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Ramos‐Vidal I, Ruíz É. The role of self-compassion and compassion toward others in burnout syndrome in a sample of medical students. Psych J 2024; 13:113-123. [PMID: 37905913 PMCID: PMC10917092 DOI: 10.1002/pchj.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 08/22/2023] [Indexed: 11/02/2023]
Abstract
Burnout produces negative effects on academic performance, and, in turn, feelings of inefficiency that are detrimental to students' psychosocial well-being. The aim of this research is to determine the effects that self-compassion and compassion toward others have on various burnout dimensions in a sample of medical students. A total of 235 medical students (61.7% women) aged between 16 and 32 years old (M = 19.82; SD = 2.37) belonging to a Colombian university participated. A cluster analysis to segment the population according to burnout was carried out along with nonparametric contrasts to identify differences in the levels of self-compassion and compassion toward others between each profile. A series of regression analyses was designed to find out how each type of compassion was associated with burnout on each profile. The cluster analysis allowed us to identify three profiles. The low-involvement profile (n = 51) is characterized by low depersonalization, intermediate levels of emotional exhaustion and personal accomplishment and exhibits low levels of self-compassion and compassion fatigue compared with the other profiles. The positive-adaptation profile (n = 104) is characterized by low depersonalization levels, intermediate degrees of emotional exhaustion and high levels of personal accomplishment and exhibits the highest levels of self-compassion and compassion fatigue compared with the other profiles. The high-demand profile (n = 104) is characterized by intermediate depersonalization levels, medium-high levels of emotional exhaustion and high levels of personal accomplishment and exhibits intermediate levels of self-compassion and low levels of compassion fatigue. Establishing profiles based on burnout allows students to be segmented and for precise knowledge to be acquired about the effects that both types of compassion have on the dimensions of burnout.
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Affiliation(s)
- Ignacio Ramos‐Vidal
- Departamento de Psicología SocialUniversidad de Sevilla, Facultad de PsicologíaSevillaSpain
| | - Érika Ruíz
- Facultad de PsicologíaUniversidad Pontificia BolivarianaMonteriaColombia
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Tavella G, Hadzi-Pavlovic D, Bayes A, Jebejian A, Manicavasagar V, Walker P, Parker G. Burnout and depression: Points of convergence and divergence. J Affect Disord 2023; 339:561-570. [PMID: 37479038 DOI: 10.1016/j.jad.2023.07.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Debate is ongoing as to whether burnout can be differentiated from depression. This study evaluated whether burnout and depression could be distinguished using a new burnout measure and other variables. METHODS Scores on the Sydney Burnout Measure (SBM) were compared between participants with self-diagnosed burnout (BO-all group; n = 622) and clinically-diagnosed depression (DEP-all group; n = 90). The latter group was split into melancholic (DEP-mel; n = 56) and non-melancholic (DEP-nonmel; n = 34) depression subgroups for subsequent analyses. Differences in reporting of depressive symptoms and causal attributions were also evaluated. RESULTS While total SBM scores showed poor differentiation, the BO-all group had lower social withdrawal and higher empathy loss subscale scores than the depression groups. Odds ratios were significant for several of the depressive symptoms and causal attribution items when comparing the BO-all group to the DEP-all and DEP-mel groups, while only a few items were significant when comparing the BO-all and DEP-nonmel groups. LIMITATIONS Participants in the depression group were assigned by clinician-based depression diagnoses, rather than by a standardised diagnostic interview, and the group had a relatively small sample size. Participants in the burnout group were self-diagnosed and not assessed for comorbid psychiatric diagnoses. CONCLUSIONS There were some nuanced symptoms differences between burnout and depression, but many of the SBM symptoms were not specific to burnout. Results also suggested that burnout overlaps more with non-melancholic than melancholic depression, and that differentiation of burnout and depression may rely more on weighting causal factors over symptoms.
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Affiliation(s)
- Gabriela Tavella
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia
| | - Dusan Hadzi-Pavlovic
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia
| | - Adam Bayes
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia; Black Dog Institute, Hospital Rd, Randwick, New South Wales, Australia
| | - Artin Jebejian
- Gordon Private Hospital, Sydney, New South Wales, Australia
| | - Vijaya Manicavasagar
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia; Black Dog Institute, Hospital Rd, Randwick, New South Wales, Australia
| | - Peter Walker
- Lumiere Clinical Psychology, Sydney, New South Wales, Australia
| | - Gordon Parker
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia; Gordon Private Hospital, Sydney, New South Wales, Australia.
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Tekin ÖA, Üngüren E, Doğrucan A, Yıldız S. How Does Organizational Toxicity Affect Depression? A Moderated Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3834. [PMID: 36900844 PMCID: PMC10001265 DOI: 10.3390/ijerph20053834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Organizational toxicity is a key organizational issue today, impacting the success of both employees and organizations negatively alike. Negative working conditions revealed by organizational toxicity pave the way for an organizational atmosphere to arise, which negatively influences the physical and psychological well-being of employees, causing burn-out syndrome and depression. Thus, organizational toxicity is observed to have a destructive impact on employees and can threaten the future of companies. In this framework, this study examines the mediating role of burnout and moderator role of occupational self-efficacy, in the relationship between organizational toxicity and depression. Conducted as cross-sectional, this study adopts a quantitative research approach. To that end, convenience sampling was used to collect data from 727 respondents who are employed at five-star hotels. Data analysis was completed with SPSS 24.0 and AMOS 24 packages. Consequent to the analyses, organizational toxicity was determined to have a positive effect on burnout syndrome and depression. Moreover, burnout syndrome was found to have a mediating effect on the relationship between organizational toxicity and depression. In addition, occupational self-efficacy was found to have a moderator role on the effect of employees' burnout levels on their depression levels. According to the findings, occupational self-efficacy is an influential variable on reducing the impact that organizational toxicity and burnout have on depression.
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Affiliation(s)
- Ömer Akgün Tekin
- Department of Gastronomy and Culinary Arts, Manavgat Faculty of Tourism, Akdeniz University, Antalya 07600, Turkey
| | - Engin Üngüren
- Department of Business Management, Faculty of Economics, Administrative and Social Sciences, Alanya Alaaddin Keykubat University, Antalya 07450, Turkey
| | - Ayşegül Doğrucan
- Department of Philosophy, Faculty of Letters, Akdeniz University, Antalya 07600, Turkey
| | - Sevcan Yıldız
- Department of Tourism and Travel Services, Social Sciences Vocational School, Akdeniz University, Antalya 07600, Turkey
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Burnout and depression in nurses: A systematic review and meta-analysis. Int J Nurs Stud 2021; 124:104099. [PMID: 34715576 DOI: 10.1016/j.ijnurstu.2021.104099] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 09/20/2021] [Accepted: 09/25/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Nurses work in stressful and demanding settings and often suffer from depression and burnout. Despite overlapping symptoms, research has been inconclusive regarding the discriminant validity of measures of burnout with regard to measures of depression. Such inconclusive discriminant validity might cause clinicians to fail to recognize and manage depression separately from burnout. OBJECTIVES This meta-analysis aimed to clarify the distinctiveness of burnout as a separate construct by examining the size of the relationship between burnout and depression among nurses as well as potential moderators. METHOD A stepwise method was used by searching 4 databases (PubMed, CINAHL, PsycINFO, and EMBASE) to retrieve published papers in English examining the relationship between burnout and depression among nurses and reporting the effect sizes of their findings. RESULTS We identified a total of 37 eligible studies. The pooled estimate showed a positive association between burnout and depression among nurses (r = 0.403, 95% CI [0.327, 0.474], p < 0.0001) and a slightly higher correlation coefficient for the Emotional Exhaustion subscale of the Maslach Burnout Inventory (MBI) measure (0.494, 95% CI [0.41, 0.57]). CONCLUSIONS AND IMPLICATIONS This review confirms a large burnout - depression correlation in nursing samples, adding to existing literature encompassing a variety of occupations. Future studies should focus on path analysis to assess the causal relationship as well as investigate potential moderators.
