Showing papers on "Burnout published in 2009"

How changes in job demands and resources predict burnout, work engagement, and sickness absenteeism

Abstract: The present longitudinal survey among 201 telecom managers supports the Job Demands-Resources (JD-R) model that postulates a health impairment process and a motivational process. As hypothesized, results of structural equation modeling analyses revealed that: (1) increases in job demands (i.e., overload, emotional demands, and work-home interference) and decreases in job resources (i.e., social support, autonomy, opportunities to learn, and feedback) predict burnout, (2) increases in job resources predict work engagement, and (3) burnout (positively) and engagement (negatively) predict registered sickness duration (“involuntary” absence) and frequency (“involuntary” absence), respectively. Finally, consistent with predictions results suggest a positive gain spiral: initial work engagement predicts an increase in job resources, which, in its turn, further increases work engagement. Copyright © 2009 John Wiley & Sons, Ltd.

Association of an Educational Program in Mindful Communication With Burnout, Empathy, and Attitudes Among Primary Care Physicians

Abstract: Context Primary care physicians report high levels of distress, which is linked to burnout, attrition, and poorer quality of care. Programs to reduce burnout before it results in impairment are rare; data on these programs are scarce. Objective To determine whether an intensive educational program in mindfulness, communication, and self-awareness is associated with improvement in primary care physicians' well-being, psychological distress, burnout, and capacity for relating to patients. Design, Setting, and Participants Before-and-after study of 70 primary care physicians in Rochester, New York, in a continuing medical education (CME) course in 2007-2008. The course included mindfulness meditation, self-awareness exercises, narratives about meaningful clinical experiences, appreciative interviews, didactic material, and discussion. An 8-week intensive phase (2.5 h/wk, 7-hour retreat) was followed by a 10-month maintenance phase (2.5 h/mo). Main Outcome Measures Mindfulness (2 subscales), burnout (3 subscales), empathy (3 subscales), psychosocial orientation, personality (5 factors), and mood (6 subscales) measured at baseline and at 2, 12, and 15 months. Results Over the course of the program and follow-up, participants demonstrated improvements in mindfulness (raw score, 45.2 to 54.1; raw score change [Δ], 8.9; 95% confidence interval [CI], 7.0 to 10.8); burnout (emotional exhaustion, 26.8 to 20.0; Δ = −6.8; 95% CI, −4.8 to −8.8; depersonalization, 8.4 to 5.9; Δ = −2.5; 95% CI, −1.4 to −3.6; and personal accomplishment, 40.2 to 42.6; Δ = 2.4; 95% CI, 1.2 to 3.6); empathy (116.6 to 121.2; Δ = 4.6; 95% CI, 2.2 to 7.0); physician belief scale (76.7 to 72.6; Δ = −4.1; 95% CI, −1.8 to −6.4); total mood disturbance (33.2 to 16.1; Δ = −17.1; 95% CI, −11 to −23.2), and personality (conscientiousness, 6.5 to 6.8; Δ = 0.3; 95% CI, 0.1 to 5 and emotional stability, 6.1 to 6.6; Δ = 0.5; 95% CI, 0.3 to 0.7). Improvements in mindfulness were correlated with improvements in total mood disturbance (r = −0.39, P Conclusions Participation in a mindful communication program was associated with short-term and sustained improvements in well-being and attitudes associated with patient-centered care. Because before-and-after designs limit inferences about intervention effects, these findings warrant randomized trials involving a variety of practicing physicians.

Burnout: 35 years of research and practice

Abstract: Purpose – The purpose of this paper is to focus on the career of the burnout concept itself, rather than reviewing research findings on burnout.Design/methodology/approach – The paper presents an overview of the concept of burnout.Findings – The roots of the burnout concept seem to be embedded within broad social, economic, and cultural developments that took place in the last quarter of the past century and signify the rapid and profound transformation from an industrial society into a service economy. This social transformation goes along with psychological pressures that may translate into burnout. After the turn of the century, burnout is increasingly considered as an erosion of a positive psychological state. Although burnout seems to be a global phenomenon, the meaning of the concept differs between countries. For instance, in some countries burnout is used as a medical diagnosis, whereas in other countries it is a non‐medical, socially accepted label that carries a minimum stigma in terms of a psyc...

