Showing papers on "Emotional exhaustion published in 2017"

A systematic review including meta-analysis of work environment and burnout symptoms

Abstract: Practitioners and decision makers in the medical and insurance systems need knowledge on the relationship between work exposures and burnout. Many burnout studies – original as well as reviews - restricted their analyses to emotional exhaustion or did not report results on cynicism, personal accomplishment or global burnout. To meet this need we carried out this review and meta-analyses with the aim to provide systematically graded evidence for associations between working conditions and near-future development of burnout symptoms. A wide range of work exposure factors was screened. Inclusion criteria were: 1) Study performed in Europe, North America, Australia and New Zealand 1990–2013. 2) Prospective or comparable case control design. 3) Assessments of exposure (work) and outcome at baseline and at least once again during follow up 1–5 years later. Twenty-five articles met the predefined relevance and quality criteria. The GRADE-system with its 4-grade evidence scale was used. Most of the 25 studies focused emotional exhaustion, fewer cynicism and still fewer personal accomplishment. Moderately strong evidence (grade 3) was concluded for the association between job control and reduced emotional exhaustion and between low workplace support and increased emotional exhaustion. Limited evidence (grade 2) was found for the associations between workplace justice, demands, high work load, low reward, low supervisor support, low co-worker support, job insecurity and change in emotional exhaustion. Cynicism was associated with most of these work factors. Reduced personal accomplishment was only associated with low reward. There were few prospective studies with sufficient quality on adverse chemical, biological and physical factors and burnout. While high levels of job support and workplace justice were protective for emotional exhaustion, high demands, low job control, high work load, low reward and job insecurity increased the risk for developing exhaustion. Our approach with a wide range of work exposure factors analysed in relation to the separate dimensions of burnout expanded the knowledge of associations, evidence as well as research needs. The potential of organizational interventions is illustrated by the findings that burnout symptoms are strongly influenced by structural factors such as job demands, support and the possibility to exert control.

The Relationship Between Professional Burnout and Quality and Safety in Healthcare: A Meta-Analysis.

Abstract: Background Healthcare provider burnout is considered a factor in quality of care, yet little is known about the consistency and magnitude of this relationship This meta-analysis examined relationships between provider burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) and the quality (perceived quality, patient satisfaction) and safety of healthcare

Interventions to Prevent and Reduce Physician Burnout: A Systematic Review and Meta-analysis

Abstract: Summary Background Physician burnout has reached epidemic levels, as documented in national studies of both physicians in training and practising physicians. The consequences are negative effects on patient care, professionalism, physicians' own care and safety, and the viability of health-care systems. A more complete understanding than at present of the quality and outcomes of the literature on approaches to prevent and reduce burnout is necessary. Methods In this systematic review and meta-analysis, we searched MEDLINE, Embase, PsycINFO, Scopus, Web of Science, and the Education Resources Information Center from inception to Jan 15, 2016, for studies of interventions to prevent and reduce physician burnout, including single-arm pre-post comparison studies. We required studies to provide physician-specific burnout data using burnout measures with validity support from commonly accepted sources of evidence. We excluded studies of medical students and non-physician health-care providers. We considered potential eligibility of the abstracts and extracted data from eligible studies using a standardised form. Outcomes were changes in overall burnout, emotional exhaustion score (and high emotional exhaustion), and depersonalisation score (and high depersonalisation). We used random-effects models to calculate pooled mean difference estimates for changes in each outcome. Findings We identified 2617 articles, of which 15 randomised trials including 716 physicians and 37 cohort studies including 2914 physicians met inclusion criteria. Overall burnout decreased from 54% to 44% (difference 10% [95% CI 5–14]; p I 2 =15%; 14 studies), emotional exhaustion score decreased from 23·82 points to 21·17 points (2·65 points [1·67–3·64]; p I 2 =82%; 40 studies), and depersonalisation score decreased from 9·05 to 8·41 (0·64 points [0·15–1·14]; p=0·01; I 2 =58%; 36 studies). High emotional exhaustion decreased from 38% to 24% (14% [11–18]; p I 2 =0%; 21 studies) and high depersonalisation decreased from 38% to 34% (4% [0–8]; p=0·04; I 2 =0%; 16 studies). Interpretation The literature indicates that both individual-focused and structural or organisational strategies can result in clinically meaningful reductions in burnout among physicians. Further research is needed to establish which interventions are most effective in specific populations, as well as how individual and organisational solutions might be combined to deliver even greater improvements in physician wellbeing than those achieved with individual solutions. Funding Arnold P Gold Foundation Research Institute.

