Understanding burnout according to individual differences: ongoing explanatory power evaluation of two models for measuring burnout types

Measures of empathy and compassion: A scoping review

Evidence to date indicates that compassion and empathy are health-enhancing qualities. Research points to interventions and practices involving compassion and empathy being beneficial, as well as being salient outcomes of contemplative practices such as mindfulness. Advancing the science of compassion and empathy requires that we select measures best suited to evaluating effectiveness of training and answering research questions. The objective of this scoping review was to 1) determine what instruments are currently available for measuring empathy and compassion, 2) assess how and to what extent they have been validated, and 3) provide an online tool to assist researchers and program evaluators in selecting appropriate measures for their settings and populations. A scoping review and broad evidence map were employed to systematically search and present an overview of the large and diverse body of literature pertaining to measuring compassion and empathy. A search string yielded 19,446 articles, and screening resulted in 559 measure development or validation articles reporting on 503 measures focusing on or containing subscales designed to measure empathy and/or compassion. For each measure, we identified the type of measure, construct being measured, in what context or population it was validated, response set, sample items, and how many different types of psychometrics had been assessed for that measure. We provide tables summarizing these data, as well as an open-source online interactive data visualization allowing viewers to search for measures of empathy and compassion, review their basic qualities, and access original citations containing more detail. Finally, we provide a rubric to help readers determine which measure(s) might best fit their context.

A narrative review of the physiology and health effects of burnout associated with veterinarian-pertinent occupational stressors

Chronic workplace stress and burnout are serious problems in veterinary medicine. Although not classified as a medical condition, burnout can affect sleep patterns and contributes to chronic low grade systemic inflammation, autonomic imbalance, hormonal imbalances and immunodeficiencies, thereby increasing the risks of physical and psychological ill health in affected individuals. Cultural misconceptions in the profession often lead to perceptions of burnout as a personal failure, ideas that healthcare professionals are somehow at lower risk for suffering, and beliefs that affected individuals can or should somehow heal themselves. However, these concepts are antiquated, harmful and incorrect, preventing the design of appropriate solutions for this serious and growing challenge to the veterinary profession. Veterinarians must first correctly identify the nature of the problem and understand its causes and impacts before rational solutions can be implemented. In this first part of two companion reviews, burnout will be defined, pathophysiology discussed, and healthcare and veterinary-relevant occupational stressors that lead to burnout identified.

Comparative analysis of the burnout syndrome index between contract and freelance physiotherapists: An observational study

BACKGROUND

Burnout syndrome has been extensively studied in different health science professions. It has been less studied in physiotherapy than in professions such as medicine. Moreover, it is not known how the working condition influences this syndrome.

OBJECTIVE

The main objective of this study was to compare the burnout index between contract and freelance physiotherapists in the private sector in the Community of Madrid, Spain.

METHODS

A cross-sectional study was performed with 174 participants divided into 2 groups; one group was composed of contract physiotherapists (n = 87) and the other group was composed of freelance physiotherapists (n = 87). A Mann-Whitney U test was performed for comparison between the groups. Spearman's correlation coefficient was used to analyze the correlations between the burnout syndrome index and the secondary variables.

RESULTS

There were statistically significant differences when comparing the groups, with a large effect size for the burnout index with a higher rate among contract physiotherapists (78 [71-84.75]) than in freelance physiotherapists (61.5 [55-72.75]).There were also significant differences in the type of patients treated, number of patients treated per day, time spent per patient, and the annual salary range between the contract and freelance physiotherapists.

CONCLUSION

Contract physiotherapists who participated in this study had a significantly higher burnout syndrome index than freelance physiotherapists. Other socio-occupational variables were also found to be related to the burnout syndrome index in freelance physiotherapists and contract physiotherapists. The results of this study could be of interest for new occupational health strategies to reduce the burnout index in contract physiotherapists.