Burnout and career satisfaction among American surgeons.

Abstract: Objective:To determine the incidence of burnout among American surgeons and evaluate personal and professional characteristics associated with surgeon burnout.Background:Burnout is a syndrome of emotional exhaustion and depersonalization that leads to decreased effectiveness at work. A limited amoun

An Appraisal Perspective of Teacher Burnout: Examining the Emotional Work of Teachers

Abstract: K-12 teaching is a profession characterized by high levels of burnout and emotional exhaustion. Teacher burnout has been widely reviewed and studied; however, only limited literature examines the emotional aspects of teachers’ lives and its connection with teacher burnout. The purpose of this article is to review the literature on teacher burnout and teachers’ emotions and to examine the role of teachers' appraisal of their emotional exhaustion. Through reviewing the literature on teacher burnout and emotions, I argue that the habitual patterns in teachers’ judgments about student behavior and other teaching tasks may contribute significantly to teachers’ repeated experience of unpleasant emotions and those emotions may eventually lead to burnout. In order to ease teacher burnout, I argue that more studies on the antecedent appraisals that teachers make are necessary to help teachers better understand how their emotions were triggered and then learn how to regulate those emotions.

Nurse turnover: the mediating role of burnout

Abstract: Aim This study tested whether the mediation model of burnout could predict nurses’ turnover intentions Background A better understanding of what factors support a commitment to a nursing career could inform both policies and workplace practices The mediation model of burnout provides a way of linking the quality of a nurse’s worklife to various outcomes, such as turnover Method Data on areas of worklife, burnout, and turnover intentions were collected by surveying 667 Canadian nurses in the Atlantic Provinces Results The findings supported the mediation model of burnout, in which areas of worklife predicted burnout, which in turn predicted turnover intentions Cynicism was the key burnout dimension for turnover, and the most critical areas of worklife were value conflicts and inadequate rewards Conclusions The results of this study provide some new insights into how the intention of nurses to leave their job is related to particular aspects of their worklife and to burnout Implications for nursing management These results suggest what may be the most appropriate areas to target for interventions to reduce the risk of nurses exiting early from their chosen career

Relationships between personality variables and burnout: A meta-analysis

Abstract: Most burnout research has focussed on environmental correlates, but it is likely that personality factors also play an important part in the development of burnout. Previous meta-analyses, however, have been limited in scope. The present meta-analysis examined the relationship between personality and three dimensions of the Maslach Burnout Inventory (MBI): emotional exhaustion, depersonalization, and personal accomplishment. Consistent with our hypotheses, self-esteem, self-efficacy, locus of control, emotional stability, extraversion, conscientiousness, agreeableness, positive affectivity, negative affectivity, optimism, proactive personality, and hardiness, each yielded significant relationships with burnout. Type A Personality, however, was only related to personal accomplishment. Furthermore, regression analysis found that core self-evaluations, the Five-Factor Model personality characteristics, and positive and negative affectivity explained significant variance in each of the burnout dimens...

Workplace empowerment, incivility, and burnout: impact on staff nurse recruitment and retention outcomes

