The Role of Formal Knowledge Management Practices in Reducing

Burnout Among Healthcare Professionals

Rita Marques

1,4 a

, Andreia Luís

1,4 b

, Liliana Martins

2,4 c

Gisela Cotrim

1,4 d

and Marta Correia Sampaio

3,4 e

CUF Hospital, Santarém, Portugal

Arco Ribeirinho Local Health Unit., Barreiro, Portugal

Cefage, Évora, Portugal

Polytechnic Institute of Santarém, School of Management and Technology, Santarém, Portugal

Keywords: Burnout, Knowledge Management, Healthcare Professionals, Formal Knowledge Management Practices.

Abstract: This study examines relationship between formal knowledge management practices and burnout among

Portuguese healthcare professionals. Drawing upon the Maslach Burnout Inventory Scale and an adapted

formal knowledge management practices scale, we examine the extent to which the adoption of structured

knowledge management strategies is associated with lower levels of emotional exhaustion, depersonalisation,

and reduced personal accomplishment. Our sample (N=218) reveals elevated burnout rates, with 39%

presenting high emotional exhaustion and 45.4% reporting low personal accomplishment. Statistical analysis

indicates that greater adoption of formal knowledge management practices correlates negatively with burnout,

particularly in preserving personal accomplishment (ρ=-0.320, p<0.001). The private sector demonstrates

higher formal knowledge management practices adoption rates than the public sector. Age and professional

experience influence burnout patterns, with younger and less experienced professionals displaying higher

rates. This study contributes to the literature by clarifying formal knowledge management practice’s

protective role in occupational well-being and suggests that organisational policy reforms promoting

knowledge sharing could mitigate burnout in healthcare contexts.

1 INTRODUCTION

Burnout is strongly associated with psychological

phenomena related to occupational stress, frequently

affecting healthcare professionals whose work is

centred on responding to the needs of others and

fostering healthy work environments (Khan, 2023).

The World Health Organization (2019) defines

burnout as the result of chronic workplace stress that

has not been successfully managed, expressed in

three dimensions: emotional exhaustion,

depersonalisation, and reduced personal

accomplishment. In Portugal, recent studies indicate

that between 32% and over 40% of healthcare

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https://orcid.org/0000-0003-0004-601X

professionals present elevated symptoms or are at risk

of burnout (Viana et al., 2022; Gonçalves &

Gaudêncio, 2023).

Knowledge is recognised as a strategic resource

within healthcare organisations, with Knowledge

Management (KM) positioned as a core

organisational capability that enables the capture,

distribution, and effective application of information

(Nonaka & Takeuchi, 1995; Davenport & Prusak,

1998). In healthcare, KM initiatives have been linked

to improvements in clinical decision-making, patient

safety, and staff engagement (Ayatollahi & Zeraatkar,

2020). Formal Knowledge Management Practices

(FKMP) comprise structured, policy-driven

approaches — including standardised protocols,

492

Marques, R., Luís, A., Martins, L., Cotrim, G. and Sampaio, M. C.

The Role of Formal Knowledge Management Practices in Reducing Burnout Among Healthcare Professionals.

DOI: 10.5220/0013777900004000

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 17th International Joint Conference on Knowledge Discovery, Knowledge Engineering and Knowledge Management (IC3K 2025) - Volume 2: KEOD and KMIS, pages

492-499

ISBN: 978-989-758-769-6; ISSN: 2184-3228

resource allocation frameworks, and formalised

information systems — designed to ensure the

consistent use of knowledge.

Despite a growing body of literature on the

organisational benefits of KM, empirical evidence

exploring its relationship with burnout remains

scarce, particularly within European healthcare

contexts. This study aims to address that gap by

assessing the impact of FKMP on burnout among

healthcare professionals and by comparing outcomes

across the public and private sectors. Three

hypotheses guide the analysis: (1) the adoption of

FKMP is associated with burnout levels; (2) age

influences both burnout levels and the adoption of

FKMP; and (3) professionals in the public sector

experience lower emotional exhaustion than those in

the private sector. The expected findings will

contribute to a deeper understanding of the role of

KM in mitigating burnout and provide actionable

strategies for people management in the health sector.

