The New Zealand government approach to stress and fatigue

Abstract

Self-control involves inhibiting undesired behaviours and emotions, and it can be particularly relevant in the service sectors. Recent theoretical developments in cognitive and social psychology suggest that the demands on an individual of exercising self-control have an effect as a source of stress at work. In turn, burnout could be associated with being unable to meet those demands. It was expected that cognitive control deficits, as assessed by a questionnaire measure of self-reported failures in perception, memory, and action, would function as a vulnerability factor in the relationship between self-control demands and indicators of job strain. Data from 630 staff members of a German municipal administration revealed significant main effects of both self-control demands and cognitive control deficits on the burnout dimensions of emotional exhaustion and depersonalization. Both predictors were positively related to burnout. In addition, the results provided clear evidence of the vulnerability hypothesis of cognitive control deficits. By way of contrast, musculoskeletal complaints did not reflect similar main and interactive effects of self-control demands and cognitive control deficits. The requirements for self control in the service sector are expected to increase as the sector expands, and the practical implications for this are discussed.     

Burnout and impaired cognitive functioning: The role of executive control in the performance of cognitive tasks

Abstract

Burnout patients often report deficits in cognitive control, and there is a need to understand the processes involved. Drawing on recent findings, we hypothesized that emotional exhaustion and task-related demands on executive control would interact in predicting performance in tasks requiring the updating and monitoring of working memory as well as the inhibition of prepotent (dominant or automatic) responses. In accordance with recent conceptualizations of burnout, we focused on emotional exhaustion as the core symptom of burnout. The sample comprised 81 employees recruited from nursing homes for elderly care in Germany, who participated in a laboratory study involving cognitive tasks. Based on a median split, participants were divided into two groups: those with high burnout and those with low burnout. In line with our hypotheses, the high exhaustion participants performed less well than those with low exhaustion only when tasks put high demands on their executive control. As predicted, high levels of emotional exhaustion were associated with more errors and longer reaction times when demands on executive control were high, whereas no performance differences were found when both tasks put low demands on executive control. The implications for practice are discussed.     

Work stress and attentional difficulties: An initial study on burnout and cognitive failures

Professional burnout is a stress-related disorder, having mental exhaustion due to work stress as its most important characteristic. Burned out individuals also often complain about attentional problems. However, it is currently not clear whether such complaints are based on true cognitive deficits or whether they merely reflect the way burned out individuals rate their own cognitive performance. To confirm the cognitive complaints we used a cognitive failure questionnaire (CFQ) to assess the level of self-reported attentional difficulties in daily life. We also measured performance on tasks of sustained attention and response inhibition (the SART and the Bourdon-Wiersma Test). We compared three groups: (1) a group of 'burned out' individuals (n=13) who stopped working due to their symptoms and sought professional treatment; (2) teachers at a vocational training institute (n=16) who reported high levels of burnout symptoms but continued to work; and (3) teachers from the same institute (n=14) who reported no burnout symptoms. The level of burnout symptoms was found to be significantly related to the number of cognitive failures in daily life, and to inhibition errors and performance variability in the attentional tasks. To our knowledge, explicit tests of objective cognitive deficits in burned out individuals have not been conducted before. Consequently, this is the first study to indicate that burnout is associated with difficulties in voluntary control over attention and that the level of such difficulties varies with the severity of burnout symptoms.     

The association between job skill discretion, decision authority and burnout

This paper reports on the relationship between dimensions of control (skill discretion and decision authority) and burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) among 164 human service workers. It examines the differential influence of job demands, control (skill discretion and decision authority) and social support (supervisor, co-workers, others) on each burnout dimension. Then it examines the moderating effects of higher skill discretion, higher decision authority, and higher social support on burnout. Low skill discretion was found to be associated with high emotional exhaustion and depersonalization and low personal accomplishment. The effects of decision authority were not statistically significant. High job demands were associated with high emotional exhaustion only. Social support (supervisor, co-worker, and others) was not associated with burnout when demographic variables and job characteristics were controlled for. Neither dimension of control moderated the impact of high job demands on burnout. Social support did not moderate the impact of high demands, low skill discretion, or low decision authority on any burnout dimension. The full model explained 44% of the variance in emotional exhaustion, 25% in depersonalization, and 42% in personal accomplishment. Despite its limitations, the study suggests that the Job Demand-Control model may provide a useful theoretical foundation for the study of burnout, but that the control dimensions need to be evaluated independently since they appear to be differentially related to the burnout dimensions.     