Abstract: Aim The aim of this study was to examine the influence of empowering work conditions and workplace incivility on nurses’ experiences of burnout and important nurse retention factors identified in the literature. Background A major cause of turnover among nurses is related to unsatisfying workplaces. Recently, there have been numerous anecdotal reports of uncivil behaviour in health care settings. Method We examined the impact of workplace empowerment, supervisor and coworker incivility, and burnout on three employee retention outcomes: job satisfaction, organizational commitment, and turnover intentions in a sample of 612 Canadian staff nurses. Results Hierarchical multiple linear regression analyses revealed that empowerment, workplace incivility, and burnout explained significant variance in all three retention factors: job satisfaction (R2 = 0.46), organizational commitment (R2 = 0.29) and turnover intentions (R2 = 0.28). Empowerment, supervisor incivility, and cynicism most strongly predicted job dissatisfaction and low commitment (P < 0.001), whereas emotional exhaustion, cynicism, and supervisor incivility most strongly predicted turnover intentions. Conclusions In our study, nurses’ perceptions of empowerment, supervisor incivility, and cynicism were strongly related to job satisfaction, organizational commitment, and turnover intentions. Implications for nursing management Managerial strategies that empower nurses for professional practice may be helpful in preventing workplace incivility, and ultimately, burnout.

Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals.

Abstract: BACKGROUND Burnout has negative effects on work performance and patient care. The current standard for burnout assessment is the Maslach Burnout Inventory (MBI), a well-validated instrument consisting of 22 items answered on a 7-point Likert scale. However, the length of the MBI can limit its utility in physician surveys.

School-Burnout Inventory (SBI) Reliability and Validity

Abstract: This study introduces a measure for school burnout and examines its validity and reliability among students in upper secondary high schools and vocational schools by using confirmatory factor analysis. School-related burnout comprises three dimensions: (a) exhaustion at school, (b) cynicism toward the meaning of school, and (c) sense of inadequacy at school. A total of 1418 (709 girls, 709 boys) adolescents from 13 postcomprehensive schools (6 upper secondary high schools, 7 vocational schools) filled in a questionnaire concerning their school burnout and background variables. The results showed that the three-factor solution, compared to one- or two-factor solutions, fit the data best and also gave the best reliability indices. The three theoretically-derived dimensions of school burnout were closely related but separate constructs. Finally, concurrent validity for the School-Burnout Inventory (SBI) was found when the correlations of depressive symptoms, school engagement, and academic achievement with e...

Career fit and burnout among academic faculty.

Abstract: BACKGROUND: Extensive literature documents personal distress among physicians and a decrease in their satisfaction with the practice of medicine over recent years. We hypothesized that physicians who spent more of their time in the aspect of work that they found most meaningful would have a lower risk of burnout. METHODS: Faculty physicians in the Department of Internal Medicine at a large academic medical center were surveyed in the fall of 2007. The survey evaluated demographic variables, work characteristics, and career satisfaction. Burnout was measured using the Maslach Burnout Inventory. Additional questions evaluated which professional activity (eg, research, education, patient care, or administration) was most personally meaningful and the percentage of effort that was devoted to each activity. RESULTS: Of 556 physicians sampled, 465 (84%) returned surveys. A majority (68%) reported that patient care was the aspect of work that they found most meaningful, with smaller percentages reporting research (19%), education (9%), or administration (3%) as being most meaningful. Overall, 34% of faculty members met the criteria for burnout. The amount of time spent working on the most meaningful activity was strongly related to the risk of burnout. Those spending less than 20% of their time (approximately 1 d/wk) on the activity that is most meaningful to them had higher rates of burnout (53.8% vs 29.9%; P<.001). Time spent on the most meaningful activity was the largest predictor of burnout on multivariate analysis (odds ratio, 2.75; P = .001). CONCLUSIONS: The extent to which faculty physicians are able to focus on the aspect of work that is most meaningful to them has a strong inverse relationship to their risk of burnout. Efforts to optimize career fit may promote physician satisfaction and help to reduce attrition among academic faculty physicians.

Burnout During Residency Training: A Literature Review

Abstract: Objective Burnout is a state of mental and physical exhaustion related to work or care giving activities. Burnout during residency training has gained significant attention secondary to concerns regarding job performance and patient care. This article reviews the relevant literature on burnout in order to provide information to educators about its prevalence, features, impact, and potential interventions. Methods Studies were identified through a Medline and PsychInfo search from 1974 to 2009. Fifty-one studies were identified. Definition and description of burnout and measurement methods are presented followed by a thorough review of the studies. Results An examination of the burnout literature reveals that it is prevalent in medical students (28%–45%), residents (27%–75%, depending on specialty), as well as practicing physicians. Psychological distress and physical symptoms can impact work performance and patient safety. Distress during medical school can lead to burnout, which in turn can resu...

