Burnout and depressive symptoms are not primarily linked to perceived organizational problems

Evidence-based approach to mitigate cumulative stress in pediatric nurses through the development of respite rooms

BACKGROUND

The cumulative stress toll on nurses increased during the COVID-19 pandemic. An evidence-based practice (EBP) project was conducted to understand what is known about the impacts of cumulative stress within nursing and if there are ways to mitigate stress during a nurse's shift.

AIM/IMPLEMENTATION

A project team from three clinical units completed an extensive literature review and identified the need to promote detachment while supporting parasympathetic recovery. Based on this review, leaders from three pediatric clinical units (neonatal intensive care unit, cardiovascular intensive care unit, and acute pulmonary floor) implemented respite rooms.

OUTCOMES

Follow-up outcomes showed a statistically significant stress reduction. For all shifts combined, the Wilcoxon Signed-Rank Test revealed that perceived stress scores from an 11-point Likert scale (0 = no stress and 10 = maximum perceived stress) were significantly lower in the post-respite room (Md = 3, n = 68) compared to in the pre-respite room (Md = 6, n = 68), Z = -7.059, p < .001, with a large effect size, r = .605. Nurses and other staff frequently utilized respite rooms during shifts.

IMPLICATIONS FOR PRACTICE

Clinical inquiry and evidence-based practice processes can mitigate cumulative stress and support staff wellbeing. Respite rooms within the hospital can promote a healthy work environment among nurses and promote a self-care culture change. Evidence-based strategies to mitigate cumulative stress using respite rooms are a best practice to promote nurse wellbeing and mitigate cumulative stress.

Relationship Between Effort-Reward Imbalance, Over-Commitment and Occupational Burnout in the General Population: A Prospective Cohort Study

Objectives: To prospectively investigate the association between Effort-Reward Imbalance (ERI) and over-commitment and the scores of the burnout dimensions over a 4 years follow-up period considering potential confounders. Methods: Data stemmed from CoLaus|PsyCoLaus, a population-based cohort study including 575 participants (mean age 55 years, 50% men). Participants completed the Maslach Burnout Inventory-General Survey, ERI and over-commitment questionnaires at baseline (T1) and after a 4 years follow-up (T2), and provided demographic, behavioral, psychiatric, personality and social support information through self-reported questionnaires and semi-structured interviews. Serially adjusted linear regression models were used. Results: ERI and over-commitment were not associated longitudinally with any of the burnout dimensions when controlling for confounders. One standard deviation increases in the scores of exhaustion, cynicism and professional efficacy were associated with one standard deviation increase in the scores of the same burnout dimensions longitudinally, and these associations were independent of the effects of ERI and over-commitment. Conclusion: Future studies should re-examine the effect of ERI and over-commitment on workers' burnout, considering the effects of confounders.

Big five model personality traits and job burnout: a systematic literature review

BACKGROUND

Job burnout negatively contributes to individual well-being, enhancing public health costs due to turnover, absenteeism, and reduced job performance. Personality traits mainly explain why workers differ in experiencing burnout under the same stressful work conditions. The current systematic review was conducted with the PRISMA method and focused on the five-factor model to explain workers' burnout risk.

METHODS

The databases used were Scopus, PubMed, ScienceDirect, and PsycINFO. Keywords used were: "Burnout," "Job burnout," "Work burnout," "Personality," and "Personality traits".

RESULTS

The initial search identified 3320 papers, from which double and non-focused studies were excluded. From the 207 full texts reviewed, the studies included in this review were 83 papers. The findings show that higher levels of neuroticism (r from 0.10** to 0.642***; β from 0.16** to 0.587***) and lower agreeableness (r from - 0.12* to - 0.353***; β from - 0.08*** to - 0.523*), conscientiousness (r from -0.12* to -0.355***; β from - 0.09*** to - 0.300*), extraversion (r from - 0.034** to - 0.33***; β from - 0.06*** to - 0.31***), and openness (r from - 0.18*** to - 0.237**; β from - 0.092* to - 0.45*) are associated with higher levels of burnout.

