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PubMed2005

Burnout, role conflict, job satisfaction and psychosocial health among Hungarian health care staff: a questionnaire survey.

BACKGROUND: There is a growing interest in the psychosocial work environment of health care staff since they are at high risk for burnout, role conflict and job dissatisfaction. Burnout, as a type of prolonged response to chronic job-related stressors, has a special significance in health care where staff experience both psychological-emotional and physical stress. Burnout and the other negative aspects of the job of health care staff have major behavioural and health implications. OBJECTIVES: The present study investigated the interrelationships among burnout, role conflict and job satisfaction in a sample of Hungarian health care staff. The study also investigated how these indicators of psychosocial work climate influence respondents' frequency of psychosomatic symptoms. DESIGN: A questionnaire survey (anonymous questionnaires) has been carried out to detect these interrelationships. SETTINGS: Two major hospitals in Szeged, Hungary. PARTICIPANTS: Questionnaires were distributed to 450 health care staff among whom 55.7% were registered nurses. All together, 201 questionnaires were returned and analyzed, giving a response rate of 44.6%. METHODS: Questionnaire contained items on work and health-related information (i.e., burnout, job satisfaction, role conflict, and psychosomatic symptoms) and on some basic sociodemographics. Beyond descriptive statistics, correlation and multiple regression analyses were computed. RESULTS: Findings show that emotional exhaustion and depersonalization scores were higher, while scores on personal accomplishment was lower as compared to Canadian, Norwegian or US samples. Burnout, particularly emotional exhaustion (p<.001), was found to be strongly related to job dissatisfaction. Schooling was inversely related to satisfaction with the job (p<.05). While job satisfaction was a negative predictor of each type of burnout subscale (p<.001), role conflict was a factor contributing positively to emotional exhaustion (p<.001) and depersonalization scores (p<.001). CONCLUSIONS: The study results underline the importance of the role of psychosocial work environment and the interrelationships among burnout, role conflict, job satisfaction and psychosomatic health among Hungarian health care staff.

Adult↗
PubMedDate not supplied

The dissociative experiences of borderline patients.

The study objective was to assess the severity and quality of dissociative experiences reported by borderline patients. Two hundred ninety criteria-defined borderline patients and 72 axis II controls completed the Dissociative Experiences Scale (DES), a 28-item self-report measure with demonstrated reliability and validity. Thirty-two percent of borderline patients had a low level of dissociation, 42% a moderate level, and 26% a high level similar to that reported by patients meeting criteria for posttraumatic stress disorder (PTSD) or dissociative disorders. The controls had a significantly different distribution of overall DES scores: 71% reported a low level of dissociation, 26% reported a moderate level, and only 3% reported a high level. In addition, borderline patients had a significantly higher score than the controls on 21 of 28 DES items and a significantly higher overall DES score, as well as the score on the 3 factors that have been found to underlie the DES, absorption, amnesia, and depersonalization. The results of this study suggest that the severity of dissociation experienced by borderline patients is more heterogeneous than previously reported. They also suggest that borderline patients have a wider range of dissociative experiences than are commonly recognized, including experiences of absorption and amnesia, as well as experiences of depersonalization.

Adolescent↗
PubMed2001

Burn-out of urologists in the county of Schleswig-Holstein, Germany: a comparison of hospital and private practice urologists.

PURPOSE: Mental and physical burden of physicians, especially surgeons, is high. The degree of burn-out was estimated among urologists in the German federal county of Schleswig-Holstein, with special emphasis on differences related to age, qualification and hospital versus private practice. MATERIALS AND METHODS: The Maslach Burnout Inventory was mailed to all urologists and urologists in training registered in the county of Schleswig-Holstein to determine the frequency and intensity of the 3 burn-out subscales of emotional exhaustion, depersonalization and low personal accomplishment, together with a questionnaire covering demographic data. RESULTS: Of 128 urologists 75 (58.6%) replied. Levels of burn-out in the subscales of emotional exhaustion and depersonalization were increased among hospital urologists, urologists in training and urologists younger than 45 years. Urologists in private practices, fully trained urological specialists and urologists older than 45 years showed a low degree of burn-out, corresponding to normal values, whereas young urologists in training and working in hospitals had the highest risk of burn-out. The personal accomplishment level was generally high in all groups. CONCLUSIONS: The constellation of being a urologist in private practice and older than 45 years appears to provide some protection against burn-out that might be due to a more personal relationship to the patients, lesser hierarchical situation and workload related income. In times of increasing pressure on the health care system, the personal situation of physicians in training should not be overlooked.

Adult↗
PubMed2002

Burnout in radiation therapists: the predictive value of selected stressors.

PURPOSE: As cancer caregivers, radiation therapists experience a variety of stresses that may develop into burnout, which has been demonstrated to impact patient care, employee health, and organizational effectiveness. The purpose of the study was to assess the levels of radiation therapists' burnout at three stages. Additionally, the ability of selected workplace variables to predict each of the three stages of burnout was examined. METHODS AND MATERIALS: We used descriptive and inferential statistical analyses on reliable and valid instruments, which measured stress, burnout, and social support. RESULTS: Radiation therapists have high levels of the first two stages of burnout: emotional exhaustion and depersonalization. Although personal stress, organizational stress, guidance, reassurance of worth, and work load predicted 50% or more of the variance in emotional exhaustion and depersonalization, their predictive ability for personal accomplishment was low. CONCLUSION: Efforts to alleviate burnout among radiation therapists within an organization should have positive effects, including increased quality of patient care, improved quality of work life, higher levels of job satisfaction, and commitment and lower staff turnover.

Burnout, Professional↗
PubMed2000

Burnout in substance abuse counselors. Impact of environment, attitudes, and clients with HIV.

Due to associations between acquired immunodeficiency sydnrome (AIDS) and substance abuse, many substance abuse treatment counselors have clients with human immunodeficiency virus (HIV)/AIDS. We assess the contribution of various hypothesized predictors of burnout among 134 substance abuse counselors working with clients with HIV/AIDS. Counselors reported practice-related variables, including support from coworkers and supervisors, caseload, percentage of HIV-positive clients, and whether they worked at a methadone clinic, and personal characteristics of job efficacy and education. The three burnout dimensions were emotional exhaustion, depersonalization, and personal accomplishment. Emotional exhaustion was significantly predicted by less support, less efficacy, and working in a methadone clinic. Depersonalization was predicted by less efficacy, less support, and working in a methadone clinic. Personal accomplishment was predicted by having a lower percentage of clients with HIV/AIDS, and more efficacy, support, and education. We present empirically based suggestions for interventions that can prevent or limit burnout.

Adult↗
PubMed2001

An exploratory analysis of racial factors in staff burnout among assertive community treatment workers.

We examined racial differences in burnout among case managers working with people with severe mental illness, using the Maslach Burnout Inventory. Compared to Caucasians, African Americans reported significantly less Emotional Exhaustion and Depersonalization, but did not differ on levels of Personal Accomplishment. These differences could not be explained by geographic location or perceptions of the work environment; however, age accounted for group differences in Depersonalization. Racial incongruence with caseload appeared to be one factor in burnout, particularly for Emotional Exhaustion. Race of both staff and clients may be important to consider in understanding staff burnout.

Adult↗
PubMed1998

Computers in the consulting room: a case study of clinician and patient perspectives.

Few clinicians in the United States use computers during patient encounters and many still worry that computers will depersonalize their interactions with patients. This case study describes patient and clinician reactions to a computer-based health appraisal system. Findings showed no difference in any aspect of patient satisfaction between computer and non-computer groups. Use of a computer in the consulting room neither depersonalized nor enhanced patient satisfaction. Clinicians (in this case, nurse practitioners and physician assistants) were willing to use the system, which they perceived as having benefits for patient care, but were concerned about the increased time required for exams, effort required to learn the system while still interacting appropriately with the patient, increased monitoring of their performance, and other organizational issues. Clinicians who used the system showed a higher tolerance for uncertainty and communicated more frequently with each other and with others throughout the department. Implementation was slowed by the need to demonstrate the monetary value of the system.

Attitude of Health Personnel↗
PubMed2006

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

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.

Burnout, Professional↗
PubMed2001

Occupational stressors and coping as determinants of burnout in female hospice nurses.

