This meta-analysis examined how demand and resource correlates and behavioral and attitudinal correlates were related to each of the 3 dimensions of job burnout. Both the demand and resource correlates were more strongly related to emotional exhaustion than to either depersonalization or personal accomplishment. Consistent with the conservation of resources theory of stress, emotional exhaustion was more strongly related to the demand correlates than to the resource correlates, suggesting that workers might have been sensitive to the possibility of resource loss. The 3 burnout dimensions were differentially related to turnover intentions, organizational commitment, and control coping. Implications for research and the amelioration of burnout are discussed.

A meta-analytic examination of the correlates of the three dimensions of job burnout.

This review provides the reader with the up-to-date evidence-based basis for prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis); metabolic diseases (obesity, hyperlipidemia, metabolic syndrome, polycystic ovarian syndrome, type 2 diabetes, type 1 diabetes); cardiovascular diseases (hypertension, coronary heart disease, heart failure, cerebral apoplexy, and claudication intermittent); pulmonary diseases (chronic obstructive pulmonary disease, asthma, cystic fibrosis); musculo-skeletal disorders (osteoarthritis, osteoporosis, back pain, rheumatoid arthritis); and cancer. The effect of exercise therapy on disease pathogenesis and symptoms are given and the possible mechanisms of action are discussed. We have interpreted the scientific literature and for each disease, we provide the reader with our best advice regarding the optimal type and dose for prescription of exercise.

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Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases

Burnout is a metaphor that is commonly used to describe a state or process of mental exhaustion, similar to the smothering of a fire or the extinguishing of a candle. The dictionary defines “to burn out” as “to fail, wear out, or become exhausted by making excessive demands on energy, strength, or resources”. As such, the experience of burnout is likely to be universal and of all times. Probably the earliest written example in which “to burn out” is related to exhaustion comes from Shakespeare, who wrote in 1599 in The Passionate Pilgrim: “She burnt with loue, as straw with fire flameth. She burnt out loue, as soon as straw out burneth” (cited in Enzmann & Kleiber, 1989, p. 18). More recently, but long before the “discovery” of burnout in professional settings, individuals who suffer from it have been portrayed in great detail. For instance, Graham Greene’s 1960 novel A Burnt-Out Case tells the sad story of the world famous architect Querry, a gloomy, spiritually tormented, cynical and disillusioned character. The most illustrious example of burnout avant-la-lettre is the case-study of a psychiatric nurse, Miss Jones, published by Schwartz & Will (1953).

Burnout: An Overview of 25 Years of Research and Theorizing

Gender differences in burnout: A meta-analysis

What Works for Whom? A Critical Review of Psychotherapy Research

Relationships between empathy and burnout and possible confounding influences of sex and profession were explored in a sample of 492 male and female nurses, social workers, and teachers. Respondents completed Mehrabian's Emotional Empathy Scale, Stotland's Fantasy-Empathy Scale, and the Maslach Burnout Inventory (MBI). There were no main effects of profession on empathy or burnout variables. There was, however, an interaction effect of sex and profession on depersonalization, which was accounted for by subjects in social work and teaching. Women had significantly higher empathy scores than men; however, men had higher scores than male normative groups. Age related negatively to depersonalization and emotional exhaustion for women, whereas percentage of work time spent in direct practice correlated with depersonalization for men. The possibility that empathy and burnout might represent opposite poles of the same underlying construct was examined but not found. Instead, emotional empathy was significantly positively correlated with both emotional exhaustion and personal accomplishment, whereas emotional exhaustion was also positively related to depersonalization. It is hypothesized that high emotional empathy may predispose helping professionals to emotional exhaustion and that emotional exhaustion, if not mediated by personal accomplishment, may lead to the development of depersonalization. This more complex, interactive model of the empathy–burnout relationship needs longitudinal study.

Empathy and burnout in male and female helping professionals

This study examined relationships between the ability to recognize facial affect and affective intensity in women with Borderline Personality Disorder. Women hospitalized with borderline personality disorder and community women without psychiatric disorder (n s = 35/group) were recruited via convenience sampling. The Pictures of Facial Affect and the Affect Intensity Measure were administered to consenting women. Hypotheses related to differences in recognizing facial affect were supported, but further exploration indicated that selected negative emotions accounted for the statistical significance. Implications for practice and research are explored.

Emotion processing in borderline personality disorders.

Stress, pre-term labour and birth outcomes Preliminary studies have suggested that stress may be associated with the onset, treatment and outcomes of pre-term labour; however, a systematic comparison of the stress of women with and without pre-term labour has not been reported. Therefore, the purpose of this exploratory study was to compare the stress (daily hassles and mood states) and birth outcomes of black and white women who experienced pre-term labour (PTL) during pregnancy with those who did not. The convenience sample consisted of 35 pregnant women hospitalized in 1996-1997 for the treatment of PTL (24-35 weeks gestation) and 35 controls matched on age, race, parity, gestational age and method of hospital payment. Women in the PTL group had significantly higher tension-anxiety and depression-dejection on the Profile of Mood States (POMS), lower mean birthweight and mean gestational age, and a higher percentage of babies born <37 weeks and weighing 2500 g or less. Black women in the PTL group and white women in the control group had significantly higher scores on the fatigue sub-scale of the POMS and the work and future security sub-scales of the Daily Hassles Scale. Women in the PTL group whose babies weighed 2500 g or less had significantly higher scores on the health, inner concern and financial responsibility sub-scales of the Daily Hassles Scale. The findings from this study indicate the need for further exploration of the interaction of race and stress in understanding and preventing PTL and low birthweight and the need to examine the role of social support in preventing pre-term birth after an episode of PTL.

Stress, pre-term labour and birth outcomes.

Empathy is a topic of growing concern in a variety of disciplines. Although considerable empathy research is reported, often single dimensions of a multidimensional and multiphasic construct are ac...

Biopsychosocial elements of empathy: a multidimensional model.

Communication among nurses, patients, and physicians is a key component of effective health care. In addition to communication with patients, nurses directly or indirectly influence physician-patient communications. This secondary analysis examined registered nurses' interactions with a simulated patient regarding what the physician had told the patient about the reason for hospitalization. Taped interviews (N = 86) were transcribed and content analyzed to classify nurses' approaches to assessment and intervention. The second researcher coded 10% of the transcripts to ensure satisfactory interrater consistency. Major patterns of nursing communication were the following: assessing what the physician had told the patient (85%), encouraging clarification with the physician (62%), encouraging a second opinion, and defending the physician's competence (9%). Findings support literature suggesting that nurses mediate and clarify communications between the patient and the physician. Patient advocacy was also illustrated; however, a small number of nurses advocated most clearly for the physician.

Carol A. Williams

Papers

Empathy and burnout in male and female helping professionals

Emotion processing in borderline personality disorders.

Stress, pre-term labour and birth outcomes.

Biopsychosocial elements of empathy: a multidimensional model.

Nursing Communication: Advocacy for the Patient or Physician?: