Personal Accomplishment Subscale Research Articles

Prevalence of burnout syndrome of Greek child care workers and kindergarten teachers

The present study, employing the Maslach Burnout Inventory – Educators Survey, aims to compare and explore possible differences to the levels of burnout reported by the two main professional groups working in the early childhood education and care sector in Greece, that is kindergarten teachers and childcare workers. The correlation between the levels of burnout reported and participants’ demographic data were also examined. Research data revealed that kindergarten teachers experience slightly more feelings of emotional exhaustion, whereas childcare workers experience more feelings of depersonalisation. Furthermore, correlation analysis indicated that subscales predict one another whereas only personal accomplishment subscale had been found to be correlated with participants’ demographic data. Suggestions for future research are formulated.

Occupational Burnout Levels of Turkish Imams

The main purpose of this study was to examine the level of occupational burnout among Turkish imams. The study was a descriptive one in which the data was gathered through the “Maslach Burnout Inventory” and the “Personal Information Form”, which were given to 124 imams working in Bursa, Turkey. For the 124 imams with the study population comprised, 11 variables were examined. These variables were, marital status, age, educational level, length of service, working district, occupational difficulty, using computer technology, occupational research, part-time job, Arabic language, and size of community. For the statistical analysis of the collected data Kruskal–Wallis, t test, ANOVA χ2, and Fisher's exact test were used. The results indicated that although there was no statistical difference between the education level, marital status, Arabic, and computer knowledge variables among imams in any of the subscales, there were significant differences on emotional exhaustion, depersonalization, and personal accomplishment subscales ( p < 0.005) on age, length of service, workplace, occupational difficulty, part-time job, occupational research, and size of the community variables.

Qigong therapy for physiotherapists suffering from burnout: a preliminary study

The study was carried out in order to evaluate the prevalence of burnout in physiotherapists, and to assess whether "White Ball" Qigong exercises may be effective in burnout. This was aimed to provide preliminary data for the preparation and development of a larger study. Physiotherapists completed a demographic questionnaire and the Maslach Burnout Inventory (MBI) questionnaire. For the intervention and the control groups, the authors selected those physiotherapists with the highest levels of burnout on the most important subscale. The intervention group (eight physiotherapists) performed a specific qigong intervention as developed by the Heidelberg School of Chinese Medicine; the control group consisted of eight physiotherapists on a waiting list. At the end of a three-week period of treatment or waiting list, both groups repeated the MBI for the comparison of results. Of 106 physiotherapists (36 males and 70 females) assessed by the MBI, Emotional Exhaustion subscale was seen in 52 (49.1%), Depersonalization subscale in 36 (33.9%), and Burnout in the Personal Accomplishment subscale in 33 (31.2%), of whom 4 (3.8%) suffered to a severe degree and 29 (27.4%) moderately. Within the study group qigong lowered the mean values of Emotional Exhaustion subscale from 38.0 to 31.4, whereas in the control group the values rose from 33.9 to 37.9. The differences between the two groups were statistically significant (P=0.023). Qigong lowered the mean value of Depersonalization subscale from 10.8 to 6.8. In controls the value rose from 7.3 to 10.6. The difference between the two groups was statistically significant (P=0.013). The mean values of Personal Accomplishment subscale decreased in both groups: from 35.4 to 33.9 in the intervention group, and from 37.5 to 37.1 in the control group. The difference between the two groups was not statistically significant. The effects of "White Ball" Qigong on burnout symptoms are measurable by the MBI. The results are compatible with the thesis that this type of qigong is an effective tool for the self-management of burnout. It is easy to integrate into a daily routine as it takes only 2×5 min per day. On the basis of this evaluation, a study design can now be developed on a larger scale with appropriate blinding, follow-up testing and adequate controls.

