Gendered Pathways to Burnout: Results from the SALVEO Study

Incorporating gendered analysis and flexibility in heavy work investment studies: a systematic literature review

Introduction

Significant impacts of heavy work investment on employee well-being and organizational performance have prompted its increasing importance as a research topic. The findings about good or evil of these repercussions are nonetheless inconclusive. The intersection of Heavy Work Investment construct with gender has not been explicitly addressed by previous literature review and research. Besides, the relevance of flexibility for women, as one of the key factors for successful work-family balance management, still remains to be analyzed.

Methods

A literature review on Heavy Work Investment was conducted using the SPAR-4-SLR protocol, wherein 83 articles were selected from a pool of 208 previously identified works. Bibliometric and content analysis techniques were employed, including co-word analysis, to evaluate research production, impact, and trends in the gender perspective within Heavy Work Investment.

Results

As a result, a strategic diagram illustrates thematic topics, providing a clear understanding of the field's structure and evolution. Six thematic groups were identified, around work-family conflict as the central theme.

Discussion

The explicit consideration of a gender perspective in literature involves nuanced differences regarding the conclusions of studies with a broader focus. First, the emerging prominence of studies on China and Japan becomes clear with gender as the specific focus of the review, aiming to clarify the experiences women face in more traditional societies with a more decisive division of roles. Second, there is a shift in interest regarding the analysis of Job Demands and Job Resources. Despite the apparent decline in interest in the former, the focus in gender literature clearly shifts toward the side of Job Resources, showing potential for the future. It could be understood that in a context of talent war and employee retention efforts, priority is given to better understanding of facilitating individual and organizational factors for work-life balance, especially for women. Future research areas are identified, including gender differences in organizational support and the impact of flexible work on the work-life balance, providing valuable insights for academia, practitioners, and organizations. The need for more comprehensive cross-cultural and gender research is also made clear.

Changes in work-related stressors before and during the COVID-19 pandemic: differences by gender and parental status

PURPOSE

The COVID-19 pandemic changed people's working conditions worldwide and research suggests increases in work stressors. However, it is not known to what extent these changes differ by gender or parental status. In the present study, we investigate trends in work stressors and whether these differ by gender and parental status.

METHODS

We used cross-sectional time series data of the European Working Conditions Survey of 2015 and Living, Working and COVID-19 survey of spring 2020 to examine trends in work stressors by gender and parental status. Work stressors were working in leisure time, lack of psychological detachment and work-life conflict. We applied three-way multilevel regressions reporting prevalence ratios and reported predicted probabilities and average marginal effects to show trends and differences in changes in work stressors.

RESULTS

Our multilevel regression results showed elevated prevalence ratios during the pandemic for working leisure time (PR: 1.43, 95% CI 1.34-1.53), psychological detachment (PR: 1.70, 95% CI 1.45-1.99) and work-life conflict (PR: 1.29, 95% CI 1.17-1.43) compared to before the pandemic. Except for working in leisure time, the increase was more significant among women and mothers. The proportion of work-life conflict in 2020 was 20.7% (95% CI 18.7-22.9) for men and 25.8% (95% CI 24.0-27.6) for women, equalling a difference of 5.1% (p < 0.001).

CONCLUSIONS

There is evidence that work stressors increased disproportionately for women and mothers. This needs to be monitored and addressed to prevent widening gender inequalities in the quality of work.

Family incivility and burnout: a moderated mediation model of life satisfaction and psychological capital

Purpose

This study investigates the relationship between family incivility (FI) and burnout in line with the conservation of resources theory and work–home resources model. The authors also examine the conditional indirect effects of psychological capital (PsyCap) and life satisfaction (LS) in the aforementioned relationship. The purpose of this paper is to address these issues.

Design/methodology/approach

Data were collected using a time-lagged methodological design by administering a structured questionnaire among 296 rural doctors. The collected data were analyzed using PROCESS macro in Statistical Package for the Social Sciences (SPSS) 23.

Findings

The study indicates that FI is an emotional home demand and influences burnout at the workplace through the depletion of LS. At the same time, PsyCap proves to be a vital resource that mitigates the adverse effects of FI and burnout.

