Resident behaviors and characteristics as determinants of quality of residential care: an observational study

The effects of resident behaviors and resident characteristics on the quantity and quality of care they receive from direct-care staff was examined. Four hundred and fifty-two residents with severe and profound mental retardation and 416 direct care staff members were involved. Naturalistic observations were conducted on direct-care staff behavior, that is, staff-resident initiatives, staff affection, staff communicative behavior, on resident behaviors (i.e., maladaptive, stereotypic, and adaptive behavior, position, attending, and communicative behavior), and on resident characteristics (i.e., gender, age, ambulancy, sensory handicaps, and seizure disorder). By importance, residents' ambulancy/motoric skills, their communicative behavior, and attending behavior accounted for the greatest differences in the quality and quantity of the care they receive from direct-care staff. Given that certain resident characteristics can be ameliorated through training, residents themselves may control, to a certain extent, the care they receive from direct-care staff in residential facilities.     

Role conflict and burnout: The direct and moderating effects of political skill and perceived organizational support on burnout dimensions.

Drawing from previous research on the effect of role conflict on burnout and the Conservation of Resources theory, the authors propose that individual differences in political skill and perceptions of organizational support will be negatively related to burnout and will also moderate the relationship between perceived role conflict and burnout. In a sample of 120 professional employees, political skill was associated with less depersonalization and feelings of reduced personal accomplishment and moderated the role conflict-reduced personal accomplishment relationship. Perceived organizational support was associated with less emotional exhaustion and depersonalization and moderated the role conflict-emotional exhaustion relationship. Implications of results are discussed and directions for future research are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding stress and burnout in shelter workers.

Crisis intervention workers and other front-line mental health workers often face excessive stress and seek psychotherapy or supervision and support from professional psychologists. The authors sought information on job-related stressors, coping mechanisms, and burnout levels and found that shelter workers who reported high job-related stress and low social support may be most vulnerable to experiencing burnout symptoms. Psychologists providing clinical or consultation services to domestic violence shelter staff should emphasize the importance of creating a supportive work environment, developing a sense of personal accomplishment related to one's work, and teaching and modeling helpful coping strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spousal support and changes in distress over time in couples coping with cancer: The role of personal control.

This longitudinal study has examined the associations between perceived supportive and unsupportive spousal behavior and changes in distress in couples coping with cancer. We tested whether people relatively low in their sense of personal control were more responsive to spousal supportive and unsupportive behavior than were people relatively high in personal control. Patients with colorectal cancer and their partners (n = 70) completed questionnaires at two assessment points: 3 (at baseline) and 9 months (at follow-up) after the diagnosis. We assessed perceived spousal supportive (SSL) and unsupportive (SSL-N) behavior, sense of personal control (Pearlin & Schooler's Mastery), and depressive symptoms (CES-D) in both patients and partners. Multilevel analysis (MLwiN) was used to examine changes in distress over time in a dyadic context. Patients and partners who perceived more spousal support reported less distress over time, but this only applied to those relatively low in personal control. Moreover, partners who perceived more unsupportive spousal behavior reported more distress, again only if they were relatively low in personal control. Patients and partners relatively high in personal control reported relatively low levels of distress, regardless of spousal behavior. In conclusion, people relatively low in personal control may be more adversely affected by unsupportive behavior and benefit more from supportive behavior than people relatively high in personal control. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Organizational and individual factors influencing job satisfaction and burnout of mental health workers

Job satisfaction and burnout are important areas of study because of the financial and social effects of job satisfaction and the damaging physical/psychological impacts of burnout. Two hundred family/children and psychiatric workers of seven social service organizations were surveyed. Instruments used were the Minnesota Satisfaction Questionnaire, the Maslach Burnout Inventory, and the Staff Burnout Scale for Health Professionals. Reported levels of job satisfaction and burnout are within normal limits. Psychiatric and family/children workers report equal job satisfaction levels, but the latter group reports significantly higher burnout levels. Both groups are particularly satisfied with the amount of praise delivered by supervisors and are reportedly dissatisfied with salary levels and promotional opportunities. These three factors are strongly associated with job satisfaction and burnout levels of both groups. Findings have practical implications for social service administrators and practitioners. Correlates of satisfaction and burnout can be altered in order to maintain employee satisfaction and reduce burnout, absenteeism and turnover.     

