Showing papers on "Burnout published in 1995"

Burnout and psychiatric disorder among cancer clinicians.

Abstract: The prevalence and causes of 'burnout' and psychiatric disorder among senior oncologists and palliative care specialists have been measured in a national questionnaire-based survey. All consultant non-surgical oncologists in the UK were asked to participate. Sources of work-related stress and satisfaction were measured using study-specific questions which were aggregated into factors. Psychiatric disorder was estimated using the 12-item General Health Questionnaire. The three components of 'burnout'--emotional exhaustion, depersonalisation and low personal accomplishment--were assessed using the Maslach Burnout Inventory. Three hundred and ninety-three out of 476 (83%) consultants returned their questionnaires. The estimated prevalence of psychiatric disorder in cancer clinicians was 28%, and this is similar to the rate among British junior house officers. The study group had equivalent levels of emotional exhaustion and low personal accomplishment to those found in American doctors and nurses, but lower levels of depersonalisation. Among cancer clinicians, 'burnout' was more prevalent among clinical oncologists than among medical oncologists and palliative care specialists. Psychiatric disorder was independently associated with the stress of feeling overloaded (P < 0.0001), dealing with treatment toxicity/errors (P < 0.004) and deriving little satisfaction from professional status/esteem (P = 0.002). 'Burnout' was also related to these factors, and in addition was associated with high stress and low satisfaction from dealing with patients, and with low satisfaction from having adequate resources (each at a level of P < or = 0.002). Clinicians who felt insufficiently trained in communication and management skills had significantly higher levels of distress than those who felt sufficiently trained. If 'burnout' and psychiatric disorder among cancer clinicians are to be reduced, increased resources will be required to lessen overload and to improve training in communication and management skills.

Burnout, self- and supervisor-rated job performance, and absenteeism among nurses.

Abstract: This study examined how job stress and work support predict the experience of burnout and how burnout is related to absenteeism and job performance in a sample of 73 registered nurses. The current study expanded on previous findings by including supervisor ratings of performance and employee records of absenteeism in addition to self-report measures. It also examined the extent to which burnout may mediate the relationships of job stress and social support with these performance indicators. Analyses indicated that levels of work support and job stress were both significant predictors of burnout. Additionally, higher burnout levels were significantly associated with poorer self-rated and supervisor-rated job performance, more sick leave, and more reported absences for mental health reasons. Finally, further analyses suggest that level of burnout served as a mediator of the relationships between social support and self-rated job performance, absences for mental health reasons, and intentions to quit. The findings suggest that burnout not only may negatively impact healthcare providers, but also may influence objective absenteeism and supervisor perceptions of employee performance.

Student Behavior Patterns Contributing to Teacher Burnout

Abstract: This article reports on two studies that examined how typical student behavior patterns contribute to predicting burnout among teachers in general (Study 1) and among male and female teachers possessing different pupil control ideologies (Study 2). The sample for Study 1 involved 348 teachers from both religious and secular schools in Israel and 356 of their students. The sample for Study 2 involved 391 elementary and secondary schoolteachers (122 were classified “humanistic” and 119 “custodial”). The teachers sampled completed a questionnaire composed of an adapted version of the Maslach Burnout Inventory, the Pupil Behavior Patterns Scale (Studies 1 and 2), and an adapted version of the Pupil Control Ideology scale (Study 2). The students in Study 1 filled out an open-ended questionnaire. The typical student behaviors—disrespect, inattentiveness and sociability—accounted for 22% of teacher burnout variance for the whole sample and for 33% of burnout variance in teachers in religious schools. Hu...

A Longitudinal Study of Psychological Burnout in Teachers

Abstract: This longitudinal study examined antecedents and consequences of psychological burnout among human service professionals. Antecedents of psychological burnout included individual and situational characteristics, work stressors, and measures of social support. Consequences of psychological burnout emphasized satisfaction and emotional and physical well-being variables. Participants in the study were 362 school-based educators (teachers and administrators) employed by the same school board. Respondents completed questionnaires sent to them at their schools at two points in time, 1 year apart. Regression analyses of time-lagged data replicated many empirical findings from cross-sectional studies.

