identified between personal burnout and physical job demands (r = 0.273), suggesting that higher physical job demands are associated with greater personal burnout. Additionally, a negative correlation was found between personal burnout and social support (r = −0.208), indicating that greater social support is associated with lower levels of personal burnout. Work-related burnout exhibited a positive correlation with physical job demands (r = 0.251) and a negative correlation with job control (r = −0.228), suggesting that higher physical job demands and lower job control are associated with increased work-related burnout. Finally, a negative correlation was observed between client-related burnout and job control (r = −0.223), highlighting the relationship between lower job control and higher levels of client-related burnout.

Table 3.

Correlation matrix for the Chinese version of the job content questionnaire dimensions and Chinese version of Copenhagen burnout inventory scales among hospital administrative staff.

	Job control	Psychological job demands	Physical job demands	Social support	Personal burnout	Work-related burnout	Client-related burnout
Job control	1
Psychological job demands	0.211*	1
Physical job demands	0.070	0.365**	1
Social support	0.149	0.141	−0.056	1
Personal burnout	−0.149	0.110	0.273**	−0.208*	1
Work-related burnout	−0.228*	0.095	0.251**	−0.143	0.787**	1
Client-related burnout	−0.223*	−0.003	0.110	−0.131	0.472**	0.638**	1

*p < 0.05.

**p < 0.01.

Simple linear regression analyses identified significant predictors of burnout (Table 4). Physical job demands and social support were associated with personal burnout, while age, job control, and physical job demands were significant predictors of work-related burnout. For client-related burnout, job control was the only significant contributing factor.

Table 4.

Simple regression analysis of factors associated with burnout among hospital administrative staff.

Variables	Personal burnout		Work-related burnout		Client-related burnout
	B (95% C.I.)	P-value	B (95% C.I.)	P-value	B (95% C.I.)	P-value
Gender
Male (reference)	-	-	-	-	-	-
Female	7.66 (−1.27, 16.58)	0.09	8.46 (−1.25, 18.17)	0.09	6.36 (−3.32, 16.03)	0.20
Age, year
<30 (reference)	-	-	-	-	-	-
30–39	4.35 (−5.71, 14.41)	0.39	−3.05 (−13.78, 7.69)	0.58	5.30 (−5.57, 16.16)	0.34
40–49	1.18 (−8.38, 10.74)	0.81	−9.41 (−19.61, 0.79)	0.07	0.86 (−9.47, 11.19)	0.87
≧50	−4.46 (−15.40, 6.48)	0.42	−13.77 (−25.43, −2.09)	0.02	−2.89 (−14.71, 8.93)	0.63
Educational level
College/University or below (reference)	-	-	-	-	-	-
Graduate school	6.37 (−3.92, 16.66)	0.22	3.33 (−7.92, 14.58)	0.56	8.15 (−2.91, 19.21)	0.15
Marital status
Single (reference)	-	-	-	-	-	-
Married	1.00 (−6.30, 8.30)	0.79	−1.70 (−9.63, 6.24)	0.67	0.25 (−7.62, 8.12)	0.95
Years of administrative staff work, month	< 0.01 (−0.03, 0.04)	0.81	−0.02 (−0.06, 0.01)	0.21	−0.01 (−0.05, 0.03)	0.54
Job title
Entry-level roles (reference)	-	-	-	-	-	-
Manager-level roles or above	1.81 (−9.48, 13.11)	0.75	−1.65 (−13.93, 10.64)	0.79	−0.08 (−12.26, 12.10)	0.99
Shift work
Yes (reference)	-	-	-	-	-	-
No	1.60 (−6.14, 9.34)	0.68	1.99 (−6.43, 10.40)	0.64	−1.98 (−10.31, 6.36)	0.64
Working hours per week, hour	0.07 (−0.47, 0.61)	0.81	−0.32 (−0.90, 0.27)	0.29	−0.35 (−0.93, 0.23)	0.23
Round-trip commuting time per day, minute	0.06 (−0.05, 0.18)	0.29	0.03 (−0.10, 0.16)	0.64	−0.04 (−0.17, 0.09)	0.54
Job control	−0.43 (−0.97, 0.09)	0.11	−0.73 (−1.30, −0.15)	0.01	−0.70 (−1.27, −0.13)	0.02
Psychological job demands	1.13 (−0.75, 3.00)	0.24	1.05 (−0.99, 3.09)	0.31	−0.04 (−2.07, 2.00)	0.97
Physical job demands	8.29 (2.90, 13.68)	< 0.01	8.27 (2.37, 14.16)	< 0.01	3.58 (−2.42, 9.58)	0.24
Social support	−1.20 (−2.23, −0.16)	0.02	−0.89 (−2.03, 0.25)	0.13	−0.81 (−1.94, 0.32)	0.16

