Burnout Construct Research Articles

Burnout in the Mental Health Workforce: A Review

There are enormous concerns regarding the recruitment, retention, training, and performance of the behavioral health workforce. Paramount among these concerns is turnover, which causes disruption in continuity of care, diminishes access to care while a position remains vacant, and poses financial hardship on the provider organization through costs related to recruitment, orientation, and training of a new hire. There is frequent mention of burnout within the literature and among behavioral health managers as a potential cause of turnover. However, there is no recent or comprehensive review of burnout that examines the evidence surrounding its validity, utility, and potential relationship to turnover. The purpose of this paper is to provide such a review by examining the construct of burnout, methodological and measurement issues, its prevalence in the mental health workforce, correlates of burnout, and interventions to decrease it. The implications for provider organizations and recommendations for future research are identified.

Burnout and health: expanding our knowledge

Burnout and health: expanding our knowledge

Pastoral Burnout and the Impact of Personal Spiritual Renewal, Rest-taking, and Support System Practices

Pastors risk burnout because of inordinate ministerial demands, which may drain their emotional, cognitive, spiritual, and physical energy reserves and impair their overall effectiveness. Burnout advances across three dimensions: emotional exhaustion, depersonalization, and reduced accomplishment. The debilitating effects of pastoral burnout were examined through a survey of 270 pastors. Relationships between burnout and three potentially preventative or mitigating factors, spiritual renewal, rest-taking, and support system practices, were explored. The results identified spiritual dryness as the primary predictor of emotional exhaustion, the stress dimension of burnout. In the published literature, no other work to date has empirically substantiated a link between pastors’ spirituality and burnout. These findings expand the burnout construct and promote leader self-care practices that foster resilience, vitality, and well-being.

Psychological stress and health in undergraduate dental students: fifth year outcomes compared with first year baseline results from five European dental schools

Psychological stress in undergraduate dental students: fifth year outcomes compared with first year baseline results from five European dental schools. To compare the levels of a series of health-related indicators from a cohort of fifth year dental students from five European schools with their first year scores, and to investigate the relationship between these follow-up measures. Burnout was measured using the Maslach Burnout Inventory (MBI), consisting of three scales: Emotional Exhaustion (EE, alpha = 0.90), Depersonalisation (alpha = 0.80) and Personal Accomplishment (alpha = 0.72). Physical health was measured by the Physical Symptoms Questionnaire (alpha = 0.82), psychological distress was measured using the General Health Questionnaire (GHQ, alpha = 0.89) and student stress was captured using seven subscales of the Dental Environment Stress questionnaire (DES, alpha = 0.92). A total of 132 fifth year students responded from five dental schools (Manchester, Belfast, Cork, Helsinki and Amsterdam), a 51% response. Fifth year students showed relatively high mean MBI scores when compared with first year results, especially on EE; 39% could be labelled 'high scorers'; 44% of the students met the criteria for 'cases' on the GHQ. Highest mean scores on the DES were obtained on the subscales: Study Obligations, Patient-Related Aspects and Study Pressure respectively. Between schools interesting differences were detected on all variables. As hypothesised, a clear direct effect of stress on both burnout and physical symptoms was shown. An indirect effect of stress on mental health via burnout was shown. Dental students showed a negative development through the years from first to fifth year with regard to EE and psychological distress. Both burnout constructs related to physical and mental health. It is recommended that dental faculty focus on the importance of prevention and intervention of stress amongst undergraduates.

