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Worker Burnout: Evidence and Potential Solutions

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (15 January 2023) | Viewed by 47499

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Prof. Dr. Maura MacPhee

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School of Nursing, The University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
Interests: healthcare work environments; realist methods; complex systems; healthcare administration and leadership
Special Issues, Collections and Topics in MDPI journals

Dr. Farinaz Havaei

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Guest Editor

School of Nursing, University of British Columbia, T225-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
Interests: health services research; long-term care; staffing and workload; quality and safety of health care; healthy work environments; occupational health and safety; workplace violence
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Burnout and healthcare workers have been in the spotlight during COVID-19. Burnout research with nurses began decades ago, and there is compelling evidence that work environment factors, such as staffing and workload management, are significantly associated with nurse, patient, and organizational outcomes. Nurse burnout is characterized by emotional exhaustion, cynicism, withdrawal, intent to leave, and eventual turnover. The question is, what have we learned and what can we do to mitigate work environment factors that seriously threaten our valuable but finite health human resources?

This issue invites researchers to share new research and perspectives on burnout, especially evidence-informed strategies at different systems levels (e.g., socioecological levels, organizational levels). We must also consider our globalized world and what we have learned about culture’s influence on burnout. Although we traditionally think of burnout in relation to healthcare, we know burnout is on the rise in other professions, such as law enforcement. We welcome submissions, therefore, that explore burnout from different disciplines’ perspectives.

Prof. Dr. Maura MacPhee
Dr. Naz (Farinaz) Havaei
Guest Editors

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Keywords

burnout
healthcare workers
work environment
COVID-19

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Published Papers (11 papers)

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11 pages, 906 KiB

Open AccessArticle

Beyond the Hype: (How) Are Work Regimes Associated with Job Burnout?

by Kristen du Bois, Philippe Sterkens, Louis Lippens, Stijn Baert and Eva Derous

Int. J. Environ. Res. Public Health 2023, 20(4), 3331; https://doi.org/10.3390/ijerph20043331 - 14 Feb 2023

Cited by 6 | Viewed by 2717

Abstract

Job burnout affects countless workers and constitutes a major issue in working life. Prevention strategies such as offering part-time options and shorter working weeks have been widely advocated to address this issue. However, the relationship between shorter work regimes and burnout risk has not yet been investigated across diverse working populations applying validated measures and frameworks for job burnout. Building on the most recent operationalisation of job burnout and the seminal job demands–resources theory, the purpose of the current study is to investigate whether shorter work regimes are associated with lower burnout risk and whether the job demands–resources explain this association. To this end, a heterogenous sample of 1006 employees representative for age and gender completed the Burnout Assessment Tool (BAT) and Workplace Stressors Assessment Questionnaire (WSAQ). Our mediation analyses yield a very small but significant indirect association between work regimes and burnout risk through job demands, but no significant total or direct association between work regimes and burnout risk. Our result suggests that employees in shorter work regimes experience slightly fewer job demands, but are equally prone to developing burnout as their full-time counterparts. The latter finding raises concerns about the sustainability of burnout prevention that focuses on mere work regimes instead of the root causes of burnout. Full article

(This article belongs to the Special Issue Worker Burnout: Evidence and Potential Solutions)

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11 pages, 718 KiB

Open AccessArticle

Implementation of the Synergy Tool: A Potential Intervention to Relieve Health Care Worker Burnout

by Farinaz Havaei, Maura MacPhee, Andy Ma, Vivien W. Wong, Cecilia Li, Irene Cheung, Lina Scigliano and Amera Taylor

Int. J. Environ. Res. Public Health 2023, 20(1), 489; https://doi.org/10.3390/ijerph20010489 - 28 Dec 2022

Cited by 2 | Viewed by 2783

Abstract

(1) Background: Healthcare workers experienced rising burnout rates during and after the COVID-19 pandemic. A practice-academic collaboration between health services researchers and the surgical services program of a Canadian tertiary-care urban hospital was used to develop, implement and evaluate a potential burnout intervention, the Synergy tool. (2) Methods: Using participatory action research methods, this project involved four key phases: (I) an environmental scan and a baseline survey assessment, (II), a workshop, (III) Synergy tool implementation and (IV) a staffing plan workshop. A follow-up survey to evaluate the impact of Synergy tool use on healthcare worker burnout will be completed in 2023. (3) Results: A baseline survey assessment indicated high to severe levels of personal and work-related burnout prior to project initiation. During the project phases, there was high staff engagement with Synergy tool use to create patient care needs profiles and staffing recommendations. (4) Conclusions: As in previous research with the Synergy tool, this patient needs assessment approach is an efficient and effective way to engage direct care providers in identifying and scoring acuity and dependency needs for their specific patient populations. The Synergy tool approach to assessing patient needs holds promise as a means to engage direct care providers and to give them greater control over their practice—potentially serving as a buffer against burnout. Full article

