Low Levels Of Personal Accomplishment Research Articles

Clinical supervision and burnout: the influence of clinical supervision for community mental health nurses

The aim of this study was to establish the degree to which clinical supervision might influence levels of reported burnout in community mental health nurses in Wales, UK. The research instruments used were the Maslach Burnout Inventory and the Manchester Clinical Supervision Scale. At the time of the survey 817 community mental health nurses were reported to work within Wales. Two hundred and sixty (32%) community mental heath nurses working in 11 NHS Trusts responded to the survey. One hundred and eighty-nine (73%) community mental heath nurses had experience of clinical supervision in their present posts and 105 (40%) in their previous posts. The findings from the Maslach Burnout Inventory indicated high levels of emotional exhaustion for 36%, high levels of depersonalization for 12% and low levels of personal accomplishment for 10% of the community mental heath nurses surveyed. Univariate analysis showed that those community mental heath nurses who were younger, male and who had not experienced six or more sessions of clinical supervision were more likely to report cold negative attitudes towards their clients as indicated by higher scores on the depersonalization subscale of the Maslach Burnout Inventory. One hundred and sixty-six community mental heath nurses had experienced six or more sessions of clinical supervision and had completed the Maslach Burnout Inventory. Higher scores on the Manchester Clinical Supervision Scale were also associated with lower levels of measured burnout, with significant negative correlations between the total Manchester Clinical Supervision Scale score and the emotional exhaustion subscale (r = -0.148, P = 0.050) and the depersonalization subscale (r = -0.220, P = 0.003) of the Maslach Burnout Inventory. These findings suggest that if clinical supervision is effective then community mental heath nurses are likely to report lower levels of emotional exhaustion and depersonalization. The findings from this study suggest that if clinical supervision is effective then community mental heath nurses report lower levels of burnout. Further research is required to determine the long-term benefits of implementing clinical supervision and to determine which other factors have an influence on levels of burnout for this group of nurses. Health service organizations have a responsibility for ensuring that all individual practitioners have access to effective clinical supervision and the Nursing and Midwifery Council could extend the registered nurses personal accountability to include - to seek clinical supervision as and when necessary.

The informational roles and psychological health of members of 10 oncology multidisciplinary teams in the UK

We report here the different roles undertaken by the members of 10 multidisciplinary cancer teams in conveying information to patients during their care. Team members completed an Informational Roles Questionnaire measuring an individual's perception of their major role and that of their colleagues in giving information to patients. They also completed two standard psychological health measures, the General Health Questionnaire and Maslach Burnout Inventory. The information giving roles of the surgeon, oncologist, radiologist and clinical nurse specialist were well recognised by their colleagues; however, other team members' roles were more ambiguous and less well understood. The clinical nurse specialist provided the broadest information coverage for patients. Few professional groups regularly informed patients about clinical trials and family history and the clinical nurse specialist was often the only person to deal with patients' sexual well being, consequently these areas are likely to receive poor coverage. Probable psychiatric morbidity (GHQ⩾4) in teams ranged from 5 to 27%. High levels of emotional exhaustion were particularly apparent in team leaders and nurses and feelings of low levels of personal accomplishment were prevalent in the histopathologists and radiologists. Putative benefits to patients and healthcare professionals from multidisciplinary team working may not be realised without investment in team training.

Are there causal relationships between the dimensions of the Maslach Burnout Inventory? A review and two longitudinal tests

Arising from interest concerning the possibility of causal relationships among the three components of the Maslach Burnout Inventory, several process models have been proposed for the development of burnout. The present paper first reviews the evidence in favour of the three most influential of these (Leiter and Maslach's model (1988); Golembiewski, Boudreau, Munzenrider, & Luo's (1996) phase model; and Lee and Ashforth's model (1993)). These three models, and our own model (which integrates of two of them, and includes feedback effects of depersonalization on emotional exhaustion) are then compared with each other using structural equation modelling, drawing on longitudinal data from two Dutch samples (total N=1185). The review revealed that none of the seven previous studies on this issue provided any convincing support for any particular causal order proposed so far. In contrast, our own study showed that high levels of exhaustion were associated with high levels of depersonalization over time across both samples. Further, higher levels of depersonalization led to higher levels of emotional exhaustion and lower levels of personal accomplishment. To our knowledge, the present research is the first to provide reliable longitudinal evidence for the conceptualization of burnout as a developmental process, although the effects are not large enough to be of practical use in the recognition of burnout.

