Low Burnout among Intensive Care units?

We read with great interest the article of Vasconcelos et al. in a recent issue of the journal (1) .The authors performed a cross sectional study to analyze the existence of a relationship between burnout and depressive symptoms among intensive care unit nursing staff.They demonstrated that burnout was present in 14.29% of the nurses and 10.98% had symptoms of depression and concluded that nurses with burnout have a greater possibility of triggering depressive symptoms.The authors should be congratulated for performing a study in an important topic in nursing and medical practice (2)(3) .The need to identify specific workplace settings at risk for high burnout rates is an innovative concept that needs to be further explored (4)(5) .Although the study of Vasconcelos et al. was well designed and conducted, there are questions regarding the study that need to be clarified to confirm the author's findings.The authors reported a much lower rate of burnout than expected.We believe that the authors strict definition of burnout (high emotional exhaustion, high depersonalization and low personal accomplishment) was very strict and likely did not match the prior literature on nursing workforce.The authors did not provide any association with factors that have been commonly related to burnout (e.g., working hours, control over professional life).It would be important to elaborate why the rate of burnout in Brazilian nurses is much lower than previously reported in the world literature.Lastly, it would be important to exclude response bias by comparing respondents with non-respondents of the survey.We would welcome comments to address the aforementioned issues as they were not discussed by the authors as this would further validate the findings of this important study.