Occupational Burnout and the Protective Role of Sports Viewing Among Male ICU Physicians in China: A Nationwide Survey on Influencing Factors and Pathways

Background Occupational burnout is highly prevalent among physicians working in intensive care units (ICUs), with male clinicians being a particularly vulnerable yet understudied subgroup. However, the evidence base for investigating modifiable, non-stigmatizing protective factors against burnout—such as specific leisure-time activities—remains weak. This national study seeks to quantify the protective effect of sports spectating behavior against burnout and to elucidate the influencing factors and psychological pathways involved, thereby providing an evidence base for developing accessible mental health promotion strategies. Methods A nationwide cross-sectional survey was conducted among 1,002 male ICU physicians in China between April and October 2025. Independent risk and protective factors for burnout were identified using multivariable logistic regression. The associations of these factors with burnout severity and its distinct dimensions (Emotional Exhaustion-EE, Depersonalization-DP, and Personal Accomplishment-PA), as well as population heterogeneity, were further analyzed using ordinal logistic regression and stratified multiple linear regression models. Results Multivariable analysis identified key risk (attending title: OR = 1.64; long hours: OR = 1.31; Eastern region: OR = 2.56) and protective factors (viewing 3-5h/week: OR = 0.23; preferring football/basketball: OR = 0.59–0.65). Their graded impact on severity was confirmed by ordinal regression. Stratified by dimension, EE and DP were workload-driven, while PA was sensitive to title and region; regular viewing consistently protected all dimensions. Subgroups showed attending physicians' burnout was moderated by viewing, whereas regular viewers' burnout was driven by occupational stressors. Conclusions Regular sports viewing is an effective, dose-dependent protective factor against ICU physician burnout, with dimension-specificity. Interventions should thus be universally promoted (3–5 h/week team sports viewing) yet precisely targeted: stress-reduction for high-risk subgroups (high-title, Eastern region) and dimension-specific strategies based on individual profiles.