The Relationship Between Professional Burnout and Quality and Safety in Healthcare: A Meta-Analysis

Abstract: Background Healthcare provider burnout is considered a factor in quality of care, yet little is known about the consistency and magnitude of this relationship. This meta-analysis examined relationships between provider burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) and the quality (perceived quality, patient satisfaction) and safety of healthcare.

The state of the heart: Emotional labor as emotion regulation reviewed and revised.

Abstract: Emotional labor has been an area of burgeoning research interest in occupational health psychology in recent years. Emotional labor was conceptualized in the early 1980s by sociologist Arlie Hochschild (1983) as occupational requirements that alienate workers from their emotions. Almost 2 decades later, a model was published in Journal of Occupational Health Psychology (JOHP) that viewed emotional labor through a psychological lens, as emotion regulation strategies that differentially relate to performance and wellbeing. For this anniversary issue of JOHP, we review the emotional labor as emotion regulation model, its contributions, limitations, and the state of the evidence for its propositions. At the heart of our article, we present a revised model of emotional labor as emotion regulation, that incorporates recent findings and represents a multilevel and dynamic nature of emotional labor as emotion regulation. (PsycINFO Database Record

Emotions in the Workplace

Abstract: Beginning in the 1990s and following decades of neglect, what came to be referred to as the Affective Revolution has radically transformed our understanding of the role played by emotion in organizational psychology and organizational behavior (OPOB). In this article, we review the field of emotion in the workplace from different perspectives, corresponding to five discrete levels of analysis: (a) within-person temporal effects, (b) between-person (personality and attitudes) factors, (c) interpersonal behaviors (perception and communication of emotion), (d) group level (leadership and teams), and (e) organizational level (culture and climate). Within these perspectives, we address the importance of affective events theory (AET) and its interaction with emotional intelligence, emotional labor, and emotional contagion, as well as the role of emotion in leadership and organizational culture and climate. We conclude by presenting an integrative model that shows how the five levels are linked, followed by disc...

Moral distress and its contribution to the development of burnout syndrome among critical care providers.

Abstract: Burnout appears to be common among critical care providers. It is characterized by three components: emotional exhaustion, depersonalization and personal accomplishment. Moral distress is the inability of a moral agent to act according to his or her core values and perceived obligations due to internal and external constraints. We aimed to estimate the correlation between moral distress and burnout among all intensive care unit (ICU) and the step-down unit (SDU) providers (physicians, nurses, nurse technicians and respiratory therapists). A survey was conducted from August to September 2015. For data collection, a self-administered questionnaire for each critical care provider was used including basic demographic data, the Maslach Burnout Inventory (MBI) and the Moral Distress Scale-Revised (MDS-R). Correlation analysis between MBI domains and moral distress score and regression analysis to assess independent variables associated with burnout were performed. A total of 283 out of 389 (72.7%) critical care providers agreed to participate. The same team of physicians attended both ICU and SDU, and severe burnout was identified in 18.2% of them. Considering all others critical care providers of both units, we identified that overall 23.1% (95% CI 18.0–28.8%) presented severe burnout, and it did not differ between professional categories. The mean MDS-R rate for all ICU and SDU respondents was 111.5 and 104.5, respectively, p = 0.446. Many questions from MDS-R questionnaire were significantly associated with burnout, and those respondents with high MDS-R score (>100 points) were more likely to suffer from burnout (28.9 vs 14.4%, p = 0.010). After regression analysis, moral distress was independently associated with burnout (OR 2.4, CI 1.19–4.82, p = 0.014). Moral distress, resulting from therapeutic obstinacy and the provision of futile care, is an important issue among critical care providers’ team, and it was significantly associated with severe burnout.

