Physician Burnout and Patient Satisfaction with Consultation in Primary Health Care Settings: Evidence of Relationships from a one-with-many Design

Physician burnout, as a prolonged response to chronic emotional and interpersonal stressors on the job, has been associated with suboptimal patient care and deterioration in the patient?Cprovider relationship. Although prior studies have identified a range of factors associated with decreased patient satisfaction, most have been conducted in tertiary care settings, with staff burnout examined at the hospital unit-level. To examine the impact of physician burnout on patient satisfaction from consultation in the primary care setting, a cross-sectional survey was conducted in Western Greece. Using a one-with-many design, 30 physicians and 300 of their patients, randomly selected, responded to the survey. Results showed that patient satisfaction correlated significantly with physician emotional exhaustion (r = ?.636, p < .01) and physician depersonalization (r = ?.541, p < .01). Mixed-effects multilevel models indicated that 34.4% of total variation in patients?? satisfaction occurred at the physician level, after adjustment for patients?? characteristics. Moreover, physician emotional exhaustion and depersonalization remained significant factors associated with patient satisfaction with consultation, after controlling for patient and physician characteristics. Patients of physicians with high-exhaustion and high-depersonalization had significantly lower satisfaction scores, compared with patients of physicians with low-exhaustion and low-depersonalization, respectively. Future studies need to explore the mechanisms by which physician burnout affects patient satisfaction.     

Age and burnout syndrome in nursing professionals: moderating role of emotion-focused coping

This study examined whether the association between age and the three burnout dimensions (emotional exhaustion, depersonalisation and reduced personal accomplishment) depend on the extent of nursing professionals’ use of emotion-focused coping strategy. Participants were 283 nurses (Mage = 35 years, SD = 8.17, Range = 23–66 years) from a tertiary healthcare institution in south-eastern Nigeria. They completed self-report measures of relevant variables in paper and pencil form. Increased age was associated with reduced personal accomplishment for nurses with high emotion-focused coping, but not for those who were low or moderate in use of emotion-focused coping. Such moderation effects were not found for emotional exhaustion and depersonalisation. Findings clarify the conditions under which age may be associated with reduced sense of achievement at work among nursing professionals. The study adds to knowledge in combating burnout in nursing and could guide health managers in developing strategies that might prevent or ameliorate nurses’ burnout.     

Does role stress predict burnout over time among health care professionals?

Abstract

The main objective of this study is to test the effects over time of three role stress variables (role conflict, role ambiguity and role overload) on the three burnout dimensions (emotional exhaustion, depersonalization and personal accomplishment). Based on theoretical models on burnout and on meta-analytical research, it is hypothesized that the three role stress variables will predict changes over time in emotional exhaustion and depersonalization, but not in personal accomplishment. The results obtained by means of hierarchical regression analysis partially support the hypothesis. The three role stress variables predict emotional exhaustion over time. Role conflict and role overload predict depersonalization over time. Finally, contrary to expectations, role ambiguity predicts personal accomplishment over time.     

小学教师职业倦怠维度发展顺序探究——来自结构方程模型和交叉滞后网络分析模型的证据

教师职业倦怠的情感衰竭、去人性化和个人成就感降低3个维度相对独立但也存在相互影响, 对其发展关系进行研究, 有助于深入理解职业倦怠的发展过程, 尽早识别倦怠症状。本研究对3837名小学教师进行追踪测试, 测试间隔为3年, 采用结构方程模型和交叉滞后网络分析模型进行分析, 结果发现小学教师职业倦怠维度最优发展模型为“T1的情感衰竭和个人成就感降低分别预测T2的情感衰竭和个人成就感降低, T1的去人性化预测T2的去人性化和个人成就感降低”, 且最优发展模型具有性别间的一致性和教龄段之间的一致性。这一结果支持并强调了去人性化在小学教师职业倦怠发展中的重要作用, 对识别教师职业倦怠早期症状并采取相应措施有效阻断教师职业倦怠的进一步发展具有一定的理论和现实意义。     

The relationships of change in work climate with changes in burnout and depression: a 2-year longitudinal study of Chinese mental health care workers

