From emotional exhaustion to cynicism in academic burnout among Korean high school students: Focusing on the mediation effects of hatred of academic work

This study aimed to investigate the effect of academic hatred, referring to the hatred of academic work, on the developmental process of the core dimensions of academic burnout, namely, emotional exhaustion and cynicism. Data were collected from 1015 (57.3% female) senior high school students in South Korea. The results showed that emotional exhaustion, cynicism and academic hatred were stable across three waves. An autoregressive cross‐lagged model showed that emotional exhaustion was predictive of future academic hatred, which in turn was associated with future cynicism. Significant mediation pathways were also identified, with academic hatred mediating the longitudinal link between emotional exhaustion and cynicism. This longitudinal study can strengthen the understanding of academic hatred within the developmental process of academic burnout. The theoretical and practical implications of these findings are discussed.     

Short communication: Occupational stress and burnout among South African medical practitioners

The aim of this study was to identify job stress and burnout symptoms among randomly selected South African medical practitioners from a national survey. The sample included 402 doctors, 59.5 per cent male and 40.5 per cent female. The majority were Whites (59.3 per cent), followed by African Black (21.3 per cent), and Asians (14 per cent). Results showed that the overall job stress index indicated with 4.9, high job stress levels among the doctors. High severity job stress ratings included (1) fellow workers not doing their job, (2) inadequate salary and (3) covering work for another employee and high frequency of job stress, (4) working overtime, making critical on‐the‐spot decisions and dealing with crisis situations. Female doctors felt significantly more lack of support on job stress severity than male doctors. High levels of burnout (emotional exhaustion and depersonalization) were found among doctors. Job stress predicted emotional exhaustion and depersonalization but not personal accomplishment. Emotional exhaustion was associated with female doctors and personal accomplishment was significantly related to male doctors. White doctors reported more job stress and also burnout symptoms than doctors with colour. Copyright © 2003 John Wiley & Sons, Ltd.     

Sequential Development among Dimensions of Job Burnout and Engagement among IT Employees

The current study examined the sequential development of job burnout and job engagement and their related antecedents (job demands, job resources and personality) using a three‐wave longitudinal design. We collected usable responses from 160 Information Technology employees in China. Using M‐plus 5.0, we compared four models: the exhaustion–cynicism–inefficacy model of burnout and the vigour–dedication–absorption model of engagement, the exhaustion–cynicism–inefficacy model of burnout and the dedication–absorption–vigour model of engagement, the cynicism–inefficacy–exhaustion model of burnout and the dedication–absorption–vigour model of engagement and the cynicism–inefficacy–exhaustion model of burnout and the vigour–dedication– absorption model of engagement. The results of the model comparisons revealed that the last model had the best fit with the data. In addition, we found that job demands, job resources and personality influenced burnout and engagement in different ways. The results showed that the pathways from job demands/job resources to burnout/engagement were robust and direct, whereas personality had both a direct influence and an indirect influence (through job demands/resources) on burnout/engagement. Copyright © 2013 John Wiley & Sons, Ltd.     

Burnout in health care providers of dialysis service in Northern Italy--a multicentre study.

BACKGROUND: Few data are available regarding the prevalence of burnout among dialysis health care workers. Aims of the present study were to assess and compare burnout levels in a sample of nurses and physicians working in dialysis units, and to investigate their relationships with quality of life, in a cross-sectional observational study. METHODS: A total of 344 workers from 10 dialysis centres in Northern Italy completed a battery of questionnaires including the Maslach Burnout Inventory, the MOS-36 Item Short Form Health Survey [SF36: physical (PCS) and mental (MCS) component scores] and the 30-item General Health Questionnaire (GHQ30). Data on social and demographic characteristics and working conditions were also collected. General Estimating Equations models were used for the analysis. RESULTS: Overall, burnout scores were lower than the Italian normative sample, with no significant differences between physicians and nurses. However, 30% of nurses had high emotional exhaustion vs 18% of physicians (adjusted OR 2.38, P = 0.003). Emotional exhaustion was also predicted by number of worked hours and months worked in dialysis in the previous 2 years. Depersonalisation was predicted by male gender and bad relationship with coworkers. Having no children and having a permanent hospital position predicted low personal accomplishment. PCS was lower in nurses (50.0 vs 53.3, P < 0.001), while no significant difference was found for MCS and GHQ30. Lower PCS was associated with emotional exhaustion (P = 0.007) and GHQ30 > 5 with depersonalization (P = 0.032). CONCLUSIONS: Although burnout is not a general problem in dialysis health care providers, a subgroup of them may be identified, who would benefit from supportive measures to prevent this condition. Nurses appeared more burned-out in the emotional exhaustion scale than physicians.     