2 THEORETICAL FRAMEWORK

2.1 Burnout in Healthcare

Professionals

The term burnout is used to describe psychological

phenomena related to stress, observed in professions

focused on caring for others, such as healthcare,

which require interpersonal interactions and support

for the emotional needs of others (Maslach & Leiter,

2016 as cited in Lunn et al., 2025).

The increase in the prevalence of burnout affects

not only HCPs but also patient safety, as well as the

quality of care and the overall functionality of

healthcare systems (Hodkinson et al., 2022 as cited in

Koch et al., 2024). The daily contact of HCPs with

extreme situations of human life makes their work

physically and emotionally exhausting (Gil-Monte,

2005 as cited in Gago-Valiente et al., 2021). In 2024,

the Medscape National Physician Burnout and

Depression Report estimated a burnout rate for HCPs

of approximately 49%, suggesting much higher rates

than in the general population (Medscape National

Physician Burnout & Depression Report 2024, as

cited in Koch et al., 2024).

A widely adopted definition of burnout includes

the combination of three dimensions: emotional

exhaustion (inability to do or give more of oneself),

depersonalisation (which is reflected in professional

and personal relationships, making the individual

colder and more distant) and reduced personal

fulfilment (which leads to a loss of self-esteem and

motivation, with a consequent feeling of inadequacy

and failure) (Maslach et al., 2001 as cited in Lunn et

al., 2025; Back et al., 2016, Dréano-Hartz et al., 2016

as cited in Gonçalves & Gaudêncio, 2023).

2.2 Knowledge Management in

Healthcare

Knowledge can be understood as the intensive use of

information linked to innate and acquired human

abilities, enabling the perception, interpretation, and

understanding of data (Redha, 2016, as cited in

Gherrab & Benoussad, 2024). It is commonly

classified as explicit or tacit. Explicit knowledge

exists outside the human mind and can be transferred

through mechanisms such as document storage or

digital media (Nonaka & Takeuchi, 1995, as cited in

Bessick & Naicker, 2013). Tacit knowledge, by

contrast, is embedded in individuals, difficult to

verbalise, and cannot be fully captured, requiring

networks of experts for effective use (Bhardwaj &

Monin, 2006, as cited in Bessick & Naicker, 2013;

Alavi & Denford, 2012; Breznik, 2018; Duhon, 1998;

Grover & Davenport, 2001, as cited in Ayatollahi &

Zeraatkar, 2020). Its transfer relies on observation,

shared experiences, personal interaction, and trust

(Alwis & Hartmann, 2008; McAdam, Mason &

McCrory, 2007, as cited in Bessick & Naicker, 2013).

Knowledge Management (KM) structures the

classification, sharing, and application of knowledge,

recognising employees’ expertise as a strategic

resource for competitiveness (Bollinger & Smith,

2001; Bender & Fish, 2000, as cited in Bessick &

Naicker, 2013; Chen, 2012; Heidari, Moghimi &

Khanifar, 2013; Tabrizi & Morgan, 2014, as cited in

Ayatollahi & Zeraatkar, 2020). Healthcare

organisations, as particularly knowledge-intensive

entities, are central generators of knowledge

(Khalghania et al., 2013; Yaghobi et al., 2015, as

cited in Ayatollahi & Zeraatkar, 2020). Knowledge is

thus a key asset for value creation, competitiveness,

and overcoming challenges (Zeleny, 1989; Felton &

Finnie, 2003; Hosnavi & Ramezan, 2011, as cited in

Ayatollahi & Zeraatkar, 2020), underlining the

strategic importance of KM (Pablos-M’endez, 2005;

Salehi et al., 2015, as cited in Ayatollahi & Zeraatkar,

2020). Since its introduction in the healthcare sector

in the 21st century, KM has shown strong potential to

improve patient care and organisational outcomes by

converting information and intellectual assets into

lasting value (Guptill, 2005; Nicolini et al., 2008;

Rocha et al., 2012; Lee, Kim & Kim, 2014, as cited

in Ayatollahi & Zeraatkar, 2020). Evidence

demonstrates its contribution to patient safety,

The Role of Formal Knowledge Management Practices in Reducing Burnout Among Healthcare Professionals

493

optimised processes, cost reduction, and professional

development (Chen, 2012; Khalghania et al., 2013;

Deloitte, 2015, as cited in Ayatollahi & Zeraatkar,

2020), ultimately strengthening decision-making,

efficiency, satisfaction, and organisational

performance (Orzano et al., 2008, as cited in Kosklin

et al., 2023).