Therapeutic Strategies to Tackle Burnout and Emotional Exhaustion in Frontline Medical Staff: Narrative Review

Burnout and emotional exhaustion in frontline healthcare workers and their implications for the health of patients, individual clinicians, and organizations are increasingly described among various healthcare settings. Yet therapeutic strategies to address burnout and other work-related conditions are outpaced by innumerable descriptions of burnout prevalence across healthcare disciplines. This review provides a framework that should be helpful in beginning the process of addressing burnout and its related conditions. It begins with an elucidation of key inter-related concepts of work-related conditions that should be considered in the differential diagnosis along with other mental health conditions that are concomitantly elevated in healthcare clinicians (eg, depression and substance abuse) but require a different approach to treatment. Factors that lead to increased resilience, engagement, and thriving in clinical workplaces are considered. While strategies are dichotomized between organizational level interventions and individual or personal interventions to address burnout, the idea of identifying and addressing root causes of burnout and related conditions is highlighted. The efficacy and feasibility of interventions that incorporate mindfulness-based stress reduction, cognitive behavioral strategies, meaning-centered therapy, and compassion training are highlighted as interventions with proven efficacy and durability that should be considered based on work-related stressors and appeal to clinicians.

Testing the Intermediary Role of Perceived Stress in the Relationship between Mindfulness and Burnout Subtypes in a Large Sample of Spanish University Students

The burnout syndrome is the consequence of chronic stress that overwhelms an individual’s resources to cope with occupational or academic demands. Frenetic, under-challenged, and worn-out are different burnout subtypes. Mindfulness has been recognized to reduce stress, comprising five facets (observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience). This cross-sectional study aimed to assess the relationship between mindfulness facets, perceived stress, and burnout subtypes in a sample of 1233 students of Education, Nursing, and Psychology degrees from different universities of Valencia (Spain). Structural Equation Modelling (SEM) was computed showing an adequate fit (Chi-square, CFI, TLI, RMSEA, and SRMR). Four mindfulness facets (all but observing) significantly correlated with general second-order mindfulness. Unexpected results were found: Acting with awareness facet was positively associated with frenetic subtype, while the non-reacting facet was positively associated with frenetic and under-challenged subtype. Ultimately, mindfulness facets negatively predicted the perceived stress levels, which in turn, predicted burnout. However, mindfulness plays different roles in the early stages of burnout syndrome (i.e., frenetic and under-challenged).

Item analysis of emotional exhaustion in pharmacy practice faculty

INTRODUCTION

The primary objective of this study was to identify the single question on the Maslach Burnout Inventory - Educator Survey (MBI-ES) that correlated with high emotional exhaustion (EE) among pharmacy practice faculty.

METHODS

We analyzed data collected from the electronic administration of the MBI-ES to faculty at United States (US) colleges and schools of pharmacy in 2014. For our primary outcome, we used Spearman's rho correlation (r_s) to identify a single question on the MBI-ES that was highly correlated with high EE (one of three subscales of MBI-ES). We calculated likelihood ratio statistics for each level of the item with the largest r_s with total EE, then converted those to adjusted predicted probabilities of high EE. De-identified data were collected via Qualtrics version 60949 (Provo, Utah) and analyzed using IBM SPSS Statistics, Version 22.0 (Armonk, NY).

RESULTS

The single item, "I feel emotionally drained from my work" (r_s = 0.833, p = 0.01), was most correlated with high EE score on the MBI-ES. Faculty who reported "I feel emotionally drained from my work" once per week and few times per week had 62.8% and 93% chance of having high EE, respectively.

CONCLUSION

The single item that was most highly correlated with EE may be used for further evaluation of faculty who may be at risk for burnout. Interventions for reducing burnout among pharmacy practice faculty are critically needed for sustaining our pool of faculty.

Original targeted therapy for the management of the burnout syndrome in nurses: an innovative approach and a new opportunity in the context of predictive, preventive and personalized medicine

Background

Currently considered an occupational disease, the burnout syndrome affects 13-27% of the active population in multiple occupational sectors of the modern world.

Objectives

Considering the burnout syndrome from the new perspective of the predictive, preventive, personalized medicine concept as a pathological entity with a predictable appearance and evolution which allows a preventive approach and a personalized therapy, the main objective of the study is to highlight the possibility of psychotherapeutic interventions for producing measurable psychological changes in order to decrease the burnout level of hospital nurses.