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Jin MJ, Kim JS, Lee HS, Kwon YJ, Shim SH, Choi BS, Lee DW, Paik JW, Lee BC, Jung SW, Lee HY. The Impact of Emotional Exhaustion on Psychological Factors in Workers with Secondary Traumatic Experiences: A Multi-Group Path Analysis. Psychiatry Investig 2020; 17:1064-1072. [PMID: 33190457 PMCID: PMC7711118 DOI: 10.30773/pi.2019.0313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/31/2020] [Accepted: 02/11/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The objective of the present study was to explore causal pathways to understand how second traumatic experiences could affect the development of emotional exhaustion and psychiatric problems. METHODS A total of 582 workers who had jobs vulnerable to secondary traumatic experiences were enrolled for this study. Emotional exhaustion, secondary trauma, resilience, perceived stress, depression, anxiety, and sleep problems were evaluated. A model with pathways from secondary traumatic experience score to depression and anxiety was proposed. The participants were divided into three groups according to the resilience: the low, middle and high resilience group. RESULTS Resilience was a meaningful moderator between secondary traumatic experiences and psychiatric problems. In the path model, the secondary trauma and perceived stress directly and indirectly predicted perceived stress, emotional exhaustion, depression, anxiety, and sleep problems in all three groups. Direct effects of perceived stress on depression and anxiety were the largest in the low resilience group. However, direct effects of secondary trauma on perceived stress and emotional exhaustion were the largest in the high resilience group. CONCLUSION Understanding the needs of focusing for distinct psychological factors offers a valuable direction for the development of intervention programs to prevent emotional exhaustion among workers with secondary traumatic experiences.
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Affiliation(s)
- Min Jin Jin
- Department of Psychiatry, Wonkwang University Hospital, Iksan, Republic of Korea
- Institute of Liberal Education, Kongju National University, Gongju, Republic of Korea
| | - Ji Sun Kim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Ho-Sung Lee
- Department of Pulmonology and Allergy, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Young Joon Kwon
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Se Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Bum-Sung Choi
- Department of Psychiatry, Medical Research Institute, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Dong-Woo Lee
- Department of Psychiatry, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Jong-Woo Paik
- Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Boung Chul Lee
- Department of Neuropsychiatry, College of Medicine, Hallym University, Seoul, Republic of Korea
| | - Sung-Won Jung
- Department of Psychiatry, Keimyung University, School of Medicine, Daegu, Republic of Korea
| | - Hwa-Young Lee
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
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Båtsman A, Fahlbeck H, Hildingsson I. Depression, anxiety and stress in Swedish midwives: A cross-sectional survey. Eur J Midwifery 2020; 4:29. [PMID: 33537630 PMCID: PMC7839147 DOI: 10.18332/ejm/124941] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/26/2020] [Accepted: 07/03/2020] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Midwives are exposed to emotional strain, which could affect their overall health. Lack of emotional well-being could be a reason for workforce attrition. The aim of the study was to investigate the prevalence of depressive symptoms, anxiety and stress among Swedish midwives in relation to background variables. METHODS A random sample of 1000 midwives were asked to participate and complete a questionnaire. Participants completed the Depression, Anxiety and Stress Scale, Copenhagen Burnout Inventory and Quality of Life inventories together with demographic and work-related data. RESULTS In all, 470 midwives responded to the questionnaire (48%). The prevalence of moderate/severe/very severe symptoms of depressive symptoms was 12%, anxiety 8.6%, and stress 7.2%. Midwives aged <40 years and those with <10 years work experience reported higher levels of depressive symptoms, anxiety and stress. The factors most strongly associated with symptoms of depression were personal burnout (AOR=12.26), client burnout (AOR=1.95) and quality of life (AOR=0.26) The factors most strongly associated with symptoms of anxiety were work burnout (AOR=2.53) and personal burnout (AOR=5.61). The factors most strongly associated with stress were personal burnout (AOR=3.90) and work burnout (AOR=3.58) and high quality of life (AOR=0.34). CONCLUSIONS Swedish midwives experience symptoms of depression, anxiety and stress. Symptoms of burnout were associated with all aspects of mental health, while high quality of life was protective against these symptoms. These findings are relevant to consider in the work environment for Swedish midwives in order to reduce attrition rates.
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Affiliation(s)
- Annika Båtsman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Psychiatry, LARO, University Hospital of Umeå, Umeå, Sweden
| | - Hanna Fahlbeck
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Uppsala University Hospital, Uppsala, Sweden
| | - Ingegerd Hildingsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Nursing, Mid Sweden University, Sundsvall, Sweden
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Hemsworth D, Baregheh A, Khorakian A, Muterera J, Plough JF, Garcia-Rivera BR, Penno LN, Aoun S. The resource-based reflective risk assessment model for understanding the quality of work life of nurses. Nurs Outlook 2020; 68:194-206. [DOI: 10.1016/j.outlook.2019.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 10/03/2019] [Accepted: 10/22/2019] [Indexed: 10/25/2022]
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KAMIMURA AKARI, KAWATA YUJIRO, RAEDEKE THOMASD, HIROSAWA MASATAKA. Association of Athlete Burnout with Depression Among Japanese University Athletes. JUNTENDO MEDICAL JOURNAL 2020. [DOI: 10.14789/jmj.2020.66.jmj19-oa24] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- AKARI KAMIMURA
- Faculty of Humanities, Wayo Women’s University
- Faculty of Health and Sports Science, Juntendo University
| | - YUJIRO KAWATA
- Faculty of Health and Sports Science, Juntendo University
- Graduate School of Health and Sports Science, Juntendo University
| | | | - MASATAKA HIROSAWA
- Faculty of Health and Sports Science, Juntendo University
- Graduate School of Health and Sports Science, Juntendo University
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Riethof N, Bob P, Laker M, Varakova K, Jiraskova T, Raboch J. Burnout Syndrome, Mental Splitting and Depression in Female Health Care Professionals. Med Sci Monit 2019; 25:5237-5240. [PMID: 31302661 PMCID: PMC6647923 DOI: 10.12659/msm.915360] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background The early days of a given experience are associated with typically what might be characterized as an idealized enthusiasm. Conversely burnout syndrome experienced later in the given experience is associated with disillusionment, disappointment, and symptoms which resemble a depression. This very common propensity is a parallel to the concept of “splitting” described by Kernberg with a pronounced “black and white” perceptual dichotomy between the early idealization and later disillusionment. This study intends examination of relationships between burnout syndrome, depression, and Kernberg’s concept of splitting. Material/Methods In this present study, we assessed 132 female health care professionals working with a population of diabetic patients utilizing Burnout Measure (BM) Splitting Index (SI), Beck Depression Inventory II (BDI-II), and additional psychometric instruments, the Toronto Alexithymia Scale and the Trauma Symptoms Checklist. Results The study results indicated significant Spearman correlations between burnout syndrome as measured by BM and depression (BDI-II) (R=0.62, P<0.01), and burnout syndrome as measured by BM and splitting (SI) (R=0.45, P<0.01). These findings may have implications for prevention and treatment of burnout syndrome. Conclusions The current study findings provide implications that the defensive mechanism of splitting may allow for the prediction of burnout symptoms which in turn may allow for the prediction of burnout syndrome. This dynamics may potentially be of use in both the potential detection and prevention of burnout syndrome.