Patient-centered medical home demonstration: a prospective, quasi-experimental, before and after evaluation.

Abstract: Background A patient-centered medical home (PCMH) demonstration was undertaken at 1 healthcare system, with the goals of improving patient experience, lessening staff burnout, improving quality, and reducing downstream costs. Five design principles guided development of the PCMH changes to staffing, scheduling, point-of-care, outreach, and management. Objective To report differences in patient experience, staff burnout, quality, utilization, and costs in the first year of the PCMH demonstration. Study design Prospective before and after evaluation. Methods Baseline (2006) and 12-month (2007) measures were compared. Patient and staff experiences were measured using surveys from a random sample of patients and all staff at the PCMH and 2 control clinics. Automated data were used to measure and compare change components, quality, utilization, and costs for PCMH enrollees versus enrollees at 19 other clinics. Analyses included multivariate regressions for the different outcomes to account for baseline case mix. Results After adjusting for baseline, PCMH patients reported higher ratings than controls on 6 of 7 patient experience scales. For staff burnout, 10% of PCMH staff reported high emotional exhaustion at 12 months compared with 30% of controls, despite similar rates at baseline. PCMH patients also had gains in composite quality between 1.2% and 1.6% greater than those of other patients. PCMH patients used more e-mail, phone, and specialist visits, but fewer emergency services. At 12 months, there were no significant differences in overall costs. Conclusions A PCMH redesign can be associated with improvements in patient experience, clinician burnout, and quality without increasing overall cost.

Self-care of Physicians Caring for Patients at the End of Life: “Being Connected . . . A Key to My Survival”

Abstract: Physicians providing end-of-life care are subject to a variety of stresses that may lead to burnout and compassion fatigue at both individual and team levels. Through the story of an oncologist, we discuss the prodromal symptoms and signs leading to burnout and compassion fatigue and present the evidence for prevention. We define and discuss factors that contribute to burnout and compassion fatigue and consider factors that may mitigate burnout. We explore the practice of empathy and discuss an approach for physicians to maximize wellness through self-awareness in the setting of caring for patients with end-stage illness. Finally, we discuss some practical applications of self-care in the workplace.

The learning environment and medical student burnout: A multicentre study

Abstract: OBJECTIVES Little is known about specific personal and professional factors influencing student distress. The authors conducted a comprehensive assessment of how learning environment, clinical rotation factors, workload, demographics and personal life events relate to student burnout. METHODS All medical students (n = 3080) at five medical schools were surveyed in the spring of 2006 using a validated instrument to assess burnout. Students were also asked about the aforementioned factors. RESULTS A total of 1701 medical students (response rate 55%) completed the survey. Learning climate factors were associated with student burnout on univariate analysis (odds ratio [OR] 1.36-2.07; all P < or = 0.02). Being on a hospital ward rotation or a rotation requiring overnight call was also associated with burnout (ORs 1.69 and 1.48, respectively; both P < or = 0.02). Other workload characteristics (e.g. number of admissions) had no relation to student burnout. Students who experienced a positive personal life event had a lower frequency of burnout (OR 0.70; P < or = 0.02), whereas those who experienced negative personal life events did not have a higher frequency of burnout than students who did not experience a negative personal life event. On multivariate analysis personal characteristics, learning environment and personal life events were all independently related to student burnout. CONCLUSIONS Although a complex array of personal and professional factors influence student well-being, student satisfaction with specific characteristics of the learning environment appears to be a critical factor. Studies determining how to create a learning environment that cultivates student well-being are needed.

Stress and burnout among surgeons understanding and managing the syndrome and avoiding the adverse consequences

Abstract: Training for and practicing surgery are stressful endeavors. 1-4 Studies 5-11 involving national samples of surgeons from surgical subspecialty societies and graduates of surgical training programs suggest that burnout rates among surgeons range from 30% to 38%. These statistics indicate that a substantial number of our colleagues are struggling with personal and professional distress at a level that should be of concern to all surgeons.

