Self-perceived clinical competence,gender and workplace setting predict burnout among psychotherapists

Work-related stress, or burnout, is elevated among healthcare staff but the specific risk factors for psychotherapists are not clear, which makes it difficult to design interventions to target this population. Therefore, the aim of this study was to investigate a set of background variables and work-related risk factors for burnout among psychotherapists. Potential protective factors such as level of education, number of years in the profession and access to clinical supervision were investigated. Symptoms of burnout were measured with the Copenhagen Burnout Inventory, and data were collected from 327 psychotherapists. In this group, 62% reported moderate or high levels of burnout symptoms, with significantly higher levels of personal- and work-related burnout than client-related burnout. Being female, having low self-perceived competence and working in the public sector were associated with higher levels of burnout. Other factors, such as age, work experience, level of education or having clinical supervision, were not associated with burnout after controlling for gender, perceived competence and workplace setting. These results confirm previous research that underlines the importance of perceived competence and control over one's work environment, and that women are at higher risk of burnout, possibly because of factors outside of work. The importance of perceived competence as a protective factor suggests that methods that increase therapeutic competence may play an important role in countering work-related stress. In conclusion, there may be a need to continue to develop and integrate specific burnout prevention interventions for psychotherapists.     

Young managers’ drive to thrive: A personal work goal approach to burnout and work engagement

This study approaches young managers’ occupational well-being through their work-related goal pursuit. The main aim was to identify content categories of personal work goals and investigate their associations with background factors, goal appraisals, burnout, and work engagement. The questionnaire data consisted of 747 young Finnish managers (23-35 years; M = 31 years) who were mostly men (85.5%). Seven work-related content categories were found on the basis of qualitative data analysis: (1) competence goals (30.5%), (2) progression goals (23.7%), (3) well-being goals (15.2%), (4) job change goals (13.7%), (5) job security goals (7.4%), (6) organizational goals (5.6%), and (7) financial goals (3.9%). ANCOVA analyses, where goal appraisals and significant background factors were controlled for, indicated that organizational goals were related to low burnout and the highest level of work engagement, whereas well-being and job change goals were related to higher burnout and lower work engagement. The study shows that the contents of young managers’ work-related goals can contribute to the understanding of individual differences in occupational well-being.     

Burnout among healthcare workers at L’Aquila: its prevalence and associated factors

Burnout, which is now recognized as a real problem in terms of its negative outcome on healthcare efficiency, is a stress condition that can be increased by exposure to natural disasters, such as the 2009 L’Aquila earthquake. This study aims to evaluate burnout syndrome, its associated risk factors and stress levels, and the individual coping strategies among healthcare professionals at L’Aquila General Hospital. A cross-sectional study of 190 healthcare workers was conducted. There was a questionnaire for the collection of the socio-demographic, occupational and anamnestic data, and the Maslach Burnout Inventory, the General Health Questionnaire-12 items (GHQ-12) and the Brief COPE were used. The burnout dimensions showed high scores in Emotional Exhaustion (38.95%), in Depersonalization (23.68%) and in lack of Personal Accomplishment (23.16%), along with the presence of moderate to high levels of distress (54.21%). In addition to factors already known to be associated with burnout (job perception and high levels of distress) exposure to an earthquake emerged as a factor independently associated with the syndrome. Adaptive coping strategies such as religiosity showed a significant and negative relationship with burnout. Our research highlights the need for interventions directed at a reduction in workload and work-stressors and an improvement of adaptive coping strategies, especially in a post-disaster workplace.     