Prevalence of Burnout Syndrome in Emergency Nurses: A Meta-Analysis

Abstract: Objective To determine the prevalence of burnout (based on the Maslach Burnout Inventory on the 3 dimensions of high Emotional Exhaustion, high Depersonalization, and low Personal Accomplishment) among emergency nurses Method A search of the terms "emergency AND nurs* AND burnout" was conducted using the following databases: CINAHL, Cochrane, CUIDEN, IBECS, LILACS, PubMed, ProQuest, PsycINFO, SciELO, and Scopus Results Thirteen studies were included for the Maslach Burnout Inventory subscales of Emotional Exhaustion and Depersonalization and 11 studies for the subscale of low Personal Accomplishment The total sample of nurses was 1566 The estimated prevalence of each subscale was 31% (95% CI, 20-44) for Emotional Exhaustion, 36% (95% CI, 23-51) for Depersonalization, and 29% (95% CI, 15-44) for low Personal Accomplishment Conclusions The prevalence of burnout syndrome in emergency nurses is high; about 30% of the sample was affected with at least 1 of the 3 Maslach Burnout Inventory subscales Working conditions and personal factors should be taken into account when assessing burnout risk profiles of emergency nurses

Burnout and psychiatric morbidity among doctors in the UK: a systematic literature review of prevalence and associated factors

Abstract: Aims and method To systematically review the prevalence and associated factors of burnout and stress-related psychiatric disorders among UK doctors. An extensive search was conducted of PubMed, EBSCOhost and British medical journals for studies published over a 20-year span measuring the prevalence of psychiatric morbidity (using the General Health Questionnaire) and burnout (using the Maslach Burnout Inventory). Results Prevalence of psychiatric morbidity ranged from 17 to 52%. Burnout scores for emotional exhaustion ranged from 31 to 54.3%, depersonalisation 17.4 to 44.5% and low personal accomplishment 6 to 39.6%. General practitioners and consultants had the highest scores. Factors significantly associated with increase in the prevalence of burnout and psychiatric morbidity include low job satisfaction, overload, increased hours worked and neuroticism. Clinical implications The results indicate a worryingly high rate of burnout and psychiatric morbidity among UK doctors, which could have a huge negative impact on healthcare provision in general. Factors at personal and organisational levels contribute to burnout and psychiatric morbidity, and so efforts made to counter these problems should target both levels.

Self-care as a professional imperative: physician burnout, depression, and suicide

Abstract: Burnout has been identified in approximately half of all practicing physicians, including anesthesiologists. In this narrative review, the relationship between burnout, depression, and suicide is explored, with particular attention to the anesthesiologist. Throughout this review, we highlight our professional imperative regarding this epidemic. The authors searched the existing English language literature via PubMed from 1986 until present using the search terms physician burnout, depression, and suicide, with particular attention to studies regarding anesthesiologists and strategies to address these problems. Burnout and depression have increased among physicians, while the rate of suicide has remained relatively the same. There are many factors associated with burnout and depression as well as many causes. Certain individual factors include sex, amount of social support, and mental health history. Systems factors that play a role in burnout and depression include work compression, demands of electronic health records, production pressure, and lack of control over one’s professional life. Medical license applications include questions that reinforce the stigma of psychological stresses and discourage physicians from seeking appropriate care. The concept of physician well-being is multidimensional and includes factors related to each physician as an individual as well as to the working environment. Anesthesiologists must actively engage in self-care. Anesthesiology practices and healthcare organizations should evaluate the balance between demands they place on physicians and the resources provided to sustain an engaged, productive, and satisfied physician workforce. National efforts must be rallied to support physicians seeking help for physical and psychological health problems.

Burning Out: a Framework

Abstract: Burnout is a chronic, negative, affective response with fatigue and emotional exhaustion as its core aspects. The concept of burnout was earlier criticized for being mainly descriptive, anecdotal, and vaguely defined. This chapter briefly examines the state conception of burnout and its validity. A framework for the burnout phenomenon is then put forth where the focus is directed toward a more precise phenomenon, the process of "burning out", which eventually may progress to the state of burnout. The purpose for this framework is to distinguish burning out from similar phenomena and to outline guidelines for operationalizations and prevention. The state conception of burnout may conceal the relationship between burnout and environmental factors. The chapter also introduces three interacting, hypothetical constructs to account for the burning-out process: a vulnerability, a goal orientation, and an incongruous, threatening environment. This burning-out process is consistent with some control, cognitive, and behavioral models of reactive depression.

