Dimensions of the Burnout Measure: Relationships with shame- and guilt-proneness in neonatal intensive care unit nurses

Abstract

BackgroundBurnout in neonatal intensive care unit (NICU) nurses has been correlated with personality proneness to shame. However, the structural validities of the one-factor Burnout Measure (BM) and the two-factor Personal Feelings Questionnaire-2 (PFQ-2) used to assess burnout and shame-proneness, respectively, in these nurses were not evaluated. ObjectivesThe aim of the study was (i) to perform factor analyses of the BM and the PFQ-2 and (ii) to determine the relationships of burnout dimensions retrieved by factor analysis with similarly validated dimensions of shame- and guilt-proneness in NICU nurses. MethodsThis is a multicentre cross-sectional cohort study that involved 142 (24%) of 585 NICU nurses who were currently providing direct newborn care in six level 3–4 NICUs in New South Wales, Australia. ResultsThe BM was a multidimensional measure of burnout composed of three latent factors: demoralisation, exhaustion, and loss of motive. Based on burnout dimension mean scores of 4 or more, worryingly high levels of demoralisation, exhaustion, and loss of motive were reported by 21%, 84%, and 24% of nurses, respectively. Shame and guilt together explained 41%, 9%, and 15% of the variance in demoralisation, exhaustion, and loss of motive, respectively. Shame controlled for guilt made respective large and moderate contributions to the variance in demoralisation (β = .62, p < .001) and loss of motive (β = .33, p < .001). Guilt moderated the effect of shame on loss of motive (ΔR2 = .031, p = .027). ConclusionsFactor analysis of the BM showed burnout in NICU nurses was a multidimensional syndrome comprising exhaustion, demoralisation, and loss of motive. Worryingly high levels of exhaustion, demoralisation, and loss of motive were not uncommon. The demoralisation dimension had a strong correlation with shame-proneness. Understanding the nature of demoralisation and the phenomenology of shame and guilt should be psychoeducational components of the holistic management of burnout in NICU nurses.