From Exhaustion to Disengagement via Self-Efficacy Change: Findings from Two Longitudinal Studies among Human Services Workers

Investigating learning burnout and academic performance among management students: a longitudinal study in English courses

This study aims to move away from the cross-sectional approach related to burnout and conduct a longitudinal study to explore the factors influencing learning burnout among management students. The study primarily adopts a questionnaire survey, with students majoring in business management. Descriptive statistics and structural equation modeling (SEM) are used to analyze the data and validate the hypotheses. The findings are: (1) There is a significant negative relationship between English anxiety and self-efficacy and a significant positive relationship between past English learning performance and self-efficacy. (2) The changes in self-efficacy are negatively related to the changes in burnout, while the changes in workload are positively related to the changes in burnout. Additionally, there is a positive relationship between English anxiety and learning burnout. (3) There is a significant negative relationship between English learning performance and burnout. The direct impact of self-efficacy on English learning performance is not supported, but it has an indirect effect through the mediating role of burnout. The study proposes strategies to improve student outcomes and well-being: (1) making English courses more engaging to boost performance and confidence, reducing learning burnout; (2) encouraging and supporting students to enhance self-efficacy and motivation; (3) assigning tasks seen as useful and interesting to lessen perceived workload and emotional exhaustion; (4) and considering English anxiety in admissions to decrease learning burnout, especially as schools gain more autonomy in their policies.

Stress and burnout amongst mental health professionals in Singapore during Covid-19 endemicity

The COVID-19 pandemic has exerted a huge emotional strain on mental health professionals (MHP) in Singapore. As Singapore transited into an endemic status, it is unclear whether the psychological strain has likewise lessened. The aims of this study were to investigate the levels of stress and burnout experienced by MHP working in a tertiary psychiatric hospital in Singapore during this phase of COVID-19 endemicity (2022) in comparison to the earlier pandemic years (2020 and 2021) and to identify factors which contribute to as well as ameliorate stress and burnout. A total of 282 MHP participated in an online survey in 2022, which included 2 validated measures, namely the Perceived Stress Scale and the Oldenburg Burnout Inventory (OLBI). Participants were also asked to rank factors that contributed the most to their stress and burnout. Between-group comparisons were conducted regarding stress and burnout levels among MHP across different demographic groupings and working contexts. In addition, OLBI data completed by MHP in 2020 and 2021 were extracted from 2 published studies, and trend analysis was conducted for the proportion of MHP meeting burnout threshold across 3 time points. We found that the proportion of MHP meeting burnout threshold in 2020, 2021 and 2022 were 76.9%, 87.6% and 77.9% respectively. Professional groups, age, years of experience and income groups were associated with stress and/or burnout. High clinical workload was ranked as the top factor that contributed to stress and burnout while flexible working arrangement was ranked as the top area for improvement so as to reduce stress and burnout. As such, policy makers and hospital management may want to focus on setting clear mental health targets and facilitate manageable clinical workload, build manpower resiliency, optimize resources and provide flexible work arrangements to alleviate stress and burnout among MHP.

Chinese English as a Foreign Language Teachers' Self-Efficacy and Psychological Well-Being as Predictors of Their Work Engagement

Work engagement is widely acknowledged as an influential element in teachers' professional success; thus, remarkable attention has been paid to the physical and psychological predictors of this construct. Yet, the antecedents of English as a foreign language (EFL) teachers' work engagement have rarely been studied. To narrow the existing gap, the current inquiry aimed to delve into the psychological determinants of teacher work engagement by scrutinizing the role of psychological well-being and self-efficacy in Chinese EFL teachers' engagement. To this end, three close-ended questionnaires were given to 304 Chinese EFL teachers via WeChat messenger. Conducting correlational analyses, positive and substantial relationships were discovered between psychological well-being, self-efficacy, and teaching engagement. The function that psychological well-being and self-efficacy may serve in Chinese EFL teachers' engagement was also assessed using path analysis. Chinese EFL teachers' work engagement was found to be considerably affected by their sense of efficacy and well-being. Some pedagogical implications that might be noteworthy for teachers and institutional administrators are finally discussed.

