Integrating Self-Determination and Job Demands-Resources Theory in Predicting Mental Health Provider Burnout

Enhancing Behavioral Health Implementation in a Care Coordination Program at a Federally Qualified Health Center: A Case Study Applying Implementation Frameworks

Federally Qualified Health Centers are charged with providing comprehensive health care in traditionally underserved areas, underscoring their importance in caring for and promoting health equity for the large portion of historically marginalized communities in this setting. There is a significant need to ensure Federally Qualified Health Centers are equipped to appropriately address the immense behavioral health needs common among patients served. Care coordination is an evidence-based model that is increasingly utilized in Federally Qualified Health Centers to improve care equity and outcomes. Addressing and supporting behavioral health needs is a key aspect of such care coordination models. Context-specific considerations and programmatic supports, particularly those that address the needs of care coordinators and the complex patients they serve, are needed to ensure such models can appropriately meet and address the behavioral health concerns of the diverse populations served. The goal of this study was to present a mixed-methods case study that systematically applies implementation frameworks to conduct a needs and context assessment to inform the development and testing of evidence-based practice strategies and implementation support as part of a care coordination program within a partnered Federally Qualified Health Center.

Setting and Provider Predictors of Implementation Success for an Eating Disorder Prevention Program Delivered by College Peer Educators

INTRODUCTION

College students face increased risk for a variety of mental health problems but experience barriers to treatment access. Prevention programs, including those implemented by peer educators, may decrease treatment needs and increase service access. We examined the implementation of an evidence-based eating disorder prevention program, Body Project, delivered by college peer educators at 63 colleges/universities, comparing three levels of implementation support: (1) Train-the-Trainer (TTT) training; (2) TTT plus a technical assistance workshop (TTT + TA); and (3) TTT + TA with one year of quality assurance calls (TTT + TA + QA). The present study tested the degree to which indicators proposed by the Consolidated Framework for Implementation Research (CFIR) were associated with core implementation outcomes.

METHOD

We tested whether indices of CFIR domains (i.e., perceived intervention characteristics, outer and inner setting factors, provider characteristics, and implementation process) were correlated with three implementation outcomes (program reach, fidelity, effectiveness) during a 1-year implementation period.

RESULTS

Greater program reach was associated with implementation process, specifically the completion of more implementation activities (β = 0.46). Greater program fidelity was associated with higher positive (β = 0.44) and lower negative (β = - 0.43) perceptions of the Body Project characteristics, and greater reported general support for evidence-based practices (β = 0.41). Greater effectiveness was associated with lower negative perceptions of Body Project characteristics (d = 0.49).

CONCLUSIONS

Several implementation determinants proposed by the CFIR model predicted outcomes, especially intervention fidelity. Across the outcomes of interest, implementation determinants related to peer educator and supervisor perceived characteristics of the specific intervention and general attitudes towards evidence-based practices emerged as robust predictors to inform future work investigating ongoing implementation and sustainability of programs in university settings.

The role of psychosocial risks in burnout, psychosomatic disorders, and job satisfaction: lineal models vs a QCA approach in non-university teachers

This study aims to assess the effect of psychosocial risks and resources on burnout, psychosomatic disorders, and job satisfaction using Hierarchical Regression Modelling (HRM) and Qualitative Comparative Analysis (QCA).

METHOD

The sample consisted of 9020 non-university public education teachers (Mage = 45.33 years, SD = 9.15; 72.5% women).

RESULTS

Demands variables (Workload, Emotional labour, Imbalance, and Interpersonal conflict) were better predictors than resources variables (Job autonomy, Social support, and Resources at work). Resources also significantly improved the model's predictive capacity, except in the case of Indolence. In the QCA results, none of the conditions seems to be necessary. Regarding sufficiency, the combination of the different conditions explains between 44-49% of high levels of Burnout and between 40-47% of low levels of Burnout; between 44-47% of high levels of Psychosomatic disorders and 40-47% of low levels of Psychosomatic disorders; 49% of high Job satisfaction levels and 45-56% of low Job satisfaction levels.