(This article belongs to the Special Issue Worker Burnout: Evidence and Potential Solutions)

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14 pages, 757 KiB

Open AccessArticle

Compassionate Work Environments and Their Role in Teachers’ Life Satisfaction: The Contribution of Perceived Collective School Performance and Burnout

by Ilaria Buonomo, Martina Pansini, Sara Cervai and Paula Benevene

Int. J. Environ. Res. Public Health 2022, 19(21), 14206; https://doi.org/10.3390/ijerph192114206 - 30 Oct 2022

Cited by 2 | Viewed by 2247

Abstract

Several studies on helping professionals showed the protective role of compassion among colleagues and leaders. Despite this, studies on well-being factors at school, both preventive and protective, usually focus on teachers’ personal resources and study compassion in the teacher–student relationship. This study explores the role of received compassion at work on teachers’ life satisfaction while considering perceived school collective performance and burnout conditions as mediators in this link. One hundred and eighty-six Italian teachers (female = 85.4%, mean age = 48.5, SD = 9.46) completed a questionnaire on received compassion at work, perceived school collective performance, burnout, and life satisfaction. Through a structural equation model (χ²(21) = 30.716, p = 0.08, CFI = 0.989, TLI = 0.981, RMSEA = 0.050 (90% CI = 0.000–0.080, p = 0.465), SRMR = 0.038), it emerged that only perceived school collective performance mediated the association between received compassion and life satisfaction. To the best of our knowledge, few studies have addressed the role of compassion received from colleagues and supervisors at school and its effect on teachers’ work-related beliefs and personal well-being. Full article

(This article belongs to the Special Issue Worker Burnout: Evidence and Potential Solutions)

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11 pages, 363 KiB

Open AccessArticle

Psychometric Properties and Factor Structure of the Slovak Version of the Copenhagen Burnout Inventory

by Karol Kováč and Júlia Halamová

Int. J. Environ. Res. Public Health 2022, 19(19), 12586; https://doi.org/10.3390/ijerph191912586 - 2 Oct 2022

Viewed by 2098

Abstract

Background: Burnout is clinically significant because it has adverse consequences in the form of mental and physical illnesses and economic losses. The goal of the research study was to translate the Copenhagen Burnout Inventory (CBI) into Slovak and then assess its factor structure, reliability, validity, and psychometric properties. Methods: We collected two convenience samples: one for the psychometric properties analysis and factor analysis, which consisted of 4789 participants, and the other for the validity analysis, which consisted of 458 participants. Data were collected online. The participants filled out the following questionnaires: Copenhagen Burnout Inventory (CBI), Oldenburg Burnout Inventory (OLBI), Professional Quality of Life Scale (PROQOL), and Secondary Traumatic Stress Scale (STSS). Results: The CBI had very good reliability in both samples, calculated using Cronbach alpha coefficients (between 0.839 and 0.908). In terms of CBI validity, all the correlation coefficients between the scale and subscales were between moderately high and high and ranged from 0.505 to 0.859. Except for two items, CBI7 and CBI10, all the items fall into the original factors of the scale. Conclusions: The Slovak version of the Copenhagen Burnout Inventory is a statistically sound instrument with high coefficients of reliability as well as validity and has an acceptable factor structure. Full article

(This article belongs to the Special Issue Worker Burnout: Evidence and Potential Solutions)

14 pages, 2186 KiB

Open AccessArticle

COVID-19 Outbreak: Understanding Moral-Distress Experiences Faced by Healthcare Workers in British Columbia, Canada

by Esther Alonso-Prieto, Holly Longstaff, Agnes Black and Alice K. Virani

Int. J. Environ. Res. Public Health 2022, 19(15), 9701; https://doi.org/10.3390/ijerph19159701 - 6 Aug 2022

Cited by 9 | Viewed by 2862

Abstract

Pandemic-management plans shift the care model from patient-centred to public-centred and increase the risk of healthