Baseline Burnout and Coping Strategies among Nurses in Secondary Healthcare Centres of Garo Hills, Meghalaya, India: A Pre-intervention Cross-sectional Study

Introduction: Burnout among nurses is increasingly recognised as a critical workforce and public health issue, especially in geographically remote and resource-constrained healthcare settings. Empirical evidence describing burnout and coping patterns among nurses working in secondary-level facilities in tribal regions of Northeast India remains scarce. Aim: To assess baseline burnout levels, describe coping strategies, and compare coping patterns between nurses with moderate and high burnout in secondary healthcare centres in Garo Hills, Meghalaya, before the implementation of a burnout prevention and management programme. Materials and Methods: This pre-intervention cross-sectional study was conducted as the baseline assessment of a larger intervention study, prior to implementation of the burnout prevention and management programme, among nurses in 16 secondary-level healthcare Institutions, including district hospitals and Community Health Centres (CHCs), located across the Garo Hills region of Meghalaya, India, from 11th July 2023 to 19th August 2023. Data entry, cleaning, and analysis were carried out between September 2023 and October 2023. Participants were recruited through purposive sampling with Institutional facilitation. Burnout was measured using the Oldenburg Burnout Inventory (OLBI), while coping behaviours were assessed using the Brief Coping Orientation to Problems Experienced (BriefCOPE) inventory. Data were analysed using Jamovi version 2.7.14. Descriptive statistics were used to summarise burnout levels and coping strategies. Differences in coping patterns between nurses with moderate and high burnout were analysed using Mann-Whitney U tests with effect sizes. Results: Among 222 nurses, no participants met the criteria for low burnout. Of the total nurses, 170 (76.6%) had moderate burnout while 52 (23.4%) had high burnout. High exhaustion was more common 62 (27.9%) than high disengagement 15 (6.8%), indicating that exhaustion was the more prominent burnout dimension. Religion (median=6, IQR=3.0) and acceptance (median=6, IQR=2.0) were the most commonly used coping strategies, whereas substance use (median = 2, IQR=0.0) was the least used coping strategy. Comparison of coping strategies between moderate and high burnout groups revealed no statistically significant differences after Bonferroni correction for multiple comparisons. Conclusion: Moderate to high burnout was frequently observed among nurses in underserved secondary-level healthcare settings, with exhaustion emerging as the predominant dimension. The frequent use of adaptive coping strategies suggests existing strengths that can be reinforced through burnout prevention and management interventions. These findings provide context-specific baseline evidence to inform initiatives in resource-limited regions.