Research limitations/implications

This study adds to the work–family and well-being literature by exploring the underlying mechanism through which FI connects to different outcomes. The implications of these findings for applications and extension of the work–home resources model to the family domain is elaborated in detail.

Originality/value

This study is among the first to empirically substantiate the long-term adverse consequences of FI and its potential for negatively affecting the work domain by inducing long-term psychological disorder “burnout.”

Domains of Physical and Mental Workload in Health Work and Unpaid Domestic Work by Gender Division: A Study with Primary Health Care Workers in Brazil

Various studies indicate that workload metrics can be used to assess inequities in the division of labor according to gender and in the mental health of health care professionals. In most studies, the workload is portrayed in a way that does not integrate the different fields of work, that is, work in health services and unpaid domestic work. The objective was to determine the effects of the workload domains of health work and unpaid domestic work according to the gender division of health professionals working in primary health care (PHC), and to analyze the workload as an inducer of anxiety disorders and episodes of depression. This cross-sectional study consisted of 342 health care professionals recruited for interview at primary health care units in the extreme south of Rio Grande do Sul, Brazil. Sociodemographic and occupational variables, workload in PHC and unpaid domestic work, and dichotomies of anxiety disorders and episodes of depression were considered. Poisson and multivariate linear regression models were used for data analysis. Cohen's standardized effect size was used to assess the magnitude of the difference between women and men in terms of workload. The female professionals presented higher scores in terms of PHC work and unpaid domestic work and higher proportions of episodes of depression and anxiety disorders compared to males. The male professionals showed that anxiety disorders presented a medium standardized effect size on domestic workload and the level of frustration with family involvement was higher in those with episodes of depression. The results illustrate that the workload metric is an important indicator of female vulnerability to working conditions in PHC and in the family environment.

Professional Quality of Life in Intensive Care Unit Professionals during COVID-19 Pandemic: A Prospective Observational Cross-sectional Study

Background and aims

The coronavirus disease-2019 (COVID-19) has significant positive and negative impacts on the professional life of intensive care unit (ICU) professionals. This study was conducted to evaluate compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) in ICU professionals and to study demographic and occupational variables related to them.

Methods

This prospective observational study was undertaken on ICU professionals involved in direct care of critically ill COVID-19 patients. The online questionnaire consisting of demographic, work-related parameters, and professional quality of life scale version 5 (ProQOL 5) was sent to 1,080 ICU healthcare workers. The subgroups of ProQOL 5, CS, BO, and STS were calculated and compared across study parameters. Linear regression was performed to evaluate variables which were independently associated with ProQOL.

Results

The response rate in the present study was 39.8%, and after evaluation, 320 responses were found eligible for final analysis. There was predominance of average levels of CS, BO, and STS. Female gender, contractual job, lesser work experience, greater workload, and COVID-19 infection in close acquittance of participants were factors observed to independently associated with increase in negative aspects of ProQOL (BO and STS). Further, increase in duty hours and COVID-19 infection in close social circle were observed to independently decrease positive aspects (CS).

Conclusion

This study shows that despite majority of respondents reporting moderate levels BO and STS, CS is maintained during the COVID-19 crisis. The identification of risk factors is vital to support ICU professionals by targeted interventions.

How to cite this article

Kerai S, Doda P, Saxena KN. Professional Quality of Life in Intensive Care Unit Professionals during COVID-19 Pandemic: A Prospective Observational Cross-sectional Study. Indian J Crit Care Med 2022;26(5):604–612.

The role conflict-burnout-depression link among Chinese female health care and social service providers: the moderating effect of marriage and motherhood

Background

Women with depression disorder outnumber men, and health care and social service providers are mostly female. Drawing on conservation of resources (COR) theory, this study aims to examine the association between role conflicts and depression among health care and social service providers, and further investigate the mediating effect of burnout, as well as the moderating effect of marital status and motherhood.

Methods

The data come from the baseline of the ‘China Social Work Longitudinal Study’ conducted in 2019, which contains 1,219 female social workers who reported work-family conflict. The five items of the scale in our model were extracted from the existing literature to ensure the construct validity of potential variables, and confirmatory factor analyses (CFAs) were also conducted to ensure the validity and reliability of the scale. Descriptive analyses and correlation analyses were performed with SPSS 24, while the path analysis was conducted using Amos 24. The moderating effects of marital status and motherhood were further tested using multiple-group analyses.

Results

Female health care and social service providers experienced a high level of depression. Work-to-family conflict (WFC), family-to-work conflict (FWC), and organizational role conflict (ORC) were significantly and positively associated with female social workers’ depression. Exhaustion and cynicism fully mediated the effects of ORC on depression and partially mediated the effects of WFC on depression. In addition, FWC had only a direct effect on depression. A multiple-group analysis further indicated that both marital status and motherhood status may have played a moderating role in the conflict-burnout-depression link and that being unmarried and having no child were risk factors for depression in female health care and social service providers.

Conclusions

Marriage and motherhood have both negative and positive effects on the depression of female health care and social service providers. This suggests that marriage and motherhood may act as a form of “family clientelism” for female health care and social service providers who marry and have children.

Impact of different work organizational models on gender differences in exposure to psychosocial and ergonomic hazards at work and in mental and physical health

PURPOSE

To examine differences between genders in exposure to psychosocial and ergonomic factors at work and in work-related health, according to different work organization models.

METHODS

The study population included a sample of 9749 (women: 37.1%) and 10,374 (women: 39.9%) employees who participated in the 2010 and 2015 European Working Conditions Surveys, respectively. Multiple Correspondence Analysis was applied to work characteristics reported by workers to estimate principal components, followed by Hierarchical Clustering on principal components to identify clusters of work organization models. Gender differences in exposure to work hazards and health outcomes were assessed through Poisson robust regression. Differences of PRs across organizational models were tested through interaction between gender and type of work organization.

RESULTS

Three organizational models were identified in 2010, including lean production, Tayloristic production, and a "reflexive production" model, whereas in 2015, a "simple" or traditional model was also found. In 2010, women employed in companies adopting the Tayloristic or the lean production models were more likely than men to be exposed to unfavourable psychosocial and physical work factors, and to report musculoskeletal pain, compared to those belonging to reflexive production. In 2015, a significantly higher female/male ratio persisted in lean production for exposure to high job strain and for carrying/moving heavy loads, whereas gender differences in Tayloristic and traditional production were quite similar to those of reflexive production.

CONCLUSIONS

Our results suggest that employment in workplaces characterized by lower monotony, repetitiveness, and production constraints may contribute to reduce exposure to job strain among working women.

Burnout: Redefining its key symptoms

Burnout is currently operationalised as comprising of exhaustion, depersonalization and reduced personal accomplishment. However, questions have been raised as to whether this three-factor model accurately characterises the syndrome. We therefore sought to re-examine burnout's key symptoms and to develop a new model of the syndrome. 622 participants who self-identified as experiencing burnout completed a questionnaire covering a large item set of candidate burnout symptoms. Bifactor modelling identified a 34-item general factor that was dominated by items capturing exhaustion and cognitive dysfunction, but which also included items indicative of decreased work performance, insularity and a depressed mood. Five specific factors capturing additional data variance were identified and were interpreted as representing cognitive impairment, empathy loss, exhaustion, compromised work performance, and social withdrawal. Reliability indices indicated that the general factor alone accounted for most of the variance in observed scale scores for each specific factor, except for the loss of empathy specific factor. We concluded that burnout may therefore potentially be modelled as a unidimensional construct comprising exhaustion, cognitive impairment, compromised work performance, empathy loss and social withdrawal. Further, while those with burnout are likely to experience depressive symptoms, their presence is not of necessity indicative of clinical depression.

Occupational gender roles in relation to workplace stress, allostatic load, and mental health of psychiatric hospital workers

OBJECTIVES

Gendered inequalities in workplace stress are linked to sex-specific health trajectories that are poorly understood. Measuring gendered inequalities is challenging but necessary to better explain individual differences in occupational health. The aim of this exploratory, retrospective study was to create a measure of occupational gender-roles and use structural equation models to investigate pathways linking layers of gendered factors to workplace stress, allostatic load, and mental health in a sample of psychiatric hospital workers (N = 192).