PILOT STUDY OF TEACHER BURNOUT IN GEORGIAN CONTEXT

Modern schools have multiple demands to teachers causing prolonged stress often resulting in professional burnout. Research on teacher burnout is conducted at various countries of the world. Taking into account the significance of such research, two pilot research studies were conducted in Georgia. The objectives of the studies were to test the hypothesis that the majority of Georgian teachers are experiencing high burnout and simultaneously to test the adopted translated instruments for measuring burnout and proactive coping strategies. The first study surveyed 85 subjects and the second study - 193 subjects. For conducting pilot surveys an abridged version of Maslach–Burnout Self Test in combination with Greenglass’s 4 point-scale Proactive Coping Inventory and Maslach Educators Survey (MBI-ES) translated into Georgian language were used. The results of the first pilot study, in contrary to the hypothesis expecting to identify high burnout among Georgian teachers, showed that teachers have little signs of burnout and have high and moderate coping skills. In the second pilot study the hypothesis was partially confirmed in the Emotional Exhaustion aspect of burnout. For Emotional Exhaustion subscale the majority of the surveyed teachers showed moderate and high burnout. Teachers showed high scores on Personal Accomplishment subscale and low burnout on Depersonalization subscale. Key words: burnout, coping, distress, stress, teacher.

Personality, Burnout, and Longevity among Professional Music Therapists

The purpose of this study was to examine possible relationships between personality, burnout level, longevity, and demographic variables among professional music therapists. The Sixteen Personality Factor Questionnaire (16PF) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) were used to test personality and burnout. Subjects were 137 professional music therapists from all seven American Music Therapy Association (AMTA) regions with an overall average longevity of 17.85 years. The 16PF showed the personality traits that most describe music therapists are emotional sensitivity, reasoning, apprehension, warmth, openness to change, self-reliance, extraversion, anxiety, abstractedness, rule-consciousness, and self-control. Logistic regressions showed that the personality factor of anxiety (p < .007) significantly predicts the MBI-HSS subscale of emotional exhaustion and the personality factor of dominance (p < .01) significantly predicts the MBI-HSS subscale of personal accomplishment. While no personality factor significantly predicts the MBI-HSS subscales of depersonalization, social boldness (p < 0.07) and vigilance (p < .09) strongly contributed to this relationship. Logistic regressions also showed that highest degree earned is significantly (p < .000) predictive of longevity. Since the overall burnout level was in the average range, in essence this study described the profile of music therapists who are staying and thriving in the profession.

Association of an Educational Program in Mindful Communication With Burnout, Empathy, and Attitudes Among Primary Care Physicians

Primary care physicians report high levels of distress, which is linked to burnout, attrition, and poorer quality of care. Programs to reduce burnout before it results in impairment are rare; data on these programs are scarce. To determine whether an intensive educational program in mindfulness, communication, and self-awareness is associated with improvement in primary care physicians' well-being, psychological distress, burnout, and capacity for relating to patients. Before-and-after study of 70 primary care physicians in Rochester, New York, in a continuing medical education (CME) course in 2007-2008. The course included mindfulness meditation, self-awareness exercises, narratives about meaningful clinical experiences, appreciative interviews, didactic material, and discussion. An 8-week intensive phase (2.5 h/wk, 7-hour retreat) was followed by a 10-month maintenance phase (2.5 h/mo). Mindfulness (2 subscales), burnout (3 subscales), empathy (3 subscales), psychosocial orientation, personality (5 factors), and mood (6 subscales) measured at baseline and at 2, 12, and 15 months. Over the course of the program and follow-up, participants demonstrated improvements in mindfulness (raw score, 45.2 to 54.1; raw score change [Delta], 8.9; 95% confidence interval [CI], 7.0 to 10.8); burnout (emotional exhaustion, 26.8 to 20.0; Delta = -6.8; 95% CI, -4.8 to -8.8; depersonalization, 8.4 to 5.9; Delta = -2.5; 95% CI, -1.4 to -3.6; and personal accomplishment, 40.2 to 42.6; Delta = 2.4; 95% CI, 1.2 to 3.6); empathy (116.6 to 121.2; Delta = 4.6; 95% CI, 2.2 to 7.0); physician belief scale (76.7 to 72.6; Delta = -4.1; 95% CI, -1.8 to -6.4); total mood disturbance (33.2 to 16.1; Delta = -17.1; 95% CI, -11 to -23.2), and personality (conscientiousness, 6.5 to 6.8; Delta = 0.3; 95% CI, 0.1 to 5 and emotional stability, 6.1 to 6.6; Delta = 0.5; 95% CI, 0.3 to 0.7). Improvements in mindfulness were correlated with improvements in total mood disturbance (r = -0.39, P < .001), perspective taking subscale of physician empathy (r = 0.31, P < .001), burnout (emotional exhaustion and personal accomplishment subscales, r = -0.32 and 0.33, respectively; P < .001), and personality factors (conscientiousness and emotional stability, r = 0.29 and 0.25, respectively; P < .001). Participation in a mindful communication program was associated with short-term and sustained improvements in well-being and attitudes associated with patient-centered care. Because before-and-after designs limit inferences about intervention effects, these findings warrant randomized trials involving a variety of practicing physicians.