Longitudinal Analysis of Academic Burnout in Korean Middle School Students

The purpose of the study was to investigate the longitudinal relationships between the initial values and slopes of three dimensions of burnout syndrome (i.e. emotional exhaustion, cynicism and academic inefficacy). The study utilized four‐wave longitudinal data from a total of 367 (81.6% response rate) middle school students in South Korea. Comprising a 6‐month interval survey, the first survey was conducted in June 2010, the second in December 2010, the third in June 2011 and the fourth in December 2011. All participants were 13‐year‐olds at the first and second surveys, and 14‐year‐olds at the third and fourth surveys. The Maslach Burnout Inventory—Student Survey was used for each survey to assess the level of academic burnout. The longitudinal data were analysed using latent growth modelling. The results of the study indicated that high initial values (intercept) for emotional exhaustion were associated with a higher rate of increase (slope) in cynicism and academic inefficacy. On the other hand, high initial values for cynicism and academic inefficacy were associated with a lower rate of increase in the other dimensions. This longitudinal study should promote understanding of burned‐out students and contribute to the literature by informing the design of prevention programmes for academic burnout. Copyright © 2014 John Wiley & Sons, Ltd.     

The predictive value of individual factors,work‐related factors,and work–home interaction on burnout in female and male physicians: a longitudinal study

The purpose of this study was to examine physician burnout in association with individual factors, work characteristics and work–home interaction (job performance‐based self‐esteem, goal orientation, value congruency, workload, autonomy, work–home conflict and work–home facilitation). This two‐wave panel study includes a sample of Norwegian physicians collected in 2003 (N = 683) and 2005 (N = 523). Hierarchical multiple regression analysis was used to test the assumed effects in male and female physicians separately. The results imply that many of the assumed predictors play significant parts in physician burnout. A noticeable finding was that the pattern and strength of significant effects differed within the separate analyses of men and women. Work–home conflict was a particularly strong burnout predictor in female physicians whereas workload was the strongest burnout predictor in male physicians. The findings may have implications when planning future interventions. Copyright © 2010 John Wiley & Sons, Ltd.     

On-call stress among Finnish anaesthetists

We investigated on-call stress and its consequences among anaesthetists. A questionnaire was sent to all working Finnish anaesthetists (n = 550), with a response rate of 60%. Four categories of on-call workload and a sum variable of stress symptoms were formed. The anaesthetists had the greatest on-call workload among Finnish physicians. In our sample, 68% felt stressed during the study. The most important causes of stress were work and combining work with family. The study showed a positive correlation between stress symptoms and on-call workload (p = 0.009). Moderate burnout was present in 18%vs 45% (p = 0.008) and exhaustion in 32% and 68% (p = 0.015), in the lowest vs highest workload category, respectively. The symptoms were significantly associated with stress, gender, perceived sleep deprivation, suicidal tendencies and sick leave. Being frequently on call correlates with severe stress symptoms and these symptoms are associated with sick leave.     

Fully developed burnout and burnout risk in intensive care personnel at a university hospital

We assessed the prevalence of fully developed burnout, burnout risk and the influence of work and employment related factors in five intensive care units at a university hospital. A cross-sectional study was conducted using self-reporting questionnaires for the evaluation of the frequency and intensity of burnout syndrome (Maslach Burnout Inventory) and work and employment related factors. From a total of 320 eligible intensive care personnel, 33 physicians and 150 nurses participated in the study (59% response rate). Applying the process model for burnout, 63 participants (34.4%) were at risk for burnout and another 11 respondents (6.0%) revealed evidence of fully developed burnout (emotional exhaustion > or =4.0 and lack of personal accomplishment < or =4.0). No statistically significant difference in prevalence of fully developed burnout or burnout risk was detected in sub-groups according to age, gender level of training, years of employment and family status. The desire to choose the same profession again was significantly less in respondents with fully developed burnout (P=0.006). The opportunity to regularly attend facilitation was significantly lower for participants with fully developed burnout (P=0.002) compared to participants with no burnout. Fully developed burnout and burnout risk are common in intensive care personnel. Support from facilitators appeared to be an important preventive factor     

Work based support,emotional exhaustion,and spillover of work stress to the family environment: A study of policewomen

This study aimed to test a path model in which work stress affects policewomen's functioning in their family environment through a component of burnout, emotional exhaustion. Work role stressors assessed were role ambiguity and role overload. Work based support from supervisors, but not colleagues, was predicted to reduce role stressors and emotional exhaustion, and improve perceptions of family functioning (cohesion and conflict). Data was collected via a mail out survey to all (1081) policewomen in an Australian state police service. Useable surveys were returned by 421 policewomen. Path analysis using LISREL 8.5 indicated a good fit to the model. Supervisor, but not coworker support reduced role stressors, which had a significant path to family cohesion and conflict, through emotional exhaustion. The findings suggest that a fruitful avenue of exploration of stress transmission to the family would be an examination of behaviours linked to emotional exhaustion. Additionally, interventions designed to reduce stress in policewomen should include supervisor training in social support. Copyright © 2005 John Wiley & Sons, Ltd.     

心理收入管理对手术室护士职业倦怠的影响

目的探讨心理收入管理对手术室护士职业倦怠的影响。方法对100名手术室护士采用成就鼓励、人文关怀、化解错误、优化排班、建立科室文化、注重科研能力培养等增加心理收入,比较实施前后护士的职业倦怠。结果干预后手术室护士情绪衰竭、消极怠慢得分显著低于干预前,职业效能感得分显著高于干预前(均P0.01)。结论心理收入管理可有效改善手术室护士的职业倦怠。     

Burnout and Resilience Among Transplant Nurses in 22 Hospitals in China

Background

In this study we assessed burnout and resilience levels among transplant nurses to analyze the relationship between these 2 variables, and to address whether demographic factors were associated with burnout.

Emotional contagion and burnout among nurses and doctors: Do joy and anger from different sources of stakeholders matter?

The present study adds novel knowledge to the literature on emotional contagion (EC), discrete emotions, job burnout, and the management of healthcare professionals by simultaneously considering EC as both a job demand and a job resource with multiple social pathways. Integrating EC into the job demands‐resource model, we develop and test a conceptual model wherein multiple stakeholder sources of emotional exchanges (i.e., leaders, colleagues, patients) play a differential role in predicting caregivers' absorption of positive (i.e., joy) and negative (i.e., anger) emotions, and in turn, burnout. We tested this nomological network using structural equation modeling and invariance analyses on a sample of 252 nurses and 102 doctors from diverse healthcare wards in three Italian hospitals. Our findings show that not all emotional exchange sources contribute to the EC experience or likelihood of burnout. Specifically, we found that doctors absorbed joy and anger from their colleagues but not from their leaders or patients. In contrast, nurses absorbed joy and anger from leaders, colleagues, and patients. Surprisingly, we found that joy‐absorbed and anger‐absorbed were related to doctors' exhaustion and cynicism, but only to nurses' cynicism. We conclude with suggestions for advancing research and practice in the management of emotions for preventing burnout.     

Recognizing and Preventing Burnout among Orthopaedic Leaders

Stress, emotional exhaustion, and burnout are widespread in the medical profession in general and in orthopaedic surgery in particular. We attempted to identify variables associated with burnout as assessed by validated instruments. Surveys were sent to 282 leaders from orthopaedic surgery academic departments in the United States by e-mail and mail. Responses were received from 195 leaders for a response rate of 69%. The average surgeon worked 68.3 hours per week and more than ½ of this time was allocated to patient care. Highest stressors included excessive workload, increasing overhead, departmental budget deficits, tenure and promotion, disputes with the dean, and loss of key faculty. Personal-professional life imbalance was identified as an important risk factor for emotional exhaustion. Withdrawal, irritability, and family disagreements are early warning indicators of burnout and emotional exhaustion. Orthopaedic leaders can learn, and potentially model, ways to mitigate stress from other high-stress professions. Building on the strength of marital and family bonds, improving stress management skills and self-regulation, and improving efficiency and productivity can combine to assist the orthopaedic surgery leader in preventing burnout and emotional exhaustion.     

Relationships between social support and student burnout: A meta‐analytic approach

This study is a meta‐analysis of 19 relevant studies, with 95,434 participants, investigating the relationships between various types of social support and 3 dimensions of student burnout. The overall results indicate that social support is negatively correlated with student burnout. Specifically, school or teacher supports have the strongest negative relationship to student burnout. Social supports from parents and from peers also have a significant negative relationship with student burnout. Among the 3 dimensions of student burnout, inefficacy was more strongly related to social support than emotional exhaustion or cynicism. The results of a moderation analysis suggest that the type of schools (secondary school and postsecondary school) affected the relationships between the overall social support and student burnout. We discuss the implications to ameliorate student burnout.     

How Do Areas of Work Life Drive Burnout in Orthopaedic Attending Surgeons,Fellows, and Residents?

BackgroundConcerning levels of burnout have been reported among orthopaedic surgeons and residents. Defined as emotional exhaustion and depersonalization, physician burnout is associated with decreased productivity, increased medical errors, and increased risk of suicidal ideation. At the center of burnout research, person-centered approaches focusing on individual characteristics and coping strategies have largely been ineffective in solving this critical issue. They have failed to capture and address important institutional and organizational factors contributing to physician burnout. Similarly, little is known about the relationship between burnout and the working environments in which orthopaedic physicians practice, and on how orthopaedic surgeons at different career stages experience and perceive factors relevant to burnout.Questions/purposes(1) How does burnout differ among orthopaedic attending surgeons, fellows, and residents? (2) What specific areas of work life are problematic at each of these career stages? (3) What specific areas of work life correlate most strongly with burnout at each of these career stages?MethodsTwo hundred orthopaedic surgeons (residents, fellows, and attending physicians) at a single institution were invited to complete an electronic survey. Seventy-four percent (148 of 200) of them responded; specifically, 43 of 46 residents evenly distributed among training years, 18 of 36 fellows, and 87 of 118 attending physicians. Eighty-three percent (123 of 148) were men and 17% (25 of 148) were women. Two validated questionnaires were used. The Maslach Burnout Inventory was used to assess burnout, measuring emotional exhaustion and depersonalization. The Areas of Worklife Survey was used to measure congruency between participants and their work environment in six domains: workload, control, reward, community, fairness, and values. Participants were invited to openly share their experiences and suggest ways to improve burnout and specific work life domains. The main outcome measures were Maslach Burnout Inventory subdomains of emotional exhaustion and depersonalization, and Areas of Worklife Survey subdomains of workload, control, reward, community, fairness and values. We compared outcome measures of burnout and work life between groups. Simple linear regression models were used to report correlations between subscales. Stratified analyses were used to identify which group demonstrated higher correlations. All open comments were analyzed and coded to fully understand which areas of work life were problematic and how they were perceived in our population.ResultsNine percent (7 of 80) of attending surgeons, 6% (1 of 16) of fellows, and 34% (14 of 41) of residents reported high levels of depersonalization on the Maslach Burnout Inventory (p < 0.001). Mean depersonalization scores were higher (worse) in residents followed by attending surgeons, then fellows (10 ± 6, 5 ± 5, 4 ± 4 respectively; p < 0.001). Sixteen percent (13 of 80) of attending surgeons, 31% (5 of 16) of fellows, and 34% (14 of 41) of residents reported high levels of emotional exhaustion (p = 0.07). Mean emotional exhaustion scores were highest (worse) in residents followed by attending surgeons then fellows (21 ± 12, 17 ± 10, 16 ± 14 respectively; p = 0.11). Workload was the most problematic work life area across all stages of orthopaedic career. Scores in the Areas of Worklife Survey were the lowest (worse) in the workload domain for all subgroups: residents (2.6 ± 0.4), fellows (3.0 ± 0.6), and attending surgeons (2.8 ± 0.7); p = 0.08. Five problematic work life categories were found through open comment analysis: workload, resources, interactions, environment, and self-care. Workload was similarly the most concerning to participants. Specific workload issues identified included administrative load (limited job control, excessive tasks and expectations), technology (electronic medical platform, email overload), workflow (operating room time, patient load distribution), and conflicts between personal, clinical, and academic roles. Overall, worsening emotional exhaustion and depersonalization were most strongly associated with increasing workload (r = - 0.50; p < 0.001; and r = - 0.32; p < 0.001, respectively) and decreasing job control (r = - 0.50; p < 0.001, and r = - 0.41; p < 0.001, respectively). Specifically, in residents, worsening emotional exhaustion and depersonalization most strongly correlated with increasing workload (r = - 0.65; p < 0.001; and r = - 0.53; p < 0.001, respectively) and decreasing job control (r = - 0.49; p = 0.001; and r = - 0.51; p = 0.001, respectively). In attending surgeons, worsening emotional exhaustion was most strongly correlated with increasing workload (r = - 0.50; p < 0.001), and decreasing job control (r = - 0.44; p < 0.001). Among attending surgeons, worsening depersonalization was only correlated with increasing workload (r = - 0.23; p = 0.04). Among orthopaedic fellows, worsening emotional exhaustion and depersonalization were most strongly correlated with decreasing sense of fairness (r = - 0.76; p = 0.001; and r = - 0.87; p < 0.001, respectively), and poorer sense of community (r = - 0.72; p = 0.002; and r = - 0.65; p = 0.01, respectively).ConclusionsWe found higher levels of burnout among orthopaedic residents compared to attending surgeons and fellows. We detected strong distinct correlations between emotional exhaustion, depersonalization, and areas of work life across stages of orthopaedic career. Burnout was most strongly associated with workload and job control in orthopaedic residents and attending surgeons and with fairness and community in orthopaedic fellows.Clinical RelevanceInstitutions wishing to better understand burnout may use this approach to identify specific work life drivers of burnout, and determine possible interventions targeted to orthopaedic surgeons at each stage of career. Based on our institutional experience, leadership should investigate strategies to decrease workload by increasing administrative support and improving workflow; improve sense of autonomy by consulting physicians in decision-making; and seek to improve the sense of control in residents and sense of community in fellows.     

