Individual vulnerability to burnout in nurses: The role of Type D personality within different nursing specialty areas

The mediating effect of work-family life balance on the relationship between the sense of coherence and job satisfaction in nurses

The aim of this study was to examine the mediating effect of work-family life balance on the relationship between the sense of coherence and job satisfaction in nurses. The nursing profession is the most likely to be exposed to various stressors and therefore stress in terms of the working environment and conditions, and the responsibilities it undertakes. Therefore, the work-family life balance of nurses may deteriorate. The study was carried out with a descriptive-relational design. The population of the study consisted of 300 nurses who met the criteria for inclusion in the study. The data were obtained by the researchers using the personal information form, the Sense of Coherence Scale (SOC), Minnesota Satisfaction Questionnaire (MSQ) and Work-Family Life Balance Scale (WFLBS). SOC mean score was 52.9 ± 10.7, MSQ mean score was 2.86 ± 0.79, and WFLBS mean score was 3.32 ± 0.66. The mediating role of WFLBS was found to be moderate. Furthermore, 12 % of nurses' WFLBS scores are explained by MSQ. Besides, 14 % of SOC scores are explained by MSQ and WFLBS. As a result of this study, it was determined that the WFLBS among nurses moderately mediated the relationship between the SOC and MSQ.

Burnout and resilience at work among health professionals serving in tertiary hospitals, in Ethiopia

Background

The quality of healthcare service is strongly affected by the health professionals' levels of burnout and resilience at work (RaW). Developing resilience is a key component of medical professionalism. Although burnout and resilience are indicators used to assess the level of workplace hardship, there is a dearth of information in most developing countries, including Ethiopia.

Objective

To assess the levels of burnout and 'resilience at work' among health professionals who work in the surgical care departments in teaching Ethiopian hospitals.

Methods

A cross-sectional study design was applied among health professionals employed in surgical, gynecologic, and obstetric (Gyn/Obs) departments of two acute-care hospitals (n = 388). A structured self-administered English version questionnaire, consisting of validated scales to measure RaW and burnout, was used to collect the data;22 items of Maslach's burnout inventory human service survey tool and 20 items of Win wood's resilience at work' measuring tool" was employed to assess the health professionals' burnout level and Resilience at work, respectively. Linear logistics regression was employed for inferential statistical analysis to identify factors that predict RaW and burnout.

Results

Burnout syndrome was shown among 101 (26.0%) study participants. Furthermore, 205 (52.8%), 150 (38.7%), and 125 (32.2%) participants presented high emotional exhaustion, high depersonalization, and low personal accomplishment, respectively. Emotional exhaustion was predicted by the participants' profession, the hope of promotion, professional recognition, and workload. Depersonalization was predicted by age, profession, and perceived workload of the participants. The predictors for personal accomplishment were profession, relationship at work, professional recognition, and having a managerial position in addition to clinical duty. The participants' mean RaW score was 78.36 (Standard deviation ±17.78). A negative association was found between RaW and emotional exhaustion and depersonalization. In contrast, a positive association was identified between RaW and personal accomplishment. The type of profession and marital status were positive predictors of RaW.

Conclusion

A substantial amount of health professionals experience high burnout in one or more burnout dimensions. Level of RaW is more affected by burnout syndrome. Therefore, promoting activities that increase the level of professional RaW and recognition in their professional practice is needed to reduce job burnout. These findings are especially important concerning low socio-economic countries, as resilience is a vital component of the development of healthcare systems.

Lived experiences matter: The role of mental health professionals' psychological crises and vulnerability in shaping their health beliefs and concepts

BACKGROUND

Mental health professionals are often affected by mental health problems and disorders. Yet, the effects of these lived experiences on their causal beliefs and health concepts have not been investigated. The current study investigates how professionals' lived depressive experiences and their perceived vulnerability to mental illness affect their causal beliefs about mental disorders, their general concept of mental health and their specific concepts of depression and burnout.

