Burnout and connectedness in the job demands-resources model: studying palliative care volunteers and their families

Development and validation of the hospice professional coping scale among Chinese nurses

BACKGROUND

Hospice care professionals often experience trauma patient deaths and multiple patient deaths in a short period of time (more so than other nurses). This repeated exposure to the death process and the death of patients leads to greater psychological pressure on hospice care professionals. But at present, people pay more attention to the feelings and care burden of the family members of dying patients but pay less attention to medical staff. Thus, this study aimed to develop a scale on the burden of care for hospice care providers and assess the coping capacity of hospice professionals. Raising awareness of the psychological burden of hospice professionals.

METHODS

Through a literature review, research group discussion, Delphi method and a pre-survey of professional coping skills among nurses, 200 hospice professionals who had received training in hospice care from pilot institutions engaged in or providing hospice care were selected for investigation. Cronbach's α coefficient and split-half reliability were used to test the internal consistency of the scale, and content validity and explore factor analysis (EFA) were used to test the construct validity of the scale.

RESULTS

Two rounds of Delphi methods were carried out, and the effective recovery rate was 100%. The expert authority coefficients of the two rounds were 0.838 and 0.833, respectively. The Kendall's W coefficient of experts in the first round was 0.121 ~ 0.200 (P < 0.05), and the Kendall's W coefficient of the second round was 0.115-0.136 (P < 0.05), indicating a good level of expert coordination. The final survey scale for the care burden of hospice professionals included four dimensions-working environment (9 items), professional roles (8 items), clinical nursing (9 items) and psychological burden (7 items)-with a total of 33 items. The total Cronbach's α coefficient of the scale was 0.963, and the Cronbach's α coefficients of the working environment, professional roles, clinical nursing and psychological burden dimensions were 0.920, 0.889, 0.936 and 0.910, respectively. The total split-half reliability of the scale was 0.927, and the split-half reliability of each dimension was 0.846, 0.817, 0.891, and 0.832. The content validity of the scale items ranged from 0.90 to 1.00. Exploratory factor analysis revealed 5 common factors, with a total cumulative contribution rate of 68.878%. The common degree of each item in the scale was > 0.4, and the factor loading of each item was also > 0.4.

CONCLUSION

The scale is an open-access, short, easy-to-administer scale. And which for assessing hospice care burden among hospice professionals developed in this study demonstrated strong reliability and validity. This tool can serve as a dependable instrument for evaluating the burden of hospice care for terminally ill patients by professionals in the hospice setting.

Volunteering and health: The role of social network change

OBJECTIVES

Levels of volunteering may differentially influence multiple dimensions of health among older adults. Further, increasing evidence indicates social networks represent critical bridging and bonding contexts for the volunteering-health link. This study examines two research questions: 1) does volunteering level (low, moderate, high) influence physical and mental health in the same ways? And 2) does social network change moderate this link?

METHODS

Data come from Waves 1 and 2 of the longitudinal Social Relations Study (n = 556) collected in 1992 and 2005 and the sub-sample of adults age 50 and older at Wave 2. Regression analyses predicting self-rated health and depressive symptoms were conducted to examine main effects of volunteering and moderating effects of social network change.

RESULTS

Volunteering at a moderate level (101-300 hours per year) was associated with fewer depressive symptoms compared to those not volunteering. Social network change moderated the association between volunteering and self-rated health. Among those reporting a decrease in the proportion of non-family in their network (decrease in bridging), a moderate level of volunteering was associated with better self-rated health.

CONCLUSION

While moderate levels of volunteering are associated with better mental health, the link to physical health is only present in the context of decreasing network bridging. Identifying specific circumstances under which volunteering is beneficial is critical for developing interventions to promote health for all, including those in mid and later life.

Satisfaction With Work-Family Balance Mediates the Relationship Between Workplace Social Support and Depression Among Hospice Nurses

PURPOSE

The purpose of this study was to investigate the relationship between social support (from personal and workplace sources) and psychological distress (depression, anxiety, and stress symptoms), as well as to examine the mediating role of satisfaction with work-family balance among hospice nurses.

DESIGN AND METHOD

A cross-sectional study design was utilized with a sample of 90 hospice nurses from the southern United States. Participants completed online surveys, including (a) the Depression, Anxiety, and Stress Scale (DASS-21), (b) loosely adapted items from the Affectivity, Burnout, and Absenteeism Scales, and (c) Satisfaction with Work-Family Balance Scale.

FINDINGS

Workplace social support, not personal social support, was associated with lower psychological distress, and satisfaction with work-family balance mediated the relationship between workplace social support and depression symptoms, a component of psychological distress.