The association between job skill discretion,decision authority and burnout

This paper reports on the relationship between dimensions of control (skill discretion and decision authority) and burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) among 164 human service workers. It examines the differential influence of job demands, control (skill discretion and decision authority) and social support (supervisor, co-workers, others) on each burnout dimension. Then it examines the moderating effects of higher skill discretion, higher decision authority, and higher social support on burnout. Low skill discretion was found to be associated with high emotional exhaustion and depersonalization and low personal accomplishment. The effects of decision authority were not statistically significant. High job demands were associated with high emotional exhaustion only. Social support (supervisor, co-worker, and others) was not associated with burnout when demographic variables and job characteristics were controlled for. Neither dimension of control moderated the impact of high job demands on burnout. Social support did not moderate the impact of high demands, low skill discretion, or low decision authority on any burnout dimension. The full model explained 44% of the variance in emotional exhaustion, 25% in depersonalization, and 42% in personal accomplishment. Despite its limitations, the study suggests that the Job Demand-Control model may provide a useful theoretical foundation for the study of burnout, but that the control dimensions need to be evaluated independently since they appear to be differentially related to the burnout dimensions.     

Testing whether reduced cognitive performance in burnout can be reversed by a motivational intervention

It has been suggested that the motivation to spend effort is decreased in burnout patients, resulting in reduced cognitive performance. A question that remains is whether this decreased motivation can be reversed by motivational interventions. We investigated this by examining the effect of a motivational intervention on cognitive performance. We presented 40 burnout patients in The Netherlands and 40 matched healthy controls with a complex attention task. As expected, in a first block of trials the performance of the burnout patients was poorer than that of healthy controls. Subsequently, we provided the participants with fake positive feedback about their performance and announced that we would financially reward those who performed best in a subsequent block of trials. Contrary to the healthy controls, the burnout patients did not improve their performance and experienced more aversion to spend effort. The study demonstrated that impaired cognitive performance in burnout patients could not be reversed by motivational interventions, which is in line with contemporary theories on burnout that state that physiological changes in burnout may underlie a relatively long-term decrease in motivation. The implication of these results is that in practice employers and therapists might need to accept that there could be a reduction in cognitive performance in employees with burnout.     

The Copenhagen Burnout Inventory: A new tool for the assessment of burnout

So far, the large majority of studies on burnout in the international literature have employed the Maslach Burnout Inventory (MBI). In this paper we criticize the MBI on a number of points and present a new tool for the measurement of burnout: the Copenhagen Burnout Inventory (CBI). The CBI consists of three scales measuring personal burnout, work-related burnout, and client-related burnout, for use in different domains. On the basis of an ongoing prospective study of burnout in employees in the human service sector, the PUMA study (Project on Burnout, Motivation and Job Satisfaction; N=1914 at baseline), we analysed the validity and reliability of the CBI. All three scales were found to have very high internal reliability, and non-response rates were small. The scales differentiated well between occupational groups in the human service sector, and the expected pattern with regard to correlations with other measures of fatigue and psychological well-being was found. Furthermore, the three scales predicted future sickness absence, sleep problems, use of pain-killers, and intention to quit. Analyses of changes over time showed that substantial proportions of the employees changed with regard to burnout levels. It is concluded that the analyses indicate very satisfactory reliability and validity for the CBI instrument. The CBI is being used in a number of countries and translations into eight languages are available.     

Work-related and individual determinants of the three burnout dimensions

Applying the Conservation of Resources (COR) theory as a framework, this study among Dutch nurses (n=156) first tested whether work-related demands, resources and self-esteem were differentially associated with the three burnout dimensions (emotional exhaustion, personal accomplishment and depersonalization), respectively. In addition, the current study investigated the interrelationships between the burnout dimensions and the hypothesized moderating effect of self-esteem. As expected, emotional exhaustion was primarily associated with job demands (i.e. work overload) and-to a slightly lower extent-with resources such as social support and self-esteem. In contrast, but also according to the authors' predictions, depersonalization and personal accomplishment were not associated with job demands. Emotional exhaustion was, as predicted, an important correlate of depersonalization, whereas reduced personal accomplishment was negatively associated with self-esteem and with quality of work content, a resource. In line with earlier findings but contrary to some recent propositions, reduced personal accomplishment was positively associated with depersonalization. Finally, self-esteem did not moderate the relationships between the selected work factors and the burnout dimensions. The limitations of the study are discussed and directions for future research are proposed.     