Burnout in Medical School Deans

In Reply: We greatly appreciate the letter from Drs. West, Dyrbye, and Shanafelt about our report on burnout in medical school deans. They note that we state that only 2% of medical school deans exhibited high levels of burnout utilizing the Maslach Burnout Inventory (MBI). They emphasize that each subscale of the MBI, depersonalization, emotional exhaustion, and low personal accomplishment, should be considered separately. The MBI states, “A high degree of burnout is reflected in high scores on the emotional exhaustion and depersonalization subscales and in low scores on the personal accomplishment subscale”1. In the conclusions of our article, we emphasize that “only 2% of deans who participated in the study exhibited high levels of burnout in all three subcomponents.” We agree that the subscales should also be considered separately and that our finding that 40% of deans had high emotional exhaustion scores and that 24% had high depersonalization scores is cause for concern. For that reason, the final section of our article describes approaches the deans have taken to reduce stress and the risk for burnout. Finally, we emphasized that the pattern we observed in deans is similar to that described by Hewlett and Luce2 in their assessment of individuals with “extreme jobs.” In our study, 82% of deans had moderate to high personal accomplishment; Hewlett and Luce found that most extreme-job holders say they love their jobs. Steven G. Gabbe, MD Senior vice president for health sciences, chief executive officer, The Ohio State University Medical Center, 370 West Tenth Avenue, Columbus, Ohio; ([email protected]). Lynn Webb, PhD Chief of staff, Vanderbilt University School of Medicine, Nashville, Tennessee.

Predictors of Burnout in Children's Residential Treatment Center Staff

SUMMARY This study explored burnout among frontline staff within a children's residential treatment center (RTC) population. Data were collected from 375 full-time, frontline, children's RTC staff employed at 21 RTCs in Illinois. Using hierarchical linear modeling (HLM), results indicated that frontline staff age, training, empathic concern, communicative responsiveness, neuroticism, extraversion, job satisfaction, and managerial support were associated with subscales of the Maslach Burnout Inventory (MBI). Further, burnout scores varied significantly at the provider level of analysis for the Emotional Exhaustion and Personal Accomplishment subscales of the MBI, lending support to the hypothesis that organizational variables may be associated with workers' burnout experiences. These findings have implications for personnel hiring, burnout prevention, and future research on the organizational correlates of burnout.

Measuring Resident Well-Being: Impostorism and Burnout Syndrome in Residency

Assessing resident well-being is becoming increasingly important from a programmatic standpoint. Two measures that have been used to assess this are the Clance Impostor Scale (CIS) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). However, little is known about the relationship between the two phenomena. To explore the prevalence and association between impostorism and burnout syndrome in a sample of internal medicine residents. Anonymous, cross-sectional postal survey. Forty-eight internal medicine residents (postgraduate year [PGY] 1-3) at the Schulich School of Medicine & Dentistry (62.3% response rate). Short demographic questionnaire, CIS and MBI-HSS. Impostorism and burnout syndrome were identified in 43.8% and 12.5% of residents, respectively. With the exception of a negative correlation between CIS scores and the MBI's personal accomplishment subscale (r = -.30; 95% CI -.54 to -.02), no other significant relations were identified. Foreign-trained residents were more likely to score as impostors (odds ratio [OR] 10.7; 95% CI 1.2 to 98.2) while senior residents were more likely to experience burnout syndrome (OR 16.5 95% CI 1.6 to 168.5). Both impostorism and burnout syndrome appear to be threats to resident well-being in our program. The lack of relationship between the two would suggest that programs and researchers wishing to address the issue of resident distress should consider using both measures. The finding that foreign-trained residents appear to be more susceptible to impostorism warrants further study.

