Divergent 5-Year Trajectories of Emotional Exhaustion in Internal Medicine and Surgery: Longitudinal Associations With Patient Safety Culture.

Publication date: Jul 21, 2026

Patient safety culture (PSC) is a critical organizational determinant of health care quality and workforce well-being; however, its longitudinal relationship with emotional exhaustion across clinical contexts remains unclear. This study investigated how PSC dimensions influenced 5-year patterns of emotional exhaustion among internal medicine and surgical health care professionals in a high-pressure teaching hospital. A repeated cross-sectional design was used using data collected annually from 2020 to 2024 at a regional teaching hospital in Taiwan. The Chinese version of the Safety Attitudes Questionnaire (CSAQ) was administered, yielding 939 valid responses from internal medicine and surgical staff. Stepwise multiple linear regression analyses were conducted for each year to identify department-specific predictors and examine temporal variations in PSC influences on emotional exhaustion. Predictors of emotional exhaustion varied over time and between departments. During the early study period, organizational support factors-particularly job satisfaction and perceptions of management-were the strongest negative predictors. As the COVID-19 pandemic stabilized, stress recognition emerged as a consistent protective factor across multiple years. In surgical departments, teamwork climate showed a positive association with emotional exhaustion in certain periods, suggesting that intensive collaboration demands may increase emotional strain. Furthermore, discrepancies between perceived managerial support and actual working conditions indicated potential resource misalignment, especially within internal medicine settings. The relationship between PSC and emotional exhaustion is dynamic and context-dependent. These findings underscore the importance of phase-specific psychological support, improved alignment between task demands and organizational resources, and department-tailored interventions to enhance workforce well-being and support safer, higher-quality health care delivery.

Semantics

Original Article