<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE root>
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" article-type="research-article" dtd-version="1.1d1" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher">REMEDIUM</journal-id><journal-title-group><journal-title>REMEDIUM</journal-title></journal-title-group><issn publication-format="print">1561-5936</issn><issn publication-format="electronic">2658-3534</issn><publisher><publisher-name>Joint-Stock Company Chicot</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">1807</article-id><article-id pub-id-type="doi">10.32687/1561-5936-2025-29-3-326-332</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>On ways to overcome professional burnout and “quiet dismissal” among mid-level medical workers</article-title></title-group><contrib-group><contrib contrib-type="author"><name name-style="western"><surname>Mingazova</surname><given-names>Elmira Nurislamovna</given-names></name><bio></bio><email>elmira_mingazova@mail.ru</email><xref ref-type="aff" rid="aff-1"/><xref ref-type="aff" rid="aff-2"/><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author"><name name-style="western"><surname>Bezymyannyy</surname><given-names>Alexey Sergeevich</given-names></name><bio></bio><email>bezymyannyyas@zdrav.mos.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author"><name name-style="western"><surname>Mingazov</surname><given-names>Rustem Nailevich</given-names></name><bio></bio><email>mrn85@mail.ru</email><xref ref-type="aff" rid="aff-1"/><xref ref-type="aff" rid="aff-5"/></contrib></contrib-group><aff id="aff-1">Russian Medical Academy of Continuous Professional Education, Moscow, Russia</aff><aff id="aff-2">N. A. Semashko National Research Institute of Public Health, Moscow, Russia</aff><aff id="aff-3">Kazan State Medical University, Kazan, Russia</aff><aff id="aff-4">Diagnostic Clinical Center No. 1 of the Moscow Healthcare Department, Moscow, Russia</aff><aff id="aff-5">Research Institute for Healthcare and Medical Management of Moscow Healthcare Department, Moscow, Russia</aff><pub-date date-type="epub" iso-8601-date="2025-12-15" publication-format="electronic"><day>15</day><month>12</month><year>2025</year></pub-date><issue>3</issue><fpage>326</fpage><lpage>332</lpage><history><pub-date date-type="received" iso-8601-date="2025-10-17"><day>17</day><month>10</month><year>2025</year></pub-date></history><permissions><copyright-statement>Copyright © 2025,</copyright-statement><copyright-year>2025</copyright-year></permissions><abstract>Recently, there has been an increase in cases of so-called «quiet dismissal» among medical workers in various countries, which is manifested in a deliberate decrease in work activity, distancing from work processes and a lack of desire for initiative in professional activities. Professional burnout and «quiet dismissal» are determined not only by a set of personal factors reflected in job dissatisfaction and the desire to quit, but also by objective systemic problems, including imperfect work organization, lack of qualified personnel and insufficient attention of the management of the medical organization to the psychological well-being of employees. An effective solution to these problems is based on an integrated approach combining traditional methods of improving working conditions and organizing the activities of a medical organization, as well as extensive use of the latest achievements in the field of high technology and artificial intelligence. The introduction of intelligent workflow management systems, automation of routine tasks, the development of personalized training and professional development programs, as well as monitoring the psycho-emotional state of employees can significantly reduce the burden on medical personnel and improve the quality of medical care. Modern technologies make it possible to create adaptive personnel management models that take into account the individual characteristics of each employee, which helps reduce the risk of developing burnout syndrome, the phenomenon of «quiet dismissal» and increase motivation to work.