A National Study of Burnout Among American Transplant Surgeons

This study examines burnout in a national sample of transplant surgeons. Data analyses were conducted on a sample of 209 actively practicing transplant surgeons. Measures included the Maslach Burnout Inventory, a demographic survey, and the Surgeon Coping Inventory. Burnout was reflected in 38% of surgeons scoring high on the Emotional Exhaustion dimension, whereas 27% showed high levels of Depersonalization, and 16% had low levels of Personal Accomplishment. Several significant predictors of emotional exhaustion were identified and included questioning one's career choice, giving up activities, and perceiving oneself as having limited control over the delivery of medical services ( R 2 = 0.43). Those who perceived themselves as having a higher ability to control delivery of medical services and who felt more appreciated by patients had lower levels of depersonalization and were less likely to question their career choice ( R 2 = 0.16). Surgeons with high personal accomplishment experienced greater professional growth opportunities, perceived their institution as supportive, felt more appreciated by patients, and were less likely to question their career ( R 2 = 0.24). The prioritization of goals to reflect both professional and personal values accounted for a significant amount of the variance in predicting both emotional exhaustion and personal accomplishment in separate regression equations. Recommendations to decrease burnout would include greater institutional support, increased opportunities for professional growth, and greater surgeon control over important services to facilitate efficient work. Coping strategies to moderate stress and burnout are also beneficial and should include prioritizing goals to reflect both professional and personal values.

Emotional Exhaustion, Depersonalisation, and Personal Accomplishment— the Case of Burnout Among School Social Workers in Hong Kong

This report is based on a study conducted in 2001, of the burnout phenomenon of school social workers in Hong Kong. The major purpose is to describe the pattern of burnout of school social workers in a context of changes introduced by the Hong Kong Government to improve the cost-effectiveness of social welfare services. As conceived, burnout is a multidimensional phenomenon defined by a high level of emotional exhaustion and depersonalisation and a low level of personal accomplishment. The responses of 190 school social workers to a self-administered questionnaire distributed through 32 agencies in Hong Kong showed that slightly over half of the respondents were adjusting well in their job, and only a small proportion could be clearly identified as “burnouts”. However, a substantial proportion was found to exhibit a high level of emotional exhaustion or depersonalisation despite a high level of personal accomplishment. The findings suggest that appropriate measures should be undertaken by agencies and schools to prevent school social workers from experiencing burnout. As a developmental phenomenon, any early signs of burnout should be seriously looked into; for it would otherwise counteract the intended effects of any changes designed to enhance service effectiveness.

Burnout in psychiatric nursing

Burnout in nursing is of both individual and organizational concern with ramifications for well-being, job performance, absenteeism and turnover. Burnout is rarely assessed as part of a comprehensive model of occupational stress, a short-coming which this paper attempts to redress. A randomly selected sample of 510 psychiatric nurses from one Scottish Trust completed a questionnaire based on a psychological model of occupational stress which included the Maslach Burnout Inventory (MBI) as the dependent variable. The respondents reported average, low and average levels of emotional exhaustion, depersonalization and personal accomplishment, respectively. The study sample had significantly lower scores on emotional exhaustion and depersonalization than normative data but also significantly lower levels of personal accomplishment than a normative group of physicians and nurses. Only 2.0% of the study sample could be categorized as having high burnout overall (i.e. high emotional exhaustion, high depersonalization, low personal accomplishment) and they differed significantly from the rest only in terms of males being over-represented. Hierarchical regression analysis revealed that selected explanatory variables accounted for 41.9% of emotional exhaustion, 16.4% of depersonalization and 25.6% of personal accomplishment in the study sample. The paper discusses the implications of the findings in terms of a comprehensive approach to intervention aimed at minimizing the risk of burnout in psychiatric nurses. Such an approach will involve interventions at the organizational and individual level.

Occupational stressors and coping as determinants of burnout in female hospice nurses.

