Authors:Tara F. McKinley; Kimberly A. Boland; John D. Mahan Abstract: Publication date: Available online 2 March 2017 Source:Burnout Research Author(s): Tara F. McKinley, Kimberly A. Boland, John D. Mahan Despite an increase in interest in issues related to burnout in medical education and mandates from the national residency accrediting body, available literature is sparse in pediatrics, a medical discipline that requires special empathy and compassion, as well as enhanced communication skills to effectively care for children and their families. Burnout prevalence ranges from 17 to 67.8% of pediatric residents in recent studies. There is little that details the pathogenesis of burnout in these residents and little that compares them with those in other medical disciplines. This comprehensive literature review describes all that is published on burnout and burnout interventions since 2005 in pediatrics and other primary care oriented specialty residents, as well as key papers from pre-2005. This review, with its focus on the available information and evidence-based intervention strategies, identifies four areas for focus for future interventions and directions. It should serve as a useful resource to program directors, medical educators and graduate medical education leadership who are committed to preventing and/or treating burnout in their residents and molding these young physicians to be able to maintain resilience through their careers. This review should also be useful to investigators exploring burnout in other health care professionals.
Authors:Evangelia Tsiga; Efharis Panagopoulou; Anthony Montgomery Abstract: Publication date: Available online 20 February 2017 Source:Burnout Research Author(s): Evangelia Tsiga, Efharis Panagopoulou, Anthony Montgomery Background The aim of this cross-sectional study was to develop an evidence-based systematic Medical Error Checklist (MEC) for self-reporting of medical errors. In addition the study examined the comparative influence of individual, structural, and organizational factors on the frequency of self-reported medical errors. Research Design A three-step process was followed in order to develop three checklists, for internists, surgeons and pediatricians respectively. The Maslach Burnout Inventory (MBI), the Utrecht Work Engagement Scale (UWES) and the teamwork-subscale of the Hospital Survey on Patient Safety Culture (AHRQ) were used in order to measure physicians’ levels of burnout, job engagement and teamwork respectively. A total of 231 doctors working in a large teaching hospital in Greece participated in the study (response rate: 49.8%). Results Internal reliability coefficients were high for all three checklists. Gender, age, clinical experience, and working hours were not related to medical errors in any of the medical specialties. In surgeons, medical errors were negatively related to engagement (R2 =.210, p=.004), while teamwork and depersonalization were the only predictive factors of frequency of medical errors, in both pediatricians and internists (R2 =.306 p < .001). Conclusions The Medical Error Checklists developed in this study advance the study of medical errors by proposing a comprehensive, valid and reliable self-assessment tool. The results highlight the importance of hospital organizational factors in preventing medical errors.
Authors:Kirsi Ahola; Salla Toppinen-Tanner; Johanna Seppänen Abstract: Publication date: Available online 13 February 2017 Source:Burnout Research Author(s): Kirsi Ahola, Salla Toppinen-Tanner, Johanna Seppänen Burnout has adverse health and work-related outcomes but there is no consensus how to treat it. We systematically reviewed controlled studies evaluating the effects of individually- and occupationally-focused interventions on burnout symptoms or work status among workers suffering from burnout. Of 4430 potential abstracts, 14 studies reporting the effects of 18 interventions fulfilled the pre-set criteria. Fourteen interventions were individually-focused and four had combined individual and occupational approaches. The specific contents of the interventions varied considerably and the results were mixed. Meta-analysis of four individually-focused RCT interventions did not present effects on exhaustion and cynicism. Meta-analysis on the effect of combined interventions or on return to work could not be conducted. Tackling burnout needs more systematic intervention development and evaluation. The evaluation of interventions would benefit from consensus on definition and assessment of burnout.
Authors:Michael P. Leiter; Christina Maslach Pages: 89 - 100 Abstract: Publication date: Available online 30 September 2016 Source:Burnout Research Author(s): Michael P. Leiter, Christina Maslach Latent profile analysis, with two large datasets, was used to identify multiple person-centered profiles across the burnout – engagement continuum, as assessed by the three dimensions of the Maslach Burnout Inventory (MBI). Five profiles emerged from this analysis: Burnout (high on all three dimensions), Engagement (low on all three), Overextended (high on exhaustion only), Disengaged (high on cynicism only), and Ineffective (high on inefficacy only). Each of these profiles showed a different pattern of correlates with organizational variables. The Disengaged profile was more negative than Overextended, and closer to the Burnout profile, which argues against the use of exhaustion alone as a proxy for burnout. The results have important implications for theory, research, and interventions.
Authors:Jan Alexander de Vos; André Brouwers; Tineke Schoot; Ron Pat-El; Peter Verboon; Gérard Näring Pages: 55 - 62 Abstract: Publication date: Available online 9 June 2016 Source:Burnout Research Author(s): Jan Alexander de Vos, André Brouwers, Tineke Schoot, Ron Pat-El, Peter Verboon, Gérard Näring This study investigates burnout among Dutch nursing graduates as a process by testing a sequential-developmental model. A sample of 237 respondents was recruited from a population of Dutch early career nurses. Burnout was measured with the Dutch version of the Maslach Burnout Inventory Human Services Survey (MBI-HSS, Maslach & Jackson, 1981; Schaufeli & van Dierendonck, 2000). First, the dimensionality was tested with confirmatory factor analysis. A resulting one-dimensional model with exhaustion and depersonalisation was then analysed using a Rasch rating scale measurement model. Rasch analysis showed that these data adhered well to a sequential-developmental model. Burnout among early career nurses may be operationalized as a process that starts with fatigue as a result of strain and ends with severe exhaustion and depersonalisation towards patients. Personal accomplishment develops relatively independently. A separate Rasch analysis on the personal accomplishment items revealed a scale with almost similar item locations, resulting in redundant information.
Authors:Ross W. May; Gregory S. Seibert; Marcos A. Sanchez-Gonzalez; Frank D. Fincham Pages: 63 - 68 Abstract: Publication date: Available online 17 June 2016 Source:Burnout Research Author(s): Ross W. May, Gregory S. Seibert, Marcos A. Sanchez-Gonzalez, Frank D. Fincham This study investigated the relationship between burnout and hemodynamic and autonomic functioning in both medical students (N=55) and premedical undergraduate students (N=77). Questionnaires screened for health related issues and assessed school burnout and negative affect symptomatology (anxiety and depression). Continuous beat-to-beat blood pressure (BP) through finger plethysmography and electrocardiogram (ECG) monitoring was conducted during conditions of baseline and cardiac stress induced via the cold pressor task to produce hemodynamic, heart rate variability, and blood pressure variability indices. Independent sample t-tests demonstrated that medical students had significantly higher school burnout scores compared to their undergraduate counterparts. Controlling for age, BMI, anxiety and depressive symptoms, multiple regression analysis indicated that school burnout was a stronger predictor of elevated hemodynamics (blood pressure), decreased heart rate variability, decreased markers of vagal activity and increased markers of sympathetic tone at baseline for medical students than for undergraduates. Analyses of physiological values collected during the cold pressor task indicated greater cardiac hyperactivity for medical students than for undergraduates. The present study supports previous research linking medical school burnout to hemodynamic and autonomic functioning, suggests biomarkers for medical school burnout, and provides evidence that burnout may be implicated as a physiological risk factor in medical students. Study limitations and potential intervention avenues are discussed.
Authors:Liselotte N. Dyrbye; Colin P. West; Melanie L. Richards; Helen J. Ross; Daniel Satele; Tait D. Shanafelt Pages: 69 - 75 Abstract: Publication date: Available online 7 July 2016 Source:Burnout Research Author(s): Liselotte N. Dyrbye, Colin P. West, Melanie L. Richards, Helen J. Ross, Daniel Satele, Tait D. Shanafelt Although burnout, poor quality of life (QOL), depression, and other forms of psychological distress are common among physicians, few studies testing interventions to reduce distress have been reported. We conducted a randomized trial to determine the impact of a 10-week, individualized, online intervention on well-being among physicians (n=290). Participants were randomized to either the intervention or control arm. Those in the intervention arm received a menu of self-directed micro-tasks once a week for 10 weeks, and were asked to select and complete one task weekly. Baseline and end-of-study questionnaires evaluating well-being (i.e., burnout, depression, QOL, fatigue) and professional satisfaction (i.e., job satisfaction, work engagement, meaning in work, and satisfaction with work-life balance) were administered to both arms. Overall quality of life and fatigue improved over the 10 weeks of the study for those in the intervention arm (both p<0.01). When compared to the control arm, however, no statistically significant improvement in these dimensions of well-being was observed. At the completion of the study, those in the intervention arm were more likely to report participating in the study was worthwhile compared to those in the control arm. The findings suggest that although participants found the micro-tasks in the intervention arm worthwhile, they did not result in measurable improvements in well-being or professional satisfaction when compared to the control group. These results also highlight the critical importance of an appropriate control group in studies evaluating interventions to address physician burnout and distress.
Authors:Sarah L. Cooper; Heather L. Carleton; Stephanie A. Chamberlain; Greta G. Cummings; William Bambrick; Carole A. Estabrooks Pages: 76 - 87 Abstract: Publication date: Available online 29 June 2016 Source:Burnout Research Author(s): Sarah L. Cooper, Heather L. Carleton, Stephanie A. Chamberlain, Greta G. Cummings, William Bambrick, Carole A. Estabrooks Objective To systematically review the evidence on factors that influence burnout in health care aides working in nursing homes. Design Systematic literature review. Data Sources Two search engines (Google and EBSCO Discovery Service) and five databases (MEDLINE, Scopus, CINAHL, PsycINFO and Proquest Dissertations & Theses) through to August 2013. Keywords: nursing home, health care aide and burnout (all synonyms were included). Methods Two authors independently assessed methodological quality, data extraction, analysis and synthesis on the 10 included publications. 100% reliability was found between the first and second authors. Data extracted included precipitating and buffering factors related to burnout, interventions and demographic information for the health care aide population. Data were synthesized according to individual and organizational factors. Results Our search and screening yielded 2787 titles and abstracts resulting in 83 manuscripts for full manuscript review and 10 included publications. Methodological quality assessments revealed 3 (30%) rated as low quality, 7 (70%) rated as medium quality. Independent variables were categorized as either individual or organizational factors. Methodological problems and heterogeneity in independent and dependant variables yielded few significant results. Only personal life (attributes of provider) was found to significantly buffer burnout (depersonalization, emotional exhaustion and personal accomplishment). Equivocal evidence was found for many of the organizational factors (work environment, workload and facility) supporting the need for further robust studies in this field. Of the two intervention studies, only dementia care mapping, and training in organizational respect buffered burnout. Conclusion Factors associated with burnout in health care aides are similar to those reported among nurses, although the level of evidence and low methodological rigor of these studies suggest more robust study designs are warranted. Our findings suggest research focused on this important but largely invisible group of care providers could yield important advances in understanding burnout in this group and yield potential interventions to buffer burnout and its consequences. Without mitigating the effects of burnout on nursing home health care aides, vulnerable older adults in residential care are at risk.
Authors:Kathleen Schwarzkopf; Doris Straus; Hildburg Porschke; Hansjörg Znoj; Nathalie Conrad; Arno Schmidt-Trucksäss; Roland von Känel Pages: 25 - 33 Abstract: Publication date: Available online 10 February 2016 Source:Burnout Research Author(s): Kathleen Schwarzkopf, Doris Straus, Hildburg Porschke, Hansjörg Znoj, Nathalie Conrad, Arno Schmidt-Trucksäss, Roland von Känel Purpose The relationship between burnout and depression has been a major focus of burnout research, but personality factors might be equally important. Largely based on theoretical grounds, narcissism has repeatedly been proposed to contribute to burnout. Objective: The aim of this study was to examine empirically the relationship between burnout and narcissism Methods We investigated 723 consecutive in-patients, aged between 22 and 80 years (51.2% female), at a hospital specialized in the treatment of job stress-related disorders. patients completed the 22-item Maslach Burnout Inventory and the 20-item Narcissism Inventory, the Beck Depression Inventory, the Pittsburgh Sleep Quality Index and the Perceived Stress Scale. Results After controlling for sociodemographic factors, depressive symptoms, sleep quality, and perceived stress, narcissism explained 3.5% of the total burnout score (p<0.001); regarding burnout dimensions, narcissism explained 7.3% of emotional exhaustion (p<0.001) and 3.6% of depersonalization (p<0.001), but was unrelated to lack of achievements (p=0.45). Depressive symptoms explained 3.6% of the total burnout score, 2.6% of emotional exhaustion, 2.0% of depersonalization, and 1.4% of lack of achievements (all p-values ≤0.005). Conclusions Personality factors, especially narcissism, may be equally important as depressive symptoms, and thus should regularly be considered in burnout research and therapy.