Alzheimer Hastalarının Yakınlarında Bakımevi Tercihini Belirleyen Faktörler

Aim; The aim of this study is to determine factors which predicate nursing home preference of the Alzheimer diseases’ caregivers. Material-Method; Sample of the study has been elected from subjects who had Alzheimer disease diagnosis and their primary caregiver relatives, who refered to Ankara University School of Medicine Psychiatry Department, Geropsychiatry Policlinic. After constructed questionnaire and demographic data were collected, Alzheimer patients were evaluated by using Mini Mental State Examination (MMSE), Brief Psychiatric Rating Scale (BPRS), Personal Self-Maintaining Scale (PSMS) and Geriatric Depression Scale (GDS), while caregivers were administrated Maslach Burn-Out Inventory (MBI), Hamilton Anxiety (HAS) and Hamilton Depression Scale (HDS). Results; 44 Alzheimer disease patients and their relatives were included in the study. 37 caregiver (84%) preferred nursing their patients at home and 7 (16%) caregiver preferred nursing homes. Caregivers of Alzheimer patients’ preference of nursing home is significantly correlated with cognitive states (MMSE), behavioral and psychological symptoms (BPRS), personal selfmaintaining (PSMS), sleep deprivation of patients and maslach emotional exhaustion subscale of caregivers (p<0.05). Not any significant relationship was observed between nursing home preference and patients’ depression levels and caregivers’ maslach depersonalization and personal accomplishment subscale scores and depression and anxiety levels (p>0.05). Discussion; Factors which predicate nursing home preference among caregivers, cognitive functions, personal self maintaining, psychological and behavioral symptoms, as a symptom sleep disorder, and emotional exhaustion of caregiver were the most saliency factors. Psychological and behavioral symptoms’ and sleep deprivations’ being amendable and manegable factors were important. In previous studies, it was signified that with appropriate interventions, caregivers would rather prefer nursing home later.

Burnout and its correlates among nursing staff: questionnaire survey

This paper is a report of a study to determine the burnout level and its correlates in nurses. Healthcare providers and especially nurses are generally considered a high risk group regarding work stress and burnout and this syndrome has been a major concern in the field of occupational health. The study was carried out at a university hospital in Turkey during May-June 2005. A total of 418 nurses from the 474 working at the hospital at the time (88.2%) answered a self-administered questionnaire including the Maslach Burnout Inventory. All the nurses were female, with a mean age of 30.6 (5.4) and a median age of 29 years. The mean score was 17.99(6.35) for the Emotional Exhaustion subscale, 5.72 (3.87) for the Depersonalization subscale and 19.83 (4.66) for the Personal Accomplishment subscale. Emotional Exhaustion decreased with increasing age (P < 0.05). Total time in the job, weekly working hours, shift-working and the unit where employed influenced burnout scores (P < 0.05). Not being happy with relations with superiors, not finding the job suitable, feeling anxious about the future, perceived poor health, problems with personal life and financial difficulties were also factors influencing burnout scale scores (P < 0.05). It is necessary to consider nurses having the characteristics shown as the correlates of burnout in this study as a target group, to screen periodically the burnout status and improve their working conditions, especially relationships with colleagues.

Applicability of the Teachers' Sense of Efficacy Scale to educators teaching innovative programs

PurposeThe purpose of the present study is to examine the applicability of the Teachers' Sense of Efficacy Scale (TSES, Tschannen‐Moran and Woolfolk‐Hoy) to educators teaching an innovative program, namely, the Olympic Education Program. TSES applicability was inferred from examination of the TSES factor structure, its internal consistency and its logical, theoretical consistent pattern of relations between TSES and other measures.Design/methodology/approachA total of 175 educators completed a Greek version of the TSES along with the reduced personal accomplishment subscale of the Maslach Burnout Inventory.FindingsExploratory factor analysis showed that TSES can be applied to educators of an innovative educational program to study an overall factor of teachers' sense of competence. Mean values suggested that educators had strong efficacy beliefs. In addition, TSES responses were negatively associated with reduced personal accomplishment scores (r=−0.37).Research limitations/implicationsSelf‐reported strong sense of efficacy may not be well‐grounded or authentic, since a variety of factors (e.g. social desirability) may have influenced educators' responses.Originality/valueThe present study extends the existing evidence of the applicability of the TSES in a cultural context different from that for which it was originally developed, namely, in the Greek educational setting, for assessing educators teaching an innovative educational program.