Table 5 presents the results of multiple linear regression analyses. After adjusting for potential confounders, higher physical job demands and lower social support remained significant predictors of personal burnout. Work-related burnout was significantly associated with younger age, increased physical job demands, and lower social support. However, no significant factors were identified for client-related burnout. The adjusted R-squared values were 0.11 for personal burnout, 0.14 for work-related burnout, and 0.03 for client-related burnout, indicating the proportion of variance explained by the models.

Table 5.

Multiple regression analysis of factors associated with burnout among hospital administrative staff.

Variables	Personal burnout		Work-related burnout		Client-related burnout
	B (95% C.I.)	P-value	B (95% C.I.)	P-value	B (95% C.I.)	P-value
Gender
Male (reference)	-	-	-	-	-	-
Female	5.69 (−3.51, 14.88)	0.22	4.70 (−5.11, 14.50)	0.34	4.18 (−6.19, 14.55)	0.43
Age, year
<30 (reference)	-	-	-	-	-	-
30–39	2.09 (−7.62, 11.79)	0.67	−5.25 (−15.61, 5.10)	0.32	4.05 (−6.90, 15.00)	0.47
40–49	−1.08 (−10.71, 8.55)	0.83	−11.40 (−21.68, −1.13)	0.03	0.84 (−10.02, 11.71)	0.88
≧50	−5.13 (−16.78, 6.52)	0.38	−13.81 (−26.23, −1.38)	0.03	−0.73 (−13.88, 12.41)	0.91
Job control	−0.28 (−0.84, 0.29)	0.33	−0.49 (−1.09, 0.11)	0.11	−0.60 (−1.23, 0.04)	0.07
Psychological job demands	0.59 (−1.47, 2.65)	0.57	0.79 (−1.41, 2.99)	0.48	0.03 (−2.29, 2.36)	0.98
Physical job demands	7.43 (1.61, 13.25)	0.01	7.22 (1.01, 13.43)	0.02	3.75 (−2.81, 10.32)	0.26
Social support	−1.24 (−2.36, −0.13)	0.03	−1.28 (−2.47, −0.09)	0.04	−0.62 (−1.88, 0.65)	0.34

^* Adjusted for all above variables.

Discussion

Limited literature exists on job stress and burnout among hospital administrative staff, despite their critical role in healthcare institutions. This study aimed to investigate these factors and examine their relationship. The findings indicate that hospital administrative staff experience moderate job stress and are particularly susceptible to burnout. Notably, younger age, higher physical job demands, and lower social support were significant predictors of increased burnout levels.

The mean scores for the C-JCQ subscales in this study were as follows: job control (64.22), psychological job demands (20.42), physical job demands (2.62), and social support (24.87). These findings suggest that hospital administrative staff experience moderate job control and social support, coupled with relatively high psychological job demands and moderate physical job demands. This pattern is consistent with studies on nursing and other hospital staff populations^29,30. Previous research has highlighted the substantial psychological burden associated with healthcare-related occupations, particularly for nurses and other support staff²⁹. Additionally, the social support scores observed in this study align with those reported in prior research, potentially due to the strong collegial networks and team-based work culture commonly found in healthcare settings³⁰. The similarity in job stress levels between hospital administrative staff and clinical staff suggests that both groups face comparable organizational pressures, including high workloads, time constraints, and the emotional strain of working in a healthcare environment^7,10,31. Given the essential role of administrative staff in supporting medical services and collaborating with healthcare teams, it is crucial to evaluate their job stress and implement strategies to mitigate its impact. Considering the high psychological job demands observed in this study, occupational health and safety training is necessary to equip staff with effective coping strategies.