CONCLUSIONS

The results show that QCA models have better explanatory capacity than HRM. Some variables were not significant in HRM, but they were present in combination with other QCA model variables. The findings contribute to understanding how psychosocial risks affect workers' health and job satisfaction.

How much do we care about teacher job insecurity during the pandemic? A bibliometric review

In this study, a descriptive bibliometric analysis of the scientific production in the Web of Science on job insecurity perceived by teachers in pandemic situations was carried out. The result shows the growing interest in the topic with an upward trend with an annual growth of 41.52%. Forty-seven papers from 41 journals with 2,182 cited references were considered, with 149 researchers from 30 countries publishing at least one article. The country with the most publications was the United States, followed by Germany and Spain. The United States was the country with the most collaborations. A total of 95 institutions published papers, and the universities with the most registrations were Miami University and the University of the Basque Country, although York University and the University of the Basque Country had a higher overall citation coefficient (102 and 40, respectively). Of the 41 journals that have published on the topic, Frontiers in Education and the British Journal of Educational Psychology stood out in terms of their article numbers. However, this last one was superior in terms of the overall number of citations per year, followed by Frontiers of Psychology.

The Relationship between Teacher Autonomy and Mental Health in Primary and Secondary School Teachers: The Chain-Mediating Role of Teaching Efficacy and Job Satisfaction

Teachers in primary and secondary schools are frequently under pressure. Therefore, it is critical to understand the factors that affect their mental health. Autonomy was associated with mental health in the past. However, the mediating mechanism behind this relationship has received little attention. In this study, a chain mediation model was built to determine whether teaching efficacy and work satisfaction mediated the relationship between teacher autonomy and mental health. Our study enlisted the participation of 810 Chinese primary and secondary school teachers aged from 21 to 57 years old. They completed self-reporting measures of teacher autonomy, mental health, teaching efficacy, and job satisfaction. The results show that (1) teacher autonomy, teaching efficacy, job satisfaction, and mental health have strong positive relationships, (2) teaching efficacy and job satisfaction significantly mediate the relationship between autonomy and mental health, and (3) both teaching efficacy and job satisfaction play a chain-mediating role. The chain-mediating effect of teaching efficacy and job satisfaction plays an important role in promoting teachers' mental health. Teachers with a high level of autonomy tend to have high teaching efficacy, high job satisfaction, and improved mental health.

Long Work Hours, Overtime, and Worker Health Impairment: A Cross-Sectional Study among Stone, Sand, and Gravel Mine Workers

Background: Research has shown that long work hours and overtime are associated with health impairment, including stress, burnout, and overall health. However, this has not been thoroughly assessed among stone, sand, and gravel mine workers. As such, this study examined whether significant differences in stress, burnout, and overall health existed among workers that worked different hours each week. Methods: ANOVA analyses were completed for the outcome variables (stress, burnout, and health status). Each analysis included three categorical independent variables: age, sex, and work hours. Age and sex were control variables. BMI was added to the health status analysis as an additional control variable. Results: There were significant differences between work hour groups for all three outcomes. Post hoc analyses determined that workers working >60 h/week had more stress, more burnout, and lower health. Differences were not found between age or sex. There were no differences in health status for different BMI groups, but the interaction of BMI and work hours was significant. Conclusions: Working more than 60 h per week was problematic. Mine and safety administrators should enact programs to protect and promote worker health, particularly among those working long hours, especially if more than 60 h per week.

How Much Do We Care about Teacher Burnout during the Pandemic: A Bibliometric Review

In this study, a descriptive bibliometric analysis of the scientific production was performed in the Web of Science on burnout and/or stress in teachers in pandemic situations. The aim of the study was to analyse the scientific production on stress and burnout in teachers during the COVID-19 pandemic. A total of 75 documents from 33 journals with 3947 cited references were considered, with 307 researchers from 35 countries publishing at least one article. The country with the most publications was the USA, followed by China and Spain. The USA was the country with the most collaborations. A total of 184 institutions published documents, and the universities with the most records were Christopher Newport and Columbia, although the American University of Sharjah and Cape Breton University had a higher overall citation coefficient. Of the 33 journals that have published on the subject, Frontiers in Psychology and the International Journal of Environmental Research and Public Health stood out in terms of the number of articles, and they were also listed in this order with regard to their impact factor.

Health Care Worker Burnout During the COVID-19 Pandemic in HIV Clinics in Guangxi, China: A Cross-sectional Analysis of Risk and Protective Factors

ABSTRACT

Dual epidemics of coronavirus disease 2019 (COVID-19) and HIV cause burnout among HIV health care workers. Guided by a socioecological framework, we investigated risk and protective factors of their burnout in Guangxi, China based on an online survey (N = 1,029) from April to May 2020. Descriptive and bivariate analyses and hierarchical regression were conducted. COVID-19-related stressors (B = 0.648 [0.482-0.816], p < .001), challenges while delivering HIV services (B = 0.236 [0.174-0.298], p < .001), and working in province/city-level institutes (B = 2.302, [0.828-3.776], p =.002) were risk factors. Protective factors were resilience (B = -0.596 [-0.687 to -0.504], p < .001), workplace social support (B = -0.410 [-0.717 to -0.044], p =.03), and institutional responsiveness to COVID-19 (B = -0.138 [-0.205 to -0.071], p < .001), respectively. Burnout-related interventions may benefit from promoting resilience, creating a supportive work environment, and strengthening institutional response to public health emergencies.

Impact of Job Resources and Job Demands on Burnout among Physical Therapy Providers

Job burnout is a threat for physical therapists. Little research has been conducted to identify possible protective factors against burnout in this population. Accordingly, we utilized the job demands-resources (JD-R) model and self-determination theory to guide our examination of basic psychological needs as factors to predict burnout in physical therapists. One hundred and two licensed physical therapists completed surveys. Higher levels of autonomy, competence and relatedness predicted burnout, even after accounting for job demands. Job resources, such as the basic psychological needs outlined by the self-determination theory, along with perceived respect, buffer the negative effects of secondary trauma on burnout. The job resource of perceived respect also buffers the negative effects of the physical demands of the job on burnout. These findings suggest that while job demands can be difficult to change, increasing the fulfillment of job resources can help ameliorate burnout in physical therapists. The present findings highlight the need for workplace interventions which cultivate the satisfaction of the basic psychological needs of autonomy, competence, and relatedness to address burnout among physical therapists.

Exploring the role of psychological need fulfilment on stress, job satisfaction and turnover intention in support staff working in inpatient mental health hospitals in the NHS: a self-determination theory perspective

BACKGROUND

Meeting psychological needs for autonomy, competence and relatedness as described by Self-Determination Theory (SDT) has been associated with increased well-being and job satisfaction in mental health staff and improved care outcomes for patients.

AIMS

The study investigated whether psychological need satisfaction predicted stress, turnover intention and job satisfaction in health care assistants (HCA) working in inpatient mental health hospitals in the United Kingdom including full time (FT) and temporary agency worker (TAW) staff.

METHODS

A cross-sectional survey explored need satisfaction between FT (n = 63) and TAW (n = 39) staff using the Work-Related Basic Need Satisfaction Scale. Multiple regression was used to explore whether satisfaction of the needs for autonomy, competence and relatedness predicted scores on measures of stress, job satisfaction and turnover intention.

RESULTS

Results were comparable between FT and TAW staff. Autonomy was the need least satisfied, a need which predicted self-reported job satisfaction, stress and turnover intention. Relatedness also predicted job satisfaction and turnover intention.

CONCLUSIONS

Recommendations are made to explore experiences of (and barriers to) autonomy and relatedness in inpatient HCA staff to target and improve autonomy and relatedness in this workforce. Implications of doing so are considered at a staffing, organisational and patient level.

Could the connectedness of primary health care workers involved in social networks affect their job burnout? A cross-sectional study in six counties, Central China

Background

This study aimed to reveal the effects of the connectedness of primary health care (PHC) workers in social networks on their job burnout.

