Burnout, social support, and coping at work among social workers, psychologists, and nurses: the role of challenge/control appraisals

The purpose of this study is twofold: (1) to compare stress appraisals, coping strategies, social resources, and burnout at work between social workers, psychologists and nurses; and (2) to assess the effectiveness of appraisals and support in reducing burnout and enhancing effective coping strategies. Questionnaires containing assessments of work stress appraisals, coping strategies used to deal with problems at work, and social support at work, as well as burnout measures of exhaustion, depersonalization, and accomplishment were completed by 249 female professionals (age range 25-61). No differences were observed between the three professions on most psychological measures, except for the depersonalization outcome of burnout, which was significantly lower among psychologists than among nurses or social workers. High challenge/control appraisal of the job was directly related to all burnout outcomes, contributing to less exhaustion and depersonalization and to more personal accomplishment. The challenge/control appraisal was also negatively associated with emotion-focused coping. By comparison, the stress/load appraisal contributed to more exhaustion at work, while emotion-focused coping contributed to higher depersonalization. Social support was associated with higher challenge/control appraisal, with the latter mediating support effects on burnout. These data suggest that the perception of challenge/control in one's work may be an important factor in preventing work burnout in the three professions tested in the study.     

护士职业压力、应对方式与职业倦怠的相关性

目的了解重症监护病房（ICU）护士的职业压力、应对方式及职业倦怠现状,明确职业压力、应对方式与职业倦怠的相关性,为减轻ICU护士职业倦怠提供科学依据。方法 2013年10月对唐山市工人医院13个ICU 204名护士,采用护士工作压力源、简易应对方式、职业倦怠量表进行问卷调查。结果护士工作压力总分为（2.36±0.42）分,其中工作量及时间分配是其护士最主要工作压力源（2.95±0.67）分。ICU护士积极应对方式为（1.78±0.46）分,与全国常模无差异;消极应对方式为（1.16±0.54）分,低于全国常模;ICU护士情感枯竭为（26.60±10.23）分,个人成就感为（26.20±9.78）分,去人格化维度为（6.99±5.31）分。相关性分析显示,ICU护士职业压力、消极应对与情感枯竭、去人格化呈正相关,积极应对与个人成就感呈正相关（P〈0.05）。结论 ICU护士职业压力愈大,情感枯竭、去人格化程度愈重,积极应对方式可提高护士的个人成就感,消极应对方式易使情感枯竭、去人格化程度增高。     

艾滋病医护人员工作压力源、应对方式与工作倦怠的关系

目的 了解艾滋病医护人员工作倦怠与工作压力源和应对方式的关系.方法 采用中式工作倦怠量表(CMBI),简易应对方武问卷(SCSQ)以及自编工作压力源问卷对342名艾滋病医护人员进行调查.结果 ①工作倦怠3个维度与工作压力源和应对方式的多个因素有显著相关关系(P＜ 0.05和0.01).②管理问题和职业风险的压力对情感耗竭以及职业风险对人格解体的预测作用均极其显著(P＜0.01);消极应对对于情感耗竭和人格解体具有显著正向预测作用(P＜ 0.01和0.05),而积极应对对成就感降低具有显著反向预测作用(P＜0.01).③Amos路径分析表明,职业风险的压力和消极应对方式直接影响情感耗竭和人格解体,人际排斥的压力直接影响成就感降低,而积极应对反向作用于成就感降低;消极应对在压力源和工作倦怠中起着部分的中介作用.结论 应当重视艾滋病医护人员的工作压力问题,指导他们使用积极的应对方式,以降低其工作倦怠水平,提高工作生活质量.     

Interpersonal conflict, social support, and burnout among home care workers in Japan

To examine associations between interpersonal relationships in work settings and burnout, a cross-sectional survey was conducted on home care workers in Sapporo, Japan, by using the Maslach Burnout Inventory (MBI) and scales of interpersonal conflict and social support developed by the authors. Questionnaires were distributed among 303 subjects and returned by 243 subjects (80%). Complete answers were obtained from 106 subjects and were used for analysis. In multiple regression analyses, conflict with clients and their families significantly related to emotional exhaustion and depersonalization of the MBI (p<.05). Supervisory conflict significantly related to emotional exhaustion (p<.05), whereas coworker conflict significantly associated with depersonalization (p<.01). It is suggested that conflicts with clients' families, as well as clients, are important indicators for emotional exhaustion and depersonalization of home care workers.     