Method

The research design is experimental, the independent variable being the participation or non-participation of nurses in psychotherapeutic sessions where specific classical psychodrama techniques are originally used. Nurses previously identified with medium or high levels of burnout participated in the clinical study, split into two groups: the experimental one, with 150-min weekly sessions, and the control one, without any intervention. Pre- and post-intervention questionnaires were administered to the members of both groups.

Results

The statistical analysis of the differences between pre- and post-intervention revealed (a) the decrease of the levels of personal burnout and of burnout generated by the working conditions and (b) the decrease of the depression and of anxiety on four dimensions (self-awareness, ergic tension, veiled and general anxiety).

Conclusions

The classical psychodrama method can be an effective solution in the prophylaxis and treatment of the burnout syndrome. The multidisciplinary approach according to the PPPM concept including changes of the environmental factors within the professional framework associated with stress control programmes can be promising solutions for the management of this syndrome.

Burn out among Iranian dental students: psychometric properties of burnout clinical subtype questionnaire (BCSQ-12-SS) and its correlates

BACKGROUND

Burnout Clinical Subtype Questionnaire (BCSQ-12-SS) is a short valid questionnaire for assessment of burnout in students. The aim of the present study was to evaluate the psychometric properties of Persian-translated version of the BCSQ-12-SS and assess the burn out clinical subtypes and their correlates in dental students.

METHODS

In this psychometry study, the BCSQ-12-SS questionnaire in domains of overload (4 questions), lack of development (4 questions), and neglect (4 questions) was translated to Persian and back-translated. Six experts determined the content and face validity of the Persian version. The questionnaire was then piloted on 167 dental students of Tehran University of Medical Sciences in 2016. Data were analyzed using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) for construct validity and Linear Regression modeling in IBM SPSS and AMOS SPSS. To assess reliability, the questionnaire was filled out by 15 students twice and Kappa coefficient and Composite Reliability (CR) were calculated.

RESULTS

Content validity Ratio (CVR) and Content Validity Index (CVI) values and Cronbach's alphas were all over 0.8. Kappa coefficient ranged from 65 to 82.5%. The average burnout score was 29.6 out of maximum score of 60. There were no significant differences in burnout scores across the different semesters (8,10 and 12). Financial support by the family significantly affected the total score of burnout and lack of development. In addition, gender, mother's education, residential status of student, preparing for post graduate exam and financial support by the family affected the overload.

CONCLUSION

The BCSQ-12-SS has good psychometric properties and therefore can be used to assess burnout in IRANIAN dental students. The BCSQ-12-SS may provide an opportunity to identify individuals at risk for burn out and provide counseling to assist in dental student development.

The role of the personality traits and work characteristics in the prediction of the burnout syndrome among nurses-a new approach within predictive, preventive, and personalized medicine concept

BACKGROUND

The burnout syndrome is characterized by emotional exhaustion, depersonalization, and lack of personal accomplishment. It was identified in some professional categories, the most often being affected those in public health services.

OBJECTIVES

This study mainly aims to identify and analyze the value of the personality traits and work characteristics as predictive factors for the occurrence of the burnout syndrome in nurses, under the new approach of predictive, preventive, and personalized medicine.

METHOD

A total of 192 nurses were included in the study. The NEO-Five-Factor Inventory, the Copenhagen Burnout Inventory, and the Inventory of Nursing Work Characteristics were administered to all of the participants.

RESULTS

Some personality traits proved to be predictive factors for the occurrence of the burnout syndrome. Neuroticism, negative self-esteem, and negative emotionality predict burnout vulnerability. The negative correlations between sociability and the burnout dimensions show that the positive affectivity of the extraverted individuals and the strong positive orientation of the extraverts towards others are protective factors against burnout. There are also significant associations between certain personality traits and nursing work characteristics (work overload, the existence of problems in the department, and satisfaction in the professional and family life), which could be defined, also, as predictive factors for burnout.

CONCLUSIONS

This study confirms the influence of the Big Five personality traits and nursing work characteristics as predictive factors of the burnout occurrence, opening real possibilities to perform a targeted prevention and provide personalized interventions as organizational services.