Emotional Implications of Working in a Burn Unit

Burnout is a syndrome that has been characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment associated with chronic occupational stressors. The purpose of this study was to determine the prevalence of burnout in healthcare professionals involved in primary burn care and to gain an understanding of the stressors and pleasures they experience. A cross-sectional survey was administered between February and March 2004 to healthcare professionals working in the burn unit (BU, study group) and critical care unit (CrCU, control group) of a teaching hospital. Three questionnaires were administered: a demographic data sheet, the Maslach Burnout Inventory (MBI), and a questionnaire evaluating sources of stress, pleasures of work, and coping mechanisms used by staff. All 75 surveys distributed were completed (BU=36, CrCU=39). Respondents from the BU were nurses (66.7%), occupational or physical therapists (11.1%), physicians (8.3%), respiratory therapists (5.6%), social workers (2.8%), and others (5.6%). There were no significant differences between BU and CrCU professionals in years of experience on the unit (6.7 vs 8.0 years), years in the field (16.5 vs 14.7 years), weekly hours of patient care (35.1 vs 39.6 hours), and number of ventilated patients cared for per month (8.4 vs 19.3 patients). On the MBI, there were no significant differences between units with respect to the emotional exhaustion and personal accomplishment subscales. However, staff in the BU reported lower rates of depersonalization (P=.049) compared with the CrCU counterparts. There was no significant difference in the perceived sources of workplaces stressors, but differences existed in the coping mechanisms. BU professionals exercised less (P=.007), talked less with their families (P=.006), ate less (P=.002), and watched less television (P=.002) compared with CrCU professionals as a means of coping with their workplace stress. In conclusion, although BU and CrCU have similar work environments, BU staff was significantly less depersonalized compared with CrCU staff. However, the two units had comparable rates of emotional exhaustion and depersonalization. The mechanisms for coping with workplace stress differed significantly between the two units.

Stress, burnout and job satisfaction in rural psychiatric nurses: a Victorian study.

To measure the level of stress, burnout and job satisfaction in rural psychiatric nurses in Victoria, Australia. This present study presents the findings of a research study undertaken with rural psychiatric nurses (n = 136) in two rural mental health services in Victoria. The study designed to measure their level of stress, burnout and job satisfaction using the Maslach Burnout Inventory (MBI), the Nursing Stress Scale (NSS) and Job Satisfaction Scale (JSS). The findings indicated that a low number rural psychiatric nurses suffered from 'high' level of burnout and the majority of nurses reported 'low level' of emotional exhaustion and depersonalisation scores. On the personal accomplishment subscale, only 11% recorded a 'high' score and 87% recorded 'low' score. On the Nursing Stress Scale, the 'workload' was the highest perceived stressor followed by 'inadequate preparation'. Paradoxically, the majority of rural psychiatric nurses stated that they were satisfied with their job, particularly with current situation at work, aspects of support and the level of involvement in decision making.

Dietetic technicians report low to moderate levels of burnout

This study identified and described the status of burnout experienced by dietetic technicians (DTRs) in various settings. A questionnaire was sent to a random sample of 300 members from the American Dietetic Association’s (ADA’s) Dietetic Technician in Practice practice group. The Maslach Burnout Inventory—Human Services Survey was used to measure burnout. On the emotional exhaustion subscale, the respondents reported a mean score of 20.6 (high level of burnout >27), 5.3 on the depersonalization subscale (high level of burnout >14), and 38.6 on the personal accomplishment subscale (high level of burnout <30). These results suggest that the DTRs as a group perceive themselves to be moderately emotionally exhausted, to have a low level of depersonalization, and to have a high level of personal accomplishment. Further analysis also suggests that DTRs in nontraditional settings experience more personal accomplishment than those in traditional healthcare and foodservice settings.

Stress and burnout in forensic psychiatric nursing

AbstractThe relevant literature suggests that all branches of the nursing profession are subject to high levels of stress and burnout. Forensic psychiatric nursing has been considered as an area of high risk, despite a paucity of literature in this area, particularly in Australia. This paper presents the findings of a research study undertaken with forensic nurses (n = 51) and designed to measure their level of stress and burnout. The Maslach Burnout Inventory (MBI) and the Nursing Stress Scale (NSS) were the instruments used. The findings indicated that relatively few forensic nurses suffered from ‘high’ levels of burnout with considerably more forensic nurses recording ‘low’ levels of burnout. On the personal accomplishment subscale, only 17 per cent recorded a ‘high’ score. Interestingly the least reported stressor was lack of staff support for nursing activities which suggests that the amount of support received may account for lower than expected levels of stress. Copyright © 2003 John Wiley &amp; Sons, Ltd.

