Motivation matters in the anesthesia workforce: intrinsic and extrinsic work motivation and burnout among anesthesia staff in Karbala, Iraq

Healthcare professionals in anesthesia and perioperative care face sustained occupational stress, yet little is known about how motivational orientation is associated with burnout vulnerability, particularly in conflict-affected, low-resource health systems. This study examined intrinsic and extrinsic work motivation in relation to personal, work-related, and client-related burnout among anesthesia staff in Karbala, Iraq, and tested whether motivational orientation explained variance beyond demographic and occupational characteristics. A cross-sectional design was employed. A convenience sample of 150 anesthesia staff was recruited from five public and teaching hospitals in Karbala, Iraq (September–December 2025). Participants completed Arabic versions of the Copenhagen Burnout Inventory (CBI) and Work Preference Inventory (WPI), alongside a demographic-occupational questionnaire. Hierarchical multiple regression analyses tested whether intrinsic and extrinsic motivation each explained incremental variance in burnout beyond covariates, and a combined model estimated their mutual (unique) contributions. Intrinsic motivation (M = 3.82, SD = 0.62) was negatively correlated with personal (ρ = −0.48), work-related (ρ = −0.19), and client-related burnout (ρ = −0.63). Extrinsic motivation (M = 3.23, SD = 0.61) was negatively correlated with personal (ρ = −0.31) and client-related burnout (ρ = −0.56) but not with work-related burnout (ρ = −0.11, p > 0.05); the two motivation scales were strongly intercorrelated (ρ = 0.84). After accounting for covariates, intrinsic motivation explained significant additional variance in personal (ΔR² = 0.209), work-related (ΔR² = 0.053), and client-related burnout (ΔR² = 0.416; all p < 0.01). Extrinsic motivation contributed significant incremental variance to personal and client-related burnout, though less strongly, and was not a significant predictor of work-related burnout ( p = 0.146). Demographic and occupational covariates accounted for minimal variance across all models. When both scales were entered together, intrinsic motivation remained a significant negative predictor of all three burnout dimensions, whereas extrinsic motivation became a significant positive predictor of personal and work-related burnout and was unrelated to client-related burnout (Table 3). In separate models, both intrinsic and extrinsic motivation, particularly intrinsic, were associated with lower burnout among anesthesia staff in a resource-constrained, conflict-affected setting (Karbala, Iraq). After mutual adjustment, only intrinsic motivation was consistently associated with lower burnout, whereas extrinsic motivation showed a positive association with personal and work-related burnout. Although the cross-sectional design precludes causal inference, these findings describe associations only, and longitudinal or interventional research is needed to determine whether strengthening motivation could contribute to staff well-being strategies in similarly high-pressure environments. Not applicable.