Burnout as a clinical entity--its importance in health care workers

Burnout, viewed as the exhaustion of physical or emotional strength as a result of prolonged stress or frustration, was added to the mental health lexicon in the 1970s, and has been detected in a wide variety of health care providers. A study of 600 American workers indicated that burnout resulted in lowered production, and increases in absenteeism, health care costs, and personnel turnover. Many employees are vulnerable, particularly as the American job scene changes through industrial downsizing, corporate buyouts and mergers, and lengthened work time. Burnout produces both physical and behavioural changes, in some instances leading to chemical abuse. The health professionals at risk include physicians, nurses, social workers, dentists, care providers in oncology and AIDS-patient care personnel, emergency service staff members, mental health workers, and speech and language pathologists, among others. Early identification of this emotional slippage is needed to prevent the depersonalization of the provider-patient relationship. Prevention and treatment are essentially parallel efforts, including greater job control by the individual worker, group meetings, better up-and-down communication, more recognition of individual worth, job redesign, flexible work hours, full orientation to job requirements, available employee assistance programmes, and adjuvant activity. Burnout is a health care professional's occupational disease which must be recognized early and treated.     

Burnout among school psychologists: An exploratory investigation into its nature, extent, and correlates.

Studied 139 school psychologists who completed a survey that included the Maslach Burnout Inventory, a stress inventory, demographic questions, and questions designed to assess their job satisfaction, ideal caseloads, and intent to leave the profession. The results suggested that symptoms of burnout occur frequently among Ss, particularly feelings of emotional exhaustion and reduced personal accomplishment. Demographic factors related modestly to burnout, whereas job-related stressors (lack of resources, interpersonal conflict, crisis cases) related more substantially to burnout. Burnout was also related to Ss' perceptions of their caseloads, overall job satisfaction, supervision satisfaction, and the desire to leave the profession. Also, Ss reported using burnout coping methods that may not adequately address its antecedents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Burnout and coping in human service practitioners.

Do many Spanish human service practitioners suffer from burnout? What coping strategies are used to combat work stress, and are they associated with lower burnout? Which strategies may the psychologist promote to improve organizations? With an eye toward helping organizations improve their workers' quality of work life and service delivery, 211 professionals, either child protection workers or in-home caregivers, completed an inventory on coping and another on burnout. Coping strategies alone do not preclude burnout but may help prevent worker turnover. High job and salary satisfaction, together with active coping strategies play an important role in promoting personal accomplishment. Low job and salary satisfaction and the use of passive or emotional strategies predict elevated emotional exhaustion. The results suggest some possible points of intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping with job stress and burnout in the human services.

Conducted a mail survey of 141 human service workers (aged 25–65 yrs) to investigate the effects of coping on psychological strain and burnout produced by job stress. The survey assessed job stressors and coping strategies with open-ended questions and measured strain using closed-ended alienation, satisfaction, and symptom scales. Because previous research suggested that individual coping responses do not alleviate strain produced by job stress, the survey elicited information on group coping (social support) and on coping strategies initiated by agencies. Job stress was associated with high levels of strain, and group coping with low levels, but individual responses had little effect. Although Ss identified many strategies that agencies could use to reduce stress and strain, actual use of such strategies was slight. Because men and women worked in the same jobs, no sex differences in individual coping were predicted and none were found; women, however, reported more social support than men. There was no evidence for moderating (interaction) effects of stress and coping on strain. Results suggest that social service agencies should take actions to reduce stress among employees. (57 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationships of job and family involvement, family social support, and work–family conflict with job and life satisfaction.

A model of the relationship between work and family that incorporates variables from both the work-family conflict and social support literatures was developed and empirically tested. This model related bidirectional work-family conflict, family instrumental and emotional social support, and job and family involvement to job and life satisfaction. Data came from 163 workers who were living with at least 1 family member. Results suggested that relationships between work and family can have an important effect on job and life satisfaction and that the level of involvement the worker assigns to work and family roles is associated with this relationship. The results also suggested that the relationship between work and family can be simultaneously characterized by conflict and support. Higher levels of work interfering with family predicted lower levels of family emotional and instrumental support. Higher levels of family emotional and instrumental support were associated with lower levels of family interfering with work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of production control in the development of burnout

Burnout is an increasingly important problem in modern work organizations. Few studies, however, have explicitly applied an adequate theoretical understanding of the performance of modern organizations. This article aims to initiate both a discussion of this phenomenon and higher-quality research into the emergence of burnout based on an understanding of the economic-technological rationalization and control (management control) of production and service processes. In applying production control, both technical and bureaucratic, group and attitudinal control systems are increasingly integrated. This so-called systematic control strategy is one of the major causes of burnout. The cumulative effect of an increasing workload combined with reduced resources due to economic considerations and technocratic implementation of production control is assumed to be relevant to the development of burnout. The authors' propositions apply to service workers in human service organizations and to key workers in enterprises using flexible specialization combined with self-directed work groups.     