Crossover of stress, strain and resources from one spouse to another'

Abstract: Summary The main focus of the study was the crossover of burnout and of coping resources from husbands to wives and vice versa. The study was carried out on 101 couples, male military officers and their wives, who were randomly selected by the Israel Defense Force computer. They filled out questionnaires that measured their level of burnout, job stress, work support, family support concerning work problems, and their sense of control. Findings reveal that the husbands' sense of control and burnout were positively related to the corresponding variables measured for their wives. To establish the crossover effect, the theoretical model was tested by structural equation analysis (LISREL), which showed a positive effect of wives' burnout on husbands' burnout, after controlling for the husbands' own job stress and coping resources. The husbands' burnout likewise affected their wives' burnout. Thus, a crossover of burnout was exhibited from husbands to wives and vice versa. Furthermore, for both sexes, sense of control had the highest impact on their own burnout and on their spouse's burnout, after controlling for their own job stress and resources. Thus, the spouse's sense of control was found to be an additional resistance resource working to the benefit of the other partner. The relevance of these findings to burnout prevention is discussed.

Staff stress in hospice/palliative care: a review

Abstract: A review of the research in the area of staff stress in hospice/palliative care since the start of the modern hospice movement shows that, while high stress was identified as a problem in the early days of the movement, later studies have shown that stress and burnout in palliative care are by no means universal. Staff stress and burnout in hospice/palliative care has been demonstrated to be less than in professionals in many other settings. However, other studies have noted suicidal ideation, increased alcohol and drug usage, anxiety, depression, and difficulty in dealing with issues of death and dying. It is hypothesized that part of the reason that stress may be lower than expected in some settings was the early recognition of the potential stress inherent in this field and the development of appropriate organizational and personal coping strategies to deal with the identified stressors. Staff in hospice/palliative care have been found to have increased stress when mechanisms such as social support, involvement in work and decision-making, and a realistic work-load are not available. The stress that exists in palliative care is due in large measure to organizational and societal issues, although personal variables were also found to have an influence. Suggestions are given for the direction of future research in the field.

A cautionary note about the cross-national and clinical validity of cut-off points for the maslach burnout inventory

Abstract: In the present study, burnout scores of three samples, as measured with the Maslach Burnout Inventory, were compared: (1) the normative American sample from the test-manual (N = 10,067), (2) the normative Dutch sample (N = 3,892), and (3) a Dutch outpatient sample (N = 142). Generally, the highest burnout scores were found for the outpatient sample, followed by the American and Dutch normative samples, respectively. Slightly different patterns were noted for each of the three components. Probably sampling bias, i.e., the healthy worker effect, or cultural value patterns, i.e., femininity versus masculinity, might be responsible for the results. It is concluded that extreme caution is required when cut-off points are used to classify individuals by burnout scores; only nation-specific and clinically derived cut-off points should be employed.

Burnout and coping among Chinese secondary school teachers in Hong Kong

Abstract: The tripartite components of burnout and eight coping strategies were assessed in a sample of 415 Chinese secondary school teachers in Hong Kong. While emotional exhaustion and depersonalisation were relatively undifferentiated among these teachers, a reduced sense of accomplishment as a distinct component of burnout was generally reported. The findings that avoidant coping strategies were consistently related to all three aspects of burnout suggested that teachers employing escape-avoidance to cope with stressors might be more prone to burnout. Implications for promoting certain patterns of coping to combat burnout were discussed.

