Relationship between burnout and occupational stress among nurses in China

AIM: This article is a report of a study of occupational burnout among nurses in China. BACKGROUND: Burnout is described as feelings of emotional exhaustion, depersonalization and reduced personal accomplishment. It is well-known that burnout is a major problem for many professions. Nurses are considered to be particularly susceptible to this. Measuring burnout among nurses is important because their well-being has implications for stability in the healthcare workforce and for the quality of care provided. METHOD: The sample consisted of 495 nurses 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 two dimensions of occupational adjustment (occupational stress and coping resources). After statistical testing for validity and reliability of the MBI-GS with nurses in China, participants' scores were evaluated and analysed. RESULTS: Scores for burnout of surgical and medical nurses were statistically significantly higher than those of other nurses (P < 0.05). Lower educational status was associated with lower professional efficacy, and younger nurses reported higher levels of burnout. The most significant predictors of emotional exhaustion were role overload, responsibility, role insufficiency and self-care (P < 0.05). The most significant predictors of cynicism were role insufficiency, role boundary, responsibility and self-care (P < 0.05). The most significant predictors of professional efficacy were role insufficiency, social support and rational/cognitive coping (P < 0.05). CONCLUSION: It is important to reduce occupational stress in nurses and to strengthen their coping resources to prevent burnout. This could be achieved with job redesign, modification of shiftwork systems, and by offering occupational health education.     

护士工作压力、生活质量、心理健康与工作倦怠关系的研究

目的:探讨护士工作压力、生活质量、心理健康与工作倦怠的关系。方法:抽取昆明市某综合医院的护士476人,采用护士工作压力源量表、世界卫生组织生活质量评定量表、工作倦怠量表和症状自评量表进行评估。探讨护士工作压力源、生活质量、心理健康与工作倦怠的相互作用方式和途径。结果:工作倦怠可直接显著影响护士心理健康,而工作压力和生活质量都可通过工作倦怠对护士心理健康产生间接影响。结论:工作倦怠是护士工作压力、生活质量影响心理健康的中间环节。     

Burnout in psychiatric nursing

INTRODUCTION: Burnout in nursing is of both individual and organizational concern with ramifications for well-being, job performance, absenteeism and turnover. Burnout is rarely assessed as part of a comprehensive model of occupational stress, a short-coming which this paper attempts to redress. METHOD: A randomly selected sample of 510 psychiatric nurses from one Scottish Trust completed a questionnaire based on a psychological model of occupational stress which included the Maslach Burnout Inventory (MBI) as the dependent variable. FINDINGS: The respondents reported average, low and average levels of emotional exhaustion, depersonalization and personal accomplishment, respectively. The study sample had significantly lower scores on emotional exhaustion and depersonalization than normative data but also significantly lower levels of personal accomplishment than a normative group of physicians and nurses. Only 2.0% of the study sample could be categorized as having high burnout overall (i.e. high emotional exhaustion, high depersonalization, low personal accomplishment) and they differed significantly from the rest only in terms of males being over-represented. Hierarchical regression analysis revealed that selected explanatory variables accounted for 41.9% of emotional exhaustion, 16.4% of depersonalization and 25.6% of personal accomplishment in the study sample. IMPLICATIONS: The paper discusses the implications of the findings in terms of a comprehensive approach to intervention aimed at minimizing the risk of burnout in psychiatric nurses. Such an approach will involve interventions at the organizational and individual level.     

乌鲁木齐市三级甲等医院外科护士职业紧张与工作倦怠调查

目的 调查乌鲁木齐市三级甲等医院外科护士职业紧张与工作倦怠状况.方法 采用一般情况问卷、职业紧张量表(OSI-R)、工作倦怠问卷(MBI)对239名外科护士进行问卷调查.结果 在职业紧张各维度,外科护士均高于常模(P＜0.01);在工作倦怠方面,外科护士情绪耗竭和消极怠慢得分高于常模(P＜0.01),而工作成就感得分低于常模(P＜0.01).结论 外科护士承受着较高的职业紧张和工作倦怠,护理管理者应努力创造良好的工作条件,减少不适应工作的因素,以减轻护士职业紧张和工作倦怠.     

Pilot exploration of the association between self-esteem and professional satisfaction in Hellenic hospital nurses

AIM: To explore potential associations between nurses' self-esteem and professional satisfaction. BACKGROUND: Professional burnout and moderate job satisfaction have been reported consistently among nurses. However, potential associations of the above elements with personality characteristics have not been adequately addressed. METHODS: A random sample of 154 adult healthcare nurses completed the Maslach Burnout Inventory, the Berger's Scale and the Index of Work Satisfaction. Associations and comparisons across different settings and background variables were explored. RESULTS: Moderate to positive levels of self-acceptance (mean Likert rating: 3.95 +/- 0.51) and acceptance-of-others (mean Likert rating: 3.7 +/- 0.43) and low to moderate levels of professional satisfaction (mean Likert rating: 3.69 +/- 0.63) were observed. Positive correlations were detected between professional satisfaction and self-esteem indices (r = 0.249-0.313, P < or = 0.008). A mediating effect of burnout was implied. CONCLUSIONS: A potential interaction between personality and professional attitudes of Hellenic Hospital nurses was observed. The present study is limited within the correlational frame. Further study is needed to investigate a potential causal relationship between self-esteem indices and professional satisfaction, in order to inform nursing retention and support policies.     

Clinical supervision and burnout: the influence of clinical supervision for community mental health nurses

Aims. The aim of this study was to establish the degree to which clinical supervision might influence levels of reported burnout in community mental health nurses in Wales, UK. Methods. The research instruments used were the Maslach Burnout Inventory and the Manchester Clinical Supervision Scale. At the time of the survey 817 community mental health nurses were reported to work within Wales. Two hundred and sixty (32%) community mental heath nurses working in 11 NHS Trusts responded to the survey. Results. One hundred and eighty‐nine (73%) community mental heath nurses had experience of clinical supervision in their present posts and 105 (40%) in their previous posts. The findings from the Maslach Burnout Inventory indicated high levels of emotional exhaustion for 36%, high levels of depersonalization for 12% and low levels of personal accomplishment for 10% of the community mental heath nurses surveyed. Univariate analysis showed that those community mental heath nurses who were younger, male and who had not experienced six or more sessions of clinical supervision were more likely to report cold negative attitudes towards their clients as indicated by higher scores on the depersonalization subscale of the Maslach Burnout Inventory. One hundred and sixty‐six community mental heath nurses had experienced six or more sessions of clinical supervision and had completed the Maslach Burnout Inventory. Higher scores on the Manchester Clinical Supervision Scale were also associated with lower levels of measured burnout, with significant negative correlations between the total Manchester Clinical Supervision Scale score and the emotional exhaustion subscale (r = ?0·148, P = 0·050) and the depersonalization subscale (r = ?0·220, P = 0·003) of the Maslach Burnout Inventory. These findings suggest that if clinical supervision is effective then community mental heath nurses are likely to report lower levels of emotional exhaustion and depersonalization. Conclusions. The findings from this study suggest that if clinical supervision is effective then community mental heath nurses report lower levels of burnout. Further research is required to determine the long‐term benefits of implementing clinical supervision and to determine which other factors have an influence on levels of burnout for this group of nurses. Relevance to clinical practice. Health service organizations have a responsibility for ensuring that all individual practitioners have access to effective clinical supervision and the Nursing and Midwifery Council could extend the registered nurses personal accountability to include – to seek clinical supervision as and when necessary.     

Antioxidant enzymes, occupational stress and burnout in workers of a prehospitalary emergency service.

BACKGROUND: Reactive oxygen species (ROS) play an important role in many diseases and aging. Scavenging enzymes represent one of several natural defence mechanisms against ROS-induced damage. Superoxide dismutase (SOD) and catalase are enzymes that are involved in antioxidant defence. Burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment. OBJECTIVES: To determine the activity of two antioxidant enzymes, SOD and catalase, and their variation according to demographic and occupational variables in workers of a prehospitalary emergency service, and to analyse the relationship between antioxidant enzyme activities and burnout 111 healthy workers of a prehospitalary emergency service were surveyed. METHODS: SOD activity was analysed by the Minami and Yoshikawa method. Catalase activity was measured by the method of Aebi. To measure burnout, the Maslach Burnout Inventory was used. RESULTS: No significant variations with respect to sex were detected in SOD and catalase activities and levels of burnout. Significant differences in SOD activity between the control group and workers of a prehospitalary emergency service (P<0.001) were found. SOD activity was higher in workers on night and evening shifts (P<0.001). These workers also obtained higher scores in burnout subscales, but without statistical significance.     

急诊护士共情能力与职业倦怠的调查研究

[目的]了解急诊护士共情能力和职业倦怠的现状及其相关性,为提高急诊护士共情能力、降低其职业倦怠提供依据。[方法]采用人际反应指针量表(IRI-C)、Maslach职业倦怠量表(MBI)对北京市4所三级医院的140名急诊科护士进行共情能力与职业倦怠的问卷调查。[结果]急诊护士共情能力总分54.20分±9.80分;身心忧急属低水平,同情关怀、幻想力、观点取替3个维度均属中度水平;职业倦怠中情绪枯竭和个人成就感均属高度倦怠,去人格化属中度倦怠;共情能力中观点取替、同情关怀与情绪枯竭、去人格化和个人成就感呈负相关(P0.05)。[结论]急诊护士职业倦怠较严重,共情能力有待提高;提高急诊护士共情能力可以降低其职业倦怠。     

Staff Burnout –a Comparative Study of Metropolitan and Rural Mental Health Nurses within Australia

This article will present the findings of a research study that investigated the extent to which mental health nurses employed within rural and metropolitan areas of Australia are affected by burnout, using the Maslach Burnout Inventory (MBI) and a demographic questionnaire. The study also examined whether the Maslach Burnout Inventory (MBI) was a valid measure of mental health burnout within the Australian context and culture or alternatively, in what ways it needed to be refined? A cross-sectional study of mental health nurses (n = 319) from the states of New South Wales, Victoria, Queensland and Western Australia was undertaken. The 22-item Maslach Burnout Inventory (MBI) was used to measure burnout and a demographic questionnaire utilising a cluster sampling, cross-sectional design survey method, was used to gather the data. The study found that gender and level of qualification were the two major factors that showed any significance, where males experienced a higher level of depersonalisation on the frequency and intensity sub-scale scores of the MBI and that the more qualified a nurse, the greater the level of depersonalisation they experienced. These results were true for participants in both rural and metropolitan settings within Australia. Age was the third most influencing factor in terms of emotional exhaustion, where younger participants (under 30) reported higher levels of emotional exhaustion. Younger male mental health nurses experienced higher levels of depersonalisation.     

护士职业倦怠状况及其与社会支持、工作压力源的相关性研究

目的 探讨护士职业倦怠与工作压力源、社会支持的相关性.方法 对4家综合医院的医生(138人)、护士(162人)分别进行量表测查,其中对护士进行工作倦怠量表(MBI)、领悟社会支持量表(PSSS)、中国护士工作压力源量表的测查,医生仅进行工作倦怠量表的测查,并对结果进行分析.结果 护士的MBI测查结果显示情绪衰竭、非人性化评分显著高于医生,而工作成就感评分则显著低于医生;护士职业倦怠水平明显高于医生,2者比较差异有统计学意义.护士职业倦怠程度高者,其社会支持评分低于职业倦怠程度低者;而其工作压力源评分均显著高于职业倦怠程度低者.护士职业倦怠情绪衰竭、非人性化评分与社会支持、工作压力源呈负相关,而工作成就感评分与社会支持、工作压力源呈正相关.结论 护士职业倦怠状况应引起护理管理者的重视,及时采取相应措施提高其心理健康水平.     

Hopelessness and suicide risk emerge in psychiatric nurses suffering from burnout and using specific defense mechanisms

Burnout in psychiatric nurses is a phenomenon of great concern. We conducted an investigation of 120 nurses working in the psychiatric, general medicine/rehabilitation, and critical care/surgery wards to explore the correlations of level of burnout and defense mechanisms with hopelessness. The nurses were administered the Maslach Burnout Inventory, Gleser and Ihilevich's Defense Mechanisms Inventory, and Beck's Hopelessness Scale. The results indicate that burnout and some of the defense mechanisms predicted the level of hopelessness -- a predictor of suicide risk.     

Burnout in hospital nurses: a comparison of internal, surgery, psychiatry and burns wards

Introduction:  Burnout is a phenomenon in which the cumulative effects of a stressful work environment gradually overwhelm the defenses of staff members, forcing them to withdraw psychologically. This study compared the levels of burnout among nurses in different nursing specialties.
Materials and methods:  The sample of the study consisted of all the nurses working in all public hospitals in Shiraz, Iran who were graduates of either technological educational institutions or universities and had experienced clinical nursing practice for at least 1 year. Using Maslach Burnout Inventory and General Health Questionnaire (28-item version), we identified the psychiatric morbidity and burnout among nurses.
Results:  Study results indicated that nurses of psychiatry wards showed significantly higher levels of emotional exhaustion and depersonalization in comparison with nurses working in other wards, and burn wards nurses showed significantly higher levels of personal accomplishment. Also, nurses who were single were more emotionally exhausted.
Conclusion:  Different clinical working environments appear to have an impact on the development of nurses' burnout.     

Moral distress experienced by psychiatric nurses in Japan

This study aimed to: (1) develop and evaluate the Moral Distress Scale for Psychiatric nurses (MDS-P); (2) use the MDS-P to examine the moral distress experienced by Japanese psychiatric nurses; and (3) explore the correlation between moral distress and burnout. A questionnaire on the intensity and frequency of moral distress items (the MDS-P: 15 items grouped into three factors), a burnout scale (Maslach Burnout Inventory - General Survey) and demographic questions were administered to 391 Japanese psychiatric nurses in 2007-2008. These nurses experienced relatively low levels of moral distress despite the fact that they were commonly confronted by morally distressing situations. All the circumstances in which the participants experienced moral distress were included in the 'low staffing' factor, which reflects the characteristics of Japanese psychiatric care. The frequency score of the low staffing factor was a significant predictor of burnout.     

Burnout syndrome among critical care healthcare workers

PURPOSE OF REVIEW: Burnout syndrome is a psychological state resulting from prolonged exposure to job stressors. Because ICUs are characterized by a high level of work-related stress, a factor known to increase the risk of burnout syndrome, we sought to review the available literature on burnout syndrome in ICU healthcare workers. RECENT FINDINGS: Based on most recent studies, severe burnout syndrome (as measured using the Maslach Burnout Inventory) is present in about 50% of critical care physicians and in one third of critical care nurses. Strikingly, determinants of burnout syndrome are different in the two groups of caregivers. Namely, intensivists who have severe burnout syndrome are those with a high number of working hours (number of night shifts and time from last vacation) but determinants of severe burnout syndrome in ICU-nurses are related to ICU organization and end-of-life-related characteristics. ICU conflicts, however, were independent predictors of severe burnout syndrome in both groups. SUMMARY: Recent studies reported high levels of severe burnout syndrome in ICU healthcare workers and identified potential targets for preventive strategies such as ICU working groups, communication strategies during end-of-life care and prevention and management of ICU conflicts.     

Burnout in occupational therapists

Burnout is a job-related condition involving feelings of emotional exhaustion, depersonalization, and reduced personal accomplishment. The Maslach Burnout Inventory (Maslach & Jackson, 1981a) is the instrument most widely used to measure job-related stress in human service professions, such as occupational therapy. This study explored the application of the Maslach Burnout Inventory for use with occupational therapists. The subjects were 99 registered occupational therapists residing in the southeastern United States. Mean scores lower than the aggregate occupational norms provided by the test's authors on the Emotional Exhaustion and Depersonalization subscales supported the need to develop specific norms for occupational therapists. Results of this study indicate that use of the aggregate norms would underestimate the level of experienced burnout. Correlational analyses delineated significant relationships between age and Emotional Exhaustion and Depersonalization, education and Emotional Exhaustion and Depersonalization, years of work as an occupational therapist and Depersonalization and Personal Accomplishment, years in the present position and Personal Accomplishment (intensity only), hours of direct patient contact and Emotional Exhaustion (intensity only), and hours of direct patient contact and Depersonalization (frequency only). These correlates of burnout furnish clues for understanding the development of work-related stress in occupational therapists.     

工作场所暴力与护士长工作倦怠的相关分析

目的：探讨护士长工作倦怠与遭受工作场所暴力之间的关系。方法：对福建省各级医院213名护士长进行有关遭受工作场所暴力情况和工作倦怠情况的问卷调查。结果：遭受工作场所暴力的护士长工作倦怠中的情绪衰竭和去人格化两个维度比未遭受者明显严重（P〈0.05）;遭受心理暴力次数与情绪衰竭、去人格化程度呈显著正相关；多元逐步回归研究显示情绪衰竭和去人格化的影响因素是年龄和工作场所暴力，个人成就感丧失的影响因素是职称。结论：工作场所暴力事件可以导致护士长工作倦怠的产生，通过减少工作场所暴力事件，有可能减轻护士长的王作倦怠。     

Predictors of burnout and job satisfaction among Turkish physicians

BACKGROUND: Burnout is associated with decreased job performance and low career satisfaction. It has a special significance in health care, where staff experience both psychological-emotional and physical stress. AIM: To investigate levels of job satisfaction and burnout among Istanbul physicians, and the relationships between demographic characteristics, job characteristics, job satisfaction and burnout. DESIGN: Questionnaire-based survey. METHODS: We collected data from a randomly selected sample group of 598 physicians from different health-care institutions in Istanbul. A questionnaire regarding sociodemographic characteristics of the physicians, the Maslach Burnout Inventory (MBI) and the Minnesota Job Satisfaction Questionnaire (MSQ) were all administered during face-to-face interviews. RESULTS: Job satisfaction was inversely correlated with emotional exhaustion and depersonalization, and positively correlated with personal accomplishment. Under multilevel regression, the most significant and common predictors of all burnout dimensions and job satisfaction were the number of vacations at individual level, and public ownership of healthcare facilities at group level. Number of shifts per month was also a significant predictor of all burnout dimensions. DISCUSSION: Organizational efforts aimed at increasing the level of job satisfaction among physicians could help to prevent burnout.