Mental health care workers face heavy emotional demand and are prone to work burnout. Work burnout has been associated with poor mental health and work climate, which refers to individual perceptions about work setting. The purpose of this study was to examine whether intra-individual changes in work climate were associated with intra-individual changes in burnout and depression over two years. The present sample included Chinese mental health care workers (N = 312; mean age = 38.6, SD = 9.9) working in a psychosocial rehabilitation institution. The participants completed questionnaires on work climate, work burnout and depression at seven time points across two years. Parallel process latent growth modeling was used to analyze the associations of change between work climate and burnout and depression. Work climate displayed a logarithmic decreasing trend while burnout and depression displayed logarithmic increasing trends over two years. Baseline levels of work climate were negatively and moderately associated with baseline levels of burnout and depression (r = ?.44 to ?.60, p < .01). Changes in work climate were negatively and moderately associated with change in burnout (r = ?.43, p < .01) and change in depression (r = ?.31, p < .05). Change in burnout was positively and strongly associated (r = .58, p < .01) with change in depression. The current results support temporal relationships among changes in work climate, burnout and depression across time. Practical implications for future preventive work in burnout interventions were discussed within this population.     

Differential Effect of Inter-Role Conflict on Proactive Individual’s Experience of Burnout

Purpose

This study examined how proactive personality interacts with inter-role conflict, measured as work?Cfamily conflict and family?Cwork conflict, to predict burnout, measured as emotional exhaustion, depersonalization, and reduced personal accomplishment.

Design/Methodology/Approach

Participants were 171 clerical employees. Hierarchical multiple regression was used to test whether proactive personality moderated the relationship between inter-role conflict and forms of burnout.

Findings

Family?Cwork conflict was not associated with burnout, but work?Cfamily conflict explained 30% of unique variance in emotional exhaustion and 9% in depersonalization. Proactive personality explained 12% of variance in personal accomplishment. Three-way interactions indicated that at high levels of work??family conflict and family??work conflict, proactive individuals reported lower levels of emotional exhaustion and personal accomplishment and higher levels of depersonalization than less proactive individuals.

Implications

While previous research has generally documented the virtues of proactive personality, our research indicates that when simultaneously faced with work?Cfamily and family?Cwork conflict, individuals with proactive personality experience more depersonalization and less personal accomplishment relative to less proactive individuals. Overall, results of three-way interactions imply that while a certain level of proactive personality may be necessary to buffer feelings of emotional exhaustion, beyond a certain level, proactive personality may lead one to experience higher levels of depersonalization and reduced personal accomplishment.

Originality/Value

This study extends previous research by examining the influence of two types of inter-role conflict on all three dimensions of burnout. It also responds to calls for additional research on potential moderators, buffers, or even antidotes to stress by examining how proactive personality interacts with stressors.     

Relationships among burnout, job involvement, and organizational citizenship behavior

R. Cropanzano, D. E. Rupp, and Z. S. Byrne (2003) found that emotional exhaustion (i.e., 1 dimension of burnout) negatively affects organizational citizenship behavior (OCB). The authors extended this research by investigating relationships among 3 dimensions of burnout (emotional exhaustion, depersonalization, and diminished personal accomplishment) and OCB. They also affirmed the mediating effect of job involvement on these relationships. Data were collected from 296 paired samples of service employees and their supervisors from 12 hotels and restaurants in Taiwan. Findings demonstrated that emotional exhaustion and diminished personal accomplishment were related negatively to OCB, whereas depersonalization had no independent effect on OCB. Job involvement mediated the relationships among emotional exhaustion, diminished personal accomplishment, and OCB.     

员工工作倦怠的发展模型:来自纵向研究的证据

采用Maslach工作倦怠量表对263名企业员工在一年时间内的三个等距时间点(T1,T2,T3)的工作倦怠进行测量,纵向研究中国文化背景下工作倦怠的发展规律,并比较工作倦怠发展的六种因果模型。研究结果表明,去人性化影响成就感降低,且这种影响具有跨时间一致性;但是情绪衰竭和去人性化相互影响的跨时间一致性较低,如T1情绪衰竭影响T2去人性化,但是T2情绪衰竭对T3去人性化的影响不显著;T1去人性化对T2情绪衰竭的影响不显著,但是T2去人性化影响T3情绪衰竭。去人性化在工作倦怠的发展中具有非常重要的作用。     