Burnout subtypes and associated factors among police officers in Sri Lanka: A cross-sectional study

Even though policing is associated with very high levels of occupational stress and burnout, no studies have been conducted to explore burnout subtypes among police officers globally. Hence, this cross-sectional study was conducted among 750 police officers working in a police division in Sri Lanka to determine the distribution and associations of burnout subtypes using the Burnout Clinical Subtype Questionnaire. The police officers had high scores for frenetic and worn-out subtypes in comparison to the underchallenged subtype. Multivariable analysis elicited a multitude of statistically significant associations with burnout subtypes (p < 0.05). Staff adequacy and fewer working hours were negatively associated with frenetic subtype. Younger police officers had a positive association, while, being married, satisfactory infrastructure facilities, frequent superior guidance, satisfactory higher official support, satisfactory allowances and the opportunity to serve public showed negative associations with underchallenged subtype. Being married, staff adequacy, frequent superior guidance, higher official support, satisfactory allowances, satisfactory social status and overall job satisfaction elicited significant negative associations with worn-out subtype. The findings are suggestive of high burnout subtype profile among the police officers in the study population and the associated factors of the three burnout subtypes are congruent with the characteristics of the burnout subtype profile.

Assessment of Burnout and Associated Risk Factors Among Pharmacy Practice Faculty in the United States

Objectives. To measure the level of burnout among pharmacy practice faculty members at US colleges and schools of pharmacy and to identify factors associated with burnout. Methods. Using a cross-sectional, electronic, anonymous survey-design, we measured faculty burnout (n=2318) at US colleges and schools of pharmacy using the Maslach Burnout Inventory-Educators Survey (MBI-ES), which measures burnout dimensions: emotional exhaustion, depersonalization, and personal accomplishment. We assessed MBI-ES scores, demographics and possible predictors of burnout. Results. The response rate was 32.7% (n=758). Emotional exhaustion was identified in 41.3% and was higher in women, assistant professors, and those without a hobby. Participants without a mentor had higher scores of depersonalization. Those with children ages 1-12 years had higher emotional exhaustion and depersonalization compared to those with older children. Conclusion. Pharmacy practice faculty members at US colleges and schools of pharmacy are suffering from burnout, exhibited mainly through emotional exhaustion.

Burnout Subtypes and Absence of Self-Compassion in Primary Healthcare Professionals: A Cross-Sectional Study

Background

Primary healthcare professionals report high levels of distress and burnout. A new model of burnout has been developed to differentiate three clinical subtypes: ‘frenetic’, ‘underchallenged’ and ‘worn-out’. The aim of this study was to confirm the validity and reliability of the burnout subtype model in Spanish primary healthcare professionals, and to assess the explanatory power of the self-compassion construct as a possible protective factor.

Method

The study employed a cross-sectional design. A sample of n = 440 Spanish primary healthcare professionals (214 general practitioners, 184 nurses, 42 medical residents) completed the Burnout Clinical Subtype Questionnaire (BCSQ-36), the Maslach Burnout Inventory General Survey (MBI-GS), the Self-Compassion Scale (SCS), the Utrecht Work Engagement Scale (UWES) and the Positive and Negative Affect Schedule (PANAS). The factor structure of the BCSQ-36 was estimated using confirmatory factor analysis (CFA) by the unweighted least squares method from polychoric correlations. Internal consistency (R) was assessed by squaring the correlation between the latent true variable and the observed variables. The relationships between the BCSQ-36 and the other constructs were analysed using Spearman’s r and multiple linear regression models.

Results

The structure of the BCSQ-36 fit the data well, with adequate CFA indices for all the burnout subtypes. Reliability was adequate for all the scales and sub-scales (R≥0.75). Self-judgement was the self-compassion factor that explained the frenetic subtype (Beta = 0.36; p<0.001); isolation explained the underchallenged (Beta = 0.16; p = 0.010); and over-identification the worn-out (Beta = 0.25; p = 0.001). Other significant associations were observed between the different burnout subtypes and the dimensions of the MBI-GS, UWES and PANAS.

Conclusions

The typological definition of burnout through the BCSQ-36 showed good structure and appropriate internal consistence in Spanish primary healthcare professionals. The negative self-compassion dimensions seem to play a relevant role in explaining the burnout profiles in this population, and they should be considered when designing specific treatments and interventions tailored to the specific vulnerability of each subtype.

