Anxiety, burnout and coping styles in general hospital staff exposed to workplace aggression: a cyclical model of burnout and vulnerability to aggression

Although an increasing problem, the aggression ( physical assault, threatening behaviour and verbal aggression) directed toward general hospital staff rather than staff in psychiatric institutions has not been widely investigated. The present study first compared anxiety, coping styles and burnout according to the frequency of aggressive experiences. Second, a sub-sample was examined to determine any immediate after-effects from aggressive encounters. Healthcare staff ( n = 375) across professions completed the State-Trait Anxiety Inventory, the Maslach Burnout Inventory and the Coping Responses Inventory, which were analysed according to the type and frequency of aggression experienced within the preceding year. There were no significant differences in levels of anxiety or in coping styles. However, significant differences were determined in levels of burnout. Emotional exhaustion and depersonalization were significantly higher in those staff more frequently victimized suggesting that aggressive encounters might lead to an increase in burnout. Equally, the converse might be true. Therefore, a cyclical model is put forward in which we propose that elevated levels of burnout from all sources might increase vulnerability to victimization. Increases in emotional exhaustion lead directly to an increase in depersonalization as a coping mechanism, which subsequently manifests as a negative behavioural change toward patients, thus rendering staff more vulnerable to further aggression.     

Anxiety,burnout and coping styles in general hospital staff exposed to workplace aggression: A cyclical model of burnout and vulnerability to aggression

Although an increasing problem, the aggression ( physical assault, threatening behaviour and verbal aggression) directed toward general hospital staff rather than staff in psychiatric institutions has not been widely investigated. The present study first compared anxiety, coping styles and burnout according to the frequency of aggressive experiences. Second, a sub-sample was examined to determine any immediate after-effects from aggressive encounters. Healthcare staff ( n = 375) across professions completed the State-Trait Anxiety Inventory, the Maslach Burnout Inventory and the Coping Responses Inventory, which were analysed according to the type and frequency of aggression experienced within the preceding year. There were no significant differences in levels of anxiety or in coping styles. However, significant differences were determined in levels of burnout. Emotional exhaustion and depersonalization were significantly higher in those staff more frequently victimized suggesting that aggressive encounters might lead to an increase in burnout. Equally, the converse might be true. Therefore, a cyclical model is put forward in which we propose that elevated levels of burnout from all sources might increase vulnerability to victimization. Increases in emotional exhaustion lead directly to an increase in depersonalization as a coping mechanism, which subsequently manifests as a negative behavioural change toward patients, thus rendering staff more vulnerable to further aggression.     

Self-control demands, cognitive control deficits, and burnout

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.     

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.     

Self-help for stress and burnout without therapist contact: An online randomised controlled trial

Interventions designed to reduce stress and burnout may be costly and access is limited. This study examined the effectiveness of a self-help book, using Acceptance and commitment therapy (ACT) to target stress and burnout in a randomised controlled online trial without any therapist contact. Participants were recruited through a newsletter of a health insurance company. Participants (N?=?119) who reported at least moderate levels of stress were randomly assigned to an immediate intervention (n?=?61) or a waitlist group (n?=?58). Measures before and after the intervention assessed stress, burnout (primary outcomes), depression, well-being, emotion regulation (secondary outcomes) and ACT-specific constructs. Compared to the waitlist group, participants in the immediate intervention group reported lower stress and burnout and higher psychological flexibility at post-assessment. Effects between groups were large for stress (d?=?0.9), moderate to large for burnout (d?=?0.5–0.8) and large for psychological flexibility (d?=?0.8). All primary and most secondary outcomes and ACT processes continued to improve in the 3-month-follow-up period. Results suggest that an ACT self-help book without any therapist contact is effective in reducing stress and burnout for various occupations. Thus, it may provide a cost-effective public health intervention for reducing stress and burnout.     

裁员决策的经济理性分析

本文从员工行为取向角度对裁员决策的经济理性进行了分析.裁员决策的依据是员工能否忠实地履行自己的职责.裁员是一把双刃剑,虽然裁的是员工,最受伤的往往却是企业.无论企业的经营状况如何,裁员都应该是一种最后的、不得已的选择.本文探讨了裁员的经济因果,分析了裁员决策中的薪酬策略和目标策略等补救措施,指出了应该如何把握裁员的时机,理性地选择裁员对象.     

Evaluation of the Service Review Model With Performance Scorecards

The current study combined a management technique termed “Service Review” with performance scorecards to enhance staff and consumer behavior in a human service setting consisting of 11 supervisors and 56 front-line staff working with 9 adult consumers with challenging behaviors. Results of our intervention showed that service review and scorecards produced significant staff behavior changes that were maintained over time. Positive consumer outcomes were also correlated with staff performance changes. The behavioral package of training, clinical consultation, service review, biweekly manager meetings, scorecards, and public posting has the potential to reduce the need for monetary staff incentives.     

Controlled burn! Physician executives must be ready to handle job burnout, career stress

Job burnout for workers in any career can be frightening. It's truly debilitating to think that your job and career are worthless, that your future isn't bright. There are, however, some steps you can take to recognize, avoid or overcome the stress and anxiety that leads to job burnout.     

Organizational climate and burnout in a New Zealand social service agency

A two-phase study was conducted on the relationship between organizational climate variables and burnout among personnel in a multifunction community service agency. Initial interviews with a small pilot sample identified major sources of stress, which were then incorporated into a second-phase questionnaire to all staff. Multiple regression analyses illustrated that perceived interactions between head office administrators and sections of the agency contributed significantly to emotional exhaustion, whereas perceptions of within-section interactions and involvement in decision-making had a positive impact on personal accomplishment. Perceived communication levels, however, were negatively related to personal accomplishment. The findings suggest the importance of organizational variables and highlight strategies for burnout reduction and effective stress management in human service organizations.     

结构式团体在临床护士心理压力调解中的应用

目的探讨应用结构式团体在临床护士心理压力调解中的改善效果。方法选择临床护士60例,均为2020年06月~2020年12月间我院在册在岗内科病区护士,依据护士入科先后顺序采取分组,即前期入科护理人员30例采取自我调节方式应用心理压力,观察组为后期入科护理人员30例,采取结构式团体干预模式进行心理压力调节,对比护士不同调节方式下,情绪分值变化及对自我职业的倦怠评分、心理健康状态评分,并采取科室设计的满意度问卷展开评估。结果由自评量表结果所示,观察组护理人员在干预前焦虑、抑郁分值均无明显变化(P>0.05),干预后观察组护理人员焦虑、抑郁分值有所下降,与对照组呈鲜明对比(P<0.05)。职业倦怠量表测评结果所示,观察组护理人员情绪衰竭、工作态度、个人成就感三个维度的分值均低于对照组,差异显著(P<0.05)。由科室自我设计满意度问卷所示,观察组对自我工作满意度较高,与对照组比值差异明显(P<0.05)。两组在SCL-90量表测评下,观察组护理人员各项指标得分低于对照组(P<0.05)。结论结构式团体在临床护士心理压力的调解中的应用效果值得肯定,可改善职业倦怠感,提高工作效率。     

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.     

Construct validity of the Maslach Burnout Inventory-General Survey: a two-sample examination of its factor structure and correlates

This research examines the construct validity of Schaufeli, Leiter, Maslach, and Jackson's (1996) general burnout measure, the Maslach Burnout Inventory-General Survey (MBI-GS). Whereas burnout is traditionally defined and measured in terms of a phenomenon occurring among workers who work with people, the MBI-GS is intended for use outside the human services. The authors first address the internal validity of the MBI-GS using data from two Dutch samples (179 software engineers and 284 university staff members). Confirmatory factor analysis revealed that the distinction among the three subscales of the MBI-GS was retained. To examine external validity, these subscales were then related to selected work characteristics. Based on conservation of resources theory, differential patterns of effects were predicted among the correlates and the three burnout subscales. Expectations were largely supported, suggesting that the meaning of the three subscales is quite different. These results largely replicate findings obtained in similar studies on the validity of the contactual version of the MBI.     

The construct validity of an alternative measure of burnout: Investigating the English translation of the Oldenburg Burnout Inventory

While the most commonly employed burnout measure has been the Maslach Burnout Inventory (MBI), researchers have been troubled by some of the psychometric limitations of that scale (e.g. wording of the scale items) as well as the limited conceptualization of burnout upon which it is based. As a result, Demerouti et al. have developed an alternative measure of burnout, the Oldenburg Burnout Inventory (OLBI). The purpose of this paper is to develop evidence for the validity and reliability of an English-language translation of the OLBI. As such, this study is among the first validation studies of the OLBI, and the first to assess the characteristics of the OLBI an English-speaking sample. Using data from 2599 employees across two samples from the United States (a generalized sample of working adults and a sample of fire department employees), our preliminary multi-trait, multi-method (MTMM) and confirmatory factor analyses suggested that the OLBI may be a viable alternative to the Maslach Burnout Inventory-General Survey (MBI-GS). It demonstrates acceptable reliability (test-retest reliability and internal consistency) as well as factorial, convergent, and discriminant validity. We discuss the implications of this study for the measurement and conceptualization of burnout and suggest a variety of research directions that stem from our findings. Our findings suggest that the OLBI offers researchers an alternative measure of burnout that offers balanced wording, that can also be used to measure the opposite phenomenon (engagement), and provides an expanded conceptualization of the exhaustion component of burnout.     