职业应激对工作疲竭感影响的层次回归分析

目的探讨职业人群中工作疲竭感的影响因素。方法以456名教师与外企员工为研究对象,问卷评估工作疲竭感,同时运用工作要求-自主模式与付出-回报失衡模式问卷评估职业应激程度。运用层次多元回归分析工作疲竭感与个体拓征和职业应激程度之间的关系。结果工作疲竭感3个维度情感耗竭得分为19．70±8．92,人格解体得分为11．95±4．45,个体成就感降低得分为28．10±10．08。职业应激对工作疲竭感的3个维度影响不同。工作要求、工作付出、内在驱动均对情感耗竭呈正向作用,而工作自主性对情感耗竭呈负向作用。人格解体受个体的年龄、性别和受教育程度的明显影响；同时工作自主程度、工作回报及内在驱动影响人格解体得分。个人成就感得分与受教育程度及社会支持关系密切。结论工作疲竭感的预防需要降低职业应激程度,同时关注个体特征。     

Prevalence of burnout syndrome among Italian volunteers of the Red Cross: a cross-sectional study

Burnout syndrome (BOS) is a work-related constellation of symptoms characterized by emotional exhaustion, depersonalization, and personal accomplishment. A cross-sectional survey was performed to study the prevalence of BOS among a randomly selected sample of 280 Italian Red Cross volunteers. A socio-demographic questionnaire and the Maslach Burnout Inventory (MBI)-HSS were used to collect data. 241 volunteers participated (response rate: 86.1%). A significant proportion of the workers had BOS subscale scores in the highest tertile: emotional exhaustion 8.0%, depersonalization 35.9% and perceived lack of accomplishment 23.5%, respectively. Volunteers in emergency care reported higher levels of emotional exhaustion (p=0.004) and depersonalization (p=0.001), and lower level of personal accomplishment (p=0.042) than volunteers engaged in non-healthcare social and administrative duties. These findings support the opportunity of a set of administrative, organizational and individual preventive interventions for emergency volunteers’ mental health.     

An investigation of social support and burnout among residential counselors

Maslach and Jackson's (1986) three dimensions of burnout, emotional exhaustion, lack of personal accomplishment and depersonalization, were investigated among 78 counselors at a short-term, residential treatment facility for emotionally disturbed children and adolescents. Two waves of data were collected so that possible changes in burnout over time could be assessed. Measures of co-worker support (team cohesion and perceived quality of friendships) were better predictors of burnout than supervisor support. High levels of co-worker support were consistently and positively related to greater personal accomplishment. Levels of personal accomplishment increased and emotional exhaustion decreased as staff accumulated more counseling experience. Women residential counselors experienced higher levels of emotional exhaustion than did their male counterparts. Initial levels of burnout were powerful predictors of later levels of burnout. Theoretical and practical implications of these findings for human services providers are discussed.Thanks are extended to Harry Parad, Jack Wright, and Elaine Sweeney for their assistance in the research project.     

职业倦怠在急诊科护士的工作场所暴力与离职意愿关系中的中介作用

目的 探索职业倦怠在急诊科护士的工作场所暴力与离职意愿关系中的中介作用。方法 从安徽省8所三级甲等医院急诊科随机选择199名在职在岗护士接受本次横断面调查,数据采用描述性统计、Spearman相关分析,使用结构方程模型验证职业倦怠在急诊科护士的工作场所暴力与离职意愿关系中的中介作用。结果 急诊科护士职业场所暴力与职业倦怠中情感衰竭、去人格化以及离职倾向呈正相关（均有P<0.05）,职业倦怠中情感衰竭以及去人格化与离职倾向之间呈正相关（均有P<0.05）。路径分析显示,职业场所暴力通过情感衰竭和去人格化对离职倾向的间接效应分别为（t=6.21,95% CI:0.021~0.059）和（t=5.39,95% CI:0.019~0.056）。结论 工作场所暴力和职业倦怠是影响离职倾向的重要因素,情感衰竭和去人格化在工作场所暴力对离职倾向的影响中发挥重要的中介作用。     

