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"Back on the Right Track" Rehabilitees' and their Spouses' Experiences of Burnout and Recovery
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Background: High job demands and low job resources may cause job strain and eventually result in burnout. However, previous research has generally ignored the roles of time and self-regulation.
Objectives: This theoretical article synthesizes the literature to propose a multilevel model that delineates how acute job strain translates into enduring and severe job burnout.
Methods: We integrate self-regulation perspectives in job demands-resources (JD-R) theory to propose that short-term job strain and eventually enduring burnout is the result of consistently high job demands and low job resources – combined with failed self-regulation.
Results: The model shows that when employees are confronted with increased job strain, they are more likely to use maladaptive self-regulation strategies, such as coping inflexibility and self-undermining. In addition, when job strain increases, employees are less likely to use adaptive self-regulation strategies, such as job stress recovery and job crafting. It follows that when the job becomes more stressful, stable resources become more important. Organizational resources such as human resource practices and healthy leadership may help employees to regulate their short-term fatigue and avoid enduring burnout. Furthermore, key personal resources like emotional intelligence and proactive personality may help employees to recognize and regulate their fatigue in an effective way.
Conclusion: The proposed model of burnout expands JD-R theory and offers important practical implications for the prevention and reduction of burnout.
The aim of the present study was twofold: First, to profile the long-term development of burnout symptoms (exhaustion, cynicism and reduced professional efficacy), and second, to investigate the associations of developmental burnout profiles with job demands and resources. The study focused on Finnish white-collar professionals (N = 169) who participated in a survey five times during eight years (in 2006, 2008, 2010, 2012, and 2014). At each measurement time, the participants filled in the same scales of burnout, job demands and job resources. Using Latent Profile Analysis (LPA), three developmental profiles of burnout symptoms were identified: 1) Stable, low burnout (78%), 2) Exhaustion instigated, increasing burnout (12%), and 3) Cynicism and reduced professional efficacy dominated, inverted U-shaped burnout (10%). Exhaustion instigated, increasing burnout profile displayed the highest levels of job demands, whereas Cynicism and reduced professional efficacy dominated, inverted U-shaped burnout profile reported the lowest levels of job resources compared to members in other profiles. Recognizing the existence of the multiple sequential development of burnout symptoms and different patterns of job demands and the job resources behind them, this study suggests that burnout development does not follow a uniform shape, which reconciles previously inconsistent findings of variable-centred burnout research.
Sufferers from burnout might experience a sincere bonding to their lost lifeworld, which can result in their holding on to their previous worlds while simultaneously trying to unleash themselves. In this article, four experiential dimensions are presented in discussion with the phenomenological insights provided by Merleau-Ponty. These dimensions are “Trapped in the present body,” “the balancing act,” “precious moments of joy,” and “this is my Lifeworld now.” In the rehabilitation process, the participants demonstrated deliberate choices and reflective self-cultivation to adjust to their present situation. The illness seemed to promote a search for meaning—and out of the existential chaos, a “new” habitual body might appear. The study provides invaluable information about the rehabilitation process and the need for humanistic interventions.
The aim of the current research is to investigate the effect of work conditions on job strains, including burnout and depression. In addition, we are interested to know how strains cross over between spouses at home. We predicted that job demands would lead to employees’ burnout and depression, and then cross over to their spouse at home. A total of 150 dyads (each consisting of both husband and wife) were included in this study. All participants were from dual-earner families. The hypotheses were tested using the structural equation modeling (SEM) AMOS software. Firstly, we discovered that work conditions predicted husbands’ burnout and depression but not that of wives. Secondly, husbands’ burnout and depression were found to cross over to their wives. However, no crossover effects were observed from wives to husbands. The contributions of the study are then discussed.
Background: Burnout is a psychological syndrome characterized by emotional exhaustion, feelings of cynicism and reduced personal accomplishment. In the past years there has been disagreement on whether burnout and depression are the same or different constructs, as they appear to share some common features (e.g., loss of interest and impaired concentration). However, the results so far are inconclusive and researchers disagree with regard to the degree to which we should expect such overlap. The aim of this systematic review and meta-analysis is to examine the relationship between burnout and depression. Additionally, given that burnout is the result of chronic stress and that working environments can often trigger anxious reactions, we also investigated the relationship between burnout and anxiety.
Method: We searched the online databases SCOPUS, Web of Science, MEDLINE (PubMed), and Google Scholar for studies examining the relationship between burnout and depression and burnout and anxiety, which were published between January 2007 and August 2018. Inclusion criteria were used for all studies and included both cross-sectional and longitudinal designs, published and unpublished research articles, full-text articles, articles written in the English language, studies that present the effects sizes of their findings and that used reliable research tools.
Results: Our results showed a significant association between burnout and depression (r = 0.520, SE = 0.012, 95% CI = 0.492, 0.547) and burnout and anxiety (r = 0.460, SE = 0.014, 95% CI = 0.421, 0.497). However, moderation analysis for both burnout–depression and burnout–anxiety relationships revealed that the studies in which either the MBI test was used or were rated as having better quality showed lower effect sizes.
Conclusions: Our research aims to clarify the relationship between burnout–depression and burnout–anxiety relationships. Our findings revealed no conclusive overlap between burnout and depression and burnout and anxiety, indicating that they are different and robust constructs. Future studies should focus on utilizing more longitudinal designs in order to assess the causal relationships between these variables.
Statement of the problem: The present study aims to provide knowledge about the recovery process during rehabilitation and two years later. It explores the manifestation of agency in its three forms – personal, proxy, and collective – in the accounts of four participants in a national rehabilitation course. As recovery paths are individual and heterogeneous, the study employs a narrative approach, which preserves the individual’s voice and enables the emergence of a unique set of meanings ascribed to the narrative.
Procedures: The study participants were selected from national rehabilitation courses funded by the Finnish social insurance institution. Rehabilitation adopts holistic and multidisciplinary approaches. It includes a comprehensive evaluation of an employee’s physical, psychological, and social conditions by various rehabilitation professionals. Intervention is conducted in groups of 4-10 persons, lasts 15 days, and is divided into an initial 10-day period and a 5-day follow-up period within at most 7 months after the first period. Four participants, whose burnout levels had decreased between the two periods of the course, were interviewed via extensive semi-structured interviews on two occasions: at the end of the course in 2012 (T1) and two years after the course, in the autumn of 2014 (T3). They also answered an electronic questionnaire 1.5 years post rehabilitation (T2), which contained a measurement instrument BBI -15 (Bergen Burnout Indicator) and questions on participants’ well-being, its maintenance and possible changes during the follow-up period. Two of the four participants had changed jobs and two had stayed in the same job between the first and second data collection points. Two of them continued on the path of recovery and two reported an increase in burnout symptoms.
Analyses: Data were analyzed by using thematic narrative analysis and interpreted through the lenses of agency, which served as the theoretical framework for the study. Furthermore, four different spheres of meaning were discerned in the narrative: 1) emotional (whether the tone in the narrative is happy or tragic); 2) explanatory (what are the causes and consequences of events); 3) moral (who bears responsibility for events); and 4) ethical (what is good/bad, right/wrong in life). Finally, common themes in the narratives were identified and examined more closely.
Results: The analysis revealed highly individual and heterogeneous paths of recovery. The first parts of the narratives demonstrated a high degree of proxy (through rehabilitation professionals) and collective agency (through the rehabilitation group). As recovery advanced, personal agency was strengthened. Enhanced personal agency was discernible in all follow-up narratives, but it was more pronounced in the narratives of continued recovery. Proxy agency in the face of occupational health professionals was exercised two years post rehabilitation in order to maintain recovery. Spheres of meaning participants attached to their stories also varied, with the rehabilitation course and the professionals involved being viewed as positive and morally good.
Three major common themes were identified: 1) The benefits of the rehabilitation course; 2) Supervisor support; and 3) Personal factors. The rehabilitation course was regarded by all as highly beneficial, awareness-raising and crucial for the commencement of recovery. Through exercising of proxy and collective agency, participants’ personal agency was re-activated and strengthened. Supervisor support was of immense importance for the recovery. A supportive supervisor could alleviate the symptoms of exhaustion and facilitate the re-adaptation to work, whereas an unsupportive or disregarding supervisor led to an increase of burnout symptoms and the experience of injustice. Finally, personal factors such as divorce, the sickness of a close family member or of oneself had a substantial impact both on the onset of burnout as well as on subsequent recovery.
