Occupational burnout and the protective role of sports viewing among male ICU physicians in China: a nationwide survey on influencing factors and pathways

Occupational burnout is highly prevalent among physicians working in intensive care units (ICUs), with male clinicians being a particularly vulnerable yet understudied subgroup. However, the evidence base for investigating modifiable, non-stigmatizing protective factors against burnout—such as specific leisure-time activities—remains weak. This national study seeks to quantify the protective effect of sports spectating behavior against burnout and to elucidate the influencing factors and psychological pathways involved, thereby providing an evidence base for developing accessible mental health promotion strategies. A nationwide cross-sectional survey was conducted among 1,002 male ICU physicians in China between April and October 2025. Independent risk and protective factors for burnout were identified using multivariable logistic regression. The associations of these factors with burnout severity and its distinct dimensions (Emotional Exhaustion-EE, Depersonalization-DP, and Personal Accomplishment-PA), as well as population heterogeneity, were further analyzed using ordinal logistic regression and stratified multiple linear regression models. Multivariable logistic regression was performed to identify independent factors associated with burnout after adjusting for potential confounders. The results, visually summarized in a forest plot, identified attending physician title (OR = 1.643, 95% CI: 1.103–2.447) and increased average weekly working hours (OR = 1.307, 95% CI: 1.127–1.515) as significant risk factors. In contrast, several protective factors were identified, including working in central (OR = 0.391, 95% CI: 0.244–0.626), western (OR = 0.579, 95% CI: 0.357–0.940), or northeastern China (OR = 0.233, 95% CI: 0.137–0.396) compared to the eastern region. Regarding leisure behavior, watching sports for 3–5 h per week (OR = 0.230, 95% CI: 0.157–0.337) and a preference for football (OR = 0.587, 95% CI: 0.428–0.807) or basketball (OR = 0.650, 95% CI: 0.476–0.886) emerged as significant independent protective factors against burnout. Regular sports viewing is an effective, dose-dependent protective factor against ICU physician burnout, with dimension-specificity. Interventions should thus be universally promoted (3–5 h/week team sports viewing) yet precisely targeted: stress-reduction for high-risk subgroups (high-title, Eastern region) and dimension-specific strategies based on individual profiles.