Abl protein kinase abrogates the response of multipotent haemopoietic cells to the growth inhibitor macrophage inflammatory protein-1 alpha

OBJECTIVE: This study compared the mental health and cognitive development of 9- to 12-year-old Eritrean war orphans living in two orphanages that differed qualitatively in patterns of staff interaction and styles of child care management. METHOD: The directors and several child care workers at each institution were asked to complete staff organization and child management questionnaires. The psychological state of 40 orphans at each institution was evaluated by comparing their behavioral symptoms and performance on cognitive measures. RESULTS: Orphans who lived in a setting where the entire staff participated in decisions affecting the children, and where the children were encouraged to become self-reliant through personal interactions with staff members, showed significantly fewer behavioral symptoms of emotional distress than orphans who lived in a setting where the director made decisions, daily routines were determined by explicit rules and schedules, and interactions between staff members and the children were impersonal. CONCLUSIONS: When orphanages are the only means of survival for war orphans, a group setting where the staff shares in the responsibilities of child management, is sensitive to the individuality of the children, and establishes stable personal ties with the children serves the emotional needs and psychological development of the orphans more effectively than a group setting that attempts to create a secure environment through an authoritative style of management with explicit rules and well-defined schedules.     

Stigma among the stigmatized: Resident mobility, communication ability, and physical appearance as predictors of staff–resident interaction.

Two studies investigated the relation between 3 types of resident stigma and staff–resident interaction in a training center for the mentally retarded. Ss were 50 residents (median age 9 yrs) classified as moderately to severely retarded. In Study 1, using the results of questionnaires administered to the staff, it was found that resident communication ability and physical appearance were significant predictors of approval interactions, and resident mobility was the only significant predictor of disapproval interactions. In Study 2, using systematic observation of staff–resident interactions, it was found that resident mobility was the only predictor of the resident-initiated neutral and disapproval interactions, whereas resident mobility, communication ability, and physical appearance were significant predictors of staff-initiated approval and disapproval interactions. Possible causal paths underlying the obtained relations between resident stigma and staff-resident interaction are discussed. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward an understanding of the burnout phenomenon.

Tested 9 hypotheses about the burnout phenomenon, defined as a 3-component syndrome of emotional exhaustion, depersonalization, and feelings of low personal accomplishment. Burnout was hypothesized to be associated with unmet employee expectations and job conditions. Hypothesized consequences of burnout included (a) preferred job type, (b) subsequent thoughts about leaving, (c) job-search behaviors, (d) training received, (e) intentions to leave, and (f) voluntary leaving. Elementary and secondary school teachers (median age 36 yrs) responded to 2 questionnaires mailed to their homes; 1 yr elapsed between completion of the 2 questionnaires. Regression analyses of time-lagged data (N?=?248) supported many of the hypothesized correlates of employee burnout. It is suggested that improved conceptualizations about the burnout phenomenon are needed. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Time Management Behavior as a Moderator for the Job Demand-Control Interaction.

The interaction effects of time management, work demands, and autonomy on burnout were investigated in a survey study of 123 elementary teachers. A 3-way interaction between time management, work demands, and autonomy was hypothesized: The combination of high work demands and low autonomy was predicted to lead to burnout for teachers low in time management and not, or to a lesser extent, for those high in time management. This hypothesis is confirmed for emotional exhaustion, the most predictive dimension of teacher burnout, and partly confirmed for the personal accomplishment dimension. Generalizability to other contactual occupations is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Burnout and inequity among human service professionals: A longitudinal study.

In a composite sample of human service professionals (N?=?245), longitudinal relations across 1 year were tested between equity in the professional–recipient relationship and burnout (i.e., emotional exhaustion, depersonalization, and reduced personal accomplishment). The 1st research question was whether inequity influenced burnout across time. The 2nd research question was whether longitudinal relations between equity and burnout were curvilinear, as predicted by equity theory. The results confirmed that inequity affects the central component of burnout (i.e., emotional exhaustion) and that this relation is curvilinear. Feeling more deprived and feeling more advantaged resulted in higher future emotional exhaustion levels. No indication was found for a longitudinal relation between inequity and depersonalization. A synchronous relation was found suggesting that personal accomplishment influences equity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Customer-Related Social Stressors and Burnout.

Although almost all literature on burnout implicitly assumes that burnout is primarily caused by stressful employee-customer interactions, only a few studies have addressed this empirically. A principal-components analysis of a newly developed instrument assessing various forms of customer-related social stressors (CSS) in 3 different service jobs (N = 591) revealed 4 themes of CSS: disproportionate customer expectations, customer verbal aggression, disliked customers, and ambiguous customer expectations. These 4 CSS predict burnout beyond a variety of control variables. Contrary to other predictors of burnout analyzed in previous studies, the amount of variance explained in exhaustion (14%) by the 4 CSS scales is not higher than for personal accomplishment (14%) and is considerably lower than for depersonalization (23%). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"“Sources of social support and burnout: A meta-analytic test of the conservation of resources model”: Correction.