Relationship between job burnout and occupational stress among doctors in China

The purpose of this study was to explore the status of the job burnout of doctors and the variables associated with this in China. The sample consisted of 543 doctors from three provincial hospitals in China. The Maslach Burnout Inventory‐General Survey (MBI‐GS) was used to measure burnout, and the occupational stress inventory revised edition was used to measure the two dimensions of occupational adjustment (including occupational stress and coping resources). After the statistical testing for validity and reliability of MBI‐GS with nurses in China, the participants' scores were evaluated and analysed. The main results were as follows. The scores of job burnout of the surgeon and physician were significantly higher than the others (p < 0.05). The score of exhaustion (EX) was significantly higher in the 30‐ to 40‐year age group than that in any other groups. The score of professional efficacy (PE) decreased with age, while this increased with educational status. Occupational stress was significantly positively related to all burnout dimensions (p < 0.05), while coping resources correlated negatively to all burnout dimensions. Under multilevel regression, the main significant predictors of EX were role overload, responsibility, physical environment and self‐care. The main significant predictors of cynicism were role insufficiency, role overload and responsibility, and of PE were role insufficiency, social support and rational/cognitive coping (p < 0.05). Organizational efforts aimed at reducing occupational stress and strengthening their coping resources among doctors could help prevent job burnout. Copyright © 2007 John Wiley & Sons, Ltd.     