METHODS

An online survey was conducted with 218 mental health professionals from 18 psychiatric clinic departments in the German federal states of Berlin and Brandenburg, investigating their experiences with depression, self-assessed vulnerability, their causal beliefs of mental illness, their general health concept and specific illness concepts of depression and burnout. A path model was calculated to examine the relationships between these variables. Participants with and without lived experience of depression were grouped.

RESULTS

Lived experience of depression was indicated by 126 participants. For participants with no experience of depression, perceived vulnerability negatively predicted beliefs in biological causation, which positively predicted higher differentiation between depression and burnout. For participants with previous depression experiences, perceived vulnerability positively predicted beliefs in psychological and social causation. Continuum belief was predicted only in this group by the three variables of causal beliefs. Psychological and social causation was positively associated, while biological causes were negatively associated with continuum beliefs.

CONCLUSION

Mental health professionals are not external to the clinical situation. Their lived experiences do matter, shaping their beliefs and concepts and, thus, possibly also their actions toward patients.

PERSonality, Ehical, and PROfessional quality of life in Pediatric/Adult Intensive Nurses study: PERSEPRO PAIN study

BACKGROUND

The World Health Organization included burnout syndrome criteria that reduce both professional quality of life and work satisfaction in its 11th Revision of the International Classification of Diseases in 2019 while nursing bodies have issued action calls to prevent burnout syndrome. Despite this, the effect of social factors, personality traits and cross-interaction on professional quality of life is still unclear.

AIM

To reveal the association between ethical climate, personal trait and professional quality of life.

METHOD

An online survey of registered nurses working in adult, pediatric or both ICUs. We used the ten-item personality measure based on The Big Five theory and Type-D personality Scale-14 then measured the ethical climate with the Hospital Ethical Climate Survey and the professional domains of burnout syndrome, secondary traumatic stress and compassion satisfaction by the Professional Quality of Life Scale Version 5 simultaneously. Multivariate analysis confirmed the triangular association of hospital ethical climate, personality traits and professional quality of life.

RESULT

We enrolled 310 participants from September 2019 to February 2020. Mean age was 33.1 years (± 5.9) and about 70% were female. In the multivariate analysis, neuroticism (p = 0.03, p = 0.01) and Type D personality (both of p<0.01) were associated with burnout syndrome and secondary traumatic stress while agreeableness (p<0.01) was associated with secondary traumatic stress. Conversely, extraversion (p = 0.01), agreeableness (p<0.01) and openness (p<0.01) were associated with compassion satisfaction. We also observed interactions between hospital ethical climate and conscientiousness (p = 0.01) for burnout syndrome and secondary traumatic stress. Neuroticism was related to (p<0.01) BOS and compassion satisfaction while Type D personality (p<0.01) correlated with burnout syndrome and secondary traumatic stress.

CONCLUSION

Hospital ethical climate strongly affects professional quality of life in nurses with specific personality traits. Therefore, it is important to maintain an ethical hospital climate, considering individual personalities to prevent burnout syndrome.

Prevalence, Levels and Related Factors of Burnout in Nurse Managers: A Multi-Centre Study

Aims

The aims of this study are to analyse the prevalence and levels of burnout syndrome in nurse managers and to evaluate the relationship between burnout and related sociodemographic, occupational and psychological factors.

Background

Burnout syndrome, defined as an emotional response to chronic stress, is a major problem among nurse managers.

Methods

The study was conducted using a cross‐sectional survey design and data collected by the Maslach Burnout Inventory, the revised NEO Five Factor Inventory and the Educational‐Clinical Questionnaire for Anxiety and Depression. The sample population consisted of 86 nurse managers from different hospitals from the Public Health Service of Andalusia, Spain.

Results

A total of 22.4% of the participants presented high levels of emotional exhaustion, 21% experienced depersonalisation and 57.6% had little sense of personal accomplishment. Working long shifts was related to burnout. Emotional exhaustion and depersonalization were predicted by depression, while personal accomplishment was predicted by conscientiousness, agreeableness and openness.

Conclusions

A total of 34.1% of the participants presented high levels of burnout, manifested by feelings of low personal accomplishment. Psychological and occupational factors play an important role in the development of this syndrome.