Organizational climate and burnout in a New Zealand social service agency

Abstract

A two-phase study was conducted on the relationship between organizational climate variables and burnout among personnel in a multifunction community service agency. Initial interviews with a small pilot sample identified major sources of stress, which were then incorporated into a second-phase questionnaire to all staff. Multiple regression analyses illustrated that perceived interactions between head office administrators and sections of the agency contributed significantly to emotional exhaustion, whereas perceptions of within-section interactions and involvement in decision-making had a positive impact on personal accomplishment. Perceived communication levels, however, were negatively related to personal accomplishment. The findings suggest the importance of organizational variables and highlight strategies for burnout reduction and effective stress management in human service organizations.     

Associations among altruism, burnout dimensions, and organizational citizenship behaviour

Most studies of burnout have focused on lack of resources, prevalence of burnout, and negative outcomes. In contrast, this study examined the relationships among altruism, burnout and a positive outcome, namely, the engagement in organizational citizenship behaviour. Web questionnaires were distributed to employees in three professional organizations. The results from the 178 respondents indicated that altruism is related to organizational citizenship behaviour. Of the three dimensions of burnout, only reduced personal accomplishment was (negatively) associated with engagement in organizational citizenship behaviours. Implications of the results are discussed and directions for future research are offered.     

Burnout, job stress and violent behaviour among Dutch police officers

Much has been published on burnout in the human services. However, despite the extensive literature on job stress in policing, burnout in police officers has rarely been studied. The present study examined stressors in police work, focusing specifically on the lack of reciprocity that officers experience in relations with civilians, colleagues and the police service. It also investigated the relationship between burnout and the attitudes of officers towards violence, as well as to their own use of violence. Dutch police officers (N = 358) completed a self-report questionnaire. The results showed that: (1) organizational stressors were more prevalent than task-related stressors; (2) compared to other service jobs, police officers report a particular profile on the three scales of the Maslach Burnout Inventory (MBI)?a relatively low level of emotional exhaustion,an average level of depersonalization, and a high level of personal accomplishment; (3) burnout is associated with a lack of reciprocity between investments and outcomes in the relations that officers have with citizens, colleagues and their organization; and (4) burnout is positively related to attitudes towards use of violence and the use of violence during the officers' duty.     

Job stress,burnout and substance use among urban transit operators: The potential mediating role of coping behaviour

Abstract

Urban transit operators, compared to other occupational groups, have higher rates of mortality and morbidity. A major risk factor is the highly stressful objective environment. This study used structural equation modelling to test a model hypothesizing that transit operators’ coping behaviours in responding to daily job hassles mediate the associations of work stress with burnout and substance use. The study sample consisted of 1231 transit operators who participated in the San Francisco MUNI Health and Safety Study. The results showed a direct and strong association between transit operators’ daily job stress and symptoms of occupational burnout even when a series of controls and coping behaviours were considered. In addition, use of “disengage-deny” and escapist strategies to cope with job stress was positively associated with burnout; the job stress–burnout association was partially mediated through such coping practices. Daily job stress was related to substance use only indirectly and mediated through burnout and use of “disengage-deny” and escapist coping strategies. “Disengage-deny” coping strategies might help reduce substance use whereas escapist coping strategies might increase such use. Overall, our findings suggest that coping behaviour may be an important correlate of transit operators’ ill health. Interventions enabling healthy coping behaviours may help reduce health risks for this occupational group.     

CEO burnout,managerial discretion,and firm performance: The role of CEO locus of control,structural power,and organizational factors

Despite the possibility of burnout resulting from dynamics in firms' upper echelons, little if any work has focused on chief executive officer's (CEO's) burnout and firm performance. Drawing on managerial discretion theory, this article analyzes the influence of CEO burnout on firm performance and the moderating roles of the individual (CEO locus of control), structural power (CEO duality and CEO tenure), and organizational characteristics (size, age, and resource availability) related to managerial discretion. Using a sample of 156 CEOs in Swedish firms, we find a negative association between CEOs who report higher burnout and firm performance. Our results confirm that CEO duality and resource availability ameliorate and firm size exacerbates the negative association between CEO burnout and firm performance. Contrary to our expectations, CEO locus of control, CEO tenure, and firm age do not influence this relationship. We discuss the implications of our research for upper echelons theory and strategic leadership theory.