The prevalence and impact of post traumatic stress disorder and burnout syndrome in nurses

Abstract: Objective To determine whether post-traumatic stress disorder (PTSD) and burnout syndrome (BOS) are common in nurses, and whether the co-existence of PTSD and BOS is associated with altered perceptions of work and non-work related activities.

Preventing burnout: the effects of LMX and mentoring on socialization, role stress, and burnout

Abstract: Halbesleben and Buckley's (2004) review of burnout research suggested a lingering need to examine the relationship between social support and burnout. We address that need by investigating Leader-Member Exchange (LMX) and mentoring as sources of workplace social support. We used data from 422 employees in a health care setting to test three structural models investigating the direct and indirect effects of LMX, supervisory mentoring, and nonsupervisory mentoring on organizational socialization, role stress, and burnout. Results suggest that high-LMX supervisors and nonsupervisory mentors serve as resources that minimize emotional exhaustion through increased socialization and decreased role stress. This study advances the literature on burnout by clarifying the effects of different types of social support in reducing burnout. © 2009 Wiley Periodicals, Inc.

Workaholism, burnout and well-being among junior doctors: The mediating role of role conflict

Abstract: This study, conducted on a nation-wide sample of Dutch junior doctors (also called medical residents) (N� 2115), investigated the unique relationships of workaholism with burnout and well-being, and hypothesized that (inter- and intra-) role conflict would mediate these effects. The results of multi-group structural equation modelling analyses offered support for this model. Specifically, role conflict fully mediated the relationships between workaholism (i.e. working excessively and working compulsively) and job demands (i.e. emotional, mental and organizational demands) on the one hand, and burnout (i.e. emotional exhaustion, depersonalization and reduced medical accomplishment) and well-being (job satisfaction, happiness and perceived health) on the other hand. This indicates that workaholism contributed incrementally to explaining positive (well-being) and negative (burnout) outcomes beyond common indicators of job demands.

Depressive symptoms and school burnout during adolescence: evidence from two cross-lagged longitudinal studies.

Abstract: The main purpose of this study was to examine the extent to which middle and late adolescents' depressive symptoms predict their later school burnout and, in turn, the extent to which school burnout predicts depressive symptoms. Drawing on data gathered at ages 15-19 in two-three-wave longitudinal studies, we investigated cross-lagged paths between school burnout and depressive symptoms. In Study 1 the participants were 15-year-old adolescents (Time 1: N = 611, Time 2: N = 614, Time 3: N = 725) who completed the School Burnout Inventory and depressive symptoms twice during their final term of comprehensive school and once after the transition to upper secondary high school or vocational school. In Study 2 the participants were 17-year-old adolescents whose school burnout and depressive symptoms were measured three times annually (Time 1: N = 474, Time 2: N = 412, Time 3: N = 414) during their 3 years of secondary education. Results of both studies revealed moderate stability for both school burnout and depressive symptoms. They also showed that school burnout more strongly predicted subsequent depressive symptoms later on than vice versa. Lastly, they revealed cumulative cycles between school burnout and depressive symptoms.

Vicarious Trauma, Secondary Traumatic Stress or Simply Burnout? Effect of Trauma Therapy on Mental Health Professionals

Abstract: Objectives: The aim of the present study was to perform an assessment for secondary traumatic stress (STS), vicarious trauma (VT) and workplace burnout for Australian mental health professionals in...