Implications for Nursing Management

Nurse managers should seek to detect burnout among staff and colleagues matching the risk profile for this condition and promote interventions to prevent it.

Type D Personality and Stomatognathic System Disorders in Physiotherapy Students during the COVID-19 Pandemic

Background: A person’s response to stressors is largely dependent on their personality traits that affect the way stress is controlled and relieved. This article is a quantitative analysis assessing the importance of the distressed personality in the development of stomatognathic system disorders (SSDs) in physiotherapy students during the COVID-19 pandemic. Objective: The goal of the research was to assess the presence of type D personality in students with symptoms of stomatognathic system disorders. Material and Method: The research was carried out among 300 physiotherapy students. The data were collected using the form of the occurrence of symptoms of SS disorders developed for the purpose of the study and the standardized psychological DS14 questionnaire. Results: In a group of 300 students, the presence of type D personality was found in 160 people (53.3%). People with type D personality had symptoms of SS disorders more often than the group without stressful personality traits. There was a significant difference between the groups regarding all the examined symptoms. In the group of people with type D personality, the most frequently reported symptoms of SS disorders included: headache (51.3%), pain in the neck and shoulder girdle (43.1%), and teeth clenching (35.6%). As many as 70% of the respondents in the group with symptoms of SS disorders (P1) had type D personality, whereas in the asymptomatic group (P2) this result was 23.3%. There was a significant difference between the groups (p = 0.00). Statistically significantly higher values of both D personality dimensions were observed in women than in men with symptoms of SS disorders. In people reporting symptoms of SS disorders, higher average values were observed in both dimensions of type D personality. There were significant differences between the groups. Conclusion: type D personality may contribute to the development of symptoms of stomatognathic disorders.

The effect of an online individualized program to prevent nurse burnout – a mixed method study

Purpose

Preventing burnout and promoting psychological well-being in nurses are of great importance. In this study the effect of an online, stand-alone individualized preventive program for nurse burnout based on cognitive behavioral therapy (CBT) is described and explained.

Design/methodology/approach

A mixed method study with an explanatory sequential design was applied. Quantitative data were collected from September 2015 to March 2016 during an intervention study with a pretest-posttest wait-list control group design within a population of hospital nurses in the Dutch speaking part of Belgium. Consecutively, 13 nurses from the intervention group who fully completed the program were interviewed.

Findings

All interviewed participants experienced some sort of effect due to working with the program. Emotional exhaustion remained stable in the intervention group and increased in the control group. However, this difference was not significant. Personal accomplishment decreased significantly within the intervention group when compared to the control group. This might be explained by the self-awareness that was created through the program, which confronted participants with their weaknesses and problems.

Originality/value

This study adds to the understanding of online individual burnout prevention. The results suggest the feasibility of an online program to prevent nurse burnout. This could be optimized by complementing it with organizational interventions, introducing refresher courses, reminders and follow-up. Furthermore, additional attention should be devoted to preparing the implementation in order to minimize attrition rates.

Management of work stress and burnout among community nurses arising from the COVID-19 pandemic

The COVID-19 pandemic has increased workload demands for many NHS staff including those working in the community. Nurse managers can make a difference by being authentic leaders, nurturing a supportive organisation where the workload is managed participatively and self-kindness is legitimate. Unfortunately some staff may experience burnout and this article presents a personal management plan to address the symptoms of burnout and aid recovery, although it cannot promote a total recovery if the cause of the symptoms remains unaddressed.

Severity and prevalence of burnout syndrome in paediatric intensive care nurses: A systematic review

OBJECTIVES

The aim of this study is to identify burnout syndrome severity and prevalence in paediatric intensive care unit nurses.

DESIGN

Systematic review.

SETTING

Paediatric intensive care unit.