Current Workforce Characteristics and Burnout in Pediatric Emergency Medicine

OBJECTIVES

Changes in health care delivery and graduate medical education have important consequences for the workforce in pediatric emergency medicine (PEM). This study compared career preparation and potential attrition of the PEM workforce with the prior assessment from 1998.

METHODS

An e-mail survey was sent to members of the American Academy of Pediatrics (AAP) Section on EM and to non-AAP members board certified in PEM. Information on demographics, practice characteristics and professional activities, career preparation, future plans, and burnout (using two validated screening questions) was analyzed using standard descriptive statistics.

RESULTS

Of 2,120 surveys mailed, 895 responses were received (40.8% response). Over half (53.7%) of respondents were female, compared with 44% in 1998. The majority (62.9%) practiced in the emergency department (ED) of a free-standing children's hospital. The distribution of professional activities was similar to that reported in 1998, with the majority of time (60%) spent in direct patient care. Half indicated involvement in research, and almost half had dedicated time for other activities, including emergency medical services (7.3%), disaster (6.9%), child abuse (5.0%), transport (3.6%), toxicology (2.3% of respondents), and other (13.6%); additionally, 21.3% had dedicated time for quality/safety. Respondents were highly satisfied (95.6%) with fellowship preparation for clinical care, but less satisfied with preparation for research (49.2%) and administration (38.7%). However, satisfaction with nonclinical training was higher for those within 10 years of medical school graduation. Forty-six percent plan to change clinical activity in the next 5 years, including reducing hours, changing shifts, or retiring. Overall, 11.9% of all respondents, including 20.1% of women and 2.6% of men (p < 0.001), report currently working part time. Large majorities endorsed feeling burned out at work (88.5%) or more callous toward people as a result of work (67.5%) at least monthly, with one in five reporting such feelings at least weekly.

CONCLUSIONS

While satisfaction with fellowship preparation for professional activities in PEM is improving, gaps remain in training in nonclinical skills. Symptoms of burnout are prevalent, and there is likely to be substantial attrition of PEM providers in the near future.

Mindfulness, Resilience, and Burnout Subtypes in Primary Care Physicians: The Possible Mediating Role of Positive and Negative Affect

Purpose: Primary care health professionals suffer from high levels of burnout. The aim of the present study was to evaluate the associations of mindfulness and resilience with the features of the burnout types (overload, lack of development, neglect) in primary care physicians, taking into account the potential mediating role of negative and positive affect.

Methods: A cross-sectional design was used. Six hundred and twenty-two Spanish primary care physicians were recruited from an online survey. The Mindful Attention Awareness Scale (MAAS), Connor-Davidson Resilience Scale (CD-RISC), Positive and Negative Affect Schedule (PANAS), and Burnout Clinical Subtype Questionnaire (BCSQ-12) questionnaires were administered. Polychoric correlation matrices were calculated. The unweighted least squares (ULS) method was used for developing structural equation modeling.

Results: Mindfulness and resilience presented moderately high associations (φ = 0.46). Links were found between mindfulness and overload (γ = −0.25); resilience and neglect (γ = −0.44); mindfulness and resilience, and negative affect (γ = −0.30 and γ = −0.35, respectively); resilience and positive affect (γ = 0.70); negative affect and overload (β = 0.36); positive affect and lack of development (β = −0.16). The links between the burnout types reached high and positive values between overload and lack of development (β = 0.64), and lack of development and neglect (β = 0.52). The model was a very good fit to the data (GFI = 0.96; AGFI = 0.96; RMSR = 0.06; NFI = 0.95; RFI = 0.95; PRATIO = 0.96).

Conclusions: Interventions addressing both mindfulness and resilience can influence burnout subtypes, but their impact may occur in different ways, potentially mediated by positive and negative affect. Both sorts of trainings could constitute possible tools against burnout; however, while mindfulness seems a suitable intervention for preventing its initial stages, resilience may be more effective for treating its advanced stages.

Embryologists' health: a nationwide online questionnaire

PURPOSE

The present study evaluates health status and its relation with occupational characteristics and with burnout syndrome among embryologists.

METHODS

A cross-sectional design was used to conduct an online self-assessment survey, sent to all members of the Spanish Association of Clinical Embryologists. The questionnaire contained occupational questions and two standard instruments: 'Short Form-12 Health Survey' as a measure of physical (PCS-12) and mental (MCS-12) health and the Maslach Burnout Inventory-General Survey (MBI-GS) to evaluate the degree of burnout.