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Affiliation(s)
- Norbert Riethof
- Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petr Bob
- Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic.,Central European Institute of Technology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Matthew Laker
- Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Katerina Varakova
- Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Terezie Jiraskova
- Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jiri Raboch
- Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
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Duan-Porter W, Hatch D, Pendergast JF, Freude G, Rose U, Burr H, Müller G, Martus P, Pohrt A, Potter G. 12-month trajectories of depressive symptoms among nurses-Contribution of personality, job characteristics, coping, and burnout. J Affect Disord 2018. [PMID: 29522946 PMCID: PMC6087547 DOI: 10.1016/j.jad.2018.02.090] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Job related factors have been associated with higher risk for developing depression, but past studies lacked full consideration of individual factors such as personality and coping. We sought to evaluate associations of personality, coping, job characteristics, and burnout with 12-month trajectories of depressive symptoms among nursing workers. METHODS Cohort of nursing workers (N = 281) in a private hospital system, with baseline assessments of personality, job characteristics, and coping. Burnout and depression were measured at baseline and during monthly follow-ups. Linear mixed modeling was used to examine contributions to between- and within-individual variation in monthly depressive symptoms. RESULTS Personality trait of negative affectivity accounted for 36% of between-individual variation in depressive symptoms over 12 months, while job characteristics and coping explained an additional 5% and 8% of this variation, respectively. Exhaustion dimension of burnout was associated with between-individual variation in depressive symptoms (fixed effect β coefficient 2.44, p < 0.001), but not with within-individual variation in symptoms. Disengagement dimension of burnout was not associated with between-individual variation in depressive symptoms, but contributed to within-individual variation in depressive symptoms over time (fixed effect β coefficient 0.52, p = 0.01). LIMITATIONS Participants were nursing workers within a single hospital system. Participants who were excluded due to missing baseline data were more likely of non-white race, which may also limit the generalizability of our results. We used latent variables to represent certain job and coping characteristics, which may make our results less comparable with other studies examining the role of these factors in work-associated depression. CONCLUSIONS Future interventions to prevent depression in healthcare workers should consider multiple job and individual factors. Potential components include strategies to manage negative affectivity and reduce avoidant coping, such as cognitive reframing and mindfulness-based techniques, and organizational approaches to address burnout through augmentation of job resources.
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Affiliation(s)
- Wei Duan-Porter
- Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, United States; Department of Medicine, Division of General Internal Medicine, University of Minnesota Medical School, Twin Cities Campus, MN, United States.
| | - Daniel Hatch
- Duke University Center for the Study of Aging and Human Development, Durham, NC, United States
| | - Jane F. Pendergast
- Duke University Center for the Study of Aging and Human Development, Durham, NC, United States,Duke University Claude D. Pepper Older Americans Independence Center, Durham, NC, United States,Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, United States
| | - Gabriele Freude
- Federal Institute for Occupational Safety and Health, Berlin, Germany
| | - Uwe Rose
- Federal Institute for Occupational Safety and Health, Berlin, Germany
| | - Hermann Burr
- Federal Institute for Occupational Safety and Health, Berlin, Germany
| | - Grit Müller
- Federal Institute for Occupational Safety and Health, Berlin, Germany
| | - Peter Martus
- University of Tuebingen Institute for Clinical Epidemiology and Applied Biostatistics, Tuebingen, Germany
| | - Anne Pohrt
- Federal Institute for Occupational Safety and Health, Berlin, Germany
| | - Guy Potter
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
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Griffiths AW, Wood AM, Tai S. The prospective role of defeat and entrapment in caregiver burden and depression amongst formal caregivers. PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2017.08.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Trifiletti E, Pedrazza M, Berlanda S, Pyszczynski T. Burnout Disrupts Anxiety Buffer Functioning Among Nurses: A Three-Way Interaction Model. Front Psychol 2017; 8:1362. [PMID: 28848476 PMCID: PMC5554532 DOI: 10.3389/fpsyg.2017.01362] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 07/26/2017] [Indexed: 11/13/2022] Open
Abstract
Over the last 40 years, job burnout has attracted a great deal of attention among researchers and practitioners and, after decades of research and interventions, it is still regarded as an important issue. With the aim of extending the Anxiety Buffer Disruption Theory (ABDT), in this paper we argue that high levels of burnout may disrupt the anxiety buffer functioning that protects people from death concerns. ABDT was developed from Terror Management Theory (TMT). According to TMT, reminders of one’s mortality are an essential part of humans’ daily experience and have the potential to awake paralyzing fear and anxiety. In order to cope with death concerns, people typically activate an anxiety-buffering system centered on their cultural worldview and self-esteem. Recent ABDT research shows that individuals with post-traumatic stress disorder are unable to activate such anxiety buffering defenses. In line with these results, we hypothesized that the burnout syndrome may have similar effects, and that individuals with higher levels of burnout will be less likely to activate an anxiety buffering response when their mortality is made salient. Participants were 418 nurses, who completed a questionnaire including: a mortality salience (MS) manipulation, a delay manipulation, and measures of burnout, work-related self-efficacy, and representation of oneself as a valuable caregiver. Nurses are daily exposed both to the risk of burnout and to mortality reminders, and thus constituted an ideal population for this study. In line with an anxiety buffer disruption hypothesis, we found a significant three-way interaction between burnout, MS and delay. Participants with lower levels of burnout reported higher levels of self-efficacy and a more positive representation as caregivers in the MS condition compared to the control condition, when there was a delay between MS manipulation and the assessment of the dependent measures. The difference was non-significant for participants with higher levels of burnout. Theoretical and practical implications of findings are discussed.
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Affiliation(s)
| | - Monica Pedrazza
- Department of Human Sciences, University of VeronaVerona, Italy
| | | | - Tom Pyszczynski
- Psychology Department, University of Colorado Colorado Springs, Colorado SpringsCO, United States
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Creedy DK, Sidebotham M, Gamble J, Pallant J, Fenwick J. Prevalence of burnout, depression, anxiety and stress in Australian midwives: a cross-sectional survey. BMC Pregnancy Childbirth 2017; 17:13. [PMID: 28068942 PMCID: PMC5223536 DOI: 10.1186/s12884-016-1212-5] [Citation(s) in RCA: 155] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 12/29/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The health and wellbeing of midwives are important considerations for workforce retention and quality care. The occurrence and relationships among mental health conditions such as burnout and depression have received little attention. We investigated the prevalence of burnout, depression, anxiety and stress in Australian midwives. METHODS An online survey was conducted in September 2014. Participants were recruited through the Australian College of Midwives and professional networks. The survey sought personal and professional details. Standard measures included the Copenhagen Burnout Inventory (CBI) (Personal, Work and Client subscales), and Depression, Anxiety, and Stress Scale (DASS). The sample was collapsed into two groups according to DASS clinical cut-offs (normal/mild versus moderate/severe/extreme). Effect size statistics were calculated and judged according to Cohen's guidelines. RESULTS One thousand thirty-seven surveys were received. Respondents were predominantly female (98%), with an average age of 46.43 years, and 16.51 years of practice. Using a CBI subscale cut-off score of 50 and above (moderate and higher), 64.9% (n = 643) reported personal burnout; 43.8% (n = 428) reported work-related burnout; and 10.4% (n = 102) reported client-related burnout. All burnout subscales were significantly correlated with depression, anxiety and stress, particularly personal and work-related burnout with Spearman's rho correlations ranging from .51 to .63 (p < .001). Around 20% of midwives reported moderate/ severe/ extreme levels of depression (17.3%); anxiety (20.4%), and stress (22.1%) symptoms. Mann-Whitney U tests revealed significant differences between groups with depression (r = .43), anxiety (r = .41) and stress (r = 48) having a medium size effect on burnout. CONCLUSION Prevalence of personal and work-related burnout in Australian midwives was high. The physical and psychological exhaustion associated with the different types of burnout were reflected in symptoms of depression, anxiety and stress symptoms. Further research is needed to support the personal well-being of midwives and minimize workplace burnout by developing short and long term strategies.