MAIN OUTCOME MEASURES

A librarian was consulted on methodology before the search process. MEDLINE (via PubMed), EMBASE, the Cochrane Library, CINAHL, and PsycINFO were searched for full-text studies published before September 2019 in any language. Only those observational studies exploring burnout syndrome, including paediatric intensive care unit nurses, were included. Two authors independently screened studies. We assessed the risk of bias within each study based on the Office of Health Assessment and Translation tool.

RESULT

After screening 1238 articles, we identified six studies which met the systematic review criteria. All studies included were published after 2012 and participant sample sizes were between 35 and 195 nurses. Three studies were conducted in the United States of America while the others were from the United Kingdom, Turkey and Taiwan. Prevalence of burnout syndrome in pediatric intensive care unit nurses was reported in these studies as between 42% and 77%. The assessment tools used in these studies were the (abbreviated) Maslach Burnout Inventory, Abbreviated Maslach Burnout Inventory, Occupational Burnout Inventory, and Professional Quality of Life Scale Version 5. We could not conduct a meta-analysis due to the lack of studies.

CONCLUSION

Our systematic review identifies that a low number (6 total) of relevant studies focused on burnout syndrome for pediatric intensive care unit nurses with a prevalence of burnout syndrome in paediatric intensive care unit nurses of between 42% and 77%.

Burnout Syndrome in Paediatric Nurses: A Multi-Centre Study

Background: Burnout syndrome is an increasingly prevalent problem, characterised by emotional exhaustion (EE), depersonalization (D), and low personal accomplishment (PA), feelings that appear with prolonged exposure to stress-inducing situations. The syndrome alters physical well-being and endangers the quality of services provided. Among nurses working in the paediatric area, the association between burnout and the corresponding risk profile has received little research attention, despite the highly stressful nature of this work. Materials and Methods: The study population was composed of 95 nurses working in four hospitals in the province of Granada. Data were collected using the Maslach Burnout Inventory, the NEO Personality Inventory, and the Educational-Clinical Questionnaire: Anxiety and Depression. Results: According to the results obtained, 22.0% of the nurses working in the paediatric area present high levels of EE, 18.5% present high levels of D, and 39.6% had feelings of low PA. These burnout levels do not depend on sociodemographic or labour variables, but the three domains of the syndrome are related to the psychological factors analysed. Conclusions: Among the nurses who participated in this study, 38.6% presented high levels of burnout, especially regarding feelings of low personal accomplishment. Personality factors play an important role in the development of this syndrome. This study shows the impact of burnout in paediatric nurses as well as the risk factors, providing information for the development of strategies to prevent it.

[Association between Safety Culture and Risk of Burnout: A Survey of Non-Medical Rescue Workers]

BACKGROUND

Stressors such as safety culture in organizations that increase the risk of burnout have been studied in nursing and inpatient care settings. However, investigations in the setting of preclinical emergency medical services (EMS) are still limited. The study aims at (1) investigating burnout in health care workers in preclinical EMS and their perceived safety culture, and (2) analyzing the association between the two.

METHODS

Using the Maslach Burnout Inventory (MBI) and the Emergency Medical Services - Safety Attitudes Questionnaire (EMS-SAQ), an online survey was conducted with non-medical health care workers in preclinical EMS. Descriptive analyses were performed using frequencies, mean values, percentages and the Pearson correlation coefficient. A logistic regression model was used to determine the relationship between safety culture and the risk of burnout.

RESULTS

A total of 1,101 questionnaires was considered for analysis. Most of the participants were male (86.2%) and younger than 40 years (73.2%). A high risk of burnout for participants was found for the dimensions of emotional exhaustion and depersonalization (EE 26.3% and DP 40.2%). In the context of measuring safety culture, especially management, working conditions, and safety climate were negatively perceived by the participants. Furthermore, high stress recognition (EE: OR=3.317, p<0.01; DP: OR=1.910, p<0.01), negative job satisfaction (EE: OR=0.297, p<0.01; DP: OR=0.576, p<0.01) and negatively perceived working conditions (EE: OR 0.598, p<0.05; DP: 0.937, p<0.05) were significantly associated with a high risk of burnout.