Dimensions of Teacher Burnout: Relations with Potential Stressors at School.

Abstract: The purpose of this study was to analyze how four potential stressors in the school environment (discipline problems, time pressure, low student motivation, and value dissonance) were related to dimensions of teacher burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment). Participants were 1145 teachers from grade 1 to 13. Data were analyzed by means of confirmatory factor analysis and SEM analysis. A confirmatory factor analysis including the four stressors and the three dimensions of burnout had good fit to the data and the correlations between the factors were moderate. Although all the potential stressors were significantly related to emotional exhaustion, time pressure was the far strongest predictor. In comparison, depersonalization and personal accomplishment was not significantly related to time pressure but was significantly predicted by discipline problems, low student motivation, and value dissonance. Teachers at the lowest grade levels reported more discipline problems and higher time pressure than teachers at higher grade levels, whereas teachers at the highest grade levels experienced low student motivation as a greater problem than teachers at lower grade levels.

A longitudinal study of teachers' occupational well-being: Applying the job demands-resources model.

Abstract: The job demands-resources model (JD-R model; Bakker & Demerouti, 2014) is well established in occupational research, and the proposed processes it posits have been replicated numerous times. Thus, the JD-R model provides an excellent framework for explaining the occupational well-being of beginning teachers-an occupation associated with particularly high levels of strain and consequently, high attrition rates. However, the model's assumptions have to date mostly been tested piecewise, and seldom on the basis of longitudinal models. With a series of longitudinal autoregressive SEM models (N = 1,700) we tested all assumptions of the JD-R model simultaneously in one model with an applied focus on beginning teachers. We assessed self-reports of beginning teachers at three time waves: at the beginning and end (one and a half to two years later) of their preservice period, and again, one year later. Results revealed significant direct effects of resources (self-efficacy) on engagement, of demands (classroom disturbances) on strain (emotional exhaustion), and a significant reverse path of engagement on self-efficacy. Additionally, the results showed two moderation effects: Self-efficacy buffered the demands-strain relationship, while self-efficacy also predicted engagement, especially when disturbances were high. Thus, self-efficacy in classroom management plays an important role in the teachers' stress development process, as it will, in case of high classroom disturbances, not only buffer the strain-enhancing effects, but also boost engagement. Commitment was predicted directly by emotional exhaustion and engagement, but indirectly only by self-efficacy (via engagement). Thus, we provide strong empirical support for the JD-R model. (PsycINFO Database Record

Coping With Staff Burnout and Work-Related Posttraumatic Stress in Intensive Care.

Abstract: Objective: To examine the associations with symptoms of a) burnout and b) work-related post-traumatic stress, in adult and pediatric intensive care staff, focusing on the particular contributions of resilience and coping strategies. Design: Point prevalence cross-sectional study Setting: Three adult and four pediatric ICUs Subjects: Three hundred and seventy seven ICU staff Interventions: None Measures: Brief Resilience Scale (BRS); abbreviated Maslach Burnout Inventory (aMBI); Trauma Screening Questionnaire (TSQ) and Hospital Anxiety and Depression Scale (HADS). Main Results: Prevalence of burnout (defined as high emotional exhaustion or high depersonalization) was 37%. Prevalence of clinically significant post-traumatic stress symptoms was 13%. There was a degree of overlap between burnout and other measures of distress, most notably for anxiety (OR=10.56, 95% CI:4.12,27.02, p<0.001). Hierarchical logistic regression demonstrated that self-reported resilience was strongly associated with decreased likelihood of meeting criteria for both forms of work-related distress (burnout: OR=0.52, 95% CI:0.36,0.74, p<0.001; post-traumatic stress: OR=0.28, 95% CI:0.16,0.46, p<0.001) and that physicians were twice as likely as nurses to be at risk of reporting burnout (OR=2.11, CI:1.18,3.78, p=0.012). After controlling for resilience, profession and setting, the following coping strategies were independently associated with outcomes: attending debriefing reduced risk of burnout (OR=0.45, 95% CI:0.21,0.95, p=0.036), while the odds of post-traumatic stress were less if staff used talking to seniors (OR=0.43, 95% CI:0.20,0.92, p=0.029) or hobbies (OR=0.46, 95% CI:0.23,0.93, p=0.030) to cope with stress at work. Venting emotion (OR=1.92, 95% CI:1.12,3.31, p=0.018) and using alcohol (OR=2.30, 95% CI:1.26,4.20, p=0.006) were associated with a doubling in risk of reporting burnout. Conclusions: The use of particular coping strategies was systematically associated with symptoms of burnout and work-related post-traumatic stress in this group of intensive care staff, even after controlling for resilience and other factors. More research on how best to promote adaptive coping is needed in these challenging settings.