Polish Emergency Dispatchers During a COVID-19 Pandemic - Burnout Syndrome, Perceived Stress, and Self-Efficacy. Effects of Multidimensional Path Analysis

International research has demonstrated that emergency call operators face unique risks to their mental health, in particular job stress, and occupational burnout syndrome. There is already wide knowledge about the relationship between stress, burnout and employee personal resources, which has practical application in preventing mental health. However, more research into the subtle relationships between variables is needed. The aim of the study was to check the moderation effect of differences in the intensity of latent variables on the relationship between perceived stress, self-efficacy and professional burnout. The participants were 546 call-takers and dispatchers from 14 public-safety answering point in Poland aged between 19 and 65 years. The Link Burnout Questionnaire, the 10-item Perceived Stress Scale, the Generalized Self-Efficacy Scale, and an independent questionnaire were used to gather information. The method of path analysis was used. The study confirmed the existence of negative relationships between perceived stress (assessment of the current situation) and self-efficacy (a personal trait). Taking into account the moderating effect of latent variable: psychological comfort revealed a hidden relationship between stress and burnout. The stress-burnout relationship occurred only among participants with low level of psychological comfort, so it was not a proportional relationship. In the case of participants with a high level of second latent variable: power-to-affect, the hypothesis that a high level of this variable should weaken the relationship between stress and burnout was not confirmed. The level of latent variables did not affect the self-efficacy relationship with occupational burnout. Taking into account the differences in the intensity of latent variables showed their moderating effect, which often turned out to be different from the assumed one and obtained in the research of other authors. This allowed to discover the relationships that might otherwise have been overlooked and not included in burnout prevention. The results showed a high level of occupational burnout in the ECD’s group during the COVID-19 pandemic: 32% of the responders reported emotional exhaustion, 53% loss of professional effectiveness.

Burnout and Perceived Stress of Polish Emergency Call Takers and Dispatchers

A scientific research has demonstrated that emergency call operators face unique risks to job stress and burnout. It was hypothesized that perceived stress (demonstrated as resourcefulness–helplessness dimension) may mediate relationships between work environments and burnout taking into account the buffering effect of self-efficacy. The participants of the study were 546 emergency dispatchers and call-takers from 14 Polish public-safety answering points. The Link Burnout Questionnaire, the Perceived Stress Scale and the Generalized Self-Efficacy Scale were employed. The method of path analysis was used and direct and indirect interactions between the variables were identified. Shorter work experience (fewer years on this specific job position) was associated with a higher level of burnout. The greater number of shifts per month was associated with a higher level of perceived stress (higher level of helplessness). Self-efficacy was combined with perceived stress by antagonistic relationships, but the assumed buffering effect on burnout was not confirmed. It was observed that engaging the resource of one’s own self-efficacy in professional work may lead to the loss of other personal resources, manifesting itself in the form of greater disappointment with the work performed.

The effects of job demands and resources on turnover intention: The mediating roles of emotional exhaustion and depersonalization

BACKGROUND

Although job demands, supervisory support, and burnout have been identified as significant predictors of turnover intention, little attention has been paid to the mechanisms among these determinants.

OBJECTIVE

Based on the job demand and resource (JD-R) model, this study examined the mediating roles of emotional exhaustion and depersonalization.

METHODS

Data were collected from private sector social workers in three metropolitan areas of South Korea (N = 316). Two serial multiple mediation analyses were conducted to examine the mediating effects of emotional exhaustion and depersonalization in the relationships between job demands and turnover intention and between job resources and turnover intention, respectively.

RESULTS

Job demands and resources were associated with turnover intention both directly and indirectly, through emotional exhaustion and depersonalization. Whereas job demands were positively associated with emotional exhaustion only, job resources were negatively associated with both emotional exhaustion and depersonalization. The sequential link from emotional exhaustion to depersonalization was present in both job demands and in the resources models.

CONCLUSIONS

The findings underscore the importance of addressing potential burnout to effectively reduce turnover intention among social workers in South Korea. Implications and strategies for developing interventions and policies to reduce turnover by improving work environments are suggested.

Novel Nonproprietary Measures of Ambulatory Electronic Health Record Use Associated with Physician Work Exhaustion

BACKGROUND

Accumulating evidence indicates an association between physician electronic health record (EHR) use after work hours and occupational distress including burnout. These studies are based on either physician perception of time spent in EHR through surveys which may be prone to bias or by utilizing vendor-defined EHR use measures which often rely on proprietary algorithms that may not take into account variation in physician's schedules which may underestimate time spent on the EHR outside of scheduled clinic time. The Stanford team developed and refined a nonproprietary EHR use algorithm to track the number of hours a physician spends logged into the EHR and calculates the Clinician Logged-in Outside Clinic (CLOC) time, the number of hours spent by a physician on the EHR outside of allocated time for patient care.