CONCLUSION

This is the first large scale study investigating burnout among non-medical health care workers in preclinical EMS and their perceived safety culture in Germany as well as the association between the two. The results show the necessity to focus on perceived dimensions of safety culture in organizations, to develop measures reducing stress and improve job satisfaction and working conditions. In the context of increasing skills shortage, this is especially relevant with regard to the challenges of patient safety and quality of outcomes in care.

Factors Associated With Secondary Traumatic Stress Among Nurses in Regional Trauma Centers in South Korea: A Descriptive Correlational Study

INTRODUCTION

Trauma is a leading cause of death in South Korea. This study aimed to identify the factors associated with secondary traumatic stress of nurses working at regional trauma centers.

METHODS

A survey-based cross-sectional design was utilized. Data were collected through a structured questionnaire consisting of 5 rating scales and demographic data. Data were analyzed via descriptive statistics, t test, analysis of variance, Pearson's correlation, and multiple regression.

RESULTS

One hundred eighty-six nurses participated, and most (84.4%) reported moderate to severe secondary traumatic stress. Exposure to traumatic events averaged 34.33 (SD = 6.25) out of 65 points. Average problem-focused coping was 3.00 (SD = 0.37), emotion-focused coping was 2.57 (SD = 0.26), and dysfunctional coping was 2.17 (SD = 0.41) out of 4 points. Social support from family and friends averaged 5.85 (SD = 0.75), social support from coworkers was 5.78 (SD = 0.83), and social support from supervisors was 4.65 (SD = 1.18) out of 7 points. The factors affecting the respondents' secondary traumatic stress were type D personality (β = 0.39, P < .001), dysfunctional coping (β = 0.28, P < .001), problem-focused coping (β = 0.19, P < .01), desire for job rotation (β = 0.17, P < .01), and social support from supervisors (β = -0.12, P = < .05). This regression model was statistically significant and the explanatory power was 46.7% (F = 33.47, P < .001, Adj R² = 0.47).

DISCUSSION

Along with a personal effort to engage in stress management programs, administrators, managers, and supervisors should prioritize developing practical strategies for reducing secondary traumatic stress of nurses.

Validation of the Croatian Version of the Sense of Coherence 29-Item Scale in Croatian Nurses

Introduction

The aim of the study was to validate the Croatian version of the Sense of Coherence 29-item instrument (SOC-29) within a nursing population.

Methods

The cross-sectional study was conducted between December 2017 and June 2018 at the University Hospital Centre Sisters of Mercy (UHCSM) in Zagreb, Croatia. A total of 711 nurses participated in this study. Internal consistency reliability was evaluated using Cronbach’s alpha coefficient (α), while the structure of the questionnaire was verified by exploratory factor analysis (EFA) (method of extraction: principal component analysis (PCA)) and confirmatory factor analysis (CFA).

Results

The instrument demonstrated high internal consistency (α=0.885). PCA analysis has identified five factors that together account for 48% of the variance. However, the observed factors could not be interpreted. In the CFA, none of the models fitted well, although the fit of the three-factor model (CMIN/DF=4.786, CFI=0.767, RMSEA=0.073) was slightly better in comparison with the one-factor model (CMIN/DF=6.072, CFI=0.685, RMSEA=0.084). As the three-factor model in PCA has been shown to be uninterpretable, and all three factors were mutually positive and significantly correlated (correlation coefficients: 0.365–0.521), this indicated a single factor in the background. All items also showed saturation with the first factor (accounting for 25.7% of the variance).

Conclusions

The Croatian version of the SOC-29 instrument successfully fulfilled the necessary psychometric criteria for being used on the population of Croatian nurses. The study proposes that potential users use the single-factor structure.