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Affiliation(s)
- D. K. Creedy
- Menzies Health Institute Queensland, School of Nursing & Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook, Qld 4131 Australia
| | - M. Sidebotham
- Menzies Health Institute Queensland, School of Nursing & Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook, Qld 4131 Australia
| | - J. Gamble
- Menzies Health Institute Queensland, School of Nursing & Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook, Qld 4131 Australia
| | - Julie Pallant
- Menzies Health Institute Queensland, School of Nursing & Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook, Qld 4131 Australia
| | - J. Fenwick
- Menzies Health Institute Queensland, School of Nursing & Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook, Qld 4131 Australia
- Gold Coast University Hospital, Southport, Australia
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Anxiety and Depression in Staff of Mental Units: The Role of Burnout. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 987:185-197. [PMID: 28971458 DOI: 10.1007/978-3-319-57379-3_17] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
One of the most investigated areas is the study of job stress and anxiety and its effects on the professionals' mental health status. The purpose of this study was to research the levels of anxiety and depression in staff that works in mental units and if burnout is related with these mental health parameters. The sample consisted of 217 mental health care professionals from mental health care units of all over Greece. The Greek version of the Symptoms Rating Scale for Depression and Anxiety (SRSDA) questionnaire was used to evaluate the levels of anxiety and depression and the Greek version of Maslach's Burnout Inventory (MBI) were used. Descriptive statistics were initially generated for sample characteristics. General linear models with MBI dimensions as independent variables and the anxiety and depression subscales of SRSDA as dependent variables were used to determine the relation between burnout and mental health parameters. Statistics were processed with SPSS v. 19.0. Statistical significance was set at p = 0.05. The average age of the sample was 39.00 ± 8.19 years. Regarding gender the percentage of men was 24.88% (N = 54) and of women 75.11% (N = 163). The means for the subscales of SRSDA were 4.91 ± 4.87 for Anxiety, 6.21 ± 5.92 for Depression Beck-21 and 2.83 ± 3.41 for Depression Beck-13. The results of general linear models are shown that Emotional Exhaustion and Depersonalization are statistically correlated with Anxiety and Depression Subscales of SRSDA. Burnout plays an important role in anxiety and depression levels of the staff that works in mental health units all over Greece.
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Abstract
Registered nurses suffer from depression at almost twice the rate of individuals in other professions. Major depression affects both employees and organizations. Depression is linked to increases in work absenteeism, short-term disability, and decreased productivity and presenteeism. Depression experienced by registered nurses may not be fully preventable, but realizing its presence and prevalence in the workplace is of vital importance. It is essential that we have a healthy, vibrant, and present registered nurse workforce to ensure that quality patient outcomes are achieved. This review of 36 articles assesses the current state of the science related to depression in registered nurses so that occupational health nurses can create pathways and work environments for better mental health for registered nurses.
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Weigl M, Stab N, Herms I, Angerer P, Hacker W, Glaser J. The associations of supervisor support and work overload with burnout and depression: a cross-sectional study in two nursing settings. J Adv Nurs 2016; 72:1774-88. [PMID: 26940820 DOI: 10.1111/jan.12948] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2016] [Indexed: 11/28/2022]
Abstract
AIMS To investigate the moderating effects of work overload and supervisor support on the emotional exhaustion-depressive state relationship. BACKGROUND Burnout and depression are prevalent in human service professionals and have a detrimental impact on clients. Work overload and supervisor support are two key job demands and job resources, whose role and interplay for the development and maintenance of burnout and depression are not fully understood yet. DESIGN Two consecutive cross-sectional surveys: survey 1 investigated 111 hospital nursing professionals and survey 2 examined 202 day care professionals. Data collection was completed in 2010. RESULTS After controlling for general well-being and sociodemographic characteristics, nurses' emotional exhaustion was associated with increased depressive state in both samples. We found a meaningful three-way interaction: our results show consistently that the relationship between emotional exhaustion and depressive state was strongest for nurses with high work overload and low supervisor support. Additionally, nurses with low work overload and low supervisor support were also found to have stronger associations between emotional exhaustion and depressive state. CONCLUSION The findings indicate that nurses' reported supervisor support exerts its buffering effect on the burnout-depression link differentially and serves as an important resource for nurses dealing with high self-reported work stress.
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Affiliation(s)
- Matthias Weigl
- Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University Munich, Germany
| | - Nicole Stab
- Department of Psychology, Technical University at Dresden, Germany
| | - Isabel Herms
- BAD Occupational Health and Safety Group, Munich, Germany
| | - Peter Angerer
- Institute for Occupational and Social Medicine, Medical Faculty, Düsseldorf University, Germany
| | - Winfried Hacker
- Department of Psychology, Technical University at Dresden, Germany
| | - Jürgen Glaser
- Institute of Psychology, University of Innsbruck, Austria
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Chao M, Shih CT, Hsu SF. Nurse occupational burnout and patient-rated quality of care: The boundary conditions of emotional intelligence and demographic profiles. Jpn J Nurs Sci 2015; 13:156-65. [DOI: 10.1111/jjns.12100] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 07/15/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Minston Chao
- Department of Health Care Management; Chang Gung University; Taoyuan Taiwan
| | - Chih-Ting Shih
- Department of Business Administration; National Pingtung University; Pingtung Taiwan
| | - Shu-Fen Hsu
- Nursing Department; Taipei Veterans General Hospital; Taoyuan Taiwan
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Adriaenssens J, De Gucht V, Maes S. Determinants and prevalence of burnout in emergency nurses: A systematic review of 25 years of research. Int J Nurs Stud 2015; 52:649-61. [DOI: 10.1016/j.ijnurstu.2014.11.004] [Citation(s) in RCA: 322] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Revised: 10/24/2014] [Accepted: 11/04/2014] [Indexed: 12/20/2022]
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Papathanasiou IV. Work-related Mental Consequences: Implications of Burnout on Mental Health Status Among Health Care Providers. Acta Inform Med 2015; 23:22-8. [PMID: 25870487 PMCID: PMC4384854 DOI: 10.5455/aim.2015.23.22-28] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 01/22/2015] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Burnout can create problems in every aspect of individual's' human life. It may have an adverse effect on interpersonal and family relations and can lead to a general negative attitude towards life. AIM The purpose of this study is to investigate whether burnout is associated with the mental health status of health care providers. MATERIAL AND METHODS The sample in this study consisted of 240 health care employees. The Greek version of Maslach's Burnout Inventory (MBI) was used for measuring burnout levels and the Greek version of the Symptoms Rating Scale for Depression and Anxiety (SRSDA) questionnaire was used to evaluate health care providers' mental health status. Descriptive statistics were initially generated for sample characteristics. Normality was checked by the Kolmogorov-Smirnov test and data was processed with parametric tests. General linear models with MBI dimensions as independent variables and SRSDA subscales as dependent variables were used to determine the relation between burnout and mental health status. Statistics were processed with SPSS v. 17.0 (SPSS, Chicago, IL, USA). Statistical significance was set at p=0.05. RESULTS The average age of the sample is 40.00±7.95 years. Regarding gender the percentage of men is 21.40% (N=49) and of women is 78.60% (N=180). Overall the professional burnout of health care workers is moderate. The mean score for emotional exhaustion is 26.41, for personal accomplishment 36.70 and for depersonalization 9.81. The mean for each subscale of SRSDA is 8.23±6.79 for Depression Beck-21, 3.96±4.26 for Depression Beck-13, 4.91±4.44 for Melancholia, 6.32±4.35 for Asthenia and 6.36±4.72 for Anxiety. The results of general linear models with the MBI dimensions as independent variables and the SRSDA subscales as dependent variables are shown that emotional exhaustion and personal accomplishment are statistically correlated with all subscales of SRSDA, while depersonalization is not correlated with any SRSDA subscale. CONCLUSIONS Burnout appears to implicate mental health status of healthcare providers in work index. Emotional exhaustion is the burnout dimension that is correlated the most with employees' mental health.