Burnout levels among hospital administrative staff were also assessed, with mean scores of 43.38 for personal burnout, 40.68 for work-related burnout, and 35.43 for client-related burnout. These findings are consistent with prior studies on administrative staff in regional teaching hospitals and align with burnout levels observed among other medical professionals^10,32. A systematic review on physicians in Taiwan reported comparable personal, work-related, and client-related burnout scores, highlighting the pervasive nature of burnout across different healthcare roles¹⁰. Notably, when compared to the general working population in Taiwan, where average personal burnout scores ranged from 33.9 to 36.6, and work-related burnout scores from 27.9 to 29.2, hospital administrative staff demonstrated significantly higher levels of burnout³³. This suggests that the demanding nature of healthcare-related roles contributes to heightened burnout risk, regardless of whether employees engage in direct patient care. Given these findings, it is imperative to develop and implement targeted intervention strategies to mitigate burnout among hospital administrative staff.

To reduce high psychological job demands and burnout risk, interventions should aim to minimize job stress at both individual and organizational levels³⁴. Leiter and Maslach (1999) emphasized that addressing burnout requires strategies that alleviate workload pressures while enhancing job control and social support³⁵. Promoting job autonomy can help hospital administrative staff develop a greater sense of control in their work, which is a critical factor in reducing job stress. Increasing workplace autonomy empowers employees, strengthens resilience against job stressors, and fosters a more engaged workforce^15,36. Furthermore, fostering a supportive work environment can help administrative staff gain motivation and confidence from their peers, ultimately alleviating distress and reducing long-term burnout³⁷. In practical terms, organizations can implement structured stress management workshops, such as cognitive behavioral techniques or mindfulness-based stress reduction (MBSR), to enhance individual coping capacity^38–40. At the organizational level, initiatives such as peer support groups, employee assistance programs, flexible scheduling, and leadership training to promote supportive supervision can address systemic contributors to burnout^41,42. These interventions are consistent with evidence-based occupational health practices and are vital for sustaining the psychological well-being and productivity of administrative personnel operating in high-demand hospital settings.

This study found that high physical job demands were significantly associated with both personal and work-related burnout, while social support was a protective factor against personal burnout. These findings are consistent with previous research¹⁰. Compared to clinical staff, who experience greater physical job demands and strains due to their direct involvement in patient care, administrative personnel primarily face cognitive and emotional stressors associated with their coordination responsibilities. Additionally, administrative staff often have limited discretion and decision-making authority, as their roles primarily involve implementing the directives of healthcare providers^30,43. Similar to our findings, Olivé et al. (2022) and Mijakoski et al. (2023) demonstrated that high physical job demands were linked to an increased risk of burnout among clinical staff^44,45. These results emphasize the importance of addressing job stress to enhance employee well-being and prevent burnout.

Social support plays a crucial role in mitigating workplace stress. Hospital employees experiencing high job stress often seek support from family, friends, and colleagues, or engage in coping strategies such as consulting health professionals⁴⁶. Support from coworkers and supervisors can help reduce workplace stressors and promote health-protective behaviors. Strengthening workplace support networks among hospital administrative staff could enhance coping mechanisms and reduce stress-related symptoms³⁰.

Our findings are consistent with the JDCS model, which proposes that employees are more susceptible to burnout and job strain when they are exposed to high work demands, have limited decision-making autonomy, and receive insufficient social support. In this study, we observed that greater physical job demands were associated with increased levels of both personal and work-related burnout. In contrast, higher levels of social support appeared to mitigate these effects, serving as a protective factor. This pattern aligns with a recent empirical study that has highlighted how high-demand, low-resource job profiles are closely linked to elevated burnout and decreased well-being⁴⁷. Taken together, these interpretations provide a theoretical context for our results and reinforce the need to address both workload and support structures to help prevent burnout among hospital staff.