</abstract><kwd-group xml:lang="en"><kwd>professional burnout, quiet dismissal, mid-level medical workers, nurses, staff turnover, work environment, adaptive models, personnel management</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>профессиональное выгорание, тихое увольнение, медицинские работники среднего звена, медицинские сестры, текучесть кадров, рабочая среда, адаптивные модели, управление персоналом</kwd></kwd-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Rotenstein L. S., Brown R., Sinsky C., Linzer M. The Association of Work Overload with Burnout and Intent to Leave the Job Across the Healthcare Workforce During COVID-19. J Gen Intern Med. 2023;38(8):1920—1927. DOI: 10.1007/s11606-023-08153-z</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Angel Y, Fire G. Healthcare policy changes in an era of health workforce shortage. Isr J Health Policy Res. 2023;12(1):28. DOI: 10.1186/s13584-023-00576-7</mixed-citation></ref><ref id="B3"><label>3.</label><mixed-citation>Maniscalco L., Enea M., de Vries N., Mazzucco W., Boone A., Lavreysen O., Baranski K., Miceli S., Savatteri A., Fruscione S., Kowalska M., de Winter P., Szemik S., Godderis L., Matranga D. Intention to leave, depersonalisation and job satisfaction in physicians and nurses: a cross-sectional study in Europe. Sci Rep. 2024;14(1):2312. DOI: 10.1038/s41598-024-52887-7</mixed-citation></ref><ref id="B4"><label>4.</label><mixed-citation>Muir K. J., Porat-Dahlerbruch J., Nikpour J., Leep-Lazar K., Lasater K. B. Top Factors in Nurses Ending Health Care Employment Between 2018 and 2021. JAMA Netw Open. 2024;7(4):e244121. DOI: 10.1001/jamanetworkopen.2024.4121</mixed-citation></ref><ref id="B5"><label>5.</label><mixed-citation>Kang J., Kim H., Cho O. H. Quiet quitting among healthcare professionals in hospital environments: a concept analysis and scoping review protocol. BMJ Open. 2023;13(11). DOI: 10.1136/bmjopen-2023-077811</mixed-citation></ref><ref id="B6"><label>6.</label><mixed-citation>Galanis P., Katsiroumpa A., Vraka I., Siskou O., Konstantakopoulou O., Moisoglou I., Gallos P., Kaitelidou D. The quiet quitting scale: Development and initial validation. AIMS Public Health. 2023;10(4):828—848. DOI: 10.3934/publichealth.2023055</mixed-citation></ref><ref id="B7"><label>7.</label><mixed-citation>Boy Y., Sürmeli M. Quiet quitting: A significant risk for global healthcare. J Glob Health. 2023;13:03014. DOI: 10.7189/jogh.13.03014</mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation>Galanis P., Moisoglou I., Malliarou M., Papathanasiou I. V., Katsiroumpa A., Vraka I., Siskou O., Konstantakopoulou O., Kaitelidou D. Quiet Quitting among Nurses Increases Their Turnover Intention: Evidence from Greece in the Post-COVID-19 Era. Healthcare (Basel). 2023;12(1). DOI: 10.3390/healthcare12010079</mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation>Karadas A., Çevik C. Psychometric analysis of the quiet quitting and quiet firing scale among Turkish healthcare professionals. J Eval Clin Pract. 