Trends in burnout syndrome and emotional factors: an assessment of anesthesiologists in Southern Brazil, 2012

Burnout syndrome (BOS) is the result of chronic stress at work, and is characterized by emotional exhaustion (EE), depersonalization (DP), and low professional accomplishment. Anesthesiologyis a stressful profession. The aim of this study was to assess the prevalence of burnout as well as the sociodemographic and working characteristics associated with this syndrome’s emotional factors, in anesthesiologists from Southern Brazil. We assessed burnout severity, depressive symptoms, and self-esteem using the Maslach burnout inventory, the Beck depression inventory, and the Rosenberg self-esteem scale, respectively. Of the 198 anesthesiologists included in this study, 48.7% were positive for burnout, 26.9% for EE, 41.3% for DP and 32.7% for low personal accomplishment. Trends in BOS was associated with a younger age, difficulty to conciliate family and work demands, low self-esteem, and depressive symptoms.     

Social Support, Personality, and Burnout in Nurses

This study sought to find evidence for: (a) a relationship between increased levels of work-related social support and decreased burnout, (b) a relationship between personality traits and burnout, and (c) a significant interaction of social support and extraversion in relation to burnout. Seventy-six staff nurses and their supervisors at a private medical hospital participated as subjects. Two subscales of the Work Environment Scale measured social support. Personality was measured using an instrument known as PROSCAN, and Scale H of the 16PF. Burnout was measured by the Maslach Burnout Inventory. A strong negative correlation between work-related social support and burnout was found. Also, nurses whose supervisors received positive-feedback training showed significant reductions in emotional exhaustion, compared to those whose supervisors did not receive this training. Some dimensions of personality explained a significant amount of burnout. The study also provided further evidence of the interactive effect of social support and extraversion in relation to an emotional distress variable. That is, extraverted nurses required more work-related peer support than did introverts to avoid emotional exhaustion. Suggestions for further research are given.     

Professional burnout and work stress among Israeli dental assistants

Professional burnout and work-related stress are known problems that have been the subject of in-depth examination among dentists. Nevertheless, these issues have not been widely studied among dental assistants. The aims of this study were threefold: to confirm the structure of a Work Stress Inventory (WSI) for Dental Assistants which was originally developed for Jordanian dental assistants (factor analysis); to evaluate work stress and burnout among Israeli dental assistants and to discover the factors predicting Israeli assistants’ burnout (regression analyses). The Maslach Burnout Inventory and the WSI were distributed by mail and in person. Varimax factor analysis revealed that the items which contribute to different aspects of work stress are similar among both Jordanian and Israeli populations. Among the 299 Israeli dental assistants who completed the questionnaires, the most stressful work-related factors were income, workload, and work hazards. Eighteen percent of the participants exhibited a high to very high level of burnout. Participants exhibited a moderate level of emotional exhaustion (EE), low level of depersonalization (DP), and high level of personal accomplishment (PA). Most WSI factors were found to correlate positively with EE and DP. Linear stepwise regression analyses revealed that the best predictor of EE was the dentist?assistant relationship, followed by workload, patient type, and salary. The best predictor of DP was patient suffering followed by dentist?assistant relationship, years of professional experience, and work hazards. Professional stress and burnout among dental assistants are important factors that can possibly affect the wellbeing of both dental personnel and their patients. Further studies are necessary to better understand these factors in addition to the effects of personal relationships on burnout among dentists and their assistants.     

Burnout and depressive symptoms are not primarily linked to perceived organizational problems

In this 257-participant study (76% female; mean age: 44.84), we examined two ideas that are widespread among burnout researchers: (a) the idea that burnout is primarily related to occupational-level factors; and (b) the idea that burnout should be considered a sentinel indicator in research on negative occupational outcomes. We investigated the links between burnout and a series of generic and work-related variables, namely, depressive symptoms, neuroticism, extraversion, effort-reward imbalance in the job [ERI], social support at work (SSW), and turnover intention. Burnout was assessed with the Shirom-Melamed Burnout Measure, depressive symptoms with the PHQ-9, neuroticism and extraversion with the NEO-Five Factor Inventory, ERI with the 10-item version of the Effort-Reward Imbalance Questionnaire, SSW with the Job Content Questionnaire, and turnover intention with a dedicated 3-item measure. Correlation, multiple regression, and relative weight analyses were conducted. Burnout was not found to be more strongly linked to organizational and work-contextualized variables than to personality traits. In addition, turnover intention was not associated to a greater extent with burnout than with ERI. Burnout and depressive symptoms were highly correlated and exhibited overlapping nomological networks. Overall, our findings question the way burnout has been generally conceived.     