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Khamisa N, Oldenburg B, Peltzer K, Ilic D. Work related stress, burnout, job satisfaction and general health of nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:652-66. [PMID: 25588157 PMCID: PMC4306884 DOI: 10.3390/ijerph120100652] [Citation(s) in RCA: 290] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 12/25/2014] [Indexed: 11/17/2022]
Abstract
Gaps in research focusing on work related stress, burnout, job satisfaction and general health of nurses is evident within developing contexts like South Africa. This study identified the relationship between work related stress, burnout, job satisfaction and general health of nurses. A total of 1200 nurses from four hospitals were invited to participate in this cross-sectional study (75% response rate). Participants completed five questionnaires and multiple linear regression analysis was used to determine significant relationships between variables. Staff issues are best associated with burnout as well as job satisfaction. Burnout explained the highest amount of variance in mental health of nurses. These are known to compromise productivity and performance, as well as affect the quality of patient care. Issues, such as security risks in the workplace, affect job satisfaction and health of nurses. Although this is more salient to developing contexts it is important in developing strategies and intervention programs towards improving nurse and patient related outcomes.
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Affiliation(s)
- Natasha Khamisa
- Department of Public Health, School of Health Sciences, Monash South Africa, 144 Peter Road, Roodepoort, 1725 Johannesburg, South Africa.
| | - Brian Oldenburg
- School of Population and Global Health, University of Melbourne, Victoria, 3010 Melbourne, Australia.
| | - Karl Peltzer
- Department of Psychology, University of Free State, Bloemfontein 9300, South Africa.
| | - Dragan Ilic
- Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, 3004 Melbourne, Australia.
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Ahola K, Hakanen J, Perhoniemi R, Mutanen P. Relationship between burnout and depressive symptoms: A study using the person-centred approach. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.burn.2014.03.003] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Volpe U, Luciano M, Palumbo C, Sampogna G, Del Vecchio V, Fiorillo A. Risk of burnout among early career mental health professionals. J Psychiatr Ment Health Nurs 2014; 21:774-81. [PMID: 25757038 DOI: 10.1111/jpm.12137] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/29/2013] [Indexed: 11/29/2022]
Abstract
Burnout is a stress-related syndrome that often affects mental health professionals (MHPs) and may have serious consequences on personal well-being as well as on the quality of provided psychiatric care. Established literature shows a high risk to develop burnout among MHPs. Few data are available on the incidence and on the clinical implications of the burnout syndrome in the early phases of MHP professional career. We confirmed the presence of burnout among early career MHPs: early career psychiatrists showed a lower sense of personal accomplishment, while non-medical MHPs tended to have more depersonalization and suffered from higher levels of depression. Specific programmes to identify the presence of the burnout syndrome and to cope with it should be taught within mental health training curricula. Burnout is a stress-related syndrome that often affects professionals working in emotionally loaded and highly interpersonal environments. Mental health professionals (MHPs) are long known to be at high risk to develop the burnout syndrome, but this has rarely been investigated in professionals in an early phase of career. The aim of the present study was to evaluate the presence of the burnout syndrome and of depressive symptoms among early career psychiatrists and 'non-medical' MHPs. One hundred MHPs (including 50 psychiatrists and 50 non-medical MHPs) were screened for the presence of burnout and depression, with the Maslach Burnout Inventory and the Beck Depression Inventory - revised, respectively. The relationships of burnout with socio-demographical and professional characteristics were also explored. We confirmed the presence of burnout among both groups of early career MHPs, but psychiatrists had a significantly higher degree of emotional exhaustion and a lower sense of personal accomplishment, while non-medical MHPs adopted more frequently depersonalization as a coping strategy and had higher scores for depression, which is associated with higher level of burnout. The risk of developing burnout should be properly addressed in training curricula and strategies to overcome it should be systematically taught, in order to promote personal well-being and efficient team work in mental health settings.
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Affiliation(s)
- U Volpe
- Department of Psychiatry, University of Naples SUN, Naples, Italy
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Khamisa N, Peltzer K, Oldenburg B. Burnout in relation to specific contributing factors and health outcomes among nurses: a systematic review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:2214-40. [PMID: 23727902 PMCID: PMC3717733 DOI: 10.3390/ijerph10062214] [Citation(s) in RCA: 184] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 05/16/2013] [Accepted: 05/24/2013] [Indexed: 11/16/2022]
Abstract
Nurses have been found to experience higher levels of stress-related burnout compared to other health care professionals. Despite studies showing that both job satisfaction and burnout are effects of exposure to stressful working environments, leading to poor health among nurses, little is known about the causal nature and direction of these relationships. The aim of this systematic review is to identify published research that has formally investigated relationships between these variables. Six databases (including CINAHL, COCHRANE, EMBASE, MEDLINE, PROQUEST and PsyINFO) were searched for combinations of keywords, a manual search was conducted and an independent reviewer was asked to cross validate all the electronically identified articles. Of the eighty five articles that were identified from these databases, twenty one articles were excluded based on exclusion criteria; hence, a total of seventy articles were included in the study sample. The majority of identified studies exploring two and three way relationships (n = 63) were conducted in developed countries. Existing research includes predominantly cross-sectional studies (n = 68) with only a few longitudinal studies (n = 2); hence, the evidence base for causality is still very limited. Despite minimal availability of research concerning the small number of studies to investigate the relationships between work-related stress, burnout, job satisfaction and the general health of nurses, this review has identified some contradictory evidence for the role of job satisfaction. This emphasizes the need for further research towards understanding causality.