Burnout in Social Work

Abstract: Social workers are considered an occupational group at above-average risk of burnout (Jayaratne & Chess, 1984; Pines & Kafry, 1978). Social work is strongly client related, and practitioners are involved in complex social situations. Also, evaluation criteria of the work are mostly unclear, and role conflicts are abundant. Social workers encounter uncertainty and limited resources to meet high demands. As such, social work is a prime example of the innate conflicts of human services work (Hasenfeld, 1983). Nonetheless, there are surprisingly few empirical studies on burnout in social work. In literature searches (MEDLINE, Psychological Abstracts, and Sociological Abstracts), the authors found only 18 studies that reported any findings on burnout in social workers, who were defined as people with master of social work degrees or people working in social services agencies. This article reviews these studies with three questions in mind: * Are social workers burned out? * What is associated with burnout in social workers? * What should be done about burnout in social workers? Burnout Physician Ernest W. Johnson (1988) argued that the concept of burnout has become a metaphor for "I give up"; a socially accepted word for fatigue, laziness, or change of heart; or a rationalization for "throwing in the sponge." Johnson referred to results of two studies in which the researchers dismissed "this hyperbolic claim" (that is, burnout) because they did not find any catecholamines in the urine of the investigated people. Johnson simply stated that burnout did not exist and that the concept was used by people who wanted to avoid responsibility in work. For instance, the nurse or the physician could say, "I am burned out" instead of "I detest sick people" or "I can't stand people complaining of pain" (Johnson, 1988). Analogously, the social worker could say that he or she is burned out instead of saying, "I don't want to help a lot of hoodlum clients." Burnout became popular in the mid-1970s as a characterization of adverse reactions to work, primarily in human services settings (Freudenberger, 1974). Many scientific symposia have dealt with burnout (Cherniss, 1980). Between 1980 and 1985 alone, more than 300 articles in refereed periodicals and at least a dozen books were published (Roberts, 1986). A reason for the popularity of the concept is that it carries low stigma. Unlike other labels, such as incompetence or ineptitude, burnout does not imply that the person afflicted is to blame. To be burned out could be regarded as a way to avoid role responsibilities and obligations without being labeled "deviant" or, as pointed out by Shirom (1989), to acquire a socially accepted label. But if Johnson (1988) was right in his provocations, the widespread use of the concept amounts to a massive ideological humbug. Freudenberger (1974, 1975) is usually given credit for first using the concept "burnout" in a human services setting. He took a word that was used colloquially in the 1960s to refer to the effects of chronic drug abuse and changed its meaning to characterize the psychological state of volunteers who worked in alternative health care agencies. Freudenberger's model of burnout emphasized primarily the psychology of the individual, whereas Maslach (1982) and subsequent writers investigated burnout from a social psychological perspective, with a focus on the relationship between environmental and individual factors (Farber, 1983). Definitions There are many definitions of burnout. According to Maslach (1982), there are at least 30 different definitions and descriptions of the concept. Sometimes causes are included in the definitions and sometimes consequences. Burnout has been variously defined as * "a state of fatigue or frustration brought about by devotion to a cause, way of life, or relationship that failed to produce the expected reward" (Freudenberger & Richelson, 1980, p. …

Beyond Burnout: Helping Teachers, Nurses, Therapists and Lawyers Recover From Stress and Disillusionment

Abstract: Part One: Setting the Stage: 1. The First Year: "Thought I'd Died and Gone to Hell" 2. From Stress to Burnout Part Two: The Next Decade: 3. The Flight from Public Service 4. More Compassion-For Those Who Deserve It 5. More Open to change-On Their Terms 6. Why Work? Shifting Priorities 7. Fulfillment and Regret Part Three: How Some Overcame Burnout: 8. Five Who Prevailed 9. Antidotes to Burnout: Finding Meaningful Work 10. Antidotes to Burnout: Finding Greater Professional Autonomy and Support 11. Antidotes to Burnout: What the Individual Brings to Work 12. Some Implications for Policy and Practice 13. What's Missing? The Quest for Meaning.

Organization, management, and client effects on staff burnout.

Abstract: Employee burnout is perceived to be a serious problem in human service organizations serving persons with severe mental illness. There has been considerable investigation of burnout and many of its possible causes, but little investigation of the role of client severity in relationship to burnout. Furthermore, theoretical models linking environmental context, organization structure, and management processes to burnout have seldom been proposed or examined. Building on our previous work, we employ a theoretical framework that conceptualizes environmental context, organization structure, management processes, client severity and staff characteristics as influencing work satisfaction and burnout. We examine this in a survey of 311 staff in 42 community mental health service organizations. Controlling for individual staff characteristics, results suggest that organization structure, culture, and management process are important to work environment and in turn to satisfaction and subsequently to burnout. Contrary to the literature, client severity was not associated with burnout nor to work dissatisfaction.