2024;1—9. DOI: 10.1111/jep.14136</mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation>Moisoglou I., Katsiroumpa A., Malliarou M., Papathanasiou I. V., Gallos P., Galanis P. Social Support and Resilience Are Protective Factors against COVID-19 Pandemic Burnout and Job Burnout among Nurses in the Post-COVID-19 Era. Healthcare (Basel). 2024;12(7). DOI: 10.3390/healthcare12070710</mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation>Nash C. The Health Narratives Research Group (HeNReG): A self-direction process offered to help decrease burnout in public health nurse practitioners. AIMS Public Health. 2024;11(1):176—208. DOI: 10.3934/publichealth.2024009</mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation>Shumba A. T., Montanaro T., Sergi I., Fachechi L., De Vittorio M., Patrono L. Leveraging IoT-Aware Technologies and AI Techniques for Real-Time Critical Healthcare Applications. Sensors (Basel). 2022;22(19). DOI: 10.3390/s22197675</mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation>Falebita O. S., Kok, P. J. Strategic goals for artificial intelligence integration among STEM academics and undergraduates in African higher education: a systematic review. Discov Educ. 2024;3. DOI: 10.1007/s44217-024-00252-1</mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation>Jeyaraman M., Balaji S., Jeyaraman N., Yadav S. Unraveling the Ethical Enigma: Artificial Intelligence in Healthcare. Cureus. 2023;15(8):e43262. DOI: 10.7759/cureus.43262</mixed-citation></ref><ref id="B15"><label>15.</label><mixed-citation>Yu I. C., Guo J. M. The Generative Artificial Intelligence Revolution in Nursing: A New Chapter in Enhancing Care Quality and Education. Hu Li Za Zhi. 2024;71(2):12—19. DOI: 10.6224/JN.202404_71(2).03</mixed-citation></ref><ref id="B16"><label>16.</label><mixed-citation>Kumar D., Ingole A., Choudhari S. G. Towards Ideal Health Ecosystem With Artificial Intelligence-Driven Medical Services in India: An Overview. Cureus. 2023;15(11). DOI: 10.7759/cureus.48482</mixed-citation></ref><ref id="B17"><label>17.</label><mixed-citation>Hasan H. E., Jaber D., Khabour O. F., Alzoubi K. H. Ethical considerations and concerns in the implementation of AI in pharmacy practice: a cross-sectional study. BMC Med Ethics. 2024;25(1). DOI: 10.1186/s12910-024-01062-8</mixed-citation></ref><ref id="B18"><label>18.</label><mixed-citation>Barr-Walker J. Evidence-based information needs of public health workers: a systematized review. J Med Libr Assoc. 2017;105(1):69—79. DOI: 10.5195/jmla.2017.109</mixed-citation></ref><ref id="B19"><label>19.</label><mixed-citation>Koivunen K., Kaakinen P., Päätalo K., Mattila O., Oikarinen A., Jansson M., Mikkonen K., Pölkki T., Meriläinen M., Kääriäinen M., Holopainen A., Tuomikoski A. M., Kanste O. Frontline nurse leaders&amp;apos; competences in evidence-based healthcare: A scoping review. J Adv Nurs. 2024;80(4):1314—1334. DOI: 10.1111/jan.15920</mixed-citation></ref><ref id="B20"><label>20.</label><mixed-citation>MarsVogt A., Reeve J., Lyness E., Reilly J. Future doctors as knowledge workers. Br J Gen Pract. 2022;72(715):73. DOI: 10.3399/bjgp22X718397</mixed-citation></ref><ref id="B21"><label>21.</label><mixed-citation>Health literacy WHO. Available at: https://www.who.int/ru/newsroom/fact-sheets/detail/health-literacy</mixed-citation></ref><ref id="B22"><label>22.</label><mixed-citation>Ciasullo M. V., Carli M., Lim W. M., Palumbo R. An open innovation approach to co-produce scientific knowledge: an examination of citizen science in the healthcare ecosystem. European Journal of Innovation Management. 2022;25(6):365—392. DOI: 10.1108/EJIM-02-2021-0109</mixed-citation></ref><ref id="B23"><label>23.</label><mixed-citation>Aguilar-Ferrándiz M. E., Toledano-Moreno S., Casas-Barragán A., Albornoz-Cabello M., Tapia-Haro R. M., Correa-Rodríguez M. Implementation of a coaching training for enhancing empathy and emotional intelligence skills in health science students: a prospective study. BMC Med Educ. 2024;24(1). DOI: 10.1186/s12909-024-05076-z</mixed-citation></ref><ref id="B24"><label>24.</label><mixed-citation>Altmann T., Roth M. The risk of empathy: longitudinal associations between empathy and burnout. Psychology &amp;amp; Health. 2020;36(12):1441—1460. DOI: 10.1080/08870446.2020.1838521</mixed-citation></ref><ref id="B25"><label>25.</label><mixed-citation>Galanis P., Katsiroumpa A., Moisoglou I., Kalogeropoulou M., Gallos P., Vraka I. Emotional intelligence protects nurses against quiet quitting, turnover intention, and job burnout. AIMS Public Health. 2024;11(2):601—613. DOI: 10.3934/publichealth.2024030</mixed-citation></ref><ref id="B26"><label>26.</label><mixed-citation>Baranauskas M., Kalpokas M., Kupčiūnaitė I., Lieponienė J., Stukas R. Self-Perceived Stress in Association with Emotional Experiences Following Patient Death and Coping Adequacy among Clinical Nurses in Lithuania: A Cross-Sectional Study. J Clin Med. 2024;13(9). DOI: 10.3390/jcm13092533</mixed-citation></ref><ref id="B27"><label>27.</label><mixed-citation>Galanis P., Moisoglou I., Katsiroumpa A., Malliarou M., Vraka I., Gallos P., Kalogeropoulou M., Papathanasiou I. V. Impact of Workplace Bullying on Quiet Quitting in Nurses: The Mediating Effect of Coping Strategies. Healthcare (Basel). 2024;12(7). DOI: 10.3390/healthcare12070797</mixed-citation></ref><ref id="B28"><label>28.</label><mixed-citation>Akyurt G., Dogan S. The Assessment of Cynicism and Burnout Syndrome Among Nurses; A Descriptive Study. Medical Science and Discovery. 2023;10(10):918—928. DOI: 10.36472/msd.v10i10.1084</mixed-citation></ref><ref id="B29"><label>29.</label><mixed-citation>Villarante D. M., O&amp;apos;Donoghue S. C., Medeiros M., Milton E., Walsh K., O&amp;apos;Donoghue A. L., Celi L. A., Hayes M. M., Dilibero J. A National Survey of Stress and Burnout in Critical Care Nurses: A Prepandemic Study. Dimens Crit Care Nurs. 2023;42(5):248—254. DOI: 10.1097/DCC.0000000000000598</mixed-citation></ref><ref id="B30"><label>30.</label><mixed-citation>Yeh T-F., Chang Y-C., Hsu Y-H., Huang L-L., Yang C-C. Causes of nursing staff burnout: Exploring the effects of emotional exhaustion, work—family conflict, and supervisor support. Jpn J Nurs Sci. 2021;18. DOI: 10.1111/jjns.12392</mixed-citation></ref><ref id="B31"><label>31.</label><mixed-citation>Luo D., Song Y., Cai X., Li R., Bai Y., Chen B., Liu, Y. Nurse managers&amp;apos; burnout and organizational support: The serial mediating role of leadership and resilience. Journal of Nursing Management. 2022;30(8):4251—4261. DOI: 10.1111/jonm.13852</mixed-citation></ref><ref id="B32"><label>32.</label><mixed-citation>Al Sabei S. D., Labrague L. J., Al-Rawajfah O., Abualrub R., Burney I. A., Jayapal S. K. Relationship between interprofessional teamwork and nurses&amp;apos; intent to leave work: the mediating role of job satisfaction and burnout. Nurs Forum. 2022;57:568—576. DOI: 10.1111/nuf.12706</mixed-citation></ref><ref id="B33"><label>33.</label><mixed-citation>Lee E., De Gagne J. C., Randall P. S., Kim H., Tuttle B. Effectiveness of speak-up training programs for clinical nurses: A scoping review. Int J Nurs Stud. 2022;136. DOI: 10.1016/j.ijnurstu.2022.104375</mixed-citation></ref><ref id="B34"><label>34.