工作要求-资源模型与工作倦怠的相互影响

采用间隔六个月的三波纵向设计,对国内263名企业员工的工作倦怠、工作要求、工作资源进行测量,探讨中国文化背景下企业员工工作环境的动态变化和倦怠体验的相互影响及其作用机制。研究结果表明,控制基线水平后,工作要求增量正向影响工作倦怠增量,工作资源增量负向影响工作倦怠增量;而工作倦怠增量进一步对员工所处的微工作环境产生一定的负面影响,导致工作要求进一步增加,工作资源进一步降低,因此易形成“工作环境恶化→工作倦怠加剧→工作环境进一步恶化”的恶性因果关系回路。     

Genetic and environmental influences on the association between performance‐based self‐esteem and exhaustion: A study of the self‐worth notion of burnout

In the self‐worth model, burnout is considered to be a syndrome of performance‐based self‐esteem (PBSE) and experiences of exhaustion. Studies have shown that PBSE and burnout indices such as Pines’ Burnout Measure (BM) are associated. Whether these variables have overlapping etiologies has however not been studied before. Genetic and environmental components of covariation between PBSE and exhaustion measured with Pines’ BM were examined in a bivariate Cholesky model using data from 14,875 monozygotic and dizygotic Swedish twins. Fifty‐two per cent of the phenotypic correlation (r = 0.41) between PBSE and Pines’ BM was explained by genetics and 48% by environmental factors. The findings of the present study strengthen the assumption that PBSE should be considered in the burnout process as proposed by the self‐worth conception of burnout. The present results extend our understanding of the link between this contingent self‐esteem construct and exhaustion and provide additional information about the underlying mechanisms in terms of genetics and environment. This finding corroborates the assumed syndrome view on burnout, while it also suggests an altered view of how the syndrome emerges and how it can be alleviated.     

国外关于工作倦怠研究的现状述评

文章回顾了国外关于工作倦怠的相关研究,全文分四部分进行介绍。第一部分介绍其概念以及相关量表;第二部分对工作倦怠方面研究的发展过程做一简介,主要涉及研究范围、研究方法和所关注的问题;第三部分介绍对工作倦怠产生影响的因素,分为工作特征和个体特征两方面的因素;第四部分补充介绍一些解释工作倦怠成因的理论模型。最后,文章在第五部分加以总结评述并对今后研究提出展望     

Sources of social support and burnout: a meta-analytic test of the conservation of resources model

The Conservation of Resources (COR) model of burnout (Hobfoll & Freedy, 1993) suggests that resources are differentially related to burnout dimensions. In this paper, I provide a meta-analysis of the social support and burnout literature, finding that social support, as a resource, did not yield different relationships across the 3 burnout dimensions (emotional exhaustion, depersonalization, and personal accomplishment), challenging the COR model. However, when considering the source of the social support (work vs. nonwork) as a moderator, I found that work-related sources of social support, because of their more direct relationship to work demands, were more closely associated with exhaustion than depersonalization or personal accomplishment; the opposite pattern was found with nonwork sources of support. I discuss the implications of this finding in relation to the COR model and suggest future research directions to clarify the relationship between resources and burnout dimensions.     