Factors Influencing on Burnout Experience in Working Nurses at Hospital

This study was designed to examine the factors that influence the burnout of nurses practice healthcare in a hospital setting. Subjects for this study were 245 nurses working at University K hospital in Seoul, Korea. Data for this study was collected from 15 to 27 April, 2002. The data collection instruments used for this study are as follows: Maslach Burnout Inventory(1981), Orientation to Life Questionnaire(Sense of Coherence, SOC) by Antonovsky (1987) and Modified Coping Resources Inventory developed by author. The analysis of the data was completed using the descriptive, ANOVA, Pearson correlation analysis, and stepwise multiple regression using the SAS program software. The results of this study were as follows: 1. Total mean score of burnout was 4.0. Mean scores of the subscales were; emotional exhausion 4.7, personalization 3.7, and personal accomplishment 3.4.2. Significant statistical differences according to demographic characteristics of the subjects were found in the variables of age, job position, years of working, perceived job stress, and burnout. 3. Burnout was negatively related to sense of coherence(r=-.65) and coping resources (r=-.40); subscales of SOC of comprehensibility(r=-.57), manageability (r= -.55), and meaningfulness(r= -.52); subscales of coping of self-care(r=-.36), and cognitive coping(r=-.39). 4. Job stress was the highest factor influence burnout. Sixty-one percent of the total variance of burnout was experienced by variables of comprehensibility, meaningfulness, age, self-care, manageability and leisure activities including job stress. In conclusion, it was found that a low level of burnout was related to high scores of SOC and coping resources. Job stress, manageability, and meaningfulness were the highest factors influencing the level of subscale of emotional exhausion, depersonalization, and personal accomplishment. Therefore, it is necessary to search for strategies to promote SOC and coping resources for reducing the level of burnout of nurses.

Organizational factors as predictors of teachers' burnout.

The purpose of this study was to examine the burnout experienced by a sample of Greek teachers and to explore the extent to which certain organizational factors predict teachers' scores on the Maslach Burnout Inventory. The sample consisted of 100 teachers, 28 to 59 years of age. Greek teachers' means were lower than those for burnout of U.S. teachers. Stepwise regression analysis identified satisfaction with the job itself was the only significant predictor for Depersonalization and Emotional Exhaustion subscales, while satisfaction with the job itself and satisfaction with promotion were significant predictors for the Personal Accomplishment subscale. These findings showed that stress, e.g., role conflict and role ambiguity, were not highly correlated with teachers' burnout.

ORGANIZATIONAL FACTORS AS PREDICTORS OF TEACHERS' BURNOUT

The purpose of this study was to examine the burnout experienced by a sample of Greek teachers and to explore the extent to which certain organizational factors predict teachers' scores on the Maslach Burnout Inventory. The sample consisted of 100 teachers, 28 to 59 years of age. Greek teachers' means were lower than those for burnout of U.S. teachers. Stepwise regression analysis identified satisfaction with the job itself was the only significant predictor for Depersonalization and Emotional Exhaustion subscales, while satisfaction with the job itself and satisfaction with promotion were significant predictors for the Personal Accomplishment subscale. These findings showed that stress, e.g., role conflict and role ambiguity, were not highly correlated with teachers' burnout.

Burnout and AIDS care-related factors in HIV community clinical nurse specialists in the North of England.

Burnout in Acquired Immune Deficiency Syndrome (AIDS) care nursing is well described in the literature from a hospital based perspective. No studies into the effects of AIDS care and burnout have been carried out within the community setting. A two-stage, mixed method study was carried out. In Stage one 30 Clinical Nurse Specialists in human immunodeficiency virus (HIV)/AIDS from the North of England completed the Maslach Burnout Inventory (MBI) and the AIDS Impact Scale. For Stage two five practitioners were selected randomly for semi-structured interview. Burnout morbidity was significant. Sixty-six per cent of informants scored as moderate or high burnout cases on the emotional Exhaustion and Personal Accomplishment subscales of the MBI. Only three per cent scored as cases on the depersonalization subscale. Links between the close involvement of practitioners with clients, death of clients, isolation, stigma and discrimination and the availability of support and supervision were identified as significant factors in AIDS care within this population that contributed to stress and burnout. Paradoxically, informants found the close relationships with clients, the autonomy of isolation and the exclusive nature of AIDS care positive aspects of their practice. The role of support and supervision in facilitating the continuance of a close empathic and therapeutic relationship and the prevention of an over-involved, isolated and stressful relationship is proposed as a way forward.