Effect of psychosocial work environment and job satisfaction on burnout syndrome among specialist physicians

OBJECTIVES: To describe the prevalence of burnout syndrome according to medical specialty and to examine the impact of work psychosocial risk factors, job satisfaction and professional characteristics on burnout syndrome among specialist physicians throughout Spain. METHODS: A cross-sectional survey was carried out among 1,021 Spanish physicians. The outcome variables were the 3 dimensions of burnout syndrome: emotional exhaustion, depersonalization, and personal accomplishment. The explanatory variables were work psychosocial risk factors and job satisfaction evaluated by a stress scale specifically designed for physicians. Adjusted odds ratios and their 95% confidence intervals were calculated by logistic regression. RESULTS: The probability of high emotional exhaustion and depersonalization were greater in physicians exposed to a high level of contact with suffering and death and to a negative impact of work on home life. The probability of high emotional exhaustion was greater among physicians with a high work overload. The risk of low personal accomplishment was higher among physicians with low professional satisfaction and those without training activities. Dissatisfaction with relationships with patients and relatives had a negative effect on the 3 dimensions of burnout. CONCLUSIONS: Psychosocial work environment and job satisfaction have a negative effect on burnout syndrome, especially on emotional exhaustion and depersonalization.     

医护人员工作倦怠与工作满意度现况调查及其影响因素

目的分析医护人员工作倦怠及工作满意度的影响因素。方法采用职业倦怠问卷（Maslach Burnout Inventory,MBI）及明尼苏达工作满意度问卷（Minnesota Satisfaction Questionnaire,MSQ）对辽宁省铁岭煤矿集团总医院的600名医护人员进行自填式问卷调查。结果 30～39岁年龄组及工作年数在10～19 a的医护人员的情绪衰竭、人格解体维度得分最高,分别为11.70±7.01、6.15±5.68和11.92±5.82、6.26±5.95;离异的医护人员个人成就感最低,得分为19.81±6.93。承担科主任或护士长管理职位的医护人员的工作倦怠度比未承担管理职位的医护人员低。高级技术职称的医护人员个人成就感明显高于初级职称者,没有夜班的医护人员在总体工作满意度上得分明显高于有夜班人员。医患关系严重紧张的医护人员的情绪衰竭、人格解体维度得分高于一般紧张的医护人员,而工作满意度得分低于一般紧张的医护人员。医护人员的工作满意度与情绪衰竭、人格解体、离职意愿呈负相关关系,而与个人成就感呈正相关关系。结论年龄、工作年数、婚姻状况、管理职务、技术职称、夜班工作、医患关系都影响到医护人员的工作倦怠及工作满意度。医护人员的工作倦怠及工作满意度影响离职意愿。     

制鞋工人职业应激与工作疲竭感的关系

[目的]探讨制鞋工人职业应激与工作疲竭感的关系。[方法]以制鞋业农民工为研究对象,使用职业应激调查问卷、工作疲竭感问卷进行调查,采用Spearman等级相关分析和多元逐步回归法进行分析。[结果]女性情感耗竭和人格解体评分高于男性;低工龄组情感耗竭、人格解体和工作疲竭感评分高于高工龄组;未婚组情感耗竭、个人成就感和工作疲竭感评分高于其他组。职业紧张各因素与工作疲竭感的相关性分析显示,情感耗竭、个人成就感、工作疲竭感与技能、主管支持、同事支持呈负相关;工作疲竭感与决策权呈负相关;人格解体与主管支持呈负相关;情感耗竭、人格解体、工作疲竭感与工作心理需求、外在付出、内在投入呈正相关;个人疲竭感与回报呈负相关。工作疲竭感逐步回归分析显示,贡献因素为付出与回报比、内在投入;负面影响因素为工作自主和社会支持。[结论]职业应激对工作疲竭感具有一定影响,社会应关注农民工生存状况,提高其生活质量,减轻职业应激所导致的工作疲竭感。     

Burnout in day care workers: The effects of learned helplessness and self-esteem

The study focused on the relationships between selected personality factors and burnout in day care workers. The results indicated that caregivers who experienced emotional exhaustion and depersonalization tended toward lower self-esteem and learned helplessness. Burnout did not, however, include a reduced sense of personal accomplishment in this population.     

Can skill-development training alleviate burnout in hospital social workers?

Staff development programs, which focus on imparting and improving intervention skills, are acknowledged as an efficient way to reduce burnout, but few studies have examined this effect. The aim of the present study was to detect any difference in the level of social worker's burnout before and after attending two different skill-development groups, namely group-intervention skills for more experienced social workers and general hospital social-work skills for less experienced. Twenty-five hospital social workers participated in the study. The three dimensions of burnout, namely emotional exhaustion, depersonalization, and personal accomplishment, changed between the pre-training and post-training measures: personal accomplishment rose by 12.39% and depersonalization fell by 29.75%. The difference was significant for the two dimensions in both groups. Emotional exhaustion significantly declined in the hospital social-work skills group only, and revealed a group-time effect. The level of peer support rose in the hospital-skills group and was positively related to a lowering of emotional exhaustion. This was an exploratory study, with a rather small sample, and the results are preliminary, but they show a promising possibility of burnout reduction among professional workers. Further research on the effect of skill development training on reducing burnout is needed.     

Burnout syndrome in health workers and relationship with personal and environmental factors

OBJECTIVES: High rates of professional burnout syndrome have been found among health service professionals. Our objective was to study the prevalence of burnout syndrome in hospital health workers and to determine its relationship with personal and environmental factors. METHODS: A total of 2290 health workers from five hospitals in the province of Girona (Spain) were invited to participate. Interviewees were given a specifically designed questionnaire, a questionnaire on organizational climate, and the Spanish version of the Maslach Burnout Inventory, which includes three scales: emotional exhaustion, depersonalization, and reduced personal accomplishment. RESULTS: Responses were received from 1095 health workers (a response rate of 47.8%). A high level of emotional exhaustion was found in 41.6% of staff members, especially among doctors and nurses; a high level of depersonalization was found in 23%, mainly among doctors, and reduced personal accomplishment was found in 27.9%, mainly among technicians and doctors. Multiple logistic regression revealed that a high level of emotional exhaustion was associated with frequent consumption of tranquilizers or antidepressants, whereas optimism and job satisfaction showed an inverse association. The variables that were inversely associated with a high level of depersonalization were the number of years in the profession, optimism, evaluation of work as being useful and the perception of being valued by others. Reduced personal accomplishment was also inversely associated with optimism, satisfaction with the usefulness of one's work, and satisfaction with teamwork. CONCLUSIONS: In view of the results obtained, to reduce professional burnout in hospitals, optimism and a sense of self-worth among individuals should be encouraged and the organizational environment should be improved.     

Burnout and effort–reward-imbalance in a sample of 949 German teachers

Objectives High rates of teachers’ premature retirement initiated a research investigating their occupational burden. The aim of this study was to elaborate on and extend previous investigations exploring (1) teacher burnout and (2) the relationship between teachers’ efforts and their rewards. Methods A sample of 949 German teachers in 10 Gymnasien (grammar schools) and 79 Hauptschulen (secondary modern schools) was investigated applying the Maslach Burnout Inventory (MBI-D) and the Effort Reward Imbalance Inventory (ERI). Results Compared with other studies investigating burnout in employees, we found high rates of burnout symptoms such as emotional exhaustion, depersonalisation, and low personal accomplishment. Male teachers showed significantly lower personal accomplishment and more depersonalization than female teachers. With respect to school types, teachers in Hauptschulen were more often affected by emotional exhaustion and showed more depersonalization. Part-time teachers felt less personal accomplishment than full-time teachers. The ERI cut off was exceeded by 21.6% of all teachers indicating that this subgroup is affected by an imbalance between too much effort and too little reward. With respect to the ERI, significant differences were found for school types, with a higher proportion of Hauptschulen teachers being above this cut off. Conclusions At present, the working situation of teachers appears to be characterized by a perceived imbalance of effort and reward and is associated with a high risk of developing burnout symptoms.     