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Affiliation(s)
- Natasha Khamisa
- School of Health Sciences, Department of Public Health, Monash South Africa, 144 Peter Road, Roodepoort, Johannesburg 1725, South Africa
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Melbourne 3800, Australia; E-Mail:
| | - Karl Peltzer
- Human Science Research Council, 134 Pretorius Street, Pretoria 0002, South Africa; E-Mail:
- University of Limpopo, University Street, Turfloop, Sovenga, Polokwane 0727, South Africa
- ASEAN Institute for Health Development, Mahidol University, Salaya 73170, Thailand
| | - Brian Oldenburg
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Melbourne 3800, Australia; E-Mail:
- Monash Alfred Hospital Campus, Level 3 Burnet Tower, 89 Commercial Road, Melbourne 3004, Australia
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Hakanen JJ, Schaufeli WB. Do burnout and work engagement predict depressive symptoms and life satisfaction? A three-wave seven-year prospective study. J Affect Disord 2012; 141:415-24. [PMID: 22445702 DOI: 10.1016/j.jad.2012.02.043] [Citation(s) in RCA: 338] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 02/28/2012] [Accepted: 02/28/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Burnout and work engagement have been viewed as opposite, yet distinct states of employee well-being. We investigated whether work-related indicators of well-being (i.e. burnout and work engagement) spill-over and generalize to context-free well-being (i.e. depressive symptoms and life satisfaction). More specifically, we examined the causal direction: does burnout/work engagement lead to depressive symptoms/life satisfaction, or the other way around? METHODS Three surveys were conducted. In 2003, 71% of all Finnish dentists were surveyed (n=3255), and the response rate of the 3-year follow-up was 84% (n=2555). The second follow-up was conducted four years later with a response rate of 86% (n=1964). Structural equation modeling was used to investigate the cross-lagged associations between the study variables across time. RESULTS Burnout predicted depressive symptoms and life dissatisfaction from T1 to T2 and from T2 to T3. Conversely, work engagement had a negative effect on depressive symptoms and a positive effect on life satisfaction, both from T1 to T2 and from T2 to T3, even after adjusting for the impact of burnout at every occasion. LIMITATIONS The study was conducted among one occupational group, which limits its generalizability. CONCLUSIONS Work-related well-being predicts general wellbeing in the long-term. For example, burnout predicts depressive symptoms and not vice versa. In addition, burnout and work engagement are not direct opposites. Instead, both have unique, incremental impacts on life satisfaction and depressive symptoms.
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Affiliation(s)
- Jari J Hakanen
- Finnish Institute of Occupational Health, Centre of Expertise for Work Organizations, Finland.
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CHANG YUHSUAN, WANG PENGCHIH, LI HUNGHUI, LIU YICHUNG. Relations among depression, self-efficacy and optimism in a sample of nurses in Taiwan. J Nurs Manag 2011; 19:769-76. [DOI: 10.1111/j.1365-2834.2010.01180.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Halayem-Dhouib S, Zaghdoudi L, Zremdini R, Maalej I, Béchir MB, Labbène R. [Burnout among mental health professionals: A Tunisian experience]. Rev Epidemiol Sante Publique 2010; 58:403-8. [PMID: 21094003 DOI: 10.1016/j.respe.2010.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2008] [Revised: 07/12/2010] [Accepted: 07/23/2010] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Burnout syndrome consists in physical as well as mental exhaustion observed in professionals whose work involves continuous contact with other people. Psychiatrists and psychiatry nursing staff are considered to be vulnerable to experiencing burnout. The purposes of this study aim to investigate the prevalence of burnout syndrome in practitioners, residents and nurses working in the psychiatric hospital of Tunisia. It also aims to investigate the relationship between burnout, depression, and a variety of personal variables, including age, gender, marital, parental and personal difficulties within this population. METHODS A cross-sectional study was conducted among the nursing staff (n=54), residents (n=41) and practitioners (n=11) in Razi hospital in Tunisia. The Maslach Burnout Inventory, the Beck depression inventory and a general questionnaire on demographic data were used. RESULTS High levels of burnout were detected among nurses. This was true for the emotional tiredness sub-scale (mean score: 26.18); the depersonalization subscale (mean score: 10.20) and for the alteration of personal achievements (mean score: 32.94). High scores in emotional tiredness were correlated to depression (P=0.000; R=0.56) and to personal difficulties (P=0.021; R=0.31) in this group. Residents showed high scores in personal achievements (mean score: 32.56), and practitioners did not reach the cutoff scores on the Maslach Burnout Inventory. CONCLUSION Our results are somewhat comparable to those of studies in other countries. Burnout syndrome was highly prevalent among nurses and residents. This study corroborates former results of a relation between depression and burnout. A strong relationship was found between personal difficulties and burnout, but seemed to be more specific to the nursing sample.
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Palmer-Morales Y, Prince-Vélez R, Searcy-Bernal R, Compean-Saucedo B. [Prevalence of burnout syndrome in nurses in 2 Mexican hospitals]. ENFERMERIA CLINICA 2008; 17:256-60. [PMID: 17961468 DOI: 10.1016/s1130-8621(07)71810-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine the prevalence of burnout syndrome in nursing staff in 2 different second level hospitals in the city of Mexicali, Baja California, Mexico. METHOD A cross-sectional study was conducted in all nursing staff (n = 698) in 2 second level hospitals (the Gynecology, Pediatrics and Family Medicine Hospital No. 31 and the General Specialist Hospital No. 30 in Mexicali). A stratified random sample was obtained from the 698 nurses, with a sample size of 184 nurses from each hospital. The Maslach Burn-out Inventory and a general questionnaire on demographic factors were used. Statistical analysis consisted of descriptive statistics and analysis of proportions using the chi-squared test. RESULTS A total of 368 nurses were studied, of whom 345 (93.75%) were women. The mean age was 41.21 SD (standard deviation) = 6.59 years. The mean length of service was 15.87 (SD = 6.12) years. In both hospitals, the prevalence of burnout syndrome was 6.79% (25). CONCLUSIONS Previous publications on burn-out have included studies performed in Mexico and in nurses in the emergency department of a tertiary hospital in Barcelona, as well as in other health care professionals. In comparison with these studies, the prevalence of burn-out observed in the present study was significantly lower.
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Affiliation(s)
- Yusvisaret Palmer-Morales
- Instituto Mexicano del Seguro Social, Hospital de Gineco-Pediatría con Medicina Familiar n.o31, Mexicali, BC. México.
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Ahola K, Hakanen J. Job strain, burnout, and depressive symptoms: a prospective study among dentists. J Affect Disord 2007; 104:103-10. [PMID: 17448543 DOI: 10.1016/j.jad.2007.03.004] [Citation(s) in RCA: 197] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2006] [Revised: 03/13/2007] [Accepted: 03/13/2007] [Indexed: 11/19/2022]
Abstract
BACKGROUND Burnout has been presented as an antecedent of depression, but longitudinal data are lacking. We investigated whether burnout mediates the association between job strain and depressive symptoms. METHODS Two surveys were conducted. In 2003, 71% of Finnish dentists were reached, and the response rate of the 3-year follow-up was 84% (n=2555). Burnout was measured with the Maslach Burnout Inventory and depressive symptoms with the Beck Depression Inventory. The sequences 'job strain-burnout-depressive symptoms' and 'job strain-depressive symptoms-burnout' were investigated with logistic regression analyses. RESULTS Of the burnout sufferers without depressive symptoms at baseline, 23% reported depressive symptoms at follow-up. The adjusted odds ratio of burnout for depressive symptoms was 2.6 (95% CI 2.0-3.5). The effect of job strain on depressive symptoms had an OR of 3.4 (95% CI 2.0-5.7), but it disappeared when adjusted for burnout. Of those who had depressive symptoms without burnout at baseline, 63% had burnout at follow-up. The adjusted odds ratio of depressive symptoms for burnout was 2.2 (95% CI 1.4-3.4). The effect of job strain on burnout had an OR of 27.9 (95% CI 6.5-120.2) for the men and 4.9 (95% CI 2.5-9.6) for the women. These effects remained significant after adjustment for depressive symptoms. LIMITATIONS The study was conducted among one occupational group. CONCLUSIONS There is a reciprocal relationship between burnout and depressive symptoms. Job strain predisposes to depression through burnout. In comparison, job strain predisposes to burnout directly and via depression.