The importance of context specificity in work stress research: A test of the Demand-Control-Support model in academics

The Demand-Control (D-C) (Karasek, 1979) and the Demand-Control-Support (D-C-S) (Johnson & Hall, 1988; Johnson, Hall, & Theorell, 1989; Karasek & Theorell, 1990) models of work stress suggest that jobs with high demands and low control (and low support) are stressful. In line with the support in the literature for context-specificity in occupational stress research (Sparks & Cooper, 1999) and the limited and even contradictory support for interaction effects, the main aim of the present study was to examine how the D-C-S model applied in a well-defined occupational group. Using hierarchical regression analyses, and controlling for negative affect, the D-C-S model accounted for 26%, 6%, and 8% of the variance in job satisfaction, psychological distress and burnout, respectively, among 166 academics in a UK university. No two-way or three-way interactive effects were evident, but additive effects of job demands and control on psychological well-being and of job demands and support on both burnout and job satisfaction were shown, corroborating research showing that high job strain is linked to ill health and job dissatisfaction in this homogenous occupational sample. It is recommended that, in future, research includes more variables that are specific to a particular occupation.     

The importance of context specificity in work stress research: A test of the Demand-Control-Support model in academics

Abstract

The Demand-Control (D-C) (Karasek, 1979) and the Demand-Control-Support (D-C-S) (Johnson & Hall, 1988; Johnson, Hall, & Theorell, 1989; Karasek & Theorell, 1990) models of work stress suggest that jobs with high demands and low control (and low support) are stressful. In line with the support in the literature for context-specificity in occupational stress research (Sparks & Cooper, 1999) and the limited and even contradictory support for interaction effects, the main aim of the present study was to examine how the D-C-S model applied in a well-defined occupational group. Using hierarchical regression analyses, and controlling for negative affect, the D-C-S model accounted for 26%, 6%, and 8% of the variance in job satisfaction, psychological distress and burnout, respectively, among 166 academics in a UK university. No two-way or three-way interactive effects were evident, but additive effects of job demands and control on psychological well-being and of job demands and support on both burnout and job satisfaction were shown, corroborating research showing that high job strain is linked to ill health and job dissatisfaction in this homogenous occupational sample. It is recommended that, in future, research includes more variables that are specific to a particular occupation.     

Control, stress, and job satisfaction in Canadian nurses

The main effects of four domains of control (task, decision, resource, physical environment) on job satisfaction and their interactions with three types of job stressors (task demands, role conflict, interpersonal conflict) were examined in a sample of 765 Canadian nurses. Multiple regression analyses were conducted to determine the proportion of variance in job satisfaction that could be accounted for by job stressors, control, and the interaction of stressors and control in that order. The job stressors were analysed separately and as a composite job demands score, as were the four domains of control. The results indicated that the proportion of variance in job satisfaction increased with the addition of control for the composite scores and for task, resource, and physical environment control. However, decision control did not account for additional variance in job satisfaction above that for any of the job stressors. In addition, none of the stressor x control interactions were significant. The results support previous attempts to test the moderating effects of control, suggesting that perceived control is not a moderator of job stress but rather that it has a direct influence. The relevance of the different domains of control for nurses is discussed.     

The effects of JDC model on burnout and work engagement: A multiple interaction analysis

This study investigated the moderating effects of functional social support (emotional and instrumental support) on the relationship of job demand control with burnout and work engagement. In total, 297 frontline employees from a hotpot restaurant franchise in China were surveyed. The results indicated emotional support, such as caring and inspiration, mitigated the adverse effects of high demand/low control on burnout and work engagement. Instrumental support, such as giving suggestions and solving problems, only mitigated the adverse effects of burnout. Further, the high demand/low control/low emotional support work condition was the most unfavourable for work engagement and burnout; while high demand/low control/low instrumental support was the most unfavourable condition for burnout. The theoretical and managerial implications of this research have been provided to gain a deeper insight into functional social support in the job demand control model.     