Stress in nurses’ caring for stroke patients and families: a mixed-method study

Background: Within nursing, caring for stroke patients and helping them with the recovery of their abilities can be strenuous; even more so when considering the nurse’s scope of practice includes the patient and predicts a supportive role to the caregivers. This type of rehabilitative nursing care can be demanding, and nurses may experience increased levels of stress. Despite the extensive literature about the nursing workload and its connection to occupational stress, very little research has been conducted particularly about stress levels experienced by nurses working with stroke patients, who may experience particularly high stress. The rationale for this research emerged from the scarcity of studies worldwide and especially in Irish stroke units. Methods: Nurses from stroke and medical wards (n=100) were distributed the Perceived Stress Scale and requested to complete it from the perspective of their workplace. A convenience sample of these nurses were interviewed about their experience of stress. Results: Of 48 survey respondents, 68% reported ‘moderate’ levels of stress, with higher mean levels in nurses working in medical wards (M=20.10, SD=5.42) than nurses in stroke units (M=16.17, SD=4.41; t(46)=2.757, p<0.01). In interviews with nurses on stroke units (n=11), sources of stress included work performance anxiety (e.g. fear of errors), workload burden/conflicting demands, and family/physician interactions. Coping mechanisms included brief “time outs”, direct problem-solving, and peer support.  Conclusions: The participants’ experiences of stress may help other nurses working with stroke patients to cope better with work-related stress, and provide guidance to managers in improving the organization of stroke networks.

Positive Orientation and Strategies for Coping with Stress as Predictors of Professional Burnout among Polish Nurses

Background: A psychological resource, positive orientation, may moderate stress and protect nurses from burnout. The purpose of this study was to determine the role of positive orientation and stress-coping strategies in predicting professional burnout among Polish nurses. Methods: A total of 1806 nurses employed in 23 hospitals in northeastern Poland participated in the study. The study used a standardized Positive Orientation Scale, Mini-COPE, and the Copenhagen Burnout Inventory. Results: On the stenographic scale, 21.8% of nurses had high levels of positive orientation, 46.8% were average, and 31.9% had low positive orientation. A total of 21.1% of respondents reported personal burnout. Most nurses reported work-related burnout (27%) and burnout in contacts with patients (28.4%) With increasing levels of positive orientation, nurses more often used adaptive strategies that focus on a problem and emotions. Personal burnout accounted for 16% of the variance of the dependent variable (β = −0.32; R² = 0.16), which was slightly lower than work-related burnout (10% (β = −0.23; R² = 0.10)), and burnout in contacts with patients (9% (β = −0.22; R² = 0.09)). Conclusion: The reduced level of positive orientation proved to be the main determinant of the professional burnout of Polish nurses. Burnout-prophylactic programs should be geared towards developing individual psychological resources, including positive orientation and the acquisition of effective stress-coping skills.

Vulnerability and Stressors for Burnout Within a Population of Hospital Nurses: A Qualitative Descriptive Study

BACKGROUND

The multitude of negative consequences of nurse burnout calls for interventions to protect the well-being of the individual nurses, patients, and hospital organizations. However, much is still to be discovered about the development of this complex psychological syndrome.

PURPOSE

This study aimed to describe the development of nurse burnout for a population of Flemish hospital nurses while considering vulnerability and situational stressors as indicated by the vulnerability-stress model.

METHODS

Ten registered nurses were enlisted for semistructured interviews through purposive sampling. All selected nurses were currently suffering from burnout, showed a burnout risk, or had gone through a burnout in the past. A descriptive thematic analysis was performed with themes inductively emerging from the data.

RESULTS

Four main themes emerged: "being passionate about doing well or being good," "teamwork," "manager," and "work and personal circumstances." More specifically, it was the discrepancy between the first individual vulnerability factor and the three situational stressors that led to feelings of stress and burnout.

CONCLUSIONS

The essence of the development of nurse burnout was found in the discrepancy between individual vulnerability and situational stressors. Therefore, we recommend burnout prevention to target both factors.