AIMS: Stressors, coping and demographic variables were examined as predictors of burnout in a sample of hospice nurses. The study aimed to investigate the level of burnout among hospice nurses; to ascertain which aspects of nursing work were positively or negatively related to burnout; to examine the relative contributions made by these different variables and to suggest individual and organizational interventions to reduce levels of burnout. METHODS: Eighty-nine female nurses from nine hospices completed a battery of questionnaires comprising the Maslach Burnout Inventory, Nursing Stress Scale, Ways of Coping Scale and a demographic information form. RESULTS: In general, the level of burnout (characterized by high emotional exhaustion, high depersonalization of patients and low personal accomplishment) was found to be low. In multiple regression analyses, 'death and dying', "conflict with staff', 'accepting responsibility' and higher nursing grade contributed to emotional exhaustion. 'Conflict with staff', 'inadequate preparation', 'escape' and reduced 'planful problem-solving' contributed to depersonalization. 'Inadequate preparation', 'escape', reduced 'positive reappraisal' and fewer professional qualifications contributed to lower levels of personal accomplishment. Overall, stressors made the greatest contribution to burnout and demographic factors contributed the least. CONCLUSIONS: The importance of not labelling individuals as good and bad 'copers' was discussed, as the effectiveness of a strategy may depend on the situation. It was concluded that the investigation of problem-focused and emotion-focused coping in relation to burnout, was oversimplifying the coping-burnout relationship. Suggestions for stress management included staff training in counselling skills, monitoring staff conflict, implementing stress inoculation training to teach appropriate use of coping skills and finally, monitoring particularly vulnerable groups of hospice staff such as unqualified nursing assistants and qualified nurses in management positions. It was concluded that despite the difficult nature of hospice work, the hospice is a positive environment in which to work.

Adaptation, Psychological↗
PubMed2000

Approaches to preventing burnout: the effects of personal stress management and organizational socialization.

Several approaches to preventing burnout are compared. One hundred and fifty-four nurses in five Hong Kong hospitals completed the Maslach Burnout Inventory (MBI), the Organizational Socialization Inventory (OSI), and three measures of personal stress management. Results indicated that favourable evaluations on the four OSI domains (job training, organizational understanding, coworker support and future prospects) yielded strong negative correlations with the burnout components. Also, the personal stress management measures had strong negative correlations with depersonalization and decreased personal accomplishment, but none were related to emotional exhaustion. Stepwise regression analyses indicated that training was the only (inverse) predictor of emotional exhaustion, whereas interpersonal skills and understanding were strong (inverse) predictors of depersonalization. Additionally, interpersonal skills and coworker support were excellent (inverse) predictors of decreased personal accomplishment. The findings are discussed in terms of their relevance to nursing administration.

Adult↗
PubMed2002

Aggressive behaviour and burnout among staff of homes for the elderly.

This study examines relationships between experienced aggressive behaviour and burnout of staff caring for residents living in homes for the elderly (n = 551). Burnout was conceptualized as a three-dimensional syndrome consisting of emotional exhaustion, depersonalization and reduced personal accomplishment. From the results of the hierarchical regression analyses it appeared that physical and psychological aggression and the number of weekly working hours had a significant relationship with emotional exhaustion of staff. Psychological aggression was found to have a significant relationship with depersonalization. Neither sex nor age had a relationship with any of the burnout dimensions. Implications for research and suggestions for work and training of staff caring for the elderly are discussed.

Adolescent↗
PubMed2003

Teaching holistic child health promotion using Watson's theory of human science and human care.

"Preservation and advancement of human care is a critical issue for nursing today in our increasingly depersonalized society. The mandate for nursing within science as well as within society is a demand for cherishing of the wholeness of human personality" (Watson, 1999, p. 29). Children today are being faced with having to deal with this societal "depersonalization." How children grow up to perceive themselves and others is crucial in developing future adults who genuinely care about themselves and humankind in its totality. Watson's (1999) human science and human care theory was incorporated into teaching health promotion to a group of preadolescent children.

Child↗
PubMed2002

Burnout in chairs of obstetrics and gynecology: diagnosis, treatment, and prevention.

OBJECTIVE: The purpose of this study was to determine the prevalence of burnout in chairs of academic departments of obstetrics and gynecology, identify important stressors, and develop strategies to treat and prevent burnout. STUDY DESIGN: We performed a cross-sectional study of 131 chairs in the United States and Puerto Rico. We used a 6-part questionnaire focusing on demographics, potential stressors, satisfaction with personal and professional life, self-efficacy, burnout as measured by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and support from the spouse/partner and family. Statistical analyses were performed with the chi(2) test for categorical variables and t test or analysis of variance for continuous variables. RESULTS: Questionnaires were returned from 119 chairs, 110 men and 9 women, a response rate of 91%. Chairs had served an average of 7.2 years. They worked an average of 67.4 hours each week, spending 45% of their time in administrative duties, 31% in patient care, 15% in teaching, and 8% in research. Female chairs worked significantly more hours per week than male chairs, 76.9 versus 66.7 hours (P =.005). Chairs who had served >10 years worked significantly fewer hours each week than did those who had been chairs <5 years, 63.2 versus 69.2 hours (P =.04). The most significant stressors were hospital/departmental budget deficits, Medicare/Medicaid billing audits, loss of key faculty, union disputes, and faculty, resident, and staff dismissals. To deal with stress, chairs most often spent time with family and friends. Twenty-two percent of chairs were somewhat-very dissatisfied with their positions. The MBI-HSS revealed a high subscale score for emotional exhaustion, moderate-high for depersonalization, and high for personal accomplishment. High emotional exhaustion was observed in younger chairs, those who worked nearly 70 hours each week, and those with less spouse/partner support. Burnout was more common in new chairs. CONCLUSION: Burnout in chairs of obstetrics and gynecology is characterized by a high level of emotional exhaustion, moderate-high depersonalization, and high personal accomplishment. These findings should be used to develop programs to improve the psychologic well-being of our academic leaders.

Administrative Personnel↗
PubMed1995

The relationship between team friendships and burnout among residential counselors.

The relationship between team friendships and burnout was investigated. The participants were counselors from 16 work teams in a short-term residential facility for emotionally disturbed children and adolescents that was located in the United States. The burnout dimensions were lack of personal accomplishment, emotional exhaustion, and depersonalization (Maslach & Jackson, 1986). Reciprocal nominations between team members were used as a measure of team friendships. Friendship between members of the same team was positively related to personal accomplishment and inversely related to emotional exhaustion. The frequency of three aspects of team friendships was also examined: personal discussions, work discussions, and having fun. Having fun with a team friend was positively related to personal accomplishment, and having work discussions with a team friend was inversely related to depersonalization. The women reported more frequent contact with team friends than the men did.

Adolescent↗
PubMed2007

The role of social support in burnout among Dutch medical residents.

Burnout levels among medical residents are considered high. A lack of social support has shown to have a direct effect on emotional exhaustion, and depersonalization, two of the three burnout indicators. In this study, we examined the satisfaction of medical residents with social support (emotional, appreciative and informative) received from supervisors, fellow medical residents, nurses and patients. In addition, the correlation between social support and burnout was studied. Medical residents were significantly more dissatisfied with the emotional, appreciative and informative support received from their supervisors compared with fellow residents and nurses (respectively, 13.4+/-4.0 vs. 9.9+/-2.8 and 10.0+/-2.4; 10.0+/-2.9 vs. 7.4+/-2.0 and 7.3+/-1.8; and 7.2+/-2.3 vs. 5.4+/-1.6 and 5.3+/-1.5; p<.001). Significant independent effects were found on emotional exhaustion: from dissatisfaction with emotional support [Beta=.44, p<.001, total R2=.25] and dissatisfaction with appreciative support from supervisors [Beta=.30, p<.01, total R2=.11]. Moreover, dissatisfaction with emotional support from supervisors had an independent significant effect on depersonalization [Beta=.33, p=.001, total R2=.14]. The best predictor of burnout appeared to be dissatisfaction with emotional support received from supervisors. Our results suggest that intervention programs should not only focus on the medical residents, but also on the supervisors to improve their supportive skills.

Burnout, Professional↗
PubMed1992

The occurrence and distribution of burnout among infectious diseases physicians.