The behaviour of police officers in conflict situations: how burnout and reduced dominance contribute to better outcomes

Dominance plays an important part in police-civilian interactions. However, burnout is associated with a reduction in dominance, and this might, paradoxically, lead to more effective outcomes in conflict situations. There is a lack of knowledge about the effects of burnout in professional practice, and this multi-method study was conducted to better understand these dynamics. It is unique in that it combined self-reported burnout with observed behaviour in interactions with civilians. In this study, the relationships between the imbalance between demands and rewards, occupational burnout and police officers’ behaviour in conflict situations (in terms of dominance and effectiveness) were examined. A questionnaire was used to assess job demands, rewards and burnout among 358 Dutch police officers. In addition, police officers’ interactions with civilians were observed over 122 days. The results of structural equation modelling analyses showed that the imbalance between job demands and rewards was predictive of burnout (emotional exhaustion and depersonalization). Burnout, in its turn, predicted a decrease in dominant behaviour in conflict situations and, consequently, more effective conflict outcomes. These findings show that reduced dominance associated with burnout could in fact have positive consequences for professional behaviour in conflict situations. The benefits of reduced dominance in these situations should be taken into account in the training of professionals.     

The behaviour of police officers in conflict situations: how burnout and reduced dominance contribute to better outcomes

Dominance plays an important part in police-civilian interactions. However, burnout is associated with a reduction in dominance, and this might, paradoxically, lead to more effective outcomes in conflict situations. There is a lack of knowledge about the effects of burnout in professional practice, and this multi-method study was conducted to better understand these dynamics. It is unique in that it combined self-reported burnout with observed behaviour in interactions with civilians. In this study, the relationships between the imbalance between demands and rewards, occupational burnout and police officers' behaviour in conflict situations (in terms of dominance and effectiveness) were examined. A questionnaire was used to assess job demands, rewards and burnout among 358 Dutch police officers. In addition, police officers' interactions with civilians were observed over 122 days. The results of structural equation modelling analyses showed that the imbalance between job demands and rewards was predictive of burnout (emotional exhaustion and depersonalization). Burnout, in its turn, predicted a decrease in dominant behaviour in conflict situations and, consequently, more effective conflict outcomes. These findings show that reduced dominance associated with burnout could in fact have positive consequences for professional behaviour in conflict situations. The benefits of reduced dominance in these situations should be taken into account in the training of professionals.     

Exploring the nature of control and its role in the appraisal of workplace stress

The concept of control is a prominent component of theories of stress. From a transactional framework, appraisal of control is seen as important in influencing coping behaviour. However, little attention has been paid to the measurement of the appraisal of control in a work-related situation. In this paper it is argued that situational control should not be reduced to a simple assessment of whether or not an individual has control over a given situation. Instead it is believed that it is important to identify the factors that an individual strives to have control of, as well as the perceived degree of control over those factors. A major component of the present study was the use of a measure that viewed control in this way and that examined control as a multifaceted construct (task control, predictability, self-control and general control). This paper reports on an analysis that examines the multifaceted nature of perceived control with other situational appraisals in the process of coping with workplace stress. A total of 134 employees from four public sector organizations in New Zealand took part in this research. Having control over work tasks was for this sample considered to be less important in giving a sense of control than either predictability or self-control. When it came to reporting how much control they actually had, respondents reported higher levels of self-control than other aspects of control. However, in general respondents reported lower levels of actual control than what they perceived it was important for them to have. This research emphasizes the importance of having a sense of self-control, particularly when it comes to the use of different coping strategies. Overall these findings point to the need to better understand the nature and type of control and its importance if we are to advance our knowledge of work stress.     

Exploring the nature of control and its role in the appraisal of workplace stress

The concept of control is a prominent component of theories of stress. From a transactional framework, appraisal of control is seen as important in influencing coping behaviour. However, little attention has been paid to the measurement of the appraisal of control in a work-related situation. In this paper it is argued that situational control should not be reduced to a simple assessment of whether or not an individual has control over a given situation. Instead it is believed that it is important to identify the factors that an individual strives to have control of, as well as the perceived degree of control over those factors. A major component of the present study was the use of a measure that viewed control in this way and that examined control as a multifaceted construct (task control, predictability, self-control and general control). This paper reports on an analysis that examines the multifaceted nature of perceived control with other situational appraisals in the process of coping with workplace stress. A total of 134 employees from four public sector organizations in New Zealand took part in this research. Having control over work tasks was for this sample considered to be less important in giving a sense of control than either predictability or self-control. When it came to reporting how much control they actually had, respondents reported higher levels of self-control than other aspects of control. However, in general respondents reported lower levels of actual control than what they perceived it was important for them to have. This research emphasizes the importance of having a sense of self-control, particularly when it comes to the use of different coping strategies. Overall these findings point to the need to better understand the nature and type of control and its importance if we are to advance our knowledge of work stress.     

Job resources and emotional exhaustion: The mediating role of learning opportunities

The Job Demands-Resources model predicts that job demands increase and job resources decrease emotional exhaustion in employees. In this study, we investigated one possible mechanism for this, in order to provide a deeper insight into the role of job resources in this energy-depletion process. We assumed that job resources (autonomy and task variety) reduce emotional exhaustion through the promotion of opportunities for personal growth and development, especially workplace learning. Moreover, we expected that job demands (workload, cognitive and emotional demands) would be positively related to work-related learning opportunities. Our research model was tested in a large and heterogeneous sample out of the Dutch working population (N = 4589), following a cross-validation procedure. Multi-group structural equation modelling revealed that autonomy and task variety promoted learning opportunities, which in turn partially mediated between these job resources and emotional exhaustion. With respect to job demands, our study showed mixed results: cognitive demands promoted learning opportunities, workload frustrated such opportunities, and emotional demands were not significantly related to learning opportunities. Our results contribute to a better understanding of the interplay between job demands, job resources and learning opportunities in the energy-depletion process, and support the need for the promotion of learning opportunities in the workplace.     

Test of the demands,supports-constraints framework in predicting psychological distress amongst Australian public sector employees

This paper describes the demands, supports-constraints framework originally articulated by Payne (1979) for predicting psychological distress, and reports the results of an empirical study involving 2452 white-collar, public sector employees in Australia. The study uses hierarchical regression to test for the interaction effects of the demands and constraints variables, having applied suitable controls for instance by including trait anxiety and removing curvilinear effects. The results reveal little evidence of an interactive effect but moderately strong main effects and modest support for the value of controlling for curvilinear effects. Trait anxiety is shown to have a strong effect on psychological distress and considerably reduces the size of the relationship between demands, supports-constraints and psychological distress when statistically controlled for. However, it still accounts for 18.7% of the variance when entered last in the regression and it is recommended that its effects be explored in all studies of stress that rely on self-report data.     

Test of the demands, supports-constraints framework in predicting psychological distress amongst Australian public sector employees

This paper describes the demands, supports-constraints framework originally articulated by Payne (1979) for predicting psychological distress, and reports the results of an empirical study involving 2452 white-collar, public sector employees in Australia. The study uses hierarchical regression to test for the interaction effects of the demands and constraints variables, having applied suitable controls for instance by including trait anxiety and removing curvilinear effects. The results reveal little evidence of an interactive effect but moderately strong main effects and modest support for the value of controlling for curvilinear effects. Trait anxiety is shown to have a strong effect on psychological distress and considerably reduces the size of the relationship between demands, supports-constraints and psychological distress when statistically controlled for. However, it still accounts for 18.7% of the variance when entered last in the regression and it is recommended that its effects be explored in all studies of stress that rely on self-report data.     

Does self-efficacy matter for burnout and sickness absenteeism? The mediating role of demands and resources at the individual and team levels

In team-based organizations, team members may share similar experiences, feelings and, consequently, susceptibility to burnout. This study explores the burnout process beyond the individual level of analysis and integrates Social Cognitive Theory (SCT) with the Job Demands-Resources Model (JD-R), emphasizing the role of self-efficacy in shaping the meaning that people ascribe to situations. A multilevel structural equation model was tested in which it was predicted that work self-efficacy beliefs would be associated with burnout both directly and indirectly via job demands and job resources, and at both the individual and the team level. Moreover, it was posited that, at the team level, registered sickness absences are predicted by burnout. A sample of 5406 call centre operators, clustered in 186 teams working in the same large Italian company, filled out a questionnaire, whereas team absence rates were provided by the company's HR department. The findings largely supported the hypothesized model: at both levels, job demands and job resources partially mediated the relationship between self-efficacy and burnout. Moreover, at the team level, burnout predicted subsequent sickness absenteeism. In addition, individual-level burnout was primarily associated with job demands, whereas team-level burnout was primarily associated with a lack of team-level resources.