Stress and burnout among Portuguese anaesthesiologists

BACKGROUND AND OBJECTIVE: Anaesthesiology is considered a stressful occupation. Our purpose was to assess stress and burnout among Portuguese anaesthesiologists. METHODS: A cross-sectional survey based on an anonymous questionnaire was sent to all Portuguese anaesthesiologists registered by the Portuguese Medical Association. Data on patient characteristics and professional variables, perceived stress (Perceived Stress Scale), the subscale of work satisfaction of the Pressure Management Indicator scale, burnout (Maslach Burnout Inventory) and main stress factors were collected. The proportion of participation was 31.8%. RESULTS: The average value of perceived stress scale was 24.0 (range: 0-56). Among the 263 anaesthesiologists, 57.9% experienced emotional exhaustion, 44.8% lack of personal accomplishment and 90.9% depersonalisation. Lack of personal accomplishment increased with number of children among women but not among men; depersonalisation was more frequent among anaesthesiologists working in community hospitals and anaesthesiologists with leadership functions experienced less professional stress. CONCLUSION: There are stress conditions and burnout amongst Portuguese anaesthesiologists. The prevalence of depersonalisation was extremely high in the studied sample. Emotional exhaustion is partially explained by high perceived-stress and low satisfaction with organisation in the job according to Pressure Management Indicator scale.     

Women surgeons in Hong Kong

Objective: To survey Hong Kong women surgeon's current situation: their ability to balance career, personal and family life, and to look into some gender-specific issues. Methods: A 28-item questionnaire online survey was emailed to 142 female and 761 male surgeons with questions asking about four areas: demographic data, job satisfaction, work life balance and work opportunity. Results: Fifty-eight female and 114 male surgeons completed the questionnaire. The mean age of female surgeon respondents was significantly younger than male surgeon respondents (33 vs 43 years, P < 0.001). Both female and male surgeons worked long hours (70% female and 64% male worked >= 60 hours per week, P = 0.402); however, both felt satisfied or very satisfied with their current job situation (74% female and 76% male, P = 0.536) and were happy or very happy with other aspects of their lives (84% female and 82% male). More male respondents were married (83% male vs 35 % female, P < 0.001) and more married men had biological children at the time of the survey (83% male vs 62% female, P = 0.034). Both married males and females had family commitments affecting training, career advancement and overseas training. The majority of male and female surgeons did not experience discrimination during training or career advancement; however, more females felt discriminated against during selection and training processes (25% female vs 12% male, P = 0.001) and during career advancement (18% female vs 10% male, P = 0.013). Conclusion: Our survey results showed that both female and male surgeons are able to combine productive careers with satisfactory personal and family lives. However, both female and male surgeons faced many difficulties in their working lives; women may have more difficulties regarding family issues, as our survey showed that more women surgeons remained single and more married women surgeons had no children. Policies that facilitate a work life balance are important to attract and retain the best and talented physicians, regardless of sex. In view of the increasing number of women surgeons, frequent surveys are needed to determine whether women surgeons experience a working environment that ensures a level playing field.     

Introducing new technology into the operating room: measuring the impact on job performance and satisfaction

BACKGROUND: The Massachusetts General Hospital (MGH) Operating Room of the Future (ORF) project is a test site for evaluating new surgical technologies and processes. Here we evaluate the effect on staff satisfaction and burnout of introducing a set of new technologies. METHODS: Staff satisfaction and burnout were measured via sequential surveys based on the Maslach Burnout Inventory during the introduction of a new technology system. Functional behavior of the OR was measured in terms of flow time (time to transit the OR) and wait time (time to access the OR). These data were gathered using time-motion analysis methods. RESULTS: Significant functional improvements were found in the ORF (more than 35% reduction in flow time and wait time, P < .05). During the same period, more exposure to the ORF resulted in greater sense of personal accomplishment among surgeons, a worse sense of personal accomplishment among nurses, more emotional exhaustion among surgeons, and less emotional exhaustion among nurses. However, the responses for emotional exhaustion were reversed the greater the time from exposure to the ORF. Staff with 6 to 10 years' experience were at highest risk for burnout across all categories. General surgeons experienced more emotional exhaustion than other physicians. CONCLUSIONS: Tracking the response of all users and identifying groups at high risk for burnout when exposed to new systems should be a central part of any new technology project.