The occurrence and distribution of the three dimensions of the burnout syndrome (emotional exhaustion, depersonalization, and lowered feelings of personal accomplishment) were studied among infectious diseases physicians. A written survey was mailed to the entire identified US population of infectious diseases physicians (n = 4328); a 46.3% response rate provided 1840 usable surveys. Statistical analyses of the data demonstrated that 43.5% of the physician sample reported high scores on emotional exhaustion, and 40.3% scored high on depersonalization. Personal accomplishment scores remained high, despite burnout levels, with 91.8% reporting high personal accomplishment. The highest percentage of burnout occurred among physicians in private practice settings (55%), followed by government settings (39%), and academia (37%). The high percentage of infectious diseases physicians experiencing burnout suggests the need for further research to establish trends, to determine if other types of physicians experience similar levels of burnout, to identify casual factors, and to develop avenues to reduce stress and facilitate coping.

Adult↗
PubMed2003

Ketamine alters neural processing of facial emotion recognition in healthy men: an fMRI study.

Disruption of facial emotion perception occurs in neuropsychiatric disorders where the expression of emotion is dulled or blunted, for example depersonalization disorder and schizophrenia. It has been suggested that, in the clinical context of emotional blunting, there is a shift in the relative contribution of brain regions subserving cognitive and emotional processing. The non-competitive glutamate receptor antagonist ketamine produces such emotional blunting in healthy subjects. Therefore, we hypothesised that in healthy subjects ketamine would elicit neural responses to emotional stimuli which mimicked those reported in depersonalization disorder and schizophrenia. Thus, we predicted that ketamine would produce reduced activity in limbic and visual brain regions involved in emotion processing, and increased activity in dorsal regions of the prefrontal cortex and cingulate gyrus, both associated with cognitive processing and, putatively, with emotion regulation. Measuring BOLD signal change in fMRI, we examined the neural correlates of ketamine-induced emotional blunting in eight young right-handed healthy men receiving an infusion of ketamine or saline placebo while viewing alternating 30 s blocks of faces displaying fear versus neutral expressions. The normal pattern of neural response occurred in limbic and visual cortex to fearful faces during the placebo infusion. Ketamine abolished this: significant BOLD signal change was demonstrated only in left visual cortex. However, with ketamine, neural responses were demonstrated to neutral expressions in visual cortex, cerebellum and left posterior cingulate gyrus. Emotional blunting may be associated with reduced limbic responses to emotional stimuli and a relative increase in the visual cortical response to neutral stimuli.

Adult↗
PubMed2004

Stressors, burnout and social support: nurses in acute mental health settings.

AIMS: This paper reports a study which aims (1) to investigate and compare levels of stressors and burnout of qualified and unqualified nursing staff in acute mental health settings; (2) to examine the relationships between stressors and burnout and (3) to assess the impact of social support on burnout and stressor-burnout relationships. BACKGROUND: Several studies have noted that the work of mental health nurses can be highly stressful, but relatively few have focused specifically on staff working in acute inpatient settings. Although many of the pressures faced by this group are similar to those in other nursing specialties, a number of demands relate specifically to mental health settings, including the often intense nature of nurse-patient interaction and dealing with difficult and challenging patient behaviours on a regular basis. METHODS: A convenience sample of 93 nursing staff from 11 acute adult mental health wards completed the Mental Health Professionals Stress Scale, Maslach Burnout Inventory and House and Wells Social Support Scale. RESULTS: Lack of adequate staffing was the main stressor reported by qualified staff, while dealing with physically threatening, difficult or demanding patients was the most stressful aspect for unqualified staff. Qualified nurses reported significantly higher workload stress than unqualified staff. Approximately half of all nursing staff showed signs of high burnout in terms of emotional exhaustion. A variety of stressors were positively correlated with emotional exhaustion and depersonalization. Higher levels of support from co-workers were related to lower levels of emotional exhaustion. Higher stressor scores were associated with higher levels of depersonalization for staff reporting high levels of social support, but not for those reporting low levels of support (a reverse buffering effect). CONCLUSIONS: Qualified and unqualified nursing staff differed in terms of the prominence given to individual stressors in their work environment. The findings were consistent with the notion of burnout developing in response to job-related stressors. While staff support groups may be useful in alleviating feelings of burnout, the reverse buffering effect suggests that they should be structured in a way that minimizes negative communication and encourages staff to discuss their concerns in a constructive way.

Adult↗