CONCLUSIONS

Hospice nurses' social support in the workplace and their satisfaction with the balance between their work and family lives play a role in supporting their mental health.

CLINICAL RELEVANCE

Hospice nurses may benefit from programs fostering the creation of workplace-based interpersonal relationships.

The role of transformational leadership in workplace bullying

Purpose

The purpose of this paper is to examine the moderating role of transformational leadership on the relationship between job characteristics of both leaders and followers and workplace bullying within the workgroup. The central hypotheses were that, in a process of resource erosion, leaders’ task demands would be positively associated with workplace bullying in the workgroup, but that transformational leadership would moderate this effect, and the effect of followers’ autonomy on bullying.

Design/methodology/approach

Anonymous surveys were completed by 540 volunteer fire-fighters’ from 68 fire brigades and, separately, by 68 brigade captains.

Findings

The multi-level analyses show that leaders’ task demands positively predicted both bullying outcomes, after controlling for followers’ emotional demands and autonomy. Of most interest, transformational leadership moderated the influence of leaders’ task demands and followers’ autonomy on workplace bullying assessed by two approaches: self-labeling and behavioral experience. Further, a significant three-way interaction demonstrated that transformational leadership is actually associated with higher bullying as followers’ emotional demands increase under conditions wherein followers’ autonomy is constrained, but not when followers’ autonomy is high.

Practical implications

This study offers important practical implications in terms of leadership development in bullying prevention and reduction. For transformational leadership to be effective in reducing bullying at work, the situation must be matched to support this leadership style, or bullying could actually increase.

Originality/value

The study contributes to the research on workplace bullying by advancing the understanding of organizational factors that can influence bullying at work. The study also provides the first quantitative evidence of a relationship between the demands faced by leaders and the bullying experienced by members of the workgroup.

Volunteers in Circles of Support and Accountability Job Demands, Job Resources, and Outcome

In Circles of Support and Accountability (CoSA), volunteers support a medium- to high-risk sex offender in his process toward desistance by developing a long-term empathic relationship. More knowledge is needed about the impact of this work on volunteers themselves. In a sample of 40 Dutch CoSA volunteers-at the time constituting 37% of the national population of 108 then active CoSA volunteers-we measured outcome in terms of volunteer satisfaction, determination to continue, compassion satisfaction, burnout and secondary stress, vicarious growth, civic capacities, and professional skills. We explored theoretically derived predictors of positive and negative outcome, and conceptualized them within the Job Demands-Resources model (JD-R). Volunteers reported mainly positive effects, especially high levels of volunteer satisfaction, compassion satisfaction, and determination to continue. Results indicated that job demands and most of the internal job resources were of minor importance. External job resources, especially social support and connectedness, were associated with positive outcome. Connectedness mediated the effect of social support on compassion satisfaction.

Motivationaler und gesundheitsschädigender Prozess bei Deutschen Hospizhelfern

Zusammenfassung. Eine möglichst lang anhaltende Bindung (Retention) ehrenamtlicher Hospizhelfer an ihre Freiwilligentätigkeit und die Erhaltung der psychischen Gesundheit sind für ambulante Hospizdienste angesichts steigender Zahlen an hochaltrigen Menschen in unserer Gesellschaft sowie zeit- und ressourcenaufwendiger Qualifikation der Ehrenamtlichen wichtige Kenngrößen. Basierend auf dem Job Demands-Resources Modell (JD-R) untersuchte die vorliegende Studie mögliche Prädiktoren für die Absicht, in der Freiwilligentätigkeit zu verbleiben (Retentionsabsicht), und die psychische Gesundheit bei 110 ehrenamtlichen Hospizhelfern. Im Sinne des motivationalen Prozesses zeigten wir einen positiven direkten Effekt der Ressourcen freiwilliger Hospizhelfer auf deren Retentionsabsicht. Zudem fanden wir einen signifikanten negativen indirekten Effekt von Anforderungen auf die psychische Gesundheit der Freiwilligen, welcher über Burnout vermittelt wurde. Insgesamt sprechen die Ergebnisse für eine hohe Ausprägung der Retentionsabsicht von ehrenamtlichen Hospizhelfern und für geringe Burnout-Werte, jedoch bei mehr als einem Viertel der Studienteilnehmer für Depressivitätswerte, die einer weiteren Diagnostik bedürfen.