Burnout and professional decision making: An analogue study.

Investigated the relationship between burnout and casework decision making among 70 child protection service workers using the Maslach Burnout Inventory and two simulated protection investigations in which information was acquired incrementally. For each case, Ss decided whether the stimulus child was at risk, whether the family was capable of change, and whether they would initiate legal proceedings on the child's behalf. Among those workers who decided there was no risk to the child in a case of chronic neglect, higher burnout scores predicted making this decision early and holding it with great and unwavering certainty. The findings extend the previous literature relating burnout to work avoidance by suggesting that burned-out personnel cope by denying the need for involvement in particularly demanding cases. Results are interpreted in terms of I. L. Janis and L. Mann's (1977) theory of defensive avoidance in stressful decision making. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sources of social support and burnout, job satisfaction, and productivity.

Social support has been identified as an important correlate of a variety of work outcomes. Support from different sources, including family, coworkers, and supervisors, was examined in 211 traffic enforcement agents (92 men, 119 women). Outcomes included subjective variables (burnout and job satisfaction) and an objective measure of productivity (number of summonses). Support was negatively associated with burnout and positively associated with satisfaction and productivity. A cluster of support variables accounted for 7% of the variance in burnout and productivity and 12% of the variance in job satisfaction. Family support was more closely associated with burnout than with satisfaction or productivity, whereas immediate supervisor support was related to satisfaction and productivity but not burnout. Results suggest that support may be associated with work-related outcomes through multiple pathways. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The job demands-resources model of burnout.

The job demands-resources (JD-R) model proposes that working conditions can be categorized into 2 broad categories, job demands and job resources, that are differentially related to specific outcomes. A series of LISREL analyses using self-reports as well as observer ratings of the working conditions provided strong evidence for the JD-R model: Job demands are primarily related to the exhaustion component of burnout, whereas (lack of) job resources are primarily related to disengagement. Highly similar patterns were observed in each of 3 occupational groups: human services, industry, and transport (total N?=?374). In addition, results confirmed the 2-factor structure (exhaustion and disengagement) of a new burnout instrument—the Oldenburg Burnout Inventory—and suggested that this structure is essentially invariant across occupational groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of a respite from work on burnout: Vacation relief and fade-out.

In a quasi-experiment designed to examine the relief from job stress and burnout afforded by a vacation respite, 76 clerks completed measures of job stress and burnout twice before a vacation, once during vacation, and twice after vacation. There was a decline in burnout during the vacation and a return to prevacation levels by the time of the second postvacation measure. Comparing the two prevacation measures indicated no anticipation effects. However the return to work showed gradual fade-out, as burnout returned part way toward its prevacation level by 3 days after the vacation and all the way by 3 weeks after the vacation. Women and those satisfied with their vacations experienced greater relief; however, both subsamples also experienced the quickest fade-out. The respite effect and its complete fade-out were detected among all subgroups analyzed. Burnout, relief, interpersonal stress crossover, and burnout climate at work are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of the construct validity of two burnout measures in two groups of professionals.

The authors studied certain aspects of the construct validity of the Maslach Burnout Inventory-General Survey (MBI-GS), the most popular measure of burnout, and that of the Shirom-Melamed Burnout Measure (SMBM). These burnout measures were compared with respect to their psychometric characteristics and factorial validity in two groups of professionals, human service and other professionals (N=196 and 226, respectively), who completed questionnaires at work. As hypothesized, the confirmatory factor analyses supported a two-factor and a three-factor structure invariance across the two groups considered for the SMBM and the MBI-GS, respectively, with superior fit found for the SMBM. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of open tibial fracture with Ender nail

This study was designed to examine the burnout symptoms among nurses in different settings, differing by specialty, age, gender, number of years on the job, and place of work, in the People's Republic of China. A total of 1,100 nurses completed the Maslach Burnout Inventory. Burnout symptoms in nurses were related to setting, specialty, age, gender, place of work, and number of years on the job. The findings suggest that the physical features in clinics and in obstetrics and gynecology departments should be improved and that social and public health support systems, as well as stress management skills, should be offered to new nurses in order to improve their ability to cope with stress and to improve the quality of care for patients.     