METHODS

Individual-level gender-roles were measured with the Bem Sex-Role Inventory Short-Form. Occupational gender-roles were measured using a novel web-based survey approach. Sex-specific allostatic load indices were constructed using 23 biomarkers (e.g., neuroendocrine, immune, cardiovascular, and metabolic). Workplace stress was assessed using the Job Content Questionnaire and the Effort-Reward at Work Questionnaire. Depressive symptoms were assessed with the Beck Depression Inventory-II, burnout symptoms with the Maslach Burnout Inventory - General Survey, and trauma symptoms with the PTSD Civilian Checklist.

RESULTS

Individual-level masculine gender-roles were positively associated with psychological demands (R² = 0.103) and social support (R² = 0.078). Masculine and feminine occupational gender-roles were positively associated with decisional latitude (R² = 0.157) and effort-reward ratio (R² = 0.058). Both individual masculine and feminine gender-roles had protective effects on depressive symptoms (R² = 0.289) and burnout symptoms (R² = 0.306) but only individual masculine gender-roles had protective effects on trauma symptoms (R² = 0.198). We found no association between occupational gender-roles and mental health and allostatic load.

CONCLUSION

Beyond individual gender-roles, our study shows the utility of measuring occupational gender-roles to delineate associations between workplace stressors and mental health that should be applied in future studies of sex differences in occupational health.

Linking work, occupational identity and burnout: the case of managers

Purpose

Based on identity theory, identity represents a set of meanings individuals hold for themselves based on their role in the society. Hence, they often engage in the process of verifying their role, seeking for the compatibility between these meanings and those perceived in a specific lived situation. If this compatibility is not perceived, this is likely to generate negative emotions. that could compromise their mental health. This paper examines the contribution of a weak verification of role identity in the explanation of managers ‘burnout. It aims at integrating identity theory into occupational stress research by analysing the proposition that a low level of verification of a salient role-identity will be associated with a high level of burnout. Hence, we consider identity salience as a moderating variable.

Design/methodology/approach

Cross-sectional data of 314 Canadian managers employed in 56 Quebec firms. Multilevel regression analyses were performed to analyse the data.

Findings

Low levels of verification of some standards of managers' role identity, mainly work demands and recognition which encompasses (monetary and non-monetary recognition, career prospects and job security) are significantly associated with managers' burnout. Furthermore, as predicted, results show that identity salience plays a moderating role on the relation between a weak verification of some standards of managers' role identity and burnout, mainly work demands, superior support and recognition.

Originality/value

This study proposes a relatively unexplored approach for the study of managers' burnout. It broadens the scope of research on workplace mental health issues, by the integration of the identity theory.

Work–life conflict and burnout among working women: a mediated moderated model of support and resilience

Purpose

Using job demand-control-support (JDCS) model as its foundation, the purpose of this paper is to examine the important, but under-explored, relationship between perceptions of work–life conflict and burnout being mediated and moderated by support systems and resilience among female employees in India.

Design/methodology/approach

A total of 270 female employees belonging to various sectors such as Information Technology/ Information Technology enabled services, retail, bank and hospitality located in Northern India were surveyed. The study used stratified sampling method for good coverage from different departments of the organizations. The structural equation method was used to test the direct effect, and for the mediation effects, they were tested by the method of indirect effects (Preacher and Hayes, 2004).

Findings

The results supported the hypothesized model that there exists a significant and positive relationship of work–life conflict with burnout, and work–life conflict has a negative association with both family support and organizational support. The findings also supported the hypothesis that family support and organizational support mediate the relationship of work–life conflict and burnout. This analysis expectedly confirmed that resilience not only displayed a negative relationship with burnout but also exhibited a moderated relationship with organizational and family support.

Research limitations/implications

The research design was co-relational and cross-sectional, so inferring causality is not possible. Future research must incorporate a longitudinal design to investigate the causal effects of work–life conflict on employees’ experiences of burnout and whether it gets buffered by availability of workplace support and family support.