Occupational stress : a handbook

Abstract: Part One: Theoretical Perspectives in Occupational Research Psychological Stress in the Workplace Work Stress Conceived and Researched Transactionally Measuring Occupational Stress: The Job Stress Survey. Part Two: Sources and Consequences of Occupational Stress: Model Testing Coping with Stressful Life Events: An Empirical Analysis A Field Study of Some Antecedents and Consequences of Felt Job Stress. Part Three: The Impact of Persistence on Stressor-Strain and Strain-Intentions to Leave Relationships: A Field Examination. Part Four: An Examination of Burnout Individual, Organisational, and Social Determinants of Managerial Burnout: Theoretical and Empirical Update The Relationship Between Social Support and Burnout Over Time in Teachers Burnout and Coping Strategies: A Comparative Study of Ward Nurses. Part Five: Interventions Aimed at Occupational Strain Reductions The Impact of Stress Counselling at Work Relations Between Exercise and Employee Responses to Work Stressors: A Summary of Two Studies.

Physician burnout in pediatric critical care medicine

Abstract: ObjectivesTo determine the prevalence of, and factors associated with, burnout among pediatric intensivists across a variety of practice settings.DesignA population-based survey, using a mailed questionnaire that included a previously validated Burnout Scale.SettingPrivate and academic pediatric cri

Empathy and Burnout in Human Service Work An Extension of a Communication Model

Abstract: Burnout is an often-cited danger of human service work, and emotional communication is one of the most important causes of burnout in such jobs. In this paper, we review theoretical work on emotional communication and burnout, concentrating on the Empathic Communication Model of Burnout (Miller, Stiff, & Ellis, 1988). We then argue that a consideration of job involvement, organizational role, and attitude regarding service recipients could enhance the extent to which this model constitutes a complete understanding of the burnout process. We pose several research questions and one hypothesis regarding the role of these variables in affecting the fit of the Empathic Communication Model and test them with a sample of workers who provide services to the homeless. The results of our research provide support for a modified version of the Empathic Communication Model and suggest that the moderating variables of job involvement, organizational role, and attitude about service recipients influence the impact of va...

Perceptions of control, burnout, and depressive symptomatology: A replication and extension.

Abstract: In this 2-year follow-up of 100 nurses, significant increases were observed for burnout and depressive symptomatology. Analysis of change scores and structural equations suggested that the variance shared by burnout and depression (20%) may be attributable to their co-development. A definitive temporal sequence among measures of burnout and depressive affect was not obtained. At initial assessment and follow-up, burned-out nurses displayed accurate perceptions of job uncontrollability, whereas non-burned-out nurses overestimated job control. Perceptual accuracy increased in linear fashion with degree of burnout, irrespective of depressive symptomatology. Frequency of threats to job control predicted a significant amount of the variance in perceptual accuracy, supporting the view that "burnout realism" is reality driven.

Investigation of burnout in a sample of British general practitioners.

Abstract: BACKGROUND. Recent changes in the general practitioner contract have produced increased workload and stress, poorer mental health and reduced job satisfaction. These factors might combine to increase the level of 'burnout' among general practitioners. AIM. This study set out to examine the extent of burnout among general practitioners. METHOD. A questionnaire was sent to all 295 Northamptonshire general practitioners seeking demographic details and including the Maslach burnout inventory. The results for the inventory were compared with the results from a sample of physicians and nurses in North America. RESULTS. There was a significantly higher level of burnout among the Northamptonshire doctors compared with the North American sample. There was virtually no association between age and the level of burnout, although a small negative correlation was found between age and the depersonalization of others subscale. Part-time general practitioners showed lower levels of burnout than full-time general practitioners. CONCLUSION. This study highlights the need to look both at the extent of burnout in young doctors during their training and at those characteristics of part-time general practitioners which might prevent burnout.

Practice satisfaction, occupational stress, and attrition of emergency physicians. Wellness Task Force, Illinois College of Emergency Physicians.