Job stress, social support, and burnout among counseling center staff.

We investigated the effects of stressful job experiences and social support on burnout among counseling center staff. A national sample of 169 doctoral-level staff completed a survey of job stress and social support; social support was assessed as provided by network members and as perceived by respondent. Multiple regression analyses revealed that higher amounts of job stress were associated with higher levels of burnout. Social support from supervisors and colleagues was associated with lower levels of burnout but did not serve a buffering function. We conclude that job demands need to be evaluated in terms of implications for the person who received certain forms of social support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Core Self-Evaluations and Job Burnout: The Test of Alternative Models.

Research on job burnout has traditionally focused on contextual antecedent conditions, although a theoretically appropriate conception implicates person-environment relationships. The authors tested several models featuring various combinations of personal and contextual influences on burnout and job satisfaction. Measures of core self-evaluations, organizational constraints, burnout, and job satisfaction were collected from 859 health care employees. Results from structural equations modeling analyses revealed an influence of core self-evaluations and perceived organizational constraints on job burnout and satisfaction, suggesting personal and contextual contributions. These results favor a broadening of current thinking about the impact of situational constraints on the expression of job burnout, as well as for the role of disposition for affective responding to effectively address occupational health problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recovery, Health, and Job Performance: Effects of Weekend Experiences.

This study extended research on respites by examining the extent to which experiences during the weekend contribute to health and job performance after the weekend. Longitudinal data including 3 measurement occasions from 87 emergency service workers indicated that nonwork hassles, absence of positive work reflection, and low social activity during the weekend predicted burnout and poor general well-being after the weekend. Weekend experiences also predicted different aspects of job performance after the weekend. The results reveal practical implications for individual and organizational optimization of recovery processes. Suggestions for future research on specific recovery processes and their effects on individual health and performance are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does being in the military affect nurses' perceptions of work life?

This study was a causal comparative investigation of military and civilian nurses' perceptions of selected aspects of work life. The Work Environment Scale, the Maslach Burnout Inventory and the Michigan Job Satisfaction Scale were administered to civilian and military samples matched on selected demographic variables. MANOVA procedures failed to reveal significant differences on measures of burnout and morale. Although military nurses were significantly more satisfied with issues of pay and fringe benefits, civilian nurses reported significantly greater job satisfaction, peer cohesion, supervisory support, decision making, autonomy, task orientation and opportunity to be innovative. These findings and suggested changes are discussed with attention to differences between the military and civilian work setting.     

Emotional Labor Demands and Compensating Wage Differentials.

The concept of emotional labor demands and their effects on workers has received considerable attention in recent years, with most studies concentrating on stress, burnout, satisfaction, or other affective outcomes. This study extends the literature by examining the relationship between emotional labor demands and wages at the occupational level. Theories describing the expected effects of job demands and working conditions on wages are described. Results suggest that higher levels of emotional labor demands are associated with lower wage rates for jobs low in cognitive demands and with higher wage rates for jobs high in cognitive demands. Implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some factors influencing income aspiration.

For two industrial groups (N = 534, 269), the relationships among age, length of service, total earnings, satisfaction with earnings, and earnings aspirations and expectations were studied. For the groups of Indian workers studied, it was found that job satisfaction was highly related to income expectation, and that expectations are related to earnings. Income aspirations also were related to skill level and educational level. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Symptoms of professional burnout: A review of the empirical evidence.

Reviews empirical literature, 1974–1984, concerning symptoms of burnout among human service professionals. Symptoms of burnout are grouped into 5 categories: physical, emotional, behavioral, interpersonal, and attitudinal. It is concluded that burnout is associated with poor physical health; depression; job turnover and unproductive work behaviors; problematic interpersonal relations; and negative attitudes, especially with regard to job satisfaction. Problems with research include lack of operational definition, defects in instruments, and impressionistic findings. Future needs include further exploration of content, attention to interactive effects, and alternative methodologies. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)