Practical implications

It is imperative for the organizations to take substantial steps to reduce job burden and deadline pressure on the female employees, nurture decision autonomy at all levels of hierarchy and encourage amiable relationships of employees with their supervisors and peers based on mutual trust and support.

Originality/value

Although most of the research studies on work–life conflict have been unidirectional, i.e. investigating spillover of work demands on to family domains (Greenhaus and Beutell, 1985; Byrne and Barling, 2017), these conflicts have been found to be bidirectional, meaning thereby that family issues do spill over into work realm (Makela and Suutari, 2011). This study examines both directions of work–life conflict.

Chronic diseases, age and gender: examining the contribution to burnout symptoms in a sample of 2075 Canadian workers

PURPOSE

This cross-sectional study aims to evaluate the role of chronic diseases, and their interactions with age and gender, on the emotional exhaustion component of the burnout syndrome.

METHODS

Data came from the Salveo Study conducted in 2009-2012. It contained a random sample of 2075 Canadian workers employed in 63 workplaces. Multilevel regression models were estimated. Main effects of chronic diseases were first evaluated, and then age-chronic diseases interactions were tested. Analyses were performed on the total sample and stratified by gender. All analyses were adjusted for work conditions decision latitude, physical and psychological demands, work hours, social support and rewards.

RESULTS

Mental and behavioural disorders, diseases of the nervous system, the musculoskeletal system and connective tissue, and genitourinary system are associated with a higher level of burnout symptoms. Associations with mental and behavioural disorders, and diseases of the nervous system are stronger for men than women. Age increases the association of behavioural disorders, diseases of the nervous system, and genitourinary system and burnout. Age may moderate the association of nervous and genitourinary systems diseases with burnout in women.

CONCLUSION

Workplaces must be more proactive to better recognise the role of chronic diseases on burnout and to implement preventive measures. The development of interventions towards specific risk groups is needed.

Professional Recognition at Work: The Protective Role of Esteem, Respect, and Care for Burnout Among Employees

OBJECTIVE

The present research systematically investigates the role of recognition experiences at work as a protective factor for burnout.

METHOD

In two cross-sectional studies (N = 328 and N = 220) with employees we measured via online questionnaires three forms of recognition (achievement-based social esteem, equality-based respect, and need-based care) from coworkers and supervisors as predictors and burnout among employees as outcome.

RESULTS

Using multiple regression analyses, Study 1 provided initial evidence that both supervisor and coworker recognition were negatively associated with employees' burnout. Study 2 further demonstrated that whereas respect experiences were especially crucial for lowering emotional exhaustion, care was primarily linked to reduced depersonalization and esteem to heightened personal accomplishment.

CONCLUSION

We discuss how positive recognition experiences can be fostered in organizations in order to buffer the negative effects burnout can cause.

Gendered Working Environments as a Determinant of Mental Health Inequalities: A Protocol for a Systematic Review

Both gender and employment are critical and intersecting social determinants of mental and physical health. This paper describes the protocol used to conduct a systematic literature review of the relationship between "gendered working environments" and mental health. Gendered working environments (GWE) are conceptualised as involving: (1) differences in selection into work, and more specifically, occupations; (2) variation in employment arrangements and working hours; (3) disparities in psychosocial exposures at work, and; (4) differences in selection out of work. Methods/design: The review will adhere to a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search procedure. Key words will be identified that are specific to each of the four domains of GWE. The databases used for the search will be Scopus, Pubmed, Proquest, and Web of Science. Keywords will be adapted for the specific requirements of each electronic database. Inclusion criteria are: Using a validated scale to measure mental health (outcome); including exposures related to the four domains of GWE; reporting estimates for both men and women; and use of a cohort, case-control, or cross-sectional design. Studies will be excluded if they were published more than 10 years ago, are not in English or do not present extractable data on the relationship between GWE and mental health. Discussion: The proposed review will provide evidence about the numerous and complex ways in which employment and gender intersect (and are reinforced) to influence mental health over the life course.