RESULTS

The PCS-12 obtained for the Spanish embryologists was higher than that for the reference population. However, the total MCS-12 was significantly lower than that observed in non-institutionalised males and females representative of the general Spanish population aged 35-44 years. In the linear regression model, the dependent variable PCS-12 was related indirectly with the variables number of hours worked per week, BMI, back pain, leg pain and visual discomfort. In the linear regression model, the dependent variable MCS-12 was indirectly related to the gender (male reference; female coefficient regression: -3.23), exhaustion and cynicism dimensions of the MBI-GS. A total of 87 (36.3%) embryologists presented a high score on at least one of the MBI-GS dimensions.

CONCLUSION

In this sample of Spanish embryologists, a norm measure (SF-12) showed their physical health to be better than the average for the general population, but that their mental health was poorer. A significant indirect relation was observed between mental health and burnout syndrome. Strategies to reduce occupational stress and problems should form part of the training provided for clinical embryologists.

Perceived stress latent factors and the burnout subtypes: a structural model in dental students

Background

Students of health-professions suffer high levels of stress and burnout. The aim of the present study was to evaluate the relationship between perceived stress latent factors (‘tenseness’ and ‘frustration’) and the features (‘overload’, ‘lack of development’ and ‘neglect’) of the three burnout subtypes (‘frenetic’, ‘under-challenged’ and ‘worn-out’, respectively), in a sample of Spanish dental students.

Methods

The study employed a cross-sectional design. A sample of Spanish dental students (n = 314) completed the ‘Perceived Stress Questionnaire’ and the ‘Burnout Clinical Subtype Questionnaire Student Survey’. The associations among variables were observed by means of structural equation modelling using the unweighted least squares method from polychoric correlations.

Results

Strong associations among perceived stress factors and the burnout characteristics were observed, although a distinct pattern of relations was observed for each burnout subtype. The ‘overload’ was moderately and positively associated with both ‘tenseness’ (0.45), and ‘frustration’ (0.38) dimensions of perceived stress; the ‘lack of development’ was positively associated with the ‘frustration’ dimension (0.72), but negatively associated with ‘tenseness’ (−0.69); the ‘neglect’ showed a weaker positive associated with ‘frustration’ (0.41), and a small negative association with ‘tenseness’ (−0.20). The model was a very good fit to the data (GFI  =  0.96; RSMR  =  0.07; AGFI = 0.96; NFI = 0.95; RFI = 0.95).

Conclusions

The stress factors of ‘frustration’ and ‘tenseness’ seems to be related in a distinct way to the burnout subtypes in Spanish dental students. This finding suggests that intervention programs specifically tailored to these subtypes may be a promising future direction.

Coping with stress and types of burnout: explanatory power of different coping strategies

Background

Burnout occurs when professionals use ineffective coping strategies to try to protect themselves from work-related stress. The dimensions of ‘overload’, ‘lack of development’ and ‘neglect’, belonging to the ‘frenetic’, ‘under-challenged’ and ‘worn-out’ subtypes, respectively, comprise a brief typological definition of burnout. The aim of the present study was to estimate the explanatory power of the different coping strategies on the development of burnout subtypes.

Methods

This was a cross-sectional survey with a random sample of university employees, stratified by occupation (n = 429). Multivariate linear regression models were constructed between the ‘Burnout Clinical Subtypes Questionnaire’, with its three dimensions –overload, lack of development and neglect– as dependent variables, and the ‘Coping Orientation for Problem Experiences’, with its fifteen dimensions, as independent variables. Adjusted multiple determination coefficients and beta coefficients were calculated to evaluate and compare the explanatory capacity of the different coping strategies.

Results

The ‘Coping Orientation for Problem Experiences’ subscales together explained 15% of the ‘overload’ (p<0.001), 9% of the ‘lack of development’ (p<0.001), and 21% of the ‘neglect’ (p<0.001). ‘Overload’ was mainly explained by ‘venting of emotions’ (Beta = 0.34; p<0.001); ‘lack of development’ by ‘cognitive avoidance’ (Beta = 0.21; p<0.001); and ‘neglect’ by ‘behavioural disengagement’ (Beta = 0.40; p<0.001). Other interesting associations were observed.