Reports an error in "Sources of social support and burnout: A meta-analytic test of the conservation of resources model" by Jonathon R. B. Halbesleben (Journal of Applied Psychology, 2006[Sep], Vol 91[5], 1134-1145). There were errors in transcribing the ρ values from Table 2 to the results section. In the second paragraph of page 1138, the second and third sentences should read “In the present study, work-related support was more strongly related to exhaustion (ρ = -.26) than depersonalization (ρ = -.23) and personal accomplishment (ρ = .24; F(2, 111) = 24.13, p > .01). On the other hand, non-work support was more strongly related to depersonalization (ρ = -.16) and personal accomplishment (ρ = .19) than exhaustion (ρ = -.12; F(2, 38) = 3.83, p > .05).” The values in Table 2 are correct and the substantive conclusions have not changed. (The following abstract of the original article appeared in record 2006-11397-012.) The Conservation of Resources (COR) model of burnout (Hobfoll & Freedy, 1993) suggests that resources are differentially related to burnout dimensions. In this paper, I provide a meta-analysis of the social support and burnout literature, finding that social support, as a resource, did not yield different relationships across the 3 burnout dimensions (emotional exhaustion, depersonalization, and personal accomplishment), challenging the COR model. However, when considering the source of the social support (work vs. nonwork) as a moderator, I found that work-related sources of social support, because of their more direct relationship to work demands, were more closely associated with exhaustion than depersonalization or personal accomplishment; the opposite pattern was found with nonwork sources of support. I discuss the implications of this finding in relation to the COR model and suggest future research directions to clarify the relationship between resources and burnout dimensions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Staff perceptions of emotional distress in paitents with burn trauma.

Objective: To compare staff and patient perceptions of patients' emotional distress after acute burn trauma. Design: Staff ratings of patients' psychological states on 6 dimensions of emotional functioning were compared with patient self-report. Results: Staff as a whole and by discipline tended to overestimate depression and underestimate optimism in patients. Moreover, the more experienced (more than 2 years of burn care experience) nurses and occupational/physical therapists were less accurate in estimating depression and optimism than their less experienced counterparts. Conclusion: Consistent with results from spinal cord injury research, findings from the current study indicate a distinct tendency on the part of burn care staff to overestimate their patients' emotional distress and underestimate their positive outlook, supporting the notion that staff may be imposing a "requirement for mourning" on their patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implementing individualized counseling programs: Staff perceptions of important activities.

Staff perceptions of activities that may facilitate implementation of individualized counseling programs (ICPs) were surveyed. The activities are named Discussing the ICP, Understanding Concerns, Reinforcing Others' Contributions, Adapting the ICP, Building Positive Expectations, Learning About Obstacles, and Evaluating Implementation and Outcomes (DURABLE). Ninety staff members at a residential facility providing short-term counseling services for children and adolescents with behavior problems were asked to (a) rate the relative importance of each DURABLE activity for facilitating ICP implementation, (b) rate their involvement in each activity, and (c) list any additional activities believed to be important in facilitating ICP implementation. Each DURABLE activity was perceived by respondents to be more than moderately important in facilitating ICP implementation. Of the seven DURABLE activities, Discussing the ICP was perceived to be most important, whereas Building Positive Expectations and Reinforcing Others' Contributions were rated as least important. Two other activities also reported as important in facilitating ICP implementation were (a) developing and maintaining effective communication among staff members, and (b) involving the child in ICP development and implementation. Implications of the results for practitioners and directions for research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sources of social support and burnout: A meta-analytic test of the conservation of resources model.