Which occupational risk factors are associated with burnout in nursing? A meta-analytic study

Numerous empirical studies have suggested a link between occupational factors and the burnout syndrome. The effect sizes of the association reported vary widely in nursing professionals. The objective of this research was to assess the influence of five occupational factors (job seniority, professional experience, job satisfaction, specialization and work shift) on the three burnout dimensions (emotional exhaustion, depersonalization and personal accomplishment) in nursing. We conducted a meta-analysis with a total of 81 studies met to our inclusion criteria: 31 on job seniority; 29 on professional experience; 37 on job satisfaction; 4 on specialization; and 6 on work shift. The mean effect sizes found suggest that job satisfaction and, to a lesser extent, specialization were important factors influencing the burnout syndrome. The heterogeneity analysis showed that there was a great variability in all the estimates of the mean effect size. Various moderators were found to be significant in explaining the association between occupational factors and burnout. In conclusion, it is important to prevent the substantive moderators that are influencing these associations. The improved methodological variables explain most of the contradictory results found in previous research on this field.     

Le burn-out est-il une entité nosographique distincte ?

Although it has largely been studied since the 1970s, it remains controversial to accurately define what the concept of burnout encompasses. Indeed, burnout is not consensually defined and, although some consider that it is a work-related illness, there is no clear diagnostic criteria. This problem is intensified by the fact that some studies present methodological limitations, thus impeding an appropriate characterization of burnout. As a consequence of this lack of agreement, burnout is not acknowledged as a work-related illness, which minimizes the pain of those individuals who are suffering from it. The present paper will review findings that can help to disentangle whether burnout should be considered as a medical diagnosis. Cultural differences concerning the consideration of burnout as a medical condition will be pointed out and the distinctiveness of burnout compared to depression, adjustment disorder or other stress related symptoms will be highlighted. Moreover, we will explain why considering that burnout belongs to broader diagnostic categories implies that the weight of employees’ discomfort mainly relies on personal causes and therefore weakens the role of existing working conditions. This paper will also summarize clinical, psychological and biological evidences for and against the inclusion of burnout as a medical condition, before embedding them in a wider social, political and economic context. More specifically, we will explain why burnout is intimately related to the political and economic situation of a country: when society promotes cost-effectiveness, it increases stress and psychological pressure, which makes a burnout more likely to appear. Furthermore, if burnout is recognized as a work-related disease, the consequences for organizations will be that they will have to pay for additional health care charges. Finally, more effective prevention techniques could be developed, and more appropriate care could be provided to patients, but only if an agreement on diagnostic criteria was obtained and if reliable assessment tools were developed. As long as these issues are not addressed, treatments specifically targeting burnout symptoms will be further delayed although it is a serious clinical condition associated with physical and psychological symptoms impairing patients’ quality of life. In conclusion, we suggest that burnout should be considered as a medical condition despite the economic and political impediments. Nevertheless, up to now, several methodological limitations preclude to reliably establish a pathological cut-off and to delineate burnout from other mental illnesses.     

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。     

A time-lagged analysis of the effect of authentic leadership on workplace bullying,burnout, and occupational turnover intentions

Destructive interpersonal experiences at work result in negative feelings among employees and negative work outcomes. Understanding the mechanisms through which bullying can lead to burnout and subsequent turnover is important for preventing and managing this problem. Leaders play a key role in shaping positive work environments by discouraging negative interpersonal experiences and behaviours. The aim of this study is twofold. Specifically we aim to examine the relationship between authentic leadership and new graduate nurses experiences of workplace bullying and burnout over a 1-year timeframe in Canadian healthcare settings. Furthermore we aim to examine the process from workplace bullying to subsequent burnout dimensions, and to job and career turnover intentions. Results of structural equation models on new graduate nurses working in acute care settings in Ontario (N = 205) provide support for the hypothesized model linking supervisor's authentic leadership, subsequent work-related bullying, and burnout, and these in turn to job and career turnover intentions. Thus, the more leaders were perceived to be authentic the less likely nurses’ were to experience subsequent work-related bullying and burnout and to want to leave their job and profession. The results highlight the important role of leadership in preventing negative employee and organizational outcomes.     