Methods

Cross-sectional survey data of rural PHC workers in China were analyzed. A total of 663 respondents were enrolled. Chi-square and cumulative logistic regression were used to determine the effects of the connectedness of PHC workers in social networks on their job burnout.

Results

PHC workers in rural China had high levels of emotional exhaustion (24.1%), depersonalization (15.7%), and lack of personal accomplishment (34.7%). More than half of the participants were in the middle connectedness level in terms of their advisory (70.4%) and friendship (70.3%) networks. The degree of emotional exhaustion seemed to increase when participants had a low connectedness in their friendship networks (β = 0.769, 95% CI = 0.080–1.458, P = 0.029). Respondents with the middle level of connectedness in advisory networks had higher levels of depersonalization (β = 0.739, 95% CI = 0.130–1.348, P = 0.017) and lack of personal accomplishment (β = 0.583, 95% CI = 0.111–1.055, P = 0.015) than those with the high degree of connectedness in advisory networks.

Conclusions

The connectedness of PHC workers in social networks influenced their job burnout. Thus, organizations should establish an informal communication platform and information feedback mechanism, promote and manage friendship networks, and help PHC workers overcome emotional exhaustion. Managers should also encourage individuals with a high level of connectedness in advisory networks play the role of “opinion leader” so that they can help others mitigate burnout.

Relationships between burnout, turnover intention, job satisfaction, job demands and job resources for mental health personnel in an Australian mental health service

BACKGROUND

Burnout and employee turnover in mental health services are costly and can have a negative impact on service user outcomes. Using the Job Demands-Resources model as a foundation, the aim of this study was to explore the relationships between burnout, turnover intention and job satisfaction in relation to specific job demands and job resources present in the workplace in the context of one Australian mental health service with approximately 1100 clinical staff.

METHODS

The study took a cross-sectional survey approach. The survey included demographic questions, measures of burnout, turnover intention, job satisfaction, job demands and job resources.

RESULTS

A total of 277 mental health personnel participated. Job satisfaction, turnover intention and burnout were all strongly inter-correlated. The job resources of rewards and recognition, job control, feedback and participation were associated with burnout, turnover intention and job satisfaction. Additionally, the job demands of emotional demands, shiftwork and work-home interference were associated with the exhaustion component of burnout.

CONCLUSION

This study is the largest of its kind to be completed with Australian mental health personnel. Results can be used as a foundation for the development of strategies designed to reduce burnout and turnover intention and enhance job satisfaction.

The Prevalence and Cause(s) of Burnout Among Applied Psychologists: A Systematic Review

Purpose: Burnout has been shown to develop due to chronic stress or distress, which has negative implications for both physical and mental health and well-being. Burnout research originated in the "caring-professions." However, there is a paucity of research which has focused specifically on how job demands, resources and personal characteristics affect burnout among practitioner psychologists. Methods: This PRISMA review (Moher et al., 2009) involved searches of key databases (i.e., Web of Knowledge, SCOPUS and Google Scholar) for articles published prior to 1st January, 2017. Articles concerning the prevalence and cause(s) of burnout in applied psychologists, that were published in the English language were included. Both quantitative and qualitative investigative studies were included in the review. The Crowe Critical Appraisal Tool (CCAT; Crowe, 2013) was used to appraise the quality of each paper included in this review. An inductive content analysis approach (Thomas, 2006) was subsequently conducted in order to identify the developing themes from the data. Results: The systematic review comprised 29 papers. The most commonly cited dimension of burnout by applied psychologists was emotional exhaustion (34.48% of papers). Atheoretical approaches were common among the published articles on burnout among applied psychologists. Workload and work setting are the most common job demands and factors that contribute to burnout among applied psychologists, with the resources and personal characteristics of research are age and experience, and sex the most commonly focused upon within the literature. Conclusions: The results of the current review offers evidence that burnout is a concern for those working in the delivery of psychological interventions. Emotional exhaustion is the most commonly reported dimension of burnout, with job and personal characteristics and resources also playing important roles in the development of burnout in the mental health care profession. Finally, tentative recommendations for those within the field of applied psychology.