Abstract: Objective: To define sources of job satisfaction and stress among emergency physicians and assess self–projected career longevity. Design: A survey containing questions regarding emergency medicine (EM) practice satisfaction was mailed to 1,317 diplomates of the American Board of Emergency Medicine (ABEM). Specific sources of practice satisfaction and dissatisfaction, self–reported burnout or impairment, and plans for remaining in the specialty were assessed. Data were compared between two groups of physicians, namely, those residency–trained in EM and those attaining certification through the practice or special category tracts. Results: Of the physicians returning the survey, 25.2% stated that they felt burned out or impaired and 23.1% planned to leave the practice of EM within five years. Perceptions of burnout/impairment and plans to stop practice were associated with less overall practice satisfaction but were not significantly different between the two groups of physicians. Burnout/impairment was linked with psychiatric, drug, or alcohol problems and the feeling that EM had contributed to that problem. Conclusion: This study confirms the relatively high levels of projected attrition in EM and supports the perception that stress and burnout are associated with the specialty. Differences in job satisfaction and stress between those ABEM diplomates who were residency–trained in EM and those who became eligible for the board examination through practice or special–category eligibility appear minor.

The effect of characteristics of human service workers on subsequent morale and turnover.

Abstract: The authors examine the relationship of sociopsychological characteristics of human services workers to their subsequent morale and continuance on the job. Eighty-two intensive case managers (half of them social workers) who had caseloads of clients with severe mental disorders were invited to participate in a four-wave panel study. Explored are the relationships between 16 predictors (general background, prior work experience and training, and social psychological variables) and worker outcomes (beliefs, attitudes, perceptions, and turnover). The major finding was that better personal well-being at the time of hiring was the most consistent and significant predictor of lower burnout, higher job satisfaction, and generally higher worker morale at later points in time. Those from higher social class backgrounds and those with lower starting salaries were more likely to leave the job. Those workers with more experience had a tendency to perceive greater client improvement.

Performance and burnout in intensive care units

Abstract: The relationship between three different performance measures and burnout was explored in 20 Dutch Intensive Care Units (ICUs). Burnout (i.e. emotional exhaustion and depersonalization) proved to be significantly related to nurses' perceptions of performance as well as to objectively assessed unit performance. Subjective performance measures relate negatively to burnout levels of nurses, whereas an objective performance measure relates positively to burnout. Furthermore, subjectively assessed personal performance (i.e. personal accomplishment) is more strongly related to burnout than subjectively assessed unit performance. A model test of the relationship between both types of subjective performance and burnout reveals that nurses' perception of unit performance is indirectly related to burnout through perception of personal performance. This model holds similarly for objectively well- and poor-performing ICUs.

Burnout and collegial support in state psychiatric hospital staff.

Abstract: To determine the correlates of burnout, 47 employees of a state psychiatric hospital completed measures of burnout, collegial support, prolonged anxiety, physical health, and job attitude. Results showed that burnout was associated positively with anxiety, frequency of illness, and contrary job attitudes, and correlated negatively with level of satisfaction with the collegial support network. Partial correlations showed that satisfaction with support systems diminished the effects of burnout on frequency of illness and job attitudes. Tests for divergent validity showed that these findings were specific to burnout and not other measures of job satisfaction or fulfillment. The results suggest that facilitating staff satisfaction with colleagues may reduce burnout and some of its deleterious effects.

The impact of overinvolvement on burnout and job satisfaction.

Abstract: A process model proposing that overinvolvement affects job satisfaction exclusively through its impact on worker burnout was tested. The model was supported strongly in both a current sample of social workers and an earlier study of helping professionals. Methodological limitations are discussed and implications for practice are examined.

Measuring School Principal-Experienced Burnout:

Abstract: The purpose of this study was to develop and validate a measure for school principal-perceived burnout. A total of 821 elementary and secondary school principals in Israel completed a questionnaire containing items relating to their feelings about themselves, their environment, and work. Data were factor analyzed, and three factors, covering 22 items, emerged: (a) exhaustion-feelings of emotional, physical, and cognitive fatigue, direct acknowledgment of being burned out by running the school; (b) aloofness-the principal's expressed desire to disengage from teachers, students, and parents; and (c) deprecation-having negative attitudes toward teachers, students, and parents, belittling their efforts and derogating their abilities.