Indian Model of Executive Burnout

Burnout is described as a state of depletion of a person's resources and energy resulting in apathetic and impassive behaviour towards others, having dysfunctional repercussions on the individual and adverse effects on organizations. Though an enormous amount of research is available on “stress” in both Western and Indian contexts, there is very little research on “burnout” in the Indian workplaces. For this study, important considerations included evolving an exclusive construct of “executive burnout” in the industrial context which does not exist and also developing the construct of burnout in the Indian context. The Western construct of burnout using Maslach Burnout Inventory (MBI) developed in 1982 has largely been based on people occupations (like nurses and teachers) and later extended to non-service occupations. When tested by the author on the Indian sample of executives, it revealed the following: There is a difference in the dimension of diminished personal accomplishment which was not valid on the Indian sample. Those suffering from burnout did not have low personal accomplishment; on the contrary, high achieving executives were mostly found to suffer from burnout. Some dimensions, viz., ambiguity; dissatisfaction and powerlessness; inadequacy; and physical exhaustion, which were empirically found vital for executives in the Indian context, were not covered by MBI. With technological advancements, workplaces have undergone drastic changes and many executives work in situations which require very little people contact, implying that the construct of executive burnout is qualitatively different and needs to be evolved for better understanding of this pivotal problem. The author's professional interactions with executives from a variety of industry and a study of mental health professionals in India revealed that the problem of burnout has been acute and on the increase. This study identifies the determinants of burnout among Indian executives and thus evolves an Indian model of executive burnout to help the executives/organizations in taking preventive measures to mitigate this problem. Reliable tools are used on a representative sample of middle level executives from manufacturing and service industry representing both public and private sectors. Basic statistics, Pearson's correlation, factor analysis, t-test, and hierarchical regression test the hypotheses. The analysis of data reveal the following: Emotional intelligence mediates and leads to personal effectiveness which moderates the onset of burnout. Stress personality and personal inadequacy are personality-related predictors. Role expectation conflict, role stagnation, self-role distance, role overload, role erosion, resource inadequacy, inter-role distance, and role ambiguity are role- related predictors of burnout among executives in India. The author (2005) has found that burnout can be prevented with early detection, timely intervention, and enhancement of emotional intelligence.

An Assessment of the Construct Distinctiveness of Stress Arousal and Burnout

This study examined the construct and discriminant validity of stress arousal and burnout as measured on the Stress Arousal Scale and the multidimensional role-specific version of the Maslach Burnout Inventory, respectively. The analyses utilized data from 148 individuals randomly selected from a database of 563 respondents to a larger study. The sample responded to a survey sent to members of the American Institute of Certified Public Accountants (AICPA). Sample size used in this study fell within Loehlin's 1992 prescription that for confirmatory factor analysis with two to four factors, a minimum of 100 to 200 cases should be collected. Forty-six respondents indicated that they were partners, principals, or sole practitioners in accounting firms, and 103 indicated that they were staff members (juniors, seniors, or managers). Latent variables were first constructed for the stress arousal and burnout factors. Confirmatory factor analysis was then conducted on the scale data to assess whether the factors would load on their respective underlying theoretical constructs. Finally, a nested model constraining stress arousal and burnout to load on one underlying construct was tested against the hypothesized two-factor model. The results indicated good model fit for the two-factor model and a significant loss of fit for the one-factor model, thus providing strong support for the conceptualization of stress arousal and burnout as distinct constructs.

Intrapersonal and Organizational Factors Associated With Burnout Among School Counselors

This study investigated the demographic, intrapersonal, and organizational factors associated with burnout among a population of school counselors in the northeastern United States (n = 78). Three hierarchical regression analyses were completed to determine the amount of variance that each cluster contributed to the 3 subscales on the Maslach Burnout Inventory‐Educators Survey (MBI‐ES; C. M. Maslach, S. E. Jackson, & M. P. Leiter, 1996): Emotional Exhaustion, Depersonalization, and Personal Accomplishment. The final models accounted for 45%, 30%, and 42% of the overall variation on each subscale, respectively.

Vicarious traumatization and secondary traumatic stress: A research synthesis*

Vicarious traumatization (VT) refers to harmful changes that occur in professionals’ views of themselves, others, and the world, as a result of exposure to the graphic and/or traumatic material of their clients. Secondary traumatic stress (STS) refers to a set of psychological symptoms that mimic post-traumatic stress disorder, but is acquired through exposure to persons suffering the effects of trauma. Numerous studies have sought to identify correlates of both VT and STS, yet there still exists a lack of conceptual clarity in the literature about VT, STS, and the related constructs of burnout and compassion fatigue. This has made it difficult to use the literature to inform practice and training. This study clarifies the definitions of VT and STS and uses levels of evidence analysis to synthesize the research findings to date. Originally planned as a meta-analysis, the study was re-designed as methodological issues in the literature became apparent that would call into question the validity of a meta-analysis. The current method of analysis documents the degree of evidence for the most commonly researched factors that have been researched as possible contributors to the development of both VT and STS, synthesizing the findings of published research and dissertations written in the English language from 1994–2003. Findings indicate that persuasive evidence exists for personal trauma history, reasonable evidence for perceived coping style, and some evidence for supervision experiences, as important predictors of VT. Persuasive evidence for amount of exposure to trauma material and reasonable evidence for personal trauma history are indicated as important in the development of STS. Limitations of the current study and directions for further research are discussed. *An earlier version of this paper was presented at the 112th Annual Conference of the American Psychological Association, 31 July 2004, Honolulu Hawaii, USA

Staff burnout and patient satisfaction: Evidence of relationships at the care unit level.