A moderated mediation model of the relationship between abusive supervision and knowledge sharing

Abstract: This study uses the conservation of resources theory to examine the influence of a leader's destructive behaviors by investigating how emotional exhaustion resulting from abusive supervision affects employees' knowledge-sharing behaviors. Using a moderated mediation framework, this study suggests that organizational justice moderates the positive relationship between abusive supervision and employees' emotional exhaustion and attenuates the negative indirect effect of abusive supervision on employees' knowledge-sharing behaviors. The results of this study, drawn from a sample of 202 dyads comprising full-time employees and their immediate supervisors, support most of its hypotheses. The implications and limitations of the study, as well as directions for future research, are discussed.

Prevalence of and factors associated with burnout among health care professionals in Arab countries: a systematic review

Abstract: Burnout among healthcare professionals is one of the key challenges affecting health care practice and quality of care. This systematic review aims to (1) estimate the prevalence of burnout among health care professionals (HCP) in Arab countries; and (2) explore individual and work-related factors associated with burnout in this population. Multiple electronic databases were searched for studies published in English or Arabic from January 1980 to November 2014 assessing burnout (using the Maslach Burnout Inventory; MBI) amongst health care professionals (HCP) in Arab countries. Nineteen studies (N = 4108; 49.3% females) conducted on HCP in Bahrain, Egypt, Jordan, Lebanon, Palestine, Saudi Arabia and Yemen were included in this review. There was a wide range of prevalence estimates for the three MBI subscales, high Emotional Exhaustion (20.0–81.0%), high Depersonalization (9.2–80.0%), and low Personal Accomplishment (13.3–85.8%). Gender, nationality, service duration, working hours, and shift patterns were all significantly associated with burnout. Within the constraints of the study and the range of quality papers available, our review revealed moderate-to-high estimates of self-reported burnout among HCP in Arab countries that are similar to prevalence estimates in non-Arabic speaking westernized developed countries. In order to develop culturally appropriate interventions, further research using longitudinal designs is needed to confirm the risk factors for burnout in specific HCP settings and specialties in Arab countries.

Perceived organizational support and employees’ well-being: the mediating role of organizational dehumanization

Abstract: Perceived organizational support (POS) has been found to predict important organizational outcomes such as increasing employees’ well-being. In this research, we examine a new underlying me...

Factors Associated With Burnout Among US Hospital Clinical Pharmacy Practitioners: Results of a Nationwide Pilot Survey:

Abstract: Background: In health care, burnout has been defined as a psychological process whereby human service professionals attempting to positively impact the lives of others become overwhelmed and frustrated by unforeseen job stressors. Burnout among various physician groups who primarily practice in the hospital setting has been extensively studied; however, no evidence exists regarding burnout among hospital clinical pharmacists. Objective: The aim of this study was to characterize the level of and identify factors independently associated with burnout among clinical pharmacists practicing in an inpatient hospital setting within the United States. Methods: We conducted a prospective, cross-sectional pilot study utilizing an online, Qualtrics survey. Univariate analysis related to burnout was conducted, with multivariable logistic regression analysis used to identify factors independently associated with the burnout. Results: A total of 974 responses were analyzed (11.4% response rate). The majority were females who had practiced pharmacy for a median of 8 years. The burnout rate was high (61.2%) and largely driven by high emotional exhaustion. On multivariable analysis, we identified several subjective factors as being predictors of burnout, including inadequate administrative and teaching time, uncertainty of health care reform, too many nonclinical duties, difficult pharmacist colleagues, and feeling that contributions are underappreciated. Conclusions: The burnout rate of hospital clinical pharmacy providers was very high in this pilot survey. However, the overall response rate was low at 11.4%. The negative effects of burnout require further study and intervention to determine the influence of burnout on the lives of clinical pharmacists and on other health care-related outcomes.