CONCLUSIONS

The present review highlighted the relationship between personality traits and job burnout. Results showed that personality traits were closely related to workers' burnout risk. There is still much to explore and how future research on job burnout should account for the personality factors.

The Association of Life Events Outside the Workplace and Burnout: A Cross-Sectional Study on Nursing Assistants

Background: Burnout, by definition, is related to adverse chronic workplace stressors. Life events outside the workplace have been associated with an increased risk of psychiatric morbidity. However, it is unknown whether life events outside the workplace increase the severity of burnout. Purpose: The aim of the study was to investigate the association between burnout and life events outside the workplace in nursing assistants. Methods: In an observational, cross-sectional, single-site study of 521 nursing assistants at a university hospital, we assessed burnout with the Maslach Burnout Inventory-Human Services Survey, and life events with the Social Readjustment Rating Scale. We constructed equations of multiple linear regression analyses that included each burnout subscale as the dependent variable and a domain of life events as the independent variable. Results were adjusted for potential confounders, including gender, no religion or faith, years of work, and depression. Results: An increase in the number of life events in the domain of personal changes or difficulties (e.g., personal injury or illness, sexual difficulties, change in recreation, church activities, social activities, sleeping habits, eating habits and revision of personal habits) was associated with increased severity of emotional exhaustion. An increase in the number of life events in the domain of changes in familial situation and in the domains of death of relatives or friends were associated with increased severity of depersonalization. Those associations were independent of work-related life events and other potential confounders. Conclusions: Life events outside the workplace may increase the levels of burnout in nursing assistants.

Neuroticism Trait and Mental Health Among Chinese Firefighters: The Moderating Role of Perceived Organizational Support and the Mediating Role of Burnout-A Path Analysis

Perceived organizational support (POS) in the relationship between neuroticism and job burnout among firefighters received little attention in China. A sampling of 716 firefighters in China, we drew on perceived organization support theory and the notion of support as a buffer in job burnout, examining moderating effects of POS on the relationship between neuroticism and three components of burnout (emotional exhaustion, depersonalization and reduced personal accomplishment). Also, this study explored the mediating effect of burnout on the relationship between neuroticism and mental health (i.e., anxiety and depression). We found that two components (depersonalization and emotional exhaustion) of burnout have significantly mediated the relationship between neuroticism and anxiety and depression. At the same time, POS reinforced the relationship between neuroticism and depersonalization and emotional exhaustion. Therefore, organizations can take our analysis into account when taking actions to improve firefighters' mental health. The implications of these findings were discussed.

Is Burnout Primarily Linked to Work-Situated Factors? A Relative Weight Analytic Study

It has often been asserted that burnout is primarily linked to occupational-context factors, and only secondarily to individual-level (e.g., personality) and non-work (or general) factors. We evaluated the validity of this view by examining the links between burnout and an array of 22 work-situated (effort-reward imbalance, unreasonable work tasks, unnecessary work tasks, weekly working hours, job autonomy, skill development, performance feedback, and support in work life), work-unrelated (sentimental accomplishment, familial accomplishment, number of child[ren], leisure activities, residential satisfaction, environmental quality, security in daily life, and support in personal life), dispositional (neuroticism, sex, age, and physical condition), and intersecting (work–non-work conflict and non-work–work conflict) variables. The study involved schoolteachers from three different countries: France (N = 4,395), Spain (N = 611), and Switzerland (N = 514). Burnout was assessed with the Maslach Burnout Inventory for Educators. Most of our predictors were assessed based on widely used measures (e.g., neuroticism was assessed with the NEO-Five Factor Inventory). In order to assess sentimental accomplishment and familial accomplishment, we created two self-reported measures, namely, the Sentimental Accomplishment Inventory (SAI; 9 items) and the Familial Accomplishment Inventory (FAI; 9 items). The SAI and the FAI both showed strong reliability and high factorial validity. Exploratory structural equation modeling bifactor analysis and Mokken scaling suggested that both instruments could be considered essentially unidimensional. The study results showed that neuroticism, job strain, skill development, security in daily life, and work–non-work conflict were consistently associated with burnout across the three samples. Sample-specific predictors of burnout included sex, age, unreasonable work tasks, weekly working hours, job autonomy, support in work life, sentimental accomplishment, leisure activities, support in personal life, and non-work–work conflict. Relative weight analysis indicated that neuroticism was the best predictor of burnout in each sample. Our findings suggest that burnout’s nomological network may not be primarily job-related. We conclude that the tendency to de-emphasize individual-level and non-work factors in burnout research is unwise. This tendency may constitute a roadblock in the development of effective interventional strategies. The implications of our findings for burnout’s conceptual status are discussed. The neuroticism-burnout link should be further examined in longitudinal studies.