Psychological Empowerment and Child Welfare Worker Outcomes: A Path Analysis

The purpose of this study was to investigate how work environment and psychological empowerment related to worker outcomes in public child welfare. These relationships were examined by testing a conceptual model in which psychological empowerment mediated the relationships between work environment variables (quality of supervision and role ambiguity) and worker outcome variables (emotional exhaustion and intentions to remain employed in child welfare). Responses from 234 public child welfare front-line workers in a southeastern state were used to test the proposed mediating model. The results of the study revealed that quality of supervision and psychological empowerment were directly related to workers’ intentions to remain employed in child welfare. An indirect relationship between quality of supervision and intentions to remain through the mediating variable of psychological empowerment was found. Quality of supervision was also indirectly related to worker emotional exhaustion through the mediating variable of psychological empowerment. While the work environment variable role ambiguity was not directly related to the outcomes emotional exhaustion or intentions to remain, indirect relationships through the mediating variable of psychological empowerment were found.     

医护人员心理资本、应对方式与工作倦怠关系

目的探讨医护人员心理资本、应对方式与工作倦怠的关系。方法采用心理资本量表、简易应对方式量表和Maslach工作倦怠量表通用版对河北省某省级三甲医院101名医护人员进行调查。结果(1)医生自我效能得分高于护士,成就感低落得分低于护士(P<0.05)。(2)心理资本与工作倦怠(乐观与成就感低落相关除外)呈显著负相关(P<0.01或P<0.05),消极应对与成就感低落呈显著正相关(P<0.01)。(3)希望对情绪衰竭和玩世不恭有明显负向预测(P<0.01,P<0.001),自我效能(P<0.001)和消极应对(P<0.05)对成就感低落分别有负向和或正向预测作用。结论提升心理资本水平,调整消极应对方式能有效预防和矫治医护人员工作倦怠;医院管理层应关注护士群体的心理状态。     

太原市三甲医院麻醉医生职业倦怠及相关因素分析

目的了解麻醉医生职业倦怠现状及职业倦怠与年龄、学历、工龄、性别的关系。方法采用马斯勒职业倦怠量表,对78名麻醉医生进行调查。结果麻醉医生的情绪衰竭和去人性化明显高于国内常模,低成就感明显低于国内常模。年龄与职业倦怠成负相关;学历高者情绪衰竭和去人性化要高于学历低者;工龄短者在情绪衰竭和去人性化要高于工龄长者。结论麻醉医生职业倦怠较严重。应重点关注学历高、工龄短的麻醉医生,以提升医疗质量,缓解医患矛盾。     

Mental health and related factors among massage practitioners with visual impairment

The purpose of this study was to explore the mental health conditions and related factors among 155 visually impaired massage practitioners chosen from alumni lists of ten schools for the visually impaired in Japan. It was thought massage practitioners with visual impairment did not suffer burnout and depression because their mean scores indicated "no problem". However, their mean score for anxiety was high compared with previous studies. Gender and level of education showed no significant differences on anxiety and depression. Higher scores for anxiety and depression correlated inversely with age. Scores of depersonalization, anxiety, and depression were significantly higher and those of personal accomplishment lower for unmarried subjects compared to those who were married. Scores of emotional exhaustion, anxiety, and depression were significantly higher in persons who were able to read written text compared to those who read Braille only. Massage practitioners with visual impairment working at hospitals, medical clinics, and nursing homes revealed significantly higher daily client turnover, emotional exhaustion, and depersonalization compared to those who established their own massage clinics. It was thought that massage practitioners who were young and unmarried, had slight visual impairment, high client turnover, hectic relationships between clients, little autonomy at work, and worked at medical-related workplaces were prone to burnout. It is suggested that this group of massage practitioner requires periodic education about stress management techniques and more social support.