The Relationship Between Defense Mechanisms and Nurses’ Occupational Burnout: A Cross-sectional Study

Abstract

Background: Occupational burnout is a psychological syndrome that occurs in response to chronic stress in the workplace. Nowadays, it is known as one of the most important consequences of occupational stress. Defense mechanisms may also affect occupational burnout. Objectives: Since burnout is an important factor influencing the productivity of nurses, this study was conducted to investigate the relationship between the defense mechanisms and occupational burnout among nurses in the educational hospitals of an urban area in Iran. Methods: This descriptive cross-sectional study was conducted on 318 nurses who had at least one-year of work experience in four educational hospitals in Sari city, Iran, in 2018. Sampling was performed using the proportional stratified sampling method. The data were collected by the Maslach Burnout Inventory (MBI) scale, psychological Defense Styles questionnaire (DSQ-40), and a demographic questionnaire. Data were analyzed using descriptive and inferential statistics via the SPSS software V.20. Results: A total of 318 nurses were studied, 13 (4.1%) of the nurses had a burnout. The mean score of the dimension of emotional exhaustion (EE) was 17.49, in the dimension of depersonalization (DP) it was 5.42, and in the dimension of personal achievement (PA) it was 31.58. They indicated a low level of occupational burnout, and the mean scores of FE, DP, and PA subscales indicated a low level of occupational burnout. The use of more mature defense mechanisms had a significant negative correlation with the increase of the EE score (rho = -0.210, P < 0.001), but no significant relationship was reported with other aspects of burnout. Increased use of immature defense mechanisms had a direct correlation with the increase in the score of DP (rho = 0.255 and P < 0.001), but had a significant inverse relationship with the PA score (rho = -0.238 and P < 0.001) and no significant relationship with EE (P = 0.627). No significant relationship was found between the use of neurotic defense mechanisms and burnout dimensions (PEE = 0.119, PDP = 0.174, and PPA = 0.127). Conclusions: Since there is a significant relationship between defense mechanisms and occupational burnout, using the components of defense mechanisms in job interviews can lead to choosing appropriate nurses to perform different tasks in different settings, in accordance with individual and psychological characteristics. Also, teaching problem-solving skills, stress management, and useful information can improve defense mechanisms, nurses’ job performance, and patient satisfaction.