Additionally, our study identified younger age as a significant predictor of work-related burnout. Individuals aged 40–49 and those aged 50 and above were found to have significantly lower levels of work-related burnout compared to their counterparts under the age of 30. This finding aligns with earlier research indicating that hospital staff younger than 30 years were over ten times more likely to experience work-related burnout than those aged 50 or older¹⁰. Several factors may explain this trend. Younger employees typically lack experience in managing workplace stress, which may hinder their ability to build strong support networks and employ effective coping strategies⁴⁸. They may also feel pressured to prove their competence, leading to increased workload and stress. Furthermore, early-career employees often take on more demanding tasks as they establish themselves professionally, which can heighten their risk of burnout⁴⁹. Additionally, maintaining a healthy work-life balance is often more challenging for younger employees, further exacerbating burnout⁵⁰. To address these challenges, organizations should implement mentorship programs, stress management training, and work-life balance initiatives to support younger employees and reduce their risk of burnout.

To the best of our knowledge, this is the first study to examine the relationship between job stress and burnout among hospital administrative staff in Taiwan. A major strength of this study is the use of validated instruments to assess both job stress and burnout, ensuring the reliability and accuracy of the findings. However, some limitations must be acknowledged. First, participants were recruited from a single regional hospital, which may limit the generalizability of the results. Given the variability in hospital settings and organizational cultures, future research should incorporate a broader range of medical institutions and larger sample sizes to improve external validity. Additionally, this study did not restrict participation based on length of employment, which may have introduced variability in reported job stress and burnout levels between newer and more experienced staff. Second, although our regression models included core job stress factors from the C-JCQ and adjusted for key demographics, the relatively low explanatory powers suggest that additional influential variables may not have been captured. Important factors, such as personality traits, job satisfaction, over-commitment, role conflict, and exposure to recent stressful life events were not assessed in this study^51–56which could influence burnout levels and may enhance the explanatory power of future models. Future research including broader individual and organizational variables could provide a more comprehensive understanding of the multifactorial nature of occupational burnout. Third, rather than dividing job demands and job control into high and low categories as commonly done in Karasek’s high-strain model, we analyzed these variables continuously. This approach preserves more detailed information and maintains statistical power, in line with prior methodological research^26,57. However, it may reduce comparability with studies employing categorical strain classifications^10,58. Furthermore, the demographic characteristics of our sample, primarily younger, unmarried, entry-level employees, may have influenced our findings. Future research should explore how job tenure, family responsibilities, and career stage interact with job stress and burnout. Lastly, the cross-sectional design of this study limits the ability to establish causal relationships between job stress and burnout. Longitudinal studies are needed to examine how prolonged exposure to job stress affects burnout over time.

Conclusion

This study provides new insights into job stress and burnout among hospital administrative staff, a group often overlooked in occupational health research. Our findings indicate that administrative staff experience moderate job stress and are particularly vulnerable to burnout, with physical job demands significantly contributing to both personal and work-related burnout. Younger employees were at higher risk for work-related burnout, likely due to limited experience managing workplace stress and increased career-related pressures. Social support emerged as a crucial protective factor, reducing the impact of job stress on personal burnout and work-related burnout. Given the essential role of administrative staff in healthcare institutions, targeted interventions should be implemented to mitigate job stress and burnout. Organizations should establish workload management policies, optimize task distribution, foster supportive work environments, provide mental health resources, and promote career development opportunities. Mentorship programs and professional development initiatives can help younger employees build resilience and coping skills. Future research should examine the long-term effects of burnout on job performance and healthcare system efficiency, as well as the impact of administrative staff burnout on the clinical teams they support.

Abbreviations

CBI

Copenhagen Burnout Inventory

C-CBI

Chinese version of the Copenhagen Burnout Inventory

C-JCQ

Chinese version of the Job Content Questionnaire

IRB

Institutional Review Board

JDCS

job demand-control-support

MBSR

mindfulness-based stress reduction

SD

standard deviation

Author contributions

K.H.L.: Conceptualization, Methodology, Data curation, Writing- Original draft preparation, Writing- Reviewing and Editing. C.C.H.: Conceptualization, Investigation, Methodology, Software, Writing- Original draft preparation. K.Y.L.: Methodology, Supervision, Software, Validation, Writing- Original draft preparation, Writing- Reviewing and Editing. All authors read and approved the final manuscript.

Funding

Not applicable.

Data availability

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

Declarations

Competing interests

The authors declare no competing interests.

Ethical approval and consent to participate

The study received approval from the Institutional Review Board (IRB) of Cheng Ching General Hospital (HP230018). All participants have provided verbal informed consent.

Consent for publication

Not applicable.