Practical Implications: Rehabilitation courses exert a long-lasting positive impact on recovery, and can be made more effective by training managers to handle better employees’ re-adaptation to work after burnout. Furthermore, knowledge of burnout symptoms has the potential to increase individual and organizational awareness and prevent full-scale development of burnout.
Conclusions: The four narratives demonstrated that the process and the degree of recovery from burnout may very as a multitude of factors - change of workplace, participation in rehabilitation, supervisor support, and individual effort shape the path each individual takes. On the other hand, strong personal agency combined with supervisor support, stability in the workplace, and good physical health appeared to be conducive to a steady path of recovery. Following the development of recovery over time by using qualitative methods offers a unique opportunity to uncover individual paths and sense-making processes.
Objective
The authors conducted a systematic review of the published literature to identify interventions to prevent and/or reduce burnout among medical students and residents.
Methods
The authors searched 10 databases (from the start of each through September 21, 2016) using keywords related to burnout, medical education, and prevention. Teams of two authors independently reviewed the search results to select peer-reviewed, English language articles describing educational interventions to prevent and/or reduce burnout among medical students and/or residents that were evaluated using validated burnout measures. They assessed study quality using the Medical Education Research Study Quality Instrument and the Cochrane Risk of Bias Tool.
Results
Fourteen studies met inclusion criteria and all used the Maslach Burnout Inventory as at least one measure of burnout. Four were single group pre-post studies, 6 non-randomized two-group studies, and 4 randomized controlled trials. None of the studies were designed specifically to target burnout prevention. In 12 studies, residents were the targeted learners. Six of the 14 studies reported statistically significant changes in burnout scores: 5 reported improvement and 1 reported worsening of burnout. Of the 5 studies that reported statistically significant benefit, 1 studied a complementary and alternative medicine elective, 1 studied the Respiratory One Meditation method, and 3 studied duty hour changes.
Conclusions
This review highlights the need for rigorously designed studies in burnout prevention and reduction among residents and especially medical students.
Purpose
Conducted with a staff of 562 persons working in the health sector in Quebec, mainly nurses, the purpose of this paper is to test the indirect effects of psychosocial safety climate (PSC) on workarounds through physical fatigue, cognitive weariness and emotional exhaustion as mediators.
Design/methodology/approach
The structural equation method, namely CFA, was used to test the structure of constructs, the reliability and validity of the measurement scales as well as model fit. To test the mediation effects, Hayes’s PROCESS (2013) macro and 95 percent confidence intervals were used and 5,000 bootstrapping re-samples were run. The statistical treatments were carried out with the AMOS software V.24 and SPSS v.22.
Findings
The results based on bootstrap analysis and Sobel’s test demonstrate that physical fatigue, cognitive weariness and emotional exhaustion mediate the relationship between PSC and safety workarounds.
Practical implications
The study has important practical implications in detecting blocks and obstacles in the work processes and decreasing the use of workaround behaviors, or in converting their negative consequences into positive contributions.
Originality/value
To the authors’ knowledge, this is the first study to examine the relationship between PSC, burnout and workaround behaviors. These results could contribute to a better understanding of this construct of workarounds and how to deal with it. Moreover, the test of the concepts of PSC in this study provides support for the theory of “conservation of resources” by proposing an extension of this theory.
The aim of this paper was to investigate the associations between mindfulness and acceptance (MAA) skills and burnout-related ill-being at work (ILLB) after eliminating the impact of worksite (WS) and general well-being in life (WELLB) factors. The results were derived from data on employees (n = 168) of varying professional backgrounds, who experienced relatively high levels of burnout. Analyses were conducted using structural equation modelling (SEM) and the Cholesky decomposition method, since these allow for the investigation of multiple measures and multiple factors in relation to one another. In relation to ill-being at work, the analyses revealed a general MAA factor as well as a specific cognitive fusion factor. After controlling for WS factors, MAA factor shared a 38% variance and the fusion factor a 22% variance with burnout-related ILLB. The results also indicated that cognitive fusion had a strong and unique association with ILLB, even after controlling for WS factors, general well-being, and general MAA skills. Overall, these findings support the view that skills related to psychological flexibility play an important role in enhancing well-being at work.