OBJECTIVE

The objective of our study was to measure the association between CLOC metrics and validated measures of physician burnout and professional fulfillment.

METHODS

Physicians from adult outpatient Internal Medicine, Neurology, Dermatology, Hematology, Oncology, Rheumatology, and Endocrinology departments who logged more than 8 hours of scheduled clinic time per week and answered the annual wellness survey administered in Spring 2019 were included in the analysis.

RESULTS

We observed a statistically significant positive correlation between CLOC ratio (defined as the ratio of CLOC time to allocated time for patient care) and work exhaustion (Pearson's r = 0.14; p = 0.04), but not interpersonal disengagement, burnout, or professional fulfillment.

CONCLUSION

The CLOC metrics are potential objective EHR activity-based markers associated with physician work exhaustion. Our results suggest that the impact of time spent on EHR, while associated with exhaustion, does not appear to be a dominant factor driving the high rates of occupational burnout in physicians.

A brief acceptance and commitment intervention for work-related stress and burnout amongst frontline homelessness staff: A single case experimental design series

PURPOSE

Recent intervention research for burnout amongst those working in health and social care contexts has found acceptance and commitment therapy (ACT) interventions to be of use but has provided less clarity on the role of psychological flexibility (a key ACT construct). This study further evaluated the usefulness of ACT for burnout and work-engagement and assessed the role of psychological flexibility in contributing to therapeutic change.

PROCEDURE

A nonconcurrent multiple-baseline across-participants single-case experimental design was used. Four participants were recruited from a homelessness organization in the East Midlands, England. The ACT-intervention was split into three modules to reflect the three aspects of the ACT triflex, and the sequence of delivery was randomized for each participant in order to test the relationship between these aspects.

FINDINGS

Support was found for the ACT intervention reducing exhaustion and increasing work-engagement. Psychological Flexibility increased in all participants and was temporally related to increases in other outcome variables in some instances. Delivery of the intervention focussed on any given aspect of the ACT triflex could increase different domains of psychological flexibility.

IMPLICATIONS

This study adds to the growing body of research in favour of ACT interventions for burnout and adds to the understanding of psychological flexibility as a mediating variable.

Burnout as a State: Random-Intercept Cross-Lagged Relationship Between Exhaustion and Disengagement in a 10-Day Study

Background

Burnout has been traditionally seen as a chronic and stable state in response to prolonged stress. However, measures of momentary burnout are not well established, even though the within-person approach suggests that the symptoms of burnout may vary from day to day for the same employee. The aim of this study is to examine the daily inter- and intra-personal variability of the symptoms of burnout and the cross-lagged relationship between two components of burnout, exhaustion and disengagement.

Methods

An online diary study over 10 consecutive workdays was conducted among 235 civil servants (75% women, average tenure of 15 years). Daily burnout was measured with the eight-item Oldenburg Burnout Inventory.

Results

The intra-class correlation coefficients indicate that, although significant between-person variability exists, most of the burnout variance is within persons. Using the random intercept cross-lagged panel (RI-CLP) model to control for these between-person differences, mainly insignificant “pure” within-person cross-lagged relationships between exhaustion and disengagement were revealed. Moreover, day-to-day autoregressive effects were weaker than same-day residual correlations.

Conclusion

This is one of the first studies to use daily diaries and the RI-CLP model to study burnout, including the separation of the more stable and more dynamic parts of each component. When stable parts were controlled for, the same-day relationships between exhaustion and disengagement were more pronounced than day-to-day effects. This might suggest stronger situational influences than carryover mechanism. Thus, conceptualizing burnout in terms of daily symptoms may shed promising insights into how it develops and add implications for pro-healthy changes in the workplace.

Is Exhaustion More Sensitive Than Disengagement to Burnout in Academic Anesthesia? A Study Using the Oldenburg Burnout Inventory