Stressors, coping and demographic variables were examined as predictors of burnout in a sample of hospice nurses. The study aimed to investigate the level of burnout among hospice nurses; to ascertain which aspects of nursing work were positively or negatively related to burnout; to examine the relative contributions made by these different variables and to suggest individual and organizational interventions to reduce levels of burnout. Eighty-nine female nurses from nine hospices completed a battery of questionnaires comprising the Maslach Burnout Inventory, Nursing Stress Scale, Ways of Coping Scale and a demographic information form. In general, the level of burnout (characterized by high emotional exhaustion, high depersonalization of patients and low personal accomplishment) was found to be low. In multiple regression analyses, 'death and dying', "conflict with staff', 'accepting responsibility' and higher nursing grade contributed to emotional exhaustion. 'Conflict with staff', 'inadequate preparation', 'escape' and reduced 'planful problem-solving' contributed to depersonalization. 'Inadequate preparation', 'escape', reduced 'positive reappraisal' and fewer professional qualifications contributed to lower levels of personal accomplishment. Overall, stressors made the greatest contribution to burnout and demographic factors contributed the least. The importance of not labelling individuals as good and bad 'copers' was discussed, as the effectiveness of a strategy may depend on the situation. It was concluded that the investigation of problem-focused and emotion-focused coping in relation to burnout, was oversimplifying the coping-burnout relationship. Suggestions for stress management included staff training in counselling skills, monitoring staff conflict, implementing stress inoculation training to teach appropriate use of coping skills and finally, monitoring particularly vulnerable groups of hospice staff such as unqualified nursing assistants and qualified nurses in management positions. It was concluded that despite the difficult nature of hospice work, the hospice is a positive environment in which to work.

Examining a stress-coping model of burnout and depression in extension agents.

Occupational stressors, coping strategies, and burnout and depression were examined in extension agents. Results indicated that a significant proportion of extension agents (range = 9.8%-51%) reported burnout symptoms above established cut-off scores for the burnout subscales, but fewer than 3% of the sample reported significant symptoms on all 3 dimensions of burnout. Depressive symptoms based on established cut-off scores were noted in approximately 26% of the sample. Stepwise multiple regression indicated that extension agents who used an emotion-oriented coping strategy were more likely to (a) display high levels of depression, emotional exhaustion, and depersonalization and (b) exhibit low levels of personal accomplishment. Furthermore, task-oriented coping strategies were found to be negatively associated with the 3 dimensions of burnout. Implications for interventional programming to reduce the symptoms of burnout are discussed.

Burnout among School Psychologists in the USA

A heterogeneous sample of NASP members responded to a survey that included the Maslach Burnout Inventory and a demographic and job functions questionnaire. The results cross-validated the findings of a previous, recent national survey that indicated that symptoms of burnout occur frequently among practicing school psychologists. Using Maslach and Jackson's (1986) multidimensional model of burnout, 25 percent of the sample reported high levels of emotional exhaustion, 3 percent reported high depersonalization and 12 percent reported low levels of personal accomplishment. A total of 35 percent indicated some desire to leave the profession altogether within the next five years. Levels of burnout were associated with school psychologists' ratings of importance and self-perceived competence with regard to various job functions. Positive correlations between intervention-related competencies and personal accomplishment were particularly noteworthy. Implications for further research and training are highlighted.

Gender Differences in Perceived Burnout of College Coaches

A study was undertaken to assess the level of perceived burnout in college athletic coaches, and to determine whether male coaches differed from female coaches in level of burnout. Burnout was measured with the Maslach Burnout Inventory, a self-report rating scale that provides three subscores: Emotional Exhaustion, Depersonalization, and Personal Accomplishment. Subjects were NCAA and AIAW Division I college head coaches (138 male and 93 female coaches). The sexes differed on both the emotional exhaustion and the personal accomplishment subscales, in terms of both frequency of response and intensity of response. Female coaches reported significantly higher levels of emotional exhaustion and significantly lower levels of personal accomplishment than male coaches. The largest gender difference on the frequency dimension was for the item, “ I feel frustrated by my job.” For the intensity dimension, the largest difference was for the item “I feel burned out from my work.” Possible explanations for the gender differences are presented.