Predictors of burnout and health status in Samaritans’ listening volunteers

Samaritan listening volunteers provide emotional support to people in distress or suicidal. Samaritans’ has high volunteer turnover, which may be due to burnout. This study evaluated the role of demographic and psychosocial factors in predicting Samaritans listening volunteers’ burnout and health status. Samaritans’ listening volunteers (n = 216) from seven branches across UK completed an online survey to assess their levels of burnout (emotional exhaustion, depersonalisation, personal accomplishment), subjective health status, coping, empathy and social support. Overall, listeners showed low levels of burnout and good health. Regression analysis revealed that higher emotional exhaustion was predicted by younger age and avoidant coping style; higher depersonalisation was predicted by lower empathy fantasy and higher avoidant coping style; lower personal accomplishment scores were predicted by higher empathy personal distress and worse health status was predicted by more hours per week spent on listening duties, lower social support and higher avoidant coping style. Overall, different factors influenced different facets of burnout. However, higher use of avoidant coping style consistently predicted higher burnout and worse health status, suggesting avoidant coping is an important target for intervention.     

Burnout predictors among prison officers: The moderating effect of temperamental endurance

The study investigates whether work stressors, coping styles, and work-related social support predict burnout among prison officers (N = 476). It was hypothesized that coping and social support would mediate the effects of work stressors on burnout and that these effects would be moderated by temperamental endurance. Results of structural equation modeling showed that emotion-oriented coping was positively related to emotional exhaustion, and negatively to personal accomplishment. Task-oriented coping was positively related to personal accomplishment. Social support from work was negatively related to emotional exhaustion. The effects of work stressors on burnout were mediated by work-related social support and by emotion-oriented coping. Additionally, some of these mediating effects were moderated by endurance. Work-related social support was negatively related to depersonalization only among participants with strong endurance. High level of work stressors predicted high emotion-oriented coping only among individuals with weak endurance.     

Self-handicapping and burnout

Self-handicapping is a process containing strategies of externalization in which an individual can excuse failure and internalize success. This study investigated the relationship of self-handicapping with measures of burnout. The Self-handicapping Scale and the Maslach Burnout Inventory were administered to 309 university students. Self-handicapping was positively correlated to emotional exhaustion, lowered personal accomplishment, and depersonalization. A structural equation model fit the data well and accounted for 20% of the variance in emotional exhaustion, 14% in lowered personal accomplishment, and 10% in depersonalization.     

Does role stress predict burnout over time among health care professionals?

Abstract The main objective of this study is to test the effects over time of three role stress variables (role conflict, role ambiguity and role overload) on the three burnout dimensions (emotional exhaustion, depersonalization and personal accomplishment). Based on theoretical models on burnout and on meta-analytical research, it is hypothesized that the three role stress variables will predict changes over time in emotional exhaustion and depersonalization, but not in personal accomplishment. The results obtained by means of hierarchical regression analysis partially support the hypothesis. The three role stress variables predict emotional exhaustion over time. Role conflict and role overload predict depersonalization over time. Finally, contrary to expectations, role ambiguity predicts personal accomplishment over time.     

Adjusting to job demands: The role of work self-determination and job control in predicting burnout

This study examined the dynamic interplay among job demands, job control, and work self-determination in order to predict burnout dimensions. A three-way interaction effect was found between job demands, job control and work self-determination in predicting each dimension of burnout (emotional exhaustion, depersonalization, and personal accomplishment). Overall, results showed that job control moderates the unhealthy effects of job demands in predicting emotional exhaustion and depersonalization only for employees with high levels of work self-determination. In addition, job control increases the relation between job demands and the sense of personal accomplishment only for employees with high levels of work self-determination. These results are discussed in light of the Job Demand-Control model.     

Affect Generated by Social Comparisons Among Nurses High and Low in Burnout1

The affective consequences of social comparison were examined in 2 field studies among nurses and related to the 3 dimensions of professional burnout: emotional exhaustion, reduced personal accomplishment, and depersonalization. Study t was conducted in a sample of 99 nurses of a psychiatric hospital, and Study 2 in a sample of 237 nurses employed in various settings In general, upward comparisons evoked more positive and less negative affect than did downward comparisons. However, the affective consequences of social comparison were different for those high and low in burnout. Those low in personal accomplishment reported higher levels of negative affect from upward comparisons and higher levels of positive affect from downward comparisons than did those high in personal accomplishment. In addition, in Study 2, those high in depersonalization and emotional exhaustion derived more positive affect from downward comparisons than did those with lower levels of burnout.     