Hospice Palliative Care Volunteers

Hospice palliative care volunteer work—being with dying persons and their often distraught family members—has the potential to take an emotional toll on volunteers. The aim of this review article is to examine the types of stressors hospice palliative care volunteers typically experience in their work and how they cope with them. The results of this literature review suggest that hospice palliative care volunteers do not generally perceive their volunteer work as highly stressful. Nonetheless, a number of potential stressors and challenges were identified in the literature, along with some strategies that volunteers commonly employ to cope with them. The implications for volunteers and volunteer training/management are discussed.

A Model for Art Therapy-Based Supervision for End-of-Life Care Workers in Hong Kong

End-of-life care workers and volunteers are particularly prone to burnout given the intense emotional and existential nature of their work. Supervision is one important way to provide adequate support that focuses on both professional and personal competencies. The inclusion of art therapy principles and practices within supervision further creates a dynamic platform for sustained self-reflection. A 6-week art therapy-based supervision group provided opportunities for developing emotional awareness, recognizing professional strengths, securing collegial relationships, and reflecting on death-related memories. The structure, rationale, and feedback are discussed.

Burnout in medical residents: a study based on the job demands-resources model

Purpose. Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job. The purpose of our cross-sectional study was to estimate the burnout rates among medical residents in the largest Greek hospital in 2012 and identify factors associated with it, based on the job demands-resources model (JD-R). Method. Job demands were examined via a 17-item questionnaire assessing 4 characteristics (emotional demands, intellectual demands, workload, and home-work demands' interface) and job resources were measured via a 14-item questionnaire assessing 4 characteristics (autonomy, opportunities for professional development, support from colleagues, and supervisor's support). The Maslach Burnout Inventory (MBI) was used to measure burnout. Results. Of the 290 eligible residents, 90.7% responded. In total 14.4% of the residents were found to experience burnout. Multiple logistic regression analysis revealed that each increased point in the JD-R questionnaire score regarding home-work interface was associated with an increase in the odds of burnout by 25.5%. Conversely, each increased point for autonomy, opportunities in professional development, and each extra resident per specialist were associated with a decrease in the odds of burnout by 37.1%, 39.4%, and 59.0%, respectively. Conclusions. Burnout among medical residents is associated with home-work interface, autonomy, professional development, and resident to specialist ratio.

Experience Corps Baltimore: Exploring the Stressors and Rewards of High-intensity Civic Engagement

PURPOSE

Experience Corps (EC) represents a high-intensity, intergenerational civic engagement activity where older adults serve as mentors and tutors in elementary schools. Although high-intensity volunteer opportunities are designed to enhance the health and well being of older adult volunteers, little is known about the negative and positive aspects of volunteering unique to intergenerational programs from the volunteer's perspective.

DESIGN AND METHODS

Stressors and rewards associated with volunteering in EC were explored in 8 focus group discussions with 46 volunteers from EC Baltimore. Transcripts were coded for frequently expressed themes.

RESULTS

Participants reported stressors and rewards within 5 key domains: intergenerational (children's problem behavior, working with and helping children, observing/facilitating improvement or transformation in a child, and developing a special connection with a child); external to EC (poor parenting and children's social stressors); interpersonal (challenges in working with teachers and bonding/making social connections); personal (enjoyment, self-enhancement/achievement, and being/feeling more active); and structural (satisfaction with the structural elements of the EC program).

IMPLICATIONS

Volunteers experienced unique intergenerational stressors related to children's problem behavior and societal factors external to the EC program. Overall, intergenerational, interpersonal, and personal rewards from volunteering, as well as program structure may have balanced the stress associated with volunteering. A better understanding of stressors and rewards from high-intensity volunteer programs may enhance our understanding of how intergenerational civic engagement volunteering affects well being in later life and may inform project modifications to maximize such benefits for future volunteers and those they serve.

Role Ambiguity, Role Conflict, or Burnout

Objective:

To determine whether burnout, role ambiguity, or conflict affects Australian hospice volunteers.

Method:

Hospice volunteers (n = 120) were invited to participate in this pilot survey. Quantitative data were analyzed using descriptive statistics, while the free-text responses were analyzed using thematic content analysis. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Guidelines have been used to report this data.

Results:

A total of 97 participants completed the survey. The majority were middle-aged women who had been palliative care volunteers for more than 7 years and volunteered 14 hours/week (median). Participants reported low levels of role ambiguity (x = 8.4, standard deviation [SD] ±3.0) and conflict (x = 9.8, SD ±3.4) and described enjoying their volunteering and having no symptoms of burnout (76%).

Significance:

Active hospice volunteers report low levels of role ambiguity, conflict, and burnout. Adopting a range of self-care strategies and working within a structured volunteer program appear to be important protective factors.