An Explanatory Model of Potential Changes in Burnout Diagnosis According to Personality Factors in Oncology Nurses

Burnout in a hospital oncology service takes place when there is a high level of interaction between nurses and patients. The aim of the present study is to identify models that will enable us to accurately classify a person at a given level within each of the three dimensions of burnout, according to the values presented for personality related explanatory variables, for a sample of 96 oncology nurses working in the regional health service of Andalusia (Spain). A quantitative, crosscutting, multicentre, descriptive study was designed, and for this purpose data on sociodemographic and personality variables and on the three dimensions of burnout were compiled. Three categorical-response logit ordinal models were used and the prognostic ratios for each level were obtained, with respect to every other level, according to possible changes in the explanatory variables considered. Certain personality factors are associated with one or more dimensions of burnout syndrome. Thus, nurses are more likely to develop high levels of burnout if they present high levels of neuroticism and low levels of friendliness and responsibility. Further research in this field is needed to confirm and extend these findings.

Use of the Worklife and Levels of Burnout Surveys to Assess the School Nurse Work Environment

Previous research regarding burnout in acute care settings revealed that positive work environments increase job satisfaction, decrease staff turnover, and improve patient outcomes. However, few studies address burnout among school nurses. The purpose of this study was to describe the relationship between the school nurse practice environment, school nurses’ levels of burnout, and perceived sources of work stress. A cross-sectional sample of 100 registered nurses completed a web-based version of the Maslach Burnout Inventory and Areas of Worklife Survey. Identified stressors were entered into regression models to determine associations with levels of burnout. Burnout is significantly associated with all Areas of Worklife subscales. School nurses who reported satisfactory work environments experienced little to no burnout. This study provides insights into the domains of work that can cause burnout among school nurses and provides evidence that can inform school leadership and policy makers on ways to promote healthy work environments.

Burnout among Occupational Therapists in Portugal: A Study of Specific Factors

This pilot study was conducted using a sample of 374 Portuguese occupational therapists to evaluate burnout levels and prevalence among occupational therapists as well as to relate those levels to practitioner age, gender, client age, years of professional activity, and area of practice. The Copenhagen Burnout Inventory questionnaire (Portuguese version) and a sociodemographic questionnaire was used. Results showed that ∼23%, 44%, and 45% of occupational therapists presented with client-related burnout, personal burnout (PB), and work-related burnout, respectively. Higher rates of burnout were observed across all dimensions as the age of the professionals increased, with more years of working increased the client-rated rate, and client age increased the PB rate. Outcomes suggest a need to implement intervention programs to promote personal and organizational strategies to prevent burnout.

Counterbalancing work-related stress? Work engagement among intensive care professionals

BACKGROUND AND OBJECTIVES

Working in an Intensive Care Unit (ICU) is increasingly complex and is also physically, cognitively and emotionally demanding. Although the negative emotions of work-related stress have been well studied, the opposite perspective of work engagement might also provide valuable insight into how these emotional demands may be countered. This study focused on the work engagement of ICU professionals and explored the complex relationship between work engagement, job demands and advantageous personal resources.

METHODS

This was a cross-sectional survey study among ICU professionals in a single-centre university hospital. Work engagement was measured by the Utrecht Work Engagement Scale, which included items about opinions related to the respondent's work environment. Additionally, 14 items based on the Jefferson Scale of Physician Empathy were included to measure empathic ability. A digital link to the questionnaire was sent in October 2015 to a population of 262 ICU nurses and 53 intensivists.

RESULTS

The overall response rate was 61% (n=193). Work engagement was negatively related both to cognitive demands among intensivists and to emotional demands among ICU nurses. No significant relationship was found between work engagement and empathic ability; however, agreeableness, conscientiousness, and emotional stability were highly correlated with work engagement. Only the number of hours worked per week remained as a confounding factor, with a negative effect of workload on work engagement after controlling for the effect of weekly working hours.

CONCLUSION

Work engagement counterbalances work-related stress reactions. The relatively high workload in ICUs, coupled with an especially heavy emotional burden, may be acknowledged as an integral part of ICU work. This workload does not affect the level of work engagement, which was high for both intensivists and nurses despite the known high job demands. Specific factors that contribute to a healthy and successful work life among ICU professionals need further exploration.