</label><mixed-citation>Wanko Keutchafo E. L., Kerr J., Baloyi O. B., Duma S. E. Conditions Influencing Effective Nurse Nonverbal Communication With Hospitalized Older Adults in Cameroon. Glob Qual Nurs Res. 2022;9. DOI: 10.1177/23333936221098751</mixed-citation></ref><ref id="B35"><label>35.</label><mixed-citation>Amini K., Miyanaji H., Din Mohamadi M. Bullying and burnout in critical care nurses: A cross-sectional descriptive study. Nurs Crit Care. 2023;28(2):202—210. DOI: 10.1111/nicc.12744</mixed-citation></ref><ref id="B36"><label>36.</label><mixed-citation>Bezymyannyy A. S., Mingazova E. N. Features of the prevalence of professional burnout among medical workers of different specialties. Problems of social hygiene, health care and history of medicine. 2024;32(2):180—186. (In Russ.). DOI: 10.32687/0869-866X-2024-32-2-180-186</mixed-citation></ref><ref id="B37"><label>37.</label><mixed-citation>Kamau S., Koskenranta M., Isakov T. M., Kuivila H., Oikarainen A., Tomietto M., Mikkonen K. Culturally and linguistically diverse registered nurses&amp;apos; experiences of integration into nursing workforce — A qualitative descriptive study. Nurse Educ Today. 2023;121. DOI: 10.1016/j.nedt.2022.105700</mixed-citation></ref><ref id="B38"><label>38.</label><mixed-citation>Montejo L., Fenton A., Davis G. Artificial intelligence (AI) applications in healthcare and considerations for nursing education. Nurse Educ Pract. 2024;80:104158. DOI: 10.1016/j.nepr.2024.104158</mixed-citation></ref><ref id="B39"><label>39.</label><mixed-citation>Catapano P., Cipolla S., Sampogna G., Perris F., Luciano M., Catapano F., Fiorillo A. Organizational and Individual Interventions for Managing Work-Related Stress in Healthcare Professionals: A Systematic Review. Medicina (Kaunas). 2023;59(10). DOI: 10.3390/medicina59101866</mixed-citation></ref><ref id="B40"><label>40.</label><mixed-citation>Bezymyannyy A. S., Mingazova E. N. Features of the prevalence of professional burnout among medical workers of different specialties. Remedium. 2024;28(1):69—74 (In Russ.). DOI: 10.32687/1561-5936-2024-28-1-69-74</mixed-citation></ref><ref id="B41"><label>41.</label><mixed-citation>Bezymyannyy A. S., Mingazov R. N., Mingazova E. N. International questionnaires on professional burnout, Russian experience of their adaptation in a survey of medical workers. Health Care Manager. 2024;2:93—100. (In Russ.). DOI: 10.21045/1811-0185-2024-3-93-100</mixed-citation></ref><ref id="B42"><label>42.</label><mixed-citation>Yildirim N., Yesilbas H., Kantek F. Interventions to reduce nurses&amp;apos; burnout: A systematic review and meta-analysis. Japan Journal of Nursing Science. 2023;20(4). DOI: 10.1111/jjns.12542</mixed-citation></ref><ref id="B43"><label>43.</label><mixed-citation>Bezymyannyy A. S., Mingazov R. N., Mingazova E. N. On the impact of the COVID-19 pandemic and post-pandemic stress on the burnout of medical workers. Remedium. 2024;28(4):427—433. (In Russ.). DOI: 10.32687/1561-5936-2024-28-4-427-433</mixed-citation></ref><ref id="B44"><label>44.</label><mixed-citation>Alzailai N., Barriball K. L., Xyrichis, A. Impact of and mitigation measures for burnout in frontline healthcare workers during disasters: A mixed-method systematic review. Worldviews on Evidence-Based Nursing. 2023;20:133—141. DOI: 10.1111/wvn.12633</mixed-citation></ref><ref id="B45"><label>45.</label><mixed-citation>Bezymyannyy A. S., Mingazova E. N. Technologies for the prevention of professional burnout and maintenance of the resource status of personnel in the primary level of Moscow healthcare. Health Care Manager. 2024;(6):80—86. (In Russ.). DOI: 10.21045/1811-0185-2024-6-80-86</mixed-citation></ref></ref-list></back></article>