2.3 Formal Knowledge Management

Practices (FKMP)

FKMP are deliberate, structured activities embedded

into organisational processes—such as documented

standard operating procedures, centralised

knowledge repositories, regular formal training, and

policy-driven knowledge dissemination (Värk &

Reino, 2020). Their objective is to benefit the

organisation in facing various challenges and are

carried out with the organisation's means and

resources (rooms, furniture, computer systems,

computers, etc.)” (Värk & Reino, 2020, p. 6).

Riege (2005) emphasises some barriers to

knowledge sharing in organisations, including

individual barriers (age and gender differences),

diversity in educational levels, lack of trust and lack

of recognition of intellectual property, organisational

barriers such as ineffective leadership, reluctance to

use computer systems, and lack of communication.

FKMP aim to ensure consistent and equitable

access to information, which can improve

coordination and reduce uncertainty in clinical

practice.

2.4 FKMP and Burnout: Theoretical

Linkages

The Job Demands–Resources (JD-R) model (Bakker

& Demerouti, 2017) posits that organisational

resources can buffer the impact of job demands on

burnout. FKMP, by enhancing information flow and

reducing ambiguity, can serve as

Data collection used two previously validated

self-response scales applied in Portugal, both based

on Likert-type items. Burnout was measured with the

Portuguese version of the Maslach Burnout Inventory

(MBI), which assesses emotional exhaustion (EE),

depersonalisation (DP), and personal

accomplishment (PA) on a 7-point scale ranging from

“Never” (0) to “Every day” (6). Formal Knowledge

Management Practices (FKMP) were measured using

an adapted dimension of Pais’ (2014) KM scale,

consisting of 22 items rated on a 5-point scale from

“Almost never” (1) to “Almost always” (5). Internal

consistency was confirmed with Cronbach’s α values

above 0.70. The broader KM construct is subdivided

into four dimensions: FKMP, informal practices,

cultural orientation, and competitive orientation

towards knowledge (Koo & Yang, 2025).

2.5 Data Analysis

Statistical analyses were performed in SPSS v30.

Descriptive statistics characterised the sample.

Associations between categorical variables were

tested using Chi-square or Fisher's Exact Test, with

Cramer's V for effect size. Spearman's rank

correlation was used for ordinal associations.

Significance threshold was p<0.05.

3 RESULTS

3.1 Sociodemographic Characteristics

Regarding the characteristics of the 218 participants in

this study, most participants are female (82.11%).

44.04% of respondents are nurses, followed by 25.23%

who are Senior Diagnostic and Therapeutic

Technicians (DTT), with a bachelor's degree being the

most common level of education (45.87%). In the

Greater Lisbon area, Setúbal Peninsula, West and

Tagus Valley, 61.47% of respondents are located, with

the public sector standing out with the highest number

of responses (59.17%).

3.2 Burnout Levels

According to Maslach et al. (1996, as cited in Ribas,

2010), the MBI subscales are classified into low,

medium, and high levels for emotional exhaustion

(EE), depersonalisation (DP), and personal

accomplishment (PA). Based on this framework, the

study revealed high prevalence of burnout, with 39%

of professionals scoring high on EE, 27.1% on DP,

and 45.4% on PA, the latter being the most

concerning dimension. Statistical analyses using chi-

square (χ²), Fisher’s Exact Test (FET), Cramer’s V,

and Spearman’s coefficient (Nihan, 2020; Zhao et al.,

2021; Akoglu, 2018) identified significant

associations between burnout and sociodemographic

variables. Age was significantly associated with DP

(FET=15.461; p=0.011) and PA (χ²=16.357;

p=0.008), with older professionals reporting lower

depersonalisation (4.6%) and greater personal

accomplishment (9.6%). Professional category was

also strongly linked to burnout (EE χ²=14.244;

p=0.026; DP χ²=12.710; p=0.047; PA χ²=13.289;

p=0.038), with nurses consistently showing higher

KMIS 2025 - 17th International Conference on Knowledge Management and Information Systems

494

Table 1: Association between burnout dimensions and sociodemographic variables.