Authors:Jasmine B. MacDonald; Anthony J. Saliba; Gene Hodgins; Linda A. Ovington Pages: 34 - 44 Abstract: Publication date: Available online 11 March 2016 Source:Burnout Research Author(s): Jasmine B. MacDonald, Anthony J. Saliba, Gene Hodgins, Linda A. Ovington The present study aims to provide a concise, comprehensive, and systematic review of the quantitative literature relating to the experience of burnout in journalists of various specialties and mediums. The systematic review method adopted is that prescribed by Fink (2010), which contains three main elements: Sampling the literature, screening the literature, and extracting data. Results indicate that journalists most at risk of burnout are females who are younger, with fewer years of journalism experience, working in small circulation newspapers. Editors and reporters seem to experience higher levels of burnout than those in other roles, as do journalists in non-management positions. The thorough and structured process adopted in this review provides the ability to assert with some degree of certainty what areas within the burnout and journalism literature require further consideration. This review emphasises and problematises the large focus on male reporters in newspaper settings, settings that are becoming less significant over time. Studies have tended to focus on reporters, without providing a convincing a priori rationale. What is lacking is consideration of other role groups central to broadcast news, such as camera-operators. A range of methodological and theoretical issues and future areas of research are discussed.
Authors:Claude Fernet; Olivier Torrès; Stéphanie Austin; Josée St-Pierre Pages: 45 - 53 Abstract: Publication date: Available online 29 March 2016 Source:Burnout Research Author(s): Claude Fernet, Olivier Torrès, Stéphanie Austin, Josée St-Pierre The aim of this study was to gain a deeper understanding of occupational stress in small-to-medium enterprise (SMEs) owner-managers by delving further into individual and contextual factors that make them vulnerable to burnout. From a relational perspective, the authors propose that job stressors related to SME management can predict burnout through the feeling of occupational loneliness, and that this indirect relationship is moderated by the entrepreneurial orientation of the owner-manager. The proposed moderated mediation model was supported by multiwave data collected from 377 owner-managers in France as well as its invariance across business size. The results showed that the conditional indirect effect of loneliness was stronger and significant when entrepreneurial orientation is low, but weaker and not significant when entrepreneurial orientation is high. This finding provides a starting point for further investigations of burnout in SME owner-managers, and more specifically, the complex pathways by which job stressors are related to burnout.
Authors:Katja Upadyaya; Matti Vartiainen; Katariina Salmela-Aro Abstract: Publication date: Available online 8 October 2016 Source:Burnout Research Author(s): Katja Upadyaya, Matti Vartiainen, Katariina Salmela-Aro This study investigated the cross-lagged associations between work engagement and burnout, and life satisfaction and depressive symptoms, their demands (i.e., workload) and resources (i.e., servant leadership, self-efficacy, resilience) and relationships with occupational health outcomes (i.e., recovery, number of mental health diagnoses, workaholism). This study is a part of an ongoing Occupational Health Study in which 1 415 employees (586 men, 829 women) were followed twice during two years 2011-12 through their occupational health services. The participants filled in a questionnaire on their work engagement, burnout symptoms, well-being, personal and work environmental resources and demands, and occupational health. The results showed that spillover existed, in particular, from work engagement to depressive symptoms (negatively), and to life satisfaction (positively) and from depressive symptoms to work engagement (negatively), and to burnout (positively). Work engagement was also negatively associated with work burnout, and depressive symptoms were negatively associated with life satisfaction. Moreover, servant leadership was positively associated with work engagement, which, in turn, was positively associated with high life satisfaction and recovery, and negatively associated with work burnout and depressive symptoms. High workload, in turn, was positively associated with burnout and depressive symptoms, which, in turn, were further positively associated with increased mental health diagnoses, and negatively associated with recovery.
Authors:Anne Ulla; Kinnunen Abstract: Publication date: Available online 29 December 2015 Source:Burnout Research Author(s): Anne Mäkikangas, Ulla Kinnunen The variable-oriented approach has dominated empirical burnout research, but during the last 10 years a person-oriented approach to burnout has also become common. The aim of this systematic literature review was to identify, categorize and evaluate the empirical research to date that has adopted a person-oriented approach to burnout. The results of these studies were then compared with those generated by variable-oriented burnout research. An electronic search of seven databases was conducted in spring 2015. Initially 470 publications were identified, 24 of which met the selection criteria. The reviewed articles were categorized into three groups based on their research target(s): 1) intra-individual patterns of burnout symptoms (i.e., types of burnout) (42%), 2) intra-individual development of burnout over time (i.e., burnout trajectories) (33%), and 3) patterns of well-being indicators within individuals (i.e., well-being types) (33%). The typical burnout types and trajectories identified by person-oriented research were largely parallel with the information produced by variable-oriented research, but also brought out the heterogeneity of the burnout experience by revealing atypical burnout and well-being types and individual developmental trajectories. The advantages, along with the challenges, of taking a person-oriented approach are discussed. Based on the study designs, methodologies, and main findings of the reviewed studies, five avenues for future person-oriented burnout studies are proposed.