A five-sample confirmatory factor analytic study of burnout-depression overlap

OBJECTIVE

It has been asserted that burnout-a condition ascribed to unresolvable job stress-should not be mistaken for a depressive syndrome. In this confirmatory factor analytic study, the validity of this assertion was examined.

METHODS

Five samples of employed individuals, recruited in Switzerland and France, were mobilized for this study (N = 3,113). Burnout symptoms were assessed with the Shirom-Melamed Burnout Measure, the Maslach Burnout Inventory (MBI)-General Survey, and the MBI for Educators. Depressive symptoms were measured with the PHQ-9.

RESULTS

In all five samples, the latent factors pertaining to burnout's components correlated on average more highly with the latent Depression factor than with each other, even with fatigue-related items removed from the PHQ-9. Second-order factor analyses indicated that the latent Depression factor and the latent factors pertaining to burnout's components were reflective of the same overarching factor.

CONCLUSIONS

This study suggests that the burnout-depression distinction is artificial.

Advanced Practice Provider Perspectives on Organizational Strategies for Work Stress Reduction

Unresolved work stress contributes to burnout, compassion fatigue, disengagement, and other work-contextualized factors. The impact of occupational stressors extends to the organization in a negative fashion as well. In 2017, advanced practice providers (APPs) from four health systems, including nurse practitioners, clinical nurse specialists, nurse midwives, nurse anesthetists, and physician assistants, participated in a quantitative online cross-sectional survey; 754 participants responded to a free-text question related to work stress and work–family balance. Suggested organizational strategies were ordered into 29 codes, 10 subthemes, and four main themes: “reduce job stressors,” “improve leadership and operations,” “promote APP well-being,” and “maintain the status quo.” Findings are consistent with other research related to occupational stress with many of the reported strategies considered as evidence-based. Targeted interventions for reducing job stress will need to include improved autonomy for APPs, role delineation, support for work–family balance, and better communication as part of management practices.

Burnout is associated with a depressive interpretation style

The aim of this 188-participant study (65% female; mean age = 40.31) was to examine whether burnout and depression are associated with similar interpretation biases in the processing of emotional information. Burnout symptoms were assessed with the Maslach Burnout Inventory-General Survey and depressive symptoms with the 9-item depression module of the Patient Health Questionnaire. Interpretation bias toward emotional information was examined using an amended version of the Word-Sentence Association Paradigm (WSAP). In the WSAP, participants are asked to decide whether emotionally-valenced words are related to ambiguous sentences. Burnout and depression were each associated with a higher endorsement of negative interpretations and a higher ratio of negative interpretations to positive interpretations. Negative word endorsement and positive word endorsement interacted in such a way that negative word endorsement was predictive of burnout and depression only when positive word endorsement levels were relatively low. Our findings suggest that burnout and depression are associated with similar alterations in the interpretation of ambiguous information. This study supports the view that burned out individuals perceive the world with "depressive glasses." Cognitive bias modification techniques employed in the treatment of depressive conditions may constitute relevant therapeutic options for "burned out" individuals.

Exploring burnout and job stressors among advanced practice providers

BACKGROUND

Minimal research exists on how engagement, burnout, work-family balance, and job stressors impact advanced practice nurses and physician assistants, collectively referred to advanced practice providers (APPs).