Burnout in occupational therapists and physical therapists working in head injury rehabilitation.

Abstract: OBJECTIVES Burnout has been linked to job retention in occupational therapy, physical therapy, and other health professions. Professional development activities are often suggested to reduce burnout, but little empirical evidence supports this contention. This study explored the prevalence of burnout among occupational and physical therapists working in head injury rehabilitation and evaluated the relationship between burnout and professional development activities. METHOD Forty therapists working full-time in head injury rehabilitation were surveyed. Correlations between subscale scores of the Maslach Burnout Inventory (i.e., Emotional Exhaustion, Depersonalization, and Personal Accomplishment) and responses to a survey of professional development activities are reported. RESULTS Professional development activities are most strongly associated with feelings of personal accomplishment. Emotional exhaustion was relatively high among these therapists, but few feelings of depersonalization were evident. CONCLUSIONS Professional development activities in the workplace may augment feelings of personal accomplishment and minimize burnout as an issue in job retention. Strategies to effectively identify and manage therapists' feelings of emotional exhaustion require further study.

Job burnout and job leaving in public school teachers: Implications for stress management

Abstract: This study addressed the questions of whether selected teacher and organizational variables contributed to (a) significant amounts of variance in teachers' scores on three components of burnout, and (b) teachers' intentions to leave special education teaching. Study participants (N =490) included a sample of respondents to a survey of all of the 1096 special education teachers in Hawaii. Instruments used in this study included the Maslach Burnout Inventory, the Porter Need Satisfaction Questionnaire, and the Special Education Teacher Survey. Results of multiple regression analyses indicated that for the burnout components, Emotional Exhaustion and Depersonalization, relatively large and significant amounts of variance could be accounted for by a set of predictor variables. For the third burnout component, Personal Accomplishment, the variance accounted for by a set of predictor variables was significant but small. Stepwise discriminant function analysis was used to distinguish between teachers who stated they did or did not intend to leave special education teaching. Eight variables were identified as predictors of “Intention to leave special education teaching, ” correctly classifying 73% of teachers into the appropriate “Yes-Leaving” and “No-Leaving” groups.

Direct and Buffering Effects of Internal Locus of Control Among Mental Health Professionals

Abstract: In a study of Pennsylvania clinical social workers and New York State mental health professionals, counselors with internal locus of control beliefs had more favorable scores on a number of work-related variables. For example, internal counselors reported higher job and life satisfaction, less emotional exhaustion (burnout), a neater sense of success in their work, and more favorable attitudes toward clients. For the sample of intensive case managers of severely menially ill clients, a significant and consistent buffering effect of internality was found. Only for workers with external beliefs (on a newly-developed measure of counselor locus of control) did job strain and negative work altitudes result in diminished life satisfaction and intentions to quit one's job. Secondary analyses failed to find conditions for which externality was beneficial or internality dysfunctional. The advantages of internality were consistent and pervasive. Among recommendations discussed is the incorporation of a personal con...

The evaluation of a burnout workshop for community nurses.

Abstract: This study evaluates the effects of a burnout workshop that was conducted for community nurses (N = 64). The workshop included relaxation training, didactic and cognitive stress management, interpersonal skills training, and the enhancement of a more realistic professional role. The nurses' symptom levels (i.e., emotional exhaustion, tedium, psychological strain, and somatic complaints decreased significantly. However no significant changes were observed in the attitudinal component of burnout: the nurses' negative attitudes toward their recipients (depersonalization) and toward their performance on the job (reduced personal accomplishment) did not decrease. In addition, personality (i.e., the nurses' level of reactivity) played a moderating role: low reactive nurses who, by definition, are rather resistant to stress benefited more from the workshop than did high reactive nurses who are less resistant to stress. Since no control group was included, the results of this study are tentative and should be confirmed by future research.