Psychosocial correlates of hopelessness among men

This study examined overall hopelessness, explored differences in various variables (e.g. burnout) between men reporting no/mild hopelessness and moderate/severe hopelessness, and scrutinized factors associated with hopelessness. The study design was cross-sectional, and the participants were 517 men randomly selected from the general population. About 12% of men reported moderate/severe hopelessness, and men with moderate/severe hopelessness were more often older, divorced/widowed, low educated, employed in blue-collar positions, on sick leave/other/unemployment/retirement, and financially strained. They also reported more depression, posttraumatic symptoms, and burnout. Only unemployment/retirement, depression, and posttraumatic symptoms were independently associated with an increased risk for moderate/severe hopelessness in the regression analysis, with unemployment and retirement as the most important factors. In conclusion, this study seems to corroborate previous findings and may provide new insights into men's experiences and predictors of hopelessness. More research into the predictors of hopelessness in men is warranted.     

成就目标定向对学习倦怠的影响：学业自我效能的中介作用

采用问卷法调查了1139名初中生,运用结构方程模型探讨了学业自我效能在成就目标定向与学习倦怠关系中的中介效应。结果发现：(1) 学习目标定向和成绩接近定向与学习倦怠具有负向联系,而成绩回避定向与学习倦怠具有正向的关联;（2）学业自我效能在成就目标定向与学习倦怠的关系中起着一定的中介作用;在学习目标定向与学习倦怠、成绩接近定向与学习倦怠的关系中,学业自我效能起完全中介作用,且效果较为明显;而在成绩回避定向与学习倦怠的关系中,学业自我效能起部分中介作用,中介效应较弱。     

Evidencia de validez factorial del Maslach Burnout Inventory y estudio de los niveles de burnout en profesionales sanitarios

In this research we studied the levels and the associated variables with the burnout syndrome in health professionals. This research aimed to obtain evidences of factorial validity of the Maslach Burnout Inventory (MBI), to estimate the prevalence of burnout, and to identify the risk factors for this syndrome among health professionals. A cross-sectional, quantitative, and exploratory study was conducted for this purpose. The sample consisted of 435 professionals including assistants, nurses and doctors. The results indicated proper adjustment in the tri-factorial structure of the MBI. It was also found that professional category, age and type of dedication, are risk factors for suffering from burnout. On the other hand, the results showed that nurses had higher burnout levels than the rest of the professional groups studied. The foregoing suggests that the above risk factors should be taken into account when implementing programs to prevent development of the syndrome.     

Burnout,Secondary Traumatic Stress,and Social Support

The current study examines the extent to which selected work-related variables differentially predict burnout and secondary traumatic stress (STS) and the degree to which social support mitigates both of these occupational stress syndromes. Multiple regression performed on responses from 331 professional chaplains found that: (1) the number of years worked in the same employment position was positively associated with burnout but not STS; (2) STS, but not burnout, was positively associated with the number of hours spent per week counseling patients who had had a traumatic experience; and (3) social support was negatively related to burnout and STS. Only specific sources of social support (supervisory support and family support), however, were negatively associated with burnout. Results highlight the need for counselors to be attuned to not only their clients but also to their own inner dynamics in order to mitigate the possible deleterious effects of their work.     

Burnout and risk of cardiovascular disease: evidence, possible causal paths, and promising research directions

Burnout is characterized by emotional exhaustion, physical fatigue, and cognitive weariness, resulting from prolonged exposure to work-related stress. The authors review the accumulated evidence suggesting that burnout and the related concept of vital exhaustion are associated with increased risk of cardiovascular disease and cardiovascular-related events. The authors present evidence supporting several potential mechanisms linking burnout with ill health, including the metabolic syndrome, dysregulation of the hypothalamic-pituitary-adrenal axis along with sympathetic nervous system activation, sleep disturbances, systemic inflammation, impaired immunity functions, blood coagulation and fibrinolysis, and poor health behaviors. The association of burnout and vital exhaustion with these disease mediators suggests that their impact on health may be more extensive than currently indicated.