教师教学效能感和工作倦怠的关系

为探讨教师效能感与其工作倦怠之间的关系,利用教师教学效能感问卷和工作倦怠问卷对247名中学教师进行施测。结果表明（1）教龄长短和婚姻状况对教师的个人教学效能感（p〈O．01）、人格解体（p〈0．01）和成就感降低（p〈o-01）具有显著的影响;（2）教师的一般教育效能感对其工作倦怠的耗竭因素具有显著的预测作用（p〈0．01）;（3）教师的个人教学效能感对其工作倦怠的人格解体（p〈0．01）和成就感降低因素（p〈O．01）具有显著的预测作用。     

Differences in Emotional Labor Across Cultures: A Comparison of Chinese and U.S. Service Workers

Purpose

In the global economy, the need for understanding cross-cultural differences and the customer service-related processes involved in emotional labor is evident. The current study attempts to examine this issue by developing and testing hypotheses pertaining to cross-cultural differences between U.S. and Chinese service workers on the levels of display rule perceptions, emotion regulation, and burnout (i.e., emotional exhaustion, personal accomplishment, and depersonalization) as well as the relationships among these variables.

Design/Methodology/Approach

Data was collected from service workers in the U.S. (n = 280) and China (n = 231). We tested for measurement differences, mean differences, and differences in the relationships among emotional labor variables between the two samples using a variety of analyses.

Findings

It was found that the relatively robust sequence of display rules to surface acting to burnout was observed in a U.S. sample but was not observed in a Chinese sample, with some relationships being significantly weaker in the Chinese sample (e.g., surface acting to burnout dimensions) and others exhibiting relationships with the opposite sign (e.g., display rules were negatively related to surface acting in the Chinese sample).

Implications

The results of this study suggest that many of the relationships among emotional labor variables vary as a function of the cultural context under consideration.

Originality/Value

This is the first study to directly compare emotional labor across samples from Eastern and Western cultures. Additionally, this study begins to answer questions concerning why models of emotional labor generated in a Western culture may not apply in other cultures.     

教师工作倦怠研究综述

工作倦怠是在以人为服务对象的职业领域中,个体的一种情感耗竭、人格解体和个人成就降低的症状。该文对教师工作倦怠的原因及其影响因素进行了分析,最后,还对工作倦怠的测量和诊断问题进行了介绍。     

Mindful and Resilient? Incremental Validity of Sense of Coherence Over Mindfulness and Big Five Personality Factors for Quality of Life Outcomes

Though conceptually distinct, mindfulness and sense of coherence (SOC) are empirically related aspects that promote health and wellbeing. The present research explored uniqueness by investigating criterion validity and incremental validity beyond the Big Five personality traits when predicting psychological distress, life satisfaction, and burnout. N = 1033 participated in a cross-sectional study. We used multiple regression analysis to examine the incremental validity of mindfulness (CHIME) and SOC (SOC-13) for psychological distress (SCL-K-9), life satisfaction (SWLS), and burnout (MBI-GS scales: emotional exhaustion, cynicism, personal accomplishment). Mindfulness and SOC had incremental validity over the Big Five traits. Despite a strong overlap (45% shared variance) between mindfulness and SOC, SOC was always the stronger predictor: psychological distress (β = ?.52), life satisfaction (β = .57), emotional exhaustion (β = ?.23), cynicism (β = ?.40), and personal accomplishment (β = ?.30). For psychological distress, life satisfaction, and cynicism, SOC statistically explained almost all the criterion validity of mindfulness. The clinical utility of mindfulness for predicting psychological health appears to be of minor importance relative to SOC, regardless whether meditators or non-meditators, who differed in mindfulness, were analyzed. Western approaches to assessing mindfulness may lack crucial social and existential dimensions.     

Toward a process model of burnout: Results from a secondary analysis

In this article, causal relations among three dimensions of burnout, as measured by the Maslach Burnout Inventory, were examined. Three causal models were examined using data from five earlier published longitudinal studies. Models were fitted using structural equation modelling (SEM) with multi-group analysis. In the best fitting model, personal accomplishment synchronously influenced depersonalization and depersonalization on its turn synchronously influenced emotional exhaustion. Practical implications of this model for the prevention of burnout were suggested.