Burnout, engagement and resident physicians' self-reported errors

Abstract: Burnout is a work-related syndrome that may negatively affect more than just the resident physician. On the other hand, engagement has been shown to protect employees; it may also positively affect the patient care that the residents provide. Little is known about the relationship between residents' self-reported errors and burnout and engagement. In our national study that included all residents and physicians in The Netherlands, 2115 questionnaires were returned (response rate 41.1%). The residents reported on burnout (Maslach Burnout Inventory-Health and Social Services), engagement (Utrecht Work Engagement Scale) and self-assessed patient care practices (six items, two factors: errors in action/judgment, errors due to lack of time). Ninety-four percent of the residents reported making one or more mistake without negative consequences for the patient during their training. Seventy-one percent reported performing procedures for which they did not feel properly trained. More than half (56%) of the residents stated they had made a mistake with a negative consequence. Seventy-six percent felt they had fallen short in the quality of care they provided on at least one occasion. Men reported more errors in action/judgment than women. Significant effects of specialty and clinical setting were found on both types of errors. Residents with burnout reported significantly more errors (p < 0.001). Highly engaged residents reported fewer errors (p

Athlete burnout in elite sport: a self-determination perspective.

Abstract: Using self-determination theory (Deci & Ryan, 1985) as the theoretical framework, we examined potential antecedents of athlete burnout in 201 elite Canadian athletes (121 females, 80 males; mean age 22.9 years). Employing a cross-sectional design, our primary aims were to investigate the relationships between behavioural regulations and athlete burnout and to examine whether self-determined motivation mediated relationships between basic needs satisfaction and athlete burnout. Our self-determination theory-derived hypotheses were largely supported. Relationships among athlete burnout and behavioural regulations mostly varied according to their rank on the self-determination continuum, with less self-determined motives showing positive associations and more self-determined motives showing negative correlations with burnout. The basic needs of competence and autonomy, plus self-determined motivation, accounted for significant amounts of variance in athlete burnout symptoms (exhaustion, R(2) = 0.31; devaluation, R(2) = 0.49; reduced accomplishment, R(2) = 0.61; global burnout, R(2) = 0.74). Self-determined motivation fully mediated the relationships that competence and autonomy had with exhaustion. Analyses showed indirect relationships between these two needs and devaluation, through their associations with self-determined motivation. Motivation partially mediated the needs-reduced sense of accomplishment relationships, but the direct effects were more prominent than the indirect effects.

Interventions to Manage Compassion Fatigue in Oncology Nursing

Abstract: Work-related stress emanating from close interpersonal contact with patients with cancer and their families may result in physical, emotional, social, and spiritual adversity for oncology nurses. The negative result of this cumulative distress has historically been referred to as burnout. However, this dated term does not truly depict the result of the longitudinal workplace ramifications of sadness and despair on nursing staff. This article proposes that the phrase compassion fatigue replace the outdated notion of burnout in describing this phenomenon. Although not clearly and uniformly described in the literature, this occurrence is seen regularly in clinical practice and is conceptually known by nurses. Limited information is available about interventions to manage compassion fatigue; therefore, a national survey was conducted to identify resources available to oncology nurses to counter this phenomenon. Participants provided information about the availability of interventions in three major categories: on-site professional resources, educational programs, and specialized retreats. The availability of resources ranged from 0%-60%. Survey findings, along with narrative comments by respondents, provide relevant information for oncology nurses and their employers. By recognizing the perils of inattention to this frequent nursing phenomenon and the scope of existing workplace options that may augment nurse coping, oncology nurses' recognition and management of this entity may be enhanced. Organizations also may be encouraged to periodically inventory their support and lobby for workplace interventions to manage this critical work-related issue.

Customer incivility as a social stressor: The role of race and racial identity for service employees.

Abstract: Experiencing frequent incivility from customers is a noted social stressor linked with job burnout. Race (as a surface-level characteristic and as a deep-level identity) is proposed to explain emotional exhaustion, the primary burnout dimension, for service employees. The authors did not find that "microaggressions" were more likely toward racial minorities, nor any difference in job-related exhaustion between racial minority (primarily African American) and nonminority (White) retail employees. However, the centrality of minority employees' racial identity strengthened the association of customer incivility with emotional exhaustion because of increased stress appraisals, consistent with the Group Identity Lens Model. Proposals for future research on workforce racial diversity are made.