Research on burnout has thus far focused primarily on the individual; however, in work environments in which teamwork is emphasized, it seems plausible that a meaningful group-level burnout construct could emerge. This theory was tested by examining burnout in psychosocial rehabilitation teams and its effects on patient satisfaction. Three hundred thirty-three staff from 31 behavioral health teams completed the Maslach Burnout Inventory; 405 of the clients they served completed the Consumer Satisfaction Scale. Multilevel analyses (hierarchical linear modeling) confirmed the existence of a meaningful team-level burnout construct. Team-level analyses revealed significant relationships between team burnout and patient satisfaction.

What have we learned about burnout and health?

It has been a decade since an international group of scholars came together to discuss and debate the construct of job burnout. That conference, which took place in Krakow, Poland in 1990, was a major turning point in the development of this field. Not only did it bring together a wide range of theoretical perspectives and empirical data, it generated new directions for the work that needed to be done in the future (Schaufeli et al., 1993). Now that we are 10 years into that future, it would be worthwhile to assemble a new group of international scholars and discover what progress has been made. In essence, that is what the editors of this Special Issue have done. They have invited several of the leading burnout researchers from several continents to contribute their newest studies on this important social phenomenon. Thus this Special Issue affords us the opportunity to assess the strides that have been made since that first meeting in Krakow. So what have we now learned about burnout and its relation to health?

Burnout: conceptual issues and empirical findings from a new research setting

Most research on burnout has been conducted among the helping professions. This article reports findings from a large-scale survey undertaken in a new setting, the off-shore oil industry. The same three components as reported in earlier research, i.e. emotional exhaustion, depersonalization and diminishing personal accomplishment were also found here. In addition to these three a further industry-specific component was identified, namely worry about home when absent, which indicates that the dimensionality of the burnout construct may be affected by characteristics of the work setting. Demographics included in the study to characterize persons reporting symptoms of burnout were found to possess neglible descriptive and predictive power. Some implications of the findings are considered, and avenues for further research indicated.

Teacher Burnout in Hong Kong and Germany: A Cross-Cultural Validation of the Maslach Burnout Inventory

Teacher burnout is a world-wide phenomenon that draws the attention of educational psychologists and stimulates efforts in construct elaboration and measurement. Emotional exhaustion, depersonalization (cynicism), and lack of personal accomplishments are three dimensions that constitute the burnout syndrome. Levels of this burnout syndrome were compared among 542 German and Chinese teachers. It turned out that there were only minor differences between the Germans and the Chinese, but major differences between those two groups and the U.S. American normative data. Moreover, stress resource factors were measured, namely perceived self-efficacy and proactive attitude. Their negative intercorrelations with burnout supported the validity of the burnout measure, although the associations were much closer in the German subsample. An attempt to replicate the American three-factorial structure of the burnout construct failed in both subsamples, which is in line with previous evidence and calls for a revision of the original measure.

Research Burnout in Tenured Marketing Professors: An Empirical Investigation

In 1988, an American Marketing Association (AMA) task force expressed concern that a large number of senior marketing academicians were turning into "burnouts. " This article reports findings from a large-scale study that defined and measured the research burnout construct and explored its relationship to several variables. Findings indicate that research burnout is not as widespread as envisaged by the task force. Five correlates-intrinsic motivation for research, collaborative research efforts, failure to keep up with knowledge developments, lack of performance-contingent rewards, and weak doctoral training-account for 61% of the variation in research burnout.

Relationships of occupational hazards with burnout: an assessment of measures and models.

A survey of aircraft maintenance technicians with the Canadian Forces (N = 157) found support for a model of burnout and occupational risk assessment. The model depicted employees' assessment of occupational risk as a function of the prevalence and lethalness of workplace hazards, as well as of the amount of control employees experience over their interactions with these hazards. A confirmatory factor analysis, in which LISREL analysis was used, supported an integrated model of risk perception and burnout. In this model, the employee's sense of control in managing occupational hazards was pivotal in both the experience of exhaustion and being at risk at work. Safety training contributed to perceived control and technicians' sense of effectiveness at work. The extension of the burnout construct beyond the human service domain was considered by using the Maslach Burnout Inventory-General Survey.