Reportedly, clinicians of all kinds are experiencing alarming rates of burnout, and its prevalence among anesthesia providers is high. We examined burnout in a large academic anesthesia department with a commonly used questionnaire, the Oldenburg Burnout Inventory, which provides scores on two scales, "exhaustion" and "disengagement." We examined differences in scores between exhaustion and disengagement and their prevalences. All N = 415 staff members of the department were requested to complete the Oldenburg Burnout Inventory and N = 130 (31%) did so. The mean ± standard deviation was 2.52 ± 0.51 (range, 1.13 to 3.75) for exhaustion and 2.27 ± 0.52 (range, 1.13 to 3.63) for disengagement. The mean for exhaustion exceeded that for disengagement by 0.25 ± 0.42 (range, -1.25 to 1.25), t(129)=6.68, p < 0.0001 by paired t test. Mean ratings exceeded the midpoint (2.5) between the "burned out" and "not burned out" ends of the rating scale for 49% of respondents for exhaustion, but only 30% for disengagement. More respondents (N = 87, 67%) had a higher mean for exhaustion than disengagement than the opposite pattern (N = 28, 22%), M = 29.5, p < 0.0001 by sign test. Thus, burnout symptoms were common but reflected more in exhaustion than disengagement. Literature review suggested that the difference between the exhaustion and disengagement means that we found was larger than typical, but not unusual, for health-care-related groups, and typical for other groups. Future studies should clarify circumstances under which exhaustion exceeds disengagement and vice versa, both in anesthesia and other fields.

Transcultural Adaptation of the Oldenburg Burnout Inventory (OLBI) for Brazil and Portugal

During the last few years, burnout has gained more and more attention for its strong connection with job performance, absenteeism, and presenteeism. It is a psychological phenomenon that depends on occupation, also presenting differences between sexes. However, to properly compare the burnout levels of different groups, a psychometric instrument with adequate validity evidence should be selected (i.e., with measurement invariance). This paper aims to describe the psychometric properties of the Oldenburg Burnout Inventory (OLBI) version adapted for workers from Brazil and Portugal, and to compare burnout across countries and sexes. OLBI's validity evidence based on the internal structure (dimensionality, reliability, and measurement invariance), and validity evidence based on relationships with other variables (work engagement) are described. Additionally, it aims presents a revision of different OLBI's versions-since this is the first version of the instrument developed simultaneously for both countries-it is an important instrument for understanding burnout between sexes in organizations. Data were used from 1,172 employees across two independent samples, one from Portugal and the other from Brazil, 65 percent being female. Regarding the OLBI internal structure, a reduced version (15 items) was obtained. The high correlation between disengagement and exhaustion, suggested the existence of a second-order latent factor, burnout, which presented measurement invariance for country and sex. Confirmatory factor analysis of the Portuguese OLBI version presented good goodness-of-fit indices and good internal consistency values. No statistically significant differences were found in burnout between sexes or countries. OLBI also showed psychometric properties that make it a promising and freely available instrument to measure and compare burnout levels of Portuguese and Brazilian employees.

Effects of Internet-Based Self-Efficacy Intervention on Secondary Traumatic Stress and Secondary Posttraumatic Growth among Health and Human Services Professionals Exposed to Indirect Trauma

Background: Although the evidence for the associations among self-efficacy, secondary traumatic stress (STS) and secondary posttraumatic growth (SPTG) is mounting, there is a lack of the experimental evidence for the influence of self-efficacy on positive and negative mental health outcomes among professionals indirectly exposed to trauma.

Purpose: This study investigated the effects of an internet-based self-efficacy intervention (the experimental condition), compared to an education (the active control condition) on STS and SPTG among workers exposed to traumatic events indirectly, through their clients. We hypothesized that the group assignment (experimental vs. control) would affect STS and SPTG indirectly, with a mediating role of self-efficacy beliefs.

Methods: Participants were 168 health and human services professionals (78% women), exposed indirectly to a traumatic event at work. They were randomly assigned to either a 4-session internet-based self-efficacy intervention (n = 87) or an education control group (n = 81) which received information about coping resources and consequences of stressors at work or at home. STS, SPTG, and self-efficacy were measured at the baseline (Time 1), 1-month follow-up (Time 2) and 2-month follow-up (Time 3).

Results: Analysis of covariance showed that the group assignment had a significant effect on STS (Time 2) and self-efficacy (Time 2), with lower STS and higher self-efficacy reported by the self-efficacy intervention participants. Compared to the experimental group, the active control (education) group participants reported higher SPTG at Time 2. Mediation analyses indicated that the group assignment had indirect effects on STS and SPTG at Time 3. Workers who experienced increases in self-efficacy (Time 2) through the intervention were more likely to report lower STS and higher SPTG at Time 3.

Conclusion: Elucidating the mediating processes that explain why an intervention for secondary trauma works is essential in order to develop more effective support systems that promote improved mental health outcomes among health and human services professionals. Prevention programs for workers exposed indirectly to traumatic events may target self-efficacy enhancement and education.