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Affiliation(s)
- Kirsi Ahola
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, FI-00250 Helsinki, Finland.
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Poncet MC, Toullic P, Papazian L, Kentish-Barnes N, Timsit JF, Pochard F, Chevret S, Schlemmer B, Azoulay E. Burnout syndrome in critical care nursing staff. Am J Respir Crit Care Med 2006; 175:698-704. [PMID: 17110646 DOI: 10.1164/rccm.200606-806oc] [Citation(s) in RCA: 417] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Burnout syndrome (BOS) associated with stress has been documented in health care professionals in many specialties. The intensive care unit (ICU) is a highly stressful environment. Little is known about BOS in critical care nursing staff. OBJECTIVES To identify determinants of BOS in critical care nurses. METHODS We conducted a questionnaire survey in France. Among 278 ICUs contacted for the study, 165 (59.4%) included 2,525 nursing staff members, of whom 2,392 returned questionnaires with complete Maslach Burnout Inventory data. MEASUREMENTS AND MAIN RESULTS Of the 2,392 respondents (82% female), 80% were nurses, 15% nursing assistants, and 5% head nurses. Severe BOS-related symptoms were identified in 790 (33%) respondents. By multivariate analysis, four domains were associated with severe BOS: (1) personal characteristics, such as age (odds ratio [OR], 0.97/yr; confidence interval [CI], 0.96-0.99; p=0.0008); (2) organizational factors, such as ability to choose days off (OR, 0.69; CI, 0.52-0.91; p=0.009) or participation in an ICU research group (OR, 0.74; CI, 0.56-0.97; p=0.03); (3) quality of working relations (1-10 scale), such as conflicts with patients (OR, 1.96; CI, 1.16-1.30; p=0.01), relationship with head nurse (OR, 0.92/point; CI, 0.86-0.98; p=0.02) or physicians (OR, 0.81; CI, 0.74-0.87; p=0.0001); and (4) end-of-life related factors, such as caring for a dying patient (OR, 1.39; CI, 1.04-1.85; p=0.02), and number of decisions to forego life-sustaining treatments in the last week (OR, 1.14; CI, 1.01-1.29; p=0.04). CONCLUSION One-third of ICU nursing staff had severe BOS. Areas for improvement identified in our study include conflict prevention, participation in ICU research groups, and better management of end-of-life care. Interventional studies are needed to investigate these potentially preventive strategies.
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Affiliation(s)
- Marie Cécile Poncet
- Medical ICU, Saint-Louis Hospital and Paris 7 University, Assistance Publique, Hôpitaux de Paris, Paris, France
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Tselebis A, Gournas G, Tzitzanidou G, Panagiotou A, Ilias I. Anxiety and depression in Greek nursing and medical personnel. Psychol Rep 2006; 99:93-6. [PMID: 17037454 DOI: 10.2466/pr0.99.1.93-96] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The relatively low number of nurses compared to physicians in Greece and the few available studies on the psychological problems of the health professionals led to comparison of anxiety and depression for 76 Greek nursing personnel (20 men, M age: 32.8 yr., SD: 3.8 yr., and 56 women, M age: 36.6 yr., SD: 7.7 yr.) and 66 doctors (35 men, M age: 35.9 yr., SD: 8.9 yr. and 31 women, M age: 32.7 yr., SD: 8.1 yr.) using validated translations of the Spielberger State-Trait Anxiety Inventory and the Beck Depression Inventory. Male nurses had the lowest scores on trait anxiety, while female doctors had the highest scores, followed by female nurses. Depression scores were not different between doctors and nurses, regardless of sex. Age and depression scores were positively correlated (Spearman rho = .31) only for the female nurses. The findings suggest that interventions for diagnosis and stress management in the health-care workplace should be equally targeted for nursing and medical personnel.
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Melamed S, Shirom A, Toker S, Shapira I. Burnout and risk of type 2 diabetes: a prospective study of apparently healthy employed persons. Psychosom Med 2006; 68:863-9. [PMID: 17132837 DOI: 10.1097/01.psy.0000242860.24009.f0] [Citation(s) in RCA: 116] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This prospective study was designed to test the extent to which the onset of type 2 diabetes in apparently healthy individuals was predicted by burnout, a unique affective response to combined exposure to chronic stressors. METHODS The study participants were 677 employed men and women who were followed up for 3 to 5 years (mean = 3.6 years) for the onset of diagnosed type 2 diabetes. Burnout was assessed by the Shirom-Melamed Burnout Measure with its three subscales: emotional exhaustion, physical fatigue, and cognitive weariness. RESULTS The burnout symptoms were remarkably consistent over the follow-up period irrespective of changes in place of work and in employment status. During the follow-up period, 17 workers developed type 2 diabetes. Logistic regression results indicated that burnout was associated with a 1.84-fold increased risk of diabetes (95% confidence interval [CI] = 1.19-2.85) even after adjusting for age, sex, body mass index, smoking, alcohol use, leisure time physical activity, initial job category, and follow-up duration. In a subsample of 507 workers, the relative risk of diabetes was found to be much higher after additional control for blood pressure levels (odds ratio = 4.32, 95% CI = 1.75-10.67), available only for this subsample. CONCLUSIONS These findings suggest that chronic burnout might be a risk factor for the onset of type 2 diabetes in apparently healthy individuals.
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Affiliation(s)
- Samuel Melamed
- Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
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Melamed S, Shirom A, Toker S, Berliner S, Shapira I. Burnout and risk of cardiovascular disease: evidence, possible causal paths, and promising research directions. Psychol Bull 2006; 132:327-53. [PMID: 16719565 DOI: 10.1037/0033-2909.132.3.327] [Citation(s) in RCA: 393] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Burnout is characterized by emotional exhaustion, physical fatigue, and cognitive weariness, resulting from prolonged exposure to work-related stress. The authors review the accumulated evidence suggesting that burnout and the related concept of vital exhaustion are associated with increased risk of cardiovascular disease and cardiovascular-related events. The authors present evidence supporting several potential mechanisms linking burnout with ill health, including the metabolic syndrome, dysregulation of the hypothalamic-pituitary-adrenal axis along with sympathetic nervous system activation, sleep disturbances, systemic inflammation, impaired immunity functions, blood coagulation and fibrinolysis, and poor health behaviors. The association of burnout and vital exhaustion with these disease mediators suggests that their impact on health may be more extensive than currently indicated.
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Affiliation(s)
- Samuel Melamed
- Department of Epidemiology and Preventive Medicine, Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.
