Disturbed sleep and burnout: implications for long-term health

The Impact of Psychological Contract, Physical and Mental Health on Burnout in Grassroots Civil Servants: Evidence from China

Introduction

The report of the 20th Party Congress proposes to build a high-quality cadre capable of taking on the important task of national rejuvenation. Grassroots civil servants are facing great pressure and challenges, and alleviating burnout has become an important issue in the construction of grassroots civil servants. Empirically analysing the impact of psychological contract on burnout of grassroots civil servants in the Chinese context will help to build a high-quality grassroots civil service team.

Methods

Using a sample of 1824 grassroots civil servants in China, this study empirically examined the effect of the psychological contract on burnout among grassroots civil servants using the OLS methodology, conducted a robustness test by way of substituting variables and research methods, and then discussed the mediating effect of physical and mental health in the psychological contract and burnout among grassroots civil servants.

Results

The study showed that grassroots civil servants' psychological contract had a significant negative impact on burnout; transactional psychological contract was positively related to burnout, and relational and developmental psychological contracts were negatively related to burnout in grassroots civil servants. The results of the heterogeneity analysis showed that the effect of psychological contract on burnout differed by age, gender, exercise frequency, and sleep status. The results of the mediation analysis showed that higher psychological contract scores were related to better physical and mental health, thus inhibiting burnout among grassroots civil servants. This indicates a significant mediation effect of physical and mental health in the relationship between psychological contract and burnout of grassroots civil servants.

Conclusion

The psychological contract of grassroots civil servants has a significant negative effect on burnout, and physical and mental health mediate between the two. These conclusions are of great theoretical and practical significance for alleviating the stress of grassroots civil servants and improving their work performance.

Burnout phenomenon: neurophysiological factors, clinical features, and aspects of management

Burnout syndrome is a distinct “occupational phenomenon” rather than a medical condition, comprising emotional exhaustion, physical fatigue, and cognitive weariness. Both exogenous work-related and endogenous personal factors determine the extent and the severity of symptoms in burnout syndrome. Persistent burnout is a cause of reduced quality of life and is associated with increased risk of sleep impairment and with several medical disorders including mild cognitive impairment, diabetes, and cardiovascular disease.

Active coping strategies promoting mental resilience and adaptive behavior, stress-reducing activities, improving work conditions, and reducing exposure to work stressors together may alleviate the distress of burnout and should be introduced early in the clinical course of burnout syndrome. The purpose of this review was to explain this complex and puzzling phenomenon and to describe burnout management.

Laboratory and clinical teaching experience of nursing professors in the COVID-19 pandemic era: Now and the future

Nursing professors must constantly interact with students, maintain a high level of professional performance, and meet targets and deadlines, even during a pandemic. Considering the changing educational environment, it is essential to identify contemporary limitations and problems to provide feedback for improvement. This study aimed to explore the laboratory and clinical teaching experiences of nursing professors during the COVID-19 pandemic. Focus group interviews were conducted with professors from the nursing departments of universities in Korea. In total, 19 professors who had laboratory and clinical experience participated in this study. The collected data were analyzed using thematic analysis. The analysis identified four themes. The themes included feeling helpless in the infection management system, uncertainty about the effectiveness of alternative practice training, acceptance of changes, and preparation for future practice training. As the necessity and possibility of non-face-to-face education have been confirmed by the pandemic, it is expected that classes using technology will be actively developed in nursing practice education. The roles and attitudes of teachers and educational institutions also need to change. Nursing professors should reflect upon and evaluate challenges to prepare for post-pandemic practical education.

The burnout construct with reference to healthcare providers: A narrative review

Burnout syndrome is a psychological response to long-term exposure to occupational stressors. It is characterized by emotional exhaustion, cognitive weariness and physical fatigue, and it may occur in association with any occupation, but is most frequently observed among professionals who work directly with people, particularly in institutional settings. Healthcare professionals who work directly with patients and are frequently exposed to work overload and excessive clinical demands, to ethical dilemmas, to pressing occupational schedules and to managerial challenges; who have to make complex judgements and difficult decisions; and who have relatively little autonomy over their job-related tasks are at risk of developing clinical burnout. In turn, clinical burnout among clinicians has a negative impact on the quality and safety of treatment, and on the overall professional performance of healthcare systems. Healthcare workers with burnout are more likely to make mistakes and to be subjected to medical malpractice claims, than do those who are burnout-naïve. Experiencing the emotional values of autonomy, competence and relatedness are essential work-related psychological needs, which have to be satisfied to promote feelings of self-realization and meaningfulness in relation to work activities, thus reducing burnout risk. Importantly, an autonomy-supportive rather than a controlling style of management decreases burnout risk and promotes self-actualization, self-esteem and a general feeling of well-being in both those in charge and in their subordinates. The purpose of this article is to discuss some of the elements constituting the burnout construct with the view of gaining a better understanding of the complex multifactorial nature of burnout. This may facilitate the development and implementation of both personal, behavioural and organizational interventions to deal with the burnout syndrome and its ramifications.

A Brief Mindfulness-Based Intervention (bMBI) to Reduce Teacher Stress and Burnout

Teacher stress and burnout contribute to attrition and stress-related health concerns. Despite some positive effects, previous mindfulness-based interventions (MBI) have failed to incorporate key elements of methodological rigor and have included large dosages despite research suggesting that such dosages are iatrogenic. The current study demonstrates the efficacy of a brief MBI (bMBI; four sessions, six total hours) to reduce self-reported stress, burnout, and depression, and suggests the bMBI can protect against deleterious impacts to physiological functioning. The study informs the design and implementation of future MBIs, including strategies for reducing intervention dosages, in order to improve effectiveness and maximize cost-effectiveness.

Teacher burnout profiles and proactive strategies

Teacher burnout has been identified as a significant occupational hazard. However, our understanding about individual variations in burnout risk among in-service teachers is still less than sufficient. This study explored socio-contextual burnout risk profiles and their association with the reported use of proactive strategies among in-service teachers by using a person-oriented approach. The survey data were collected from 2310 Finnish in-service primary and lower secondary school teachers using a probability sampling method. In the latent profile analysis, five socio-contextual burnout profiles were identified. The profiles differed from each other in terms of burnout symptoms and proactive strategy use. Results suggested that there is individual variation in teachers’ risk of burnout. In addition, the results imply that well-developed proactive strategies, both in terms of self- and co-regulative strategies, are related to lower risk of experiencing socio-contextual burnout. The utilization of strong co-regulative strategies was related to lower risk of experiencing exhaustion and inadequacy during teacher-pupil interactions. However, strong self-regulation combined with low levels of co-regulation was related to an increased risk of experiencing cynicism. This implies that learning proactive strategies may be useful in preventing teacher burnout.

Effects of an adjunctive, chronotype-based light therapy in hospitalized patients with severe burnout symptoms - a pilot study

Light therapy is a well-established treatment option for seasonal affective disorders and is effective in reducing sleep problems and daytime fatigue. Symptoms of severe burnout include feelings of exhaustion and impaired sleep and mood. Thus, light therapy seems promising for burnout treatment. So far, light therapy effects in burnout were investigated in outpatient settings only, with inconclusive results. The present study targeted light therapy effects in an inpatient setting. Participants with severe burnout were recruited in two psychosomatic clinics and randomly assigned to a control group with multimodal psychiatric treatment or an add-on light treatment group. Participants in the latter group were additionally exposed to morning bright light (illuminance: 4246 lux, irradiance: 1802.81 µW.cm^-2) for 3 weeks, 30 minutes a day, timed to their chronotypes. Light effects on burnout symptoms, depression, well-being, daytime sleepiness, sleep quality, and attentional performance were measured twice (pre-/postintervention design). Adjunctive chronotype-based bright light therapy was well tolerated and improved burnout symptoms and well-being without additional effect on severity of depression. Furthermore, reduced daytime sleepiness, improved nighttime sleep quality, a sleep phase advance of 25 minutes, shortened sleep latency, less sleep disturbances and increased sleep duration were observed in the light treatment group. No group differences were found in attentional performance. Chronotype-based bright light therapy seems to be effective in improving burnout symptoms and sleep problems in patients with severe burnout symptoms. Further studies with larger sample sizes and objective measures of sleep are necessary to confirm these preliminary results before practical recommendations can be made.

Burnout among foreign-born and native Swedish women: a longitudinal study

The authors of this study addressed burnout experiences (generally defined as chronic depletion of an individual's energetic resources') over time in relation to other factors (e.g., distress, sleep difficulties, job demands, etc.) among foreign-born women and Swedish native women living in Stockholm. The study design was a longitudinal panel survey with two waves one year apart. In the first wave, 3,616 of 6,000 randomly selected women took part, and 2,300 of the initial 3,616 women also participated in the second wave; 427 were foreign-born women, and 1,873 were Swedish native women. Baseline/emerging distress, emerging sleep difficulties, worsening general social support, job demands at baseline/escalating during the assessment period, emerging unemployment, constraints in social support at work, and sustained/emerging financial strain were associated with future burnout, regardless of background. More foreign-born women than Swedish native women reported burnout, with these differences maintained at one-year follow-up. The factors related to burnout were largely the same in both groups, but smoking and cardiovascular disease were related to burnout only among foreign-born women. Younger age, job demands, and working hours were associated with burnout among Swedish native women. The authors found that the women had concurrent problems such as burnout, distress, and sleep problems, but foreign background was not independently related to burnout.

Organizational traits, care processes, and burnout among chronic hemodialysis nurses

In light of evidence linking registered nurse (RN) staffing levels to patient outcomes in chronic hemodialysis facilities, U.S. government regulations have set minimum RN staffing requirements during dialysis. Consequently, facility administrators are focused on decreasing nurse attrition in this crucial practice setting. This study used a cross-sectional, correlational design to investigate the effects of workload, practice environment, and care processes on burnout among nurses in U.S. chronic hemodialysis centers and to determine the association between burnout and nurses' intentions to leave their jobs. Findings indicate that predictors were associated with an increased likelihood of nurse burnout and that nurses experiencing burnout were more likely to be planning to leave their jobs. Findings have important implications for retention of nurses, enhancement of patient safety, and adherence to new federal staffing requirements in chronic hemodialysis units.