Type D personality and post-traumatic stress disorder symptoms among intensive care unit nurses: The mediating effect of resilience

The purpose of this study was to investigate the relationship between Type D personality and post-traumatic stress disorder (PTSD) symptoms of intensive care unit (ICU) nurses and to determine the mediating effect of resilience on this relationship. A cross-sectional survey was performed with 179 ICU nurses from 7 hospitals in Gyeong-Nam province, South Korea. The Type D personality, resilience, and PTSD symptoms of subjects were measured using a self-report questionnaire. The mediating effect was analyzed by a series of hierarchical multiple regressions. A total of 38.6% of the study participants turned out to have Type D personality. The Type D personality was positively correlated with PTSD symptoms, and negatively correlated with resilience. There was a negative correlation between resilience and PTSD symptoms. The indirect effect of Type D personality on PTSD symptoms via resilience (β = .51, p < .001) was smaller than the direct effect (β = .58, p < .001). Based on the above results, it can be concluded that resilience had a partial mediating effect on the relationship between Type D personality and PTSD symptoms of ICU nurses. Further studies need to be done to develop interventions for enhancing resilience in ICU nurses.

Predictors of burnout, work engagement and nurse reported job outcomes and quality of care: a mixed method study

Background

High levels of work-related stress, burnout, job dissatisfaction, and poor health are common within the nursing profession. A comprehensive understanding of nurses’ psychosocial work environment is necessary to respond to complex patients’ needs. The aims of this study were threefold: (1) To retest and confirm two structural equation models exploring associations between practice environment and work characteristics as predictors of burnout (model 1) and engagement (model 2) as well as nurse-reported job outcome and quality of care; (2) To study staff nurses’ and nurse managers’ perceptions and experiences of staff nurses’ workload; (3) To explain and interpret the two models by using the qualitative study findings.

Method

This mixed method study is based on an explanatory sequential study design. We first performed a cross-sectional survey design in two large acute care university hospitals. Secondly, we conducted individual semi-structured interviews with staff nurses and nurse managers assigned to medical or surgical units in one of the study hospitals. Study data was collected between September 2014 and June 2015. Finally, qualitative study results assisted in explaining and interpreting the findings of the two models.

Results

The two models with burnout and engagement as mediating outcome variables fitted sufficiently to the data. Nurse-reported job outcomes and quality of care explained variances between 52 and 62%. Nurse management at the unit level and workload had a direct impact on outcome variables with explained variances between 23 and 36% and between 12 and 17%, respectively. Personal accomplishment and depersonalization had an explained variance on job outcomes of 23% and vigor of 20%. Burnout and engagement had a less relevant direct impact on quality of care (≤5%). The qualitative study revealed various themes such as organisation of daily practice and work conditions; interdisciplinary collaboration, communication and teamwork; staff nurse personal characteristics and competencies; patient centeredness, quality and patient safety. Respondents’ statements corresponded closely to the models’ associations.

Conclusion

A deep understanding of various associations and impacts on studied outcome variables such as risk factors and protective factors was gained through the retested models and the interviews with the study participants. Besides the softer work characteristics — such as decision latitude, social capital and team cohesion — more insight and knowledge of the hard work characteristic workload is essential.

Burnout Syndrome Among Health Care Students: The Role of Type D Personality

The aim of this study was to examine the effect of Type D personality, along with other personality traits (resilience and sense of coherence), on burnout syndrome and its counterpart, engagement, among students of nursing, midwifery, and psychology. A cross-sectional study was conducted on 97 university students (91.9% females; M age = 20.2 ± 1.49 years). A Type D personality subscale, School Burnout Inventory, Utrecht Work Engagement Scale, Sense of Coherence Questionnaire, and Baruth Protective Factor Inventory were used. Linear regression models, Student's t test, and Pearson's correlation analysis were employed. Negative affectivity, a dimension of Type D personality, was a significant personality predictor for burnout syndrome (β = .54; 95% CI = [0.33, 1.01]). The only significant personality predictor of engagement was a sense of coherence. Students who were identified as having Type D personality characteristics scored significantly higher on the burnout syndrome questionnaire ( t = -2.58, p < .01). In health care professions, personality predictors should be addressed to prevent burnout.