Boundary control and controlled boundaries: Organizational expectations for technology use at the work–family interface

Abstract: Summary Some studies have argued that information and communication technologies such as smartphones can pressure employees to work more from home, while others argue that they help employees manage transitions between work and family role domains. Leveraging boundary theory and the job demands–resources model, the present study examines the conditions under which work–family technology use is associated with greater boundary control. Findings show that technology use is associated with higher boundary control for those who prefer role integration and lower boundary control for those who prefer role segmentation. Findings also show that boundary control is linked to emotional exhaustion and that organizational after-hours electronic communication expectations can compel work–family technology use despite individual preferences. Copyright © 2016 John Wiley & Sons, Ltd.

Is it Better to Give or Receive? The Role of Help in Buffering the Depleting Effects of Surface Acting

Abstract: The resource-depleting effect of surface acting is well established. Yet we know less about the pervasiveness of this depleting effect and what employees can do at work to replenish their resources...

Assessment of Burnout and Associated Risk Factors Among Pharmacy Practice Faculty in the United States.

Abstract: Objectives. To measure the level of burnout among pharmacy practice faculty members at US colleges and schools of pharmacy and to identify factors associated with burnout. Methods. Using a cross-sectional, electronic, anonymous survey-design, we measured faculty burnout (n=2318) at US colleges and schools of pharmacy using the Maslach Burnout Inventory-Educators Survey (MBI-ES), which measures burnout dimensions: emotional exhaustion, depersonalization, and personal accomplishment. We assessed MBI-ES scores, demographics and possible predictors of burnout. Results. The response rate was 32.7% (n=758). Emotional exhaustion was identified in 41.3% and was higher in women, assistant professors, and those without a hobby. Participants without a mentor had higher scores of depersonalization. Those with children ages 1-12 years had higher emotional exhaustion and depersonalization compared to those with older children. Conclusion. Pharmacy practice faculty members at US colleges and schools of pharmacy are suffering from burnout, exhibited mainly through emotional exhaustion.

Nurses' Burnout: The Influence of Leader Empowering Behaviors, Work Conditions, and Demographic Traits.

Abstract: Nurse burnout is a widespread phenomenon characterized by a reduction in nurses' energy that manifests in emotional exhaustion, lack of motivation, and feelings of frustration and may lead to reductions in work efficacy. This study was conducted to assess the level of burnout among Jordanian nurses and to investigate the influence of leader empowering behaviors (LEBs) on nurses' feelings of burnout in an endeavor to improve nursing work outcomes. A cross-sectional and correlational design was used. Leader Empowering Behaviors Scale and the Maslach Burnout Inventory (MBI) were employed to collect data from 407 registered nurses, recruited from 11 hospitals in Jordan. The Jordanian nurses exhibited high levels of burnout as demonstrated by their high scores for Emotional Exhaustion (EE) and Depersonalization (DP) and moderate scores for Personal Accomplishment (PA). Factors related to work conditions, nurses' demographic traits, and LEBs were significantly correlated with the burnout categories. A stepwise regression model-exposed 4 factors predicted EE: hospital type, nurses' work shift, providing autonomy, and fostering participation in decision making. Gender, fostering participation in decision making, and department type were responsible for 5.9% of the DP variance, whereas facilitating goal attainment and nursing experience accounted for 8.3% of the PA variance. This study highlights the importance of the role of nurse leaders in improving work conditions and empowering and motivating nurses to decrease nurses' feelings of burnout, reduce turnover rates, and improve the quality of nursing care.