[Correction Notice: An erratum for this article was reported in Vol 96(1) of Journal of Applied Psychology (see record 2010-24169-001). There were errors in transcribing the ρ values from Table 2 to the results section. In the second paragraph of page 1138, the second and third sentences should read “In the present study, work-related support was more strongly related to exhaustion (ρ = -.26) than depersonalization (ρ = -.23) and personal accomplishment (ρ = .24; F(2, 111) = 24.13, p > .01). On the other hand, non-work support was more strongly related to depersonalization (ρ = .16) and personal accomplishment (ρ = .19) than exhaustion (ρ = -.12; F(2, 38) = 3.83, p > .05).” The values in Table 2 are correct and the substantive conclusions have not changed.] [Correction Notice: An erratum for this article was reported in of Journal of Applied Psychology (see record 2010-24169-001). There were errors in transcribing the ρ values from Table 2 to the results section. In the second paragraph of page 1138, the second and third sentences should read “In the present study, work-related support was more strongly related to exhaustion (ρ = -.26) than depersonalization (ρ = -.23) and personal accomplishment (ρ = .24; F(2, 111) = 24.13, p > .01). On the other hand, non-work support was more strongly related to depersonalization (ρ = -.16) and personal accomplishment (ρ = .19) than exhaustion (ρ = -.12; F(2, 38) = 3.83, p > .05).” The values in Table 2 are correct and the substantive conclusions have not changed.] The Conservation of Resources (COR) model of burnout (Hobfoll & Freedy, 1993) suggests that resources are differentially related to burnout dimensions. In this paper, I provide a meta-analysis of the social support and burnout literature, finding that social support, as a resource, did not yield different relationships across the 3 burnout dimensions (emotional exhaustion, depersonalization, and personal accomplishment), challenging the COR model. However, when considering the source of the social support (work vs. nonwork) as a moderator, I found that work-related sources of social support, because of their more direct relationship to work demands, were more closely associated with exhaustion than depersonalization or personal accomplishment; the opposite pattern was found with nonwork sources of support. I discuss the implications of this finding in relation to the COR model and suggest future research directions to clarify the relationship between resources and burnout dimensions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Antecedents and consequences of three dimensions of burnout in psychotherapists: A meta-analysis.

The present study aimed to identify the antecedents of burnout and its consequences for psychotherapists. The meta-analysis showed that, among antecedents, the over-involvement variable had the most significant positive correlation with emotional exhaustion, while the control variable had the most significant negative correlations with depersonalization and personal accomplishment. On the other hand, among consequences, the job satisfaction variable had the most significant positive correlations with emotional exhaustion, depersonalization, and personal accomplishment. Based on these results, we found resources that can assist with developing burnout prevention interventions for psychotherapists. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Examining a stress-coping model of burnout and depression in extension agents.

Occupational stressors, coping strategies, and burnout and depression were examined in extension agents. Results indicated that a significant proportion of extension agents (range?=?9.8%–51%) reported burnout symptoms above established cut-off scores for the burnout subscales, but fewer than 3% of the sample reported significant symptoms on all 3 dimensions of burnout. Depressive symptoms based on established cut-off scores were noted in approximately 26% of the sample. Stepwise multiple regression indicated that extension agents who used an emotion-oriented coping strategy were more likely to (a) display high levels of depression, emotional exhaustion, and depersonalization and (b) exhibit low levels of personal accomplishment. Furthermore, task-oriented coping strategies were found to be negatively associated with the 3 dimensions of burnout. Implications for interventional programming to reduce the symptoms of burnout are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Direct and interaction effects among the dimensions of the Maslach Burnout Inventory: Results from two German longitudinal samples.

Inspired by the idea that the three dimensions of the Maslach Burnout Inventory (emotional exhaustion, depersonalization, and personal accomplishment) are causally related to each other, five models have been proposed in the literature to explain the main processes of burnout development. Latest empirical findings based on model comparisons suggest that emotional exhaustion exerts positive lagged effects on depersonalization and that depersonalization conceptualized as a coping strategy in turn leads to exhaustion and a low sense of personal accomplishment. The present study offers a more thorough test of various models of burnout development with longitudinal data from two German samples (total N = 643). The analyses, based on structural equation modeling, showed that exhaustion is longitudinally associated with depersonalization and that accomplishment is longitudinally predicted by depersonalization and exhaustion. Furthermore, and going beyond prior research, three moderator effects of depersonalization were identified in predicting all three burnout dimensions at a later point in time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Focal damage to cochlear microcirculation measured using a non-contact laser blood flowmeter in guinea pigs

OBJECTIVE: The purpose of this study was to investigate the perceptions of community staff regarding service process and quality, while a public mental health service integrated acute inpatient and continuing care components. METHODS: The study employed a naturalistic successive measures design in which community mental health staff completed a questionnaire on three occasions during the integration process. RESULTS: Staff perceived overall service quality to improve during the integration process with continuity of care being the area subject to greatest improvement. CONCLUSIONS: The integration of acute inpatient and continuing care services resulted in changes to service process and outcome, which were judged by staff to be beneficial, especially with respect to continuity of patient care.