Variable MBI Dimension Test / Value Cramer’s V p-value

e MBI-DP FET = 15.461 0.193 0.011

e MBI-PA

² = 16.357 0.210 0.008

Professional cate

MBI-EE

² = 14.244 0.181 0.026

Professional cate

MBI-DP

² = 12.710 0.171 0.047

Professional cate

MBI-PA

² = 13.289 0.175 0.038

Education level MBI-PA FET = 16.350 0.225 0.052*

Years of professional

erience

MBI-DP χ² = 18.724 0.207 0.016

burnout, particularly in DP (55.2% vs. physicians at

10.2%).

Education level showed a marginal but notable

association with PA (FET=16.350; p=0.052;

V=0.225), as professionals with higher education

reported greater burnout (postgraduate 48.5% vs.

elementary/secondary 2.0%). Years of practice were

associated with DP (χ²=18.72; p=0.016; V=0.207),

with more experienced professionals (≥20 years)

showing lower depersonalisation compared with

those with 1–5 years. These results suggest that

professional maturity may buffer burnout, while

higher qualifications may increase vulnerability,

possibly due to workload and responsibility.

Overall, burnout was shaped by age, profession,

education, and experience, with nurses and younger

staff particularly vulnerable, while older and more

experienced professionals reported greater

accomplishment, indicating resilience-building over

time. However, higher education correlated with

greater burnout, underscoring the need for

organisational strategies to better support highly

qualified staff. In this context, Knowledge

Management (KM), and specifically Formal

Knowledge Management Practices (FKMP), emerges

as a valuable organisational tool to mitigate burnout.

Structured knowledge-sharing systems, continuous

training, and expert networks can reduce emotional

exhaustion, strengthen professional identity, and

enhance accomplishment. Previous studies confirm

KM’s role in improving decision-making, patient

safety, and staff engagement (Ayatollahi & Zeraatkar,

2020), all of which are linked to job satisfaction and

well-being. Thus, integrating FKMP within healthcare

organisations may function not only as an efficiency

mechanism but also as a strategic intervention to

address burnout, supporting evidence-based people

management policies in the health sector.

3.3 Formal Knowledge Management

Practices Adoption

There were no statistically significant associations

between FKMP and sociodemographic characteristics

in the sample under study, with the exception of the

sector of professional activity (1=Private; 2=Public),

which is associated with FKMP, as the 𝒳

test shows

(𝒳

=8.719; p-value=0.013). Cramer's V corroborates

the association and defines it as strong (0.200). The

frequencies obtained show that HCPs in the public

sector report less involvement in FKMP when

compared to professionals in the private sector (42.3%

against 57.7%).

Table 2: Association between FKMP and socio-

demographic variables.

FKMP

𝒳

FET Cramer's V

Gende

0.134

- -

p-value

0.971

7.257

p-value

0.268

Professional cate

5.075

- -

p-value

0.541

Level of education

17.160

p-value

0.400

Years of professional

erience

5.788

p-value

0.678

Region

5.612

p-value

0.684

Secto

Public

8.719

0.200

Private

p-value

0.013

The Role of Formal Knowledge Management Practices in Reducing Burnout Among Healthcare Professionals

495

3.4 Formal Knowledge Management

Practices and Burnout

Spearman’s correlations revealed negative

associations between FKMP and all burnout

dimensions (see table 3). The MBI-EE shows a

moderate positive correlation with the MBI-DP

(ρ=0.466; p-value<0.001) and a weak positive

correlation with the MBI-PA (ρ=0.277; p-

value<0.001), indicating that higher levels of burnout

tend to be associated with greater depersonalization

and lower personal accomplishment.

Regarding FKMP, there were significant negative

correlations with all the dimensions of the MBI. The

strongest correlation occurs with the MBI-PA (ρ=-

0.320; p-value<0.001), suggesting that the presence

of FKMP is associated with higher levels of personal

fulfillment. There were also negative correlations

with the MBI-EE (ρ=-0.249; p-value<0.001) and the

MBI-DP (ρ=-0.145; p-value=0.032), although these

were less evident.

These results suggest that the presence of FKMP

can play a protective role against burnout, especially

in terms of preserving personal fulfillment in

professional practice.

Table 3: Correlation between the dimensions of the MBI

and FKMP.

MBI-EE MBI-DP MBI-PA FKMP

MBI-EE

Spearman 1 0.466 0.277 -0.249

p-value <0.001 <0.001 <0.001

MBI-DP

earman 0.466 1 0.294 -0.145

-value <0.001 <0.001 0.032

MBI-PA

earman 0.277 0.294 1 -0.320

-value <0.001 <0.001

<0.001

FKMP

Spearman -0.249 -0.145 -0.320 1

p-value <0.001 0.032 <0.001

3.5 Hypothesis Testing

H1 was supported: higher FKMP adoption correlated

with lower burnout levels. H2 was partially

supported: age was associated with DP and PA but not

with FKMP adoption. H3 was not supported: public

sector HCPs did not exhibit lower emotional

exhaustion compared to private sector counterparts.

4 DISCUSSION

The research revealed concerning levels of burnout

among healthcare professionals (HCPs). High

emotional exhaustion (39%) and low personal

fulfillment (45.4%) suggest shortcomings in working

conditions and in formal knowledge-sharing

strategies that could mitigate burnout (Värk & Reino,

2020; Kosklin et al., 2023). Although

depersonalisation was less prevalent (27.1%), it still

requires attention. Romão et al. (2025) emphasise

personal development and social support as protective

factors, while integrated KM models combining

technology and collaboration can enhance staff well-

being and service quality (Guptill, 2005; Nicolini et

al., 2008; Rocha et al., 2012; Lee, Kim & Kim, 2014,

as cited in Ayatollahi & Zeraatkar, 2020). Analysis of

sociodemographic variables (Table 1) confirmed

significant associations with burnout. Age was

inversely related, with younger professionals more

vulnerable, consistent with previous studies (Santos,

2015; Marôco et al., 2016; Costa et al., 2020; Veloso,

2020; Vindegaard & Benros, 2020, as cited in

Oliveira, 2022). Professional category was also

significant, with nurses showing higher burnout

across all MBI dimensions, echoing evidence that

nurses are more susceptible than other HCPs (Vidotti

et al., 2018, as cited in Lazo et al., 2021). Burnout

compromises staff well-being and care quality, with

impacts on patients and families (West et al., 2018, as

cited in Ribeiro et al., 2023; Lazo et al., 2021).

Education level also showed an association with

burnout, in line with Maslach et al. (2001) and Maslach

& Leiter (2016, as cited in Cavalcante, 2022), who

reported higher burnout among more educated

professionals. Years of experience were also relevant:

professionals with 16–20 years of practice reported

higher burnout, consistent with Mendonça (2020), who

noted that older employees often experience greater

burnout. These findings suggest that both early- and

mid-career professionals are at risk: younger staff due

to lack of resilience, and more experienced staff due to

cumulative strain. Results on FKMP (Table 2) indicate

that organisational context influences adoption more

strongly than sociodemographic factors. In the private

sector, KM is implemented to promote growth and

profit, while in the public sector it is focused on service

quality and effectiveness (Batista, 2012, as cited in

Passos, 2021). However, public institutions often retain

a culture of “non-sharing” of knowledge, reinforcing

hierarchical structures (Batista, 2006, as cited in

Passos, 2021). A shift from “knowledge is power” to

“sharing knowledge is power” is needed (Passos, 2021,

as cited in Trindade, 2023).

KMIS 2025 - 17th International Conference on Knowledge Management and Information Systems

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The three burnout dimensions were correlated:

emotional exhaustion was linked to depersonalisation

and reduced accomplishment, while depersonalisation

was associated with low fulfillment. Associations

between burnout and FKMP showed that higher

burnout (EE, DP, PA) corresponded with lower

involvement in FKMP. This aligns with Parayitam et

al. (2021), who argue that emotional exhaustion harms

organisational performance, but that knowledge

sharing mitigates depersonalisation and strengthens

productivity. KM, through active sharing of

information and experiences, enhances professional

fulfillment by reinforcing competence and contribution

to organisational goals. However, exclusive focus on

FKMP may be limiting, as informal practices also

foster flexibility, creativity, and intrinsic motivation,

complementing formal systems (Värk & Reino, 2020).

Regarding hypotheses, results showed partial

confirmation. Hypothesis 1 was supported: FKMP

had a protective effect against burnout, with

significant correlations across all dimensions,

strongest with personal fulfillment, corroborating

Kosklin et al. (2023), Khan (2023), and Parayitam et

al. (2021). Hypothesis 2 was partially validated: age

was associated with depersonalisation and personal

accomplishment, confirming lower burnout among

older professionals (Santos, 2015; Marôco et al.,

2016; Costa et al., 2020; Veloso, 2020; Vindegaard &

Benros, 2020, as cited in Oliveira, 2022), though age

did not influence FKMP adoption. Hypothesis 3 was

not supported: contrary to expectations, public-sector

professionals did not show less emotional exhaustion.

Instead, private-sector staff were more engaged in

protective practices, reflecting differences in

organisational culture (Batista, 2006, 2012; Trindade,

2023, as cited in Passos, 2021).

Overall, this study confirms that burnout among

HCPs is shaped by sociodemographic and

organisational factors. Nurses and younger

professionals are especially vulnerable, while higher

education and mid-career experience also increase

risk. Organisational culture strongly influences KM

adoption, with private institutions more advanced

than public ones in implementing FKMP.

Importantly, higher burnout is associated with lower

KM engagement, suggesting a vicious cycle where

stress reduces resilience and inhibits knowledge

sharing. To break this cycle, healthcare organisations

must promote both formal and informal KM

practices, embedding knowledge-sharing cultures

that enhance professional well-being, improve patient

care, and strengthen organisational performance.

5 CONCLUSIONS

The aim of this research was to analyse the role of the

FKMP in reducing burnout among HCPs in Portugal.

The results show considerable levels of burnout in the

sample under study, with a special focus on high

emotional exhaustion and low personal fulfilment.

Although depersonalization is less worrying, it needs

attention, as it reflects the emotional detachment that

is detrimental to the therapeutic relationship with the

patient.

The results indicate that the organizational context

has a greater impact on the adoption of FKMP than

sociodemographic variables. In the private sector,

KM is driven by competitiveness, innovation and

profitability objectives, favoured by a results-oriented

organizational culture and knowledge sharing. In

contrast, the public sector faces cultural barriers, such

as information retention, which hinders the effective

adoption of KM. It is therefore essential to promote a

cultural change that values collaboration and shared

knowledge, a fundamental condition for the success

of KM in public organizations.

Based on the data obtained, future research will be

needed to more comprehensively explore the link

between FKMP and its impact on burnout levels. It

would also be pertinent to develop longitudinal

studies that can assess causal relationships and test the

effectiveness of specific interventions, such as the

implementation of digital knowledge-sharing

platforms.

To sum up, this research contributes to the

understanding of how FKMP influence burnout

among Portuguese HCPs. High burnout prevalence

was observed, with FKMP adoption inversely related

to burnout dimensions, especially personal

accomplishment. Organisational context, more than

demographic factors, appears to drive FKMP

implementation.

Limitations include the cross-sectional design,

non-probabilistic sampling, and reliance on self-

reported measures, which restrict causal inference

and generalisability. Future studies should adopt

longitudinal designs, incorporate informal KM

practices, and examine intervention efficacy in both

public and private sectors.

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