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Mathias S, Koerber A, Fadavi S, Punwani I. Specialty and sex as predictors of depression in dentists. J Am Dent Assoc 2005; 136:1388-95. [PMID: 16255463 DOI: 10.14219/jada.archive.2005.0052] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Stress, burnout, substance abuse and suicide among dentists have been studied, yet no study in the United States has specifically addressed depression in e dentists. The objective of the authors' study was to determine if sex and dental specialty were correlated with depression in dentists. METHODS The authors conducted a survey of a sample of dentists chosen randomly from the American Dental Association's mailing list of member dentists. The survey, stratified by sex and specialty, resulted in 560 responses, for a 53 percent response rate. The authors used the Zung Self-Rating Depression Scale to measure depression. The authors examined the respondents' sex, age, number of children, marital status, specialty, practice type, location of practice, years in practice and hours worked per week. RESULTS The rate of depression in the overall sample was 9 percent. Sex was associated with depression (P < .001), but specialty was not. However, multiple regression analysis found that sex was significantly related to depression in only two specialties: periodontics and pediatric dentistry. Overall, the regression model explained an unimpressive 6 percent of the variance in depression scores. The most important finding of the study was that only 15 percent of depressed dentists were receiving treatment. CONCLUSIONS The survey results showed that only female pediatric dentists and periodontists were more depressed than their male counterparts. None of the other variables studied contributed significantly to the understanding of depression in dentists. Depressed dentists, like other depressed people, tend not to seek treatment. CLINICAL IMPLICATIONS Depression and serious depression occur among dentists, and much of it is untreated. Because depression is harmful to dentists and raises quality-of-care issues, they should be educated to help them recognize depression and encouraged to seek treatment.
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Affiliation(s)
- Sarah Mathias
- College of Dentistry, University of Illinois at Chicago, 60612, USA
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Iacovides A, Fountoulakis KN, Kaprinis S, Kaprinis G. The relationship between job stress, burnout and clinical depression. J Affect Disord 2003; 75:209-21. [PMID: 12880934 DOI: 10.1016/s0165-0327(02)00101-5] [Citation(s) in RCA: 297] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The definition and phenomenological features of 'burnout' and its eventual relationship with depression and other clinical conditions are reviewed. Work is an indispensable way to make a decent and meaningful way of living, but can also be a source of stress for a variety of reasons. Feelings of inadequate control over one's work, frustrated hopes and expectations and the feeling of losing of life's meaning, seem to be independent causes of burnout, a term that describes a condition of professional exhaustion. It is not synonymous with 'job stress', 'fatigue', 'alienation' or 'depression'. Burnout is more common than generally believed and may affect every aspect of the individual's functioning, have a deleterious effect on interpersonal and family relationships and lead to a negative attitude towards life in general. Empirical research suggests that burnout and depression are separate entities, although they may share several 'qualitative' characteristics, especially in the more severe forms of burnout, and in vulnerable individuals, low levels of satisfaction derived from their everyday work. These final issues need further clarification and should be the focus of future clinical research.
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Affiliation(s)
- A Iacovides
- 3rd Department of Psychiatry, Aristotle University of Thessaloniki, General Hospital AHEPA, Thessaloniki, Greece
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Shirom A, Ezrachi Y. On the Discriminant Validity of Burnout, Depression and Anxiety: A Re-examination of the Burnout Measure. ANXIETY STRESS AND COPING 2003. [DOI: 10.1080/1061580021000057059] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Solano Ruiz MC, Hernández Vidal P, Vizcaya Moreno MF, Reig Ferrer A. [Burnout's syndrome in critical care nursing professionals]. ENFERMERIA INTENSIVA 2002; 13:9-16. [PMID: 12006250 DOI: 10.1016/s1130-2399(02)78049-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The concept of the "Burnout Syndrome" has come as a result of the chronic work-stress developed in workers involved in human services during their professional activity. The working conditions and the specific characteristics of the job developed at the Intensive Care Units by the nursing staff, involve a high risk for this group to acquire this syndrome. The main objective of this study is to assess the prevalence of the Burnout Syndrome in the nursing staff of the ICUs in different hospitals of the Alicante province, Spain, by means of the Malsach Burnout Inventory questionnaire. This questionnaire is self-administered and was handed to all the nursing staff at the ICUs in the University Hospitals of Alicante and Elche and in the Hospital Marina Baixa of Villajoyosa. form the total of 107 questionnaires, 83 proved to be valid. The average total of MBI was of 55.05, indicating low values of emotional tiredness, low depersonalisation, and an adequate level of personal accomplishment.
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Affiliation(s)
- Ma C Solano Ruiz
- Ayudantes de Escuela Universitaria. Departamento de Enfermería Universidad de Alicante. Spain
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Abstract
The 1980s and 1990s has seen a considerable change in the workforce structure in industrialised economies. Employees are commonly faced with greater demands and less job security, both of which are likely to be stressful, thus psychological disorders especially depression may increasingly be caused by work-related stressors. An issue of this journal in 1997 (Vol. 43, No. 1) was indeed devoted to stress in the workplace and since then, these workplace changes have progressed and a review seems timely. Because interpreting results of cross-sectional studies is limited by a potential reciprocal relation between work stressors and depression (since "effort after meaning" can influence how "distressed" individuals report stressors at work), this review largely focuses on prospective or predictive studies to minimise this bias. Not surprisingly, the findings from occupational stress research is consistent with the more general life event stress literature showing that specific acute work-related stressful experiences contribute to "depression" and, more importantly perhaps, that enduring "structural" occupational factors, which may differ according to occupation, can also contribute to psychological disorders. There are significant implications for employees, their families, employers and indeed the wider community.
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Affiliation(s)
- C Tennant
- Department of Psychological Medicine, University of Sydney and Royal North Shore Hospital, Block 4, level 5, St. Leonards, Sydney, NSW 2065, Australia.
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Lambert VA, Lambert CE. Literature review of role stress/strain on nurses: an international perspective. Nurs Health Sci 2001; 3:161-72. [PMID: 11882192 DOI: 10.1046/j.1442-2018.2001.00086.x] [Citation(s) in RCA: 129] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The presence of role stress/strain among nurses has been of concern throughout the world. However, to date, no one has conducted, from an international perspective, a literature review of research on the topic. This article assesses research from 17 countries, identifies the major areas of focus in the studies, compares and contrasts the findings, summarizes the state of the science on role stress/strain on nurses and makes recommendations for future research.
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Affiliation(s)
- V A Lambert
- Faculty of Health Sciences, Yamaguchi University School of Medicine, Ube, Japan.
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Tselebis A, Moulou A, Ilias I. Burnout versus depression and sense of coherence: study of Greek nursing staff. Nurs Health Sci 2001; 3:69-71. [PMID: 11882180 DOI: 10.1046/j.1442-2018.2001.00074.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We assessed the relationships between burn out, depression and sense of coherence (SOC) using the Maslach Burnout Inventory, Beck's depression inventory and Antonovsky's SOC questionnaire in a large sample of 17 male and 62 female Greek nurses. Analysis showed that SOC in nursing staff was correlated with burnout (BO) and depression, while the latter was correlated to a lesser degree with BO. The relationship of BO with depression seems to be the result of the relationship between depression and SOC. Thus, we could hypothesize that the degree of SOC renders persons either vulnerable or resistant to both depression and BO, though further studies are warranted. In the hospital setting, the intervention by specialized personnel in order to assist nursing staff with BO may be an appealing option. Further, prevention programs aimed at helping individuals prone to BO could also be envisaged.
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Affiliation(s)
- A Tselebis
- Department of Psychiatry, Sotiria Hospital, Athens, Greece.
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