Conclusions

These findings further our understanding of the way in which the effectiveness of interventions for burnout may be improved, by influencing new treatments and preventive programmes using features of the strategies for handling stress in the workplace.

Causes of discomfort in the academic workplace and their associations with the different burnout types: a mixed-methodology study

BACKGROUND

Burnout is the result of prolonged workplace exposure to chronic stress factors and may present itself in one of the following subtypes: "frenetic", "under-challenged" and "worn-out". The aims of the present study were to identify the causes of workplace discomfort that affect employees in large organizations and to determine the predictive power of these causes with regard to the burnout subtypes.

METHOD

We employed a qualitative and quantitative analysis (QQA), using a cross-sectional design with an online survey administered to a randomly selected sample of University workers (n = 409). To determine the causes of discomfort, we raised the following open question: "What aspects of your work generate discomfort for you?". The responses were subjected to content analysis and categorized by three independent referees. The concordance between the responses was estimated with the kappa coefficient (k). Subtype classification was assessed according to the "Burnout Clinical Subtype Questionnaire" (BCSQ-36). The degree of association between the motives for the complaint and the burnout profiles was evaluated using adjusted odds ratio (OR), which was based on multivariate logistic regression models.

RESULTS

The causes of discomfort included: physical environment (setting aspects, material conditions, journey/access), organization (schedules, structure, functions, interpersonal relations) and individual conditions (workload, powerlessness, rewards, negligence). The concordance index between the referees was k = 0.80. Employees who were upset with the hierarchical structure were more likely to be classified as frenetic (OR = 4.32; 95% CI = 1.43-13.06; p = 0.010); those who complained of routine duties were more likely to be classified as under-challenged (OR = 5.33; 95% CI = 1.84-15.40; p = 0.002); those whose discomfort was caused by structure control systems were more likely to be classified as worn-out (OR = 6.13; 95% CI = 1.57-23.91; p = 0.009).

CONCLUSIONS

The causes of discomfort among the different burnout subtypes are primarily attributable to the organization itself, in response to the structure and functions. The associations observed between the different subtypes and motives for complaint are consistent with the clinical profile-based syndrome definition, which suggests that interventions should be case-specific.

[Effectiveness of a stretching program on anxiety levels of workers in a logistic platform: a randomized controlled study]

Objetivo

Evaluar la efectividad de un programa abreviado de estiramientos sobre los niveles de ansiedad de los trabajadores de una empresa logística española.

Método

Se llevó adelante un ensayo clínico controlado, con un diseño inter-sujetos, aleatorizado mediante conglomerados. Los participantes fueron asignados al grupo experimental (n = 67), tratado con un programa de estiramientos, de 10′ de duración tras la jornada laboral, durante 3 meses, o al grupo control (n = 67), no tratado. La variable resultado principal fue la ansiedad estado y las variables secundarias el burnout, la calidad de vida y la flexibilidad. Se llevó a cabo un análisis de covarianza (ANCOVA) por intención de tratar sobre las variables resultado, controlando las puntuaciones basales, la edad y la práctica de actividades introyectivas fuera del programa, calculando el tamaño del efecto mediante eta cuadrado parcial (η²).

Resultados

Los resultados del ANCOVA señalaron un efecto moderado del programa de estiramientos sobre la ansiedad (η² = 0,06; p = 0,004). También se encontraron efectos elevados en flexibilidad (η² = 0,13; p < 0,001), moderadamente altos en dolor corporal (η² = 0,08; p = 0,001), moderados en vitalidad (η² = 0,05; p = 0,016), salud mental (η² = 0,05; p = 0,017), salud general (η² = 0,04; p = 0,028) y agotamiento (η² = 0,04; p = 0,025).

Conclusiones

La implementación de un programa de estiramientos en el lugar de trabajo resultó eficaz para disminuir los niveles de ansiedad, dolor corporal y agotamiento, así como para aumentar la vitalidad, salud mental, salud general y flexibilidad. Este tipo de intervención podría constituir una estrategia de bajo coste para la mejora del bienestar de los trabajadores.