PURPOSE

To investigate the interrelationships among burnout, job stressors, work-family balance, and engagement with APPs.

METHODS

An online questionnaire was distributed to APPs working in four healthcare systems. A total of 1,216 APPs completed the survey. A hypothesized model was tested using structural equation modeling.

FINDINGS

There was a high correlation of job stressors with development of burnout. A significant negative effect between job stress and work engagement was supported; however, indirect effects of stress through job burnout had a stronger impact on work engagement. Higher levels of work-family balance contributed to a lower level of stress experienced by providers.

DISCUSSION

Organizational leaders desiring to improve employee engagement and reduce burnout need to focus on the significance of work-family balance to job stressors.

Relationship between burnout and career choice regret among Chinese neurology postgraduates

BACKGROUND

In China, the shortage of doctors leads to stressful clinical work and increasing turnover. Medical students undergoing postgraduate specialty training will be the country's medical workforce in the coming decades, but are also subject to high workloads and academic pressure. This may have significant implications for burnout and career choice regret. Despite the importance of burnout and career choice regret, the status and relationship of these aspects in Chinese neurology postgraduates are largely unexplored, and associated factors remain unknown.

METHODS

This study investigated the prevalence of and factors influencing burnout and career choice regret among neurology postgraduates in China. We conducted a national cross-sectional study of Chinese neurology postgraduates. Data were collected using a self-administered questionnaire that covered demographic information, the Maslach Burnout Inventory, and additional item to assess career choice regret.

RESULTS

Of 4902 neurology postgraduates, 2008 returned completed questionnaires (response rate 41%). After excluding incomplete questionnaires, data for 1814 participants were analyzed. In total, 83.6% of participants had experienced symptoms of burnout, and 46.6% reported career choice regret. Binary logistic regression analysis showed postgraduate entrance examination scores, marital status, and having children were associated with burnout (all P <  0.05). Career choice regret was the strongest risk factor for burnout (odds ratio [OR] = 3.17, 95% confidence interval [CI] 2.33-4.32). Multiple logistic regression showed postgraduates with shorter work or study hours per week (OR = 0.64, 95% CI 0.47-0.88) had a low risk for career choice regret, whereas married participants (OR = 1.54, 95% CI 1.07-2.20) had a high risk for career choice regret. No symptoms of burnout (OR = 0.33, 95% CI 0.24-0.45) was also associated with a low risk for career choice regret.

CONCLUSIONS

Burnout symptoms and career choice regret are prevalent among neurology postgraduates in China. Career choice regret is an important predictor of burnout. Further research on reducing burnout and career choice regret among neurology postgraduates is needed.

Burnout is more strongly linked to neuroticism than to work-contextualized factors

Burnout has been regarded as a negative affective state resulting from unresolvable job stress. A widespread idea among burnout researchers is that burnout is primarily linked to work-contextualized factors, and only limitedly dependent on general dispositional factors. The validity of this view, however, remains unclear. This 1,759-participant study addressed the issue of whether burnout is more strongly associated with effort-reward imbalance in the job (ERI) and job support than with personality traits neuroticism and extraversion. Burnout was assessed with the Shirom-Melamed Burnout Measure, ERI with the 10-item version of the Effort-Reward Imbalance Questionnaire, job support with the Job Content Questionnaire, and neuroticism and extraversion with the NEO Five-Factor Inventory. Correlation, multiple regression, and relative weight analyses consistently indicated that burnout was primarily linked to neuroticism. Relative weight analysis revealed that the variance in burnout was explained to a much greater extent by neuroticism (53.46%) than by ERI (31.85%) or supervisor and coworker support (5.47% and 2.97%, respectively). Supervisor and coworker support did not explain more variance in burnout than extraversion (6.25%). This study questions the idea that work-contextualized factors outweigh general dispositional factors in burnout. The relevance of personality trait indicators may have been underestimated in burnout research.