Consistency of the burnout construct across occupations

This study assessed the extent to which a recently developed measure of burnout extended the concept of burnout as developed among human service providers to people in other occupations. The study replicated a factor structure derived from a study of aircraft maintenance workers, computer programmers, and administrators with staff in various occupations across two health care settings: a tertiary care hospital (N=3,312) and a residential mental health facility (N=417). Within the larger setting the analysis replicated the factor structure with four occupational groups: clerical/maintenance workers, technical personnel, nurses, and managers. The study found support for the validity of the scale through its consistency with the issues that participants raised in an open-ended questionnaire. Conceptual issues in burnout theory and suggestions for further research are presented.

Exploring the Relevance of Burnout to Mexican Blue Collar Women

The present study tested the hypothesis that both the antecedents and the experience of burnout are different in blue collar workers and in human service professionals. The sample consisted of 241 Mexican women employed in electronics (120) and garment (121) assembly plants. Burnout was measured using a Spanish modified Burnout Measure. Comparison samples of American teachers, police officers, nurses, and counselors and of nine samples of working and non-working women in and out of Mexico were also used. Results suggest that the Mexican blue collar women experience burnout differently and for different reasons than the American human service professionals. The blue collar women experienced burnout when work did not enable them to escape conditions of poverty while the white collar human service professionals experienced burnout when they felt unable to have significant impact on people′s lives. These findings raise questions about the relevance of the burnout construct to this group of blue collar Mexican women. Further research on the applicability of burnout in different social groups and occupations will help develop a comprehensive theory of burnout.

Behavioral and Psychological Consequences of Boundary Spanning Burnout for Customer Service Representatives

Marketing boundary spanners—especially customer service representatives—are notably susceptible to burnout. The authors define the burnout construct and develop hypotheses to examine if burnout act...

Behavioral and Psychological Consequences of Boundary Spanning Burnout for Customer Service Representatives

Marketing boundary spanners—especially customer service representatives—are notably susceptible to burnout. The authors define the burnout construct and develop hypotheses to examine if burnout acts as a partial mediator between role stressors and key behavioral and psychological job outcomes. Responses from 377 customer service representatives reveal that burnout levels are high relative to other burnout-prone occupations (e.g., police, nursing) and that burnout has consistent, significant, and dysfunctional effects on their behavioral and psychological outcomes. Moreover, burnout mediates the negative effects of role stressors on job outcomes, whereas the positive effects of role stressors are unmediated.

The Dimensionality of a Modified Form of the Maslach Burnout Inventory for University Students in a Teacher-Training Program

For a sample of 147 fifth-year students enrolled in a teacher training program at the elementary school level, both exploratory and confirmatory factor analyses involving orthogonal and oblique solutions were carried out on a correlation matrix of scores on 22 items from a self-report inventory of teacher burnout that was adapted with permission from the Maslach Burnout Inventory (MBI). The modifications incorporated within the new instrument, which is referred to as the College Student Survey (CSS), constituted the substitution of words within several item statements that would be more suitable in a teaching context than were the statements in the MBI which were oriented toward workers in other forms of public service. As in the instance of other factor analytic studies with the MBI, the three hypothesized constructs of burnout described as emotional exhaustion, depersonalization, and personal accomplishment were clearly defined in all factor solutions irrespective of whether the items were scored for frequency or intensity.

The measure of classroom stress and burnout among gifted and talented students

The development of the Student Stress Inventory (SSI) and the cross-validation of the Maslach Burnout Inventory (MBI) are presented. First, gifted student data (n = 311) were subjected to factor analyses for both the SSI and the MBI to assess factorial validity; five stress and three burnout factors were evident. Second, the construct validity of both the stress and burnout constructs was examined in relationship to classroom tedium and the quality of school life. Also, 14 child stress experts assisted in analyzing content validity; the majority of these rated SSI items as being relevant to very relevant to student stress. With respect to SSI reliability, alphas ranged from .63 to .85; similarly, MBI alphas ranged from .63 to .86. Additionally, most of SSI and MBI scales and subscales were moderately to strongly interrelated. Finally, an inspection of the concurrent validity of the stress and burnout constructs revealed significant relationships between stress, burnout, tedium and, to a degree, quality of school life variables.