Li, Mengyao, Shu, Qianyi, Huang, Hao et al. · Journal of advanced nursing · 2020 · DOI
This study examined whether workplace stress, violence, and lack of organizational support increase the risk of ME/CFS in nurses. Researchers surveyed 1,080 Chinese nurses and found that those experiencing high levels of overcommitment, workplace violence, and little support from their employers were significantly more likely to have ME/CFS. The findings suggest that improving workplace safety, support, and reducing internal stress could help prevent ME/CFS in this high-risk group.
This is one of the first studies examining occupational risk factors for ME/CFS in nurses, a population with notably high prevalence. The findings highlight potentially modifiable workplace factors—violence reduction, organizational support, and stress management—that could inform prevention strategies. Understanding that internal psychological stress may be more impactful than external workload could shift institutional prevention approaches.
This cross-sectional design cannot establish causation; it is unknown whether workplace stress causes ME/CFS, whether early ME/CFS symptoms increase perceived stress, or whether unmeasured confounders explain the associations. The study is limited to Chinese nurses and may not generalize to other occupations, countries, or healthcare systems. The findings do not prove that workplace interventions would reduce ME/CFS incidence.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Li, Mengyao, Shu, Qianyi, Huang, Hao, Bo, Wen, Wang, Lulu, & Wu, Hui (2020). Associations of occupational stress, workplace violence, and organizational support on chronic fatigue syndrome among nurses.. Journal of advanced nursing. https://doi.org/10.1111/jan.14312
BibTeX
@article{mecfsatlas-li-2020-associations-occupational,
author = {Li, Mengyao and Shu, Qianyi and Huang, Hao and Bo, Wen and Wang, Lulu and Wu, Hui},
title = {Associations of occupational stress, workplace violence, and organizational support on chronic fatigue syndrome among nurses.},
journal = {Journal of advanced nursing},
year = {2020},
doi = {10.1111/jan.14312},
note = {PubMed: 32011012},
url = {https://www.mecfsatlas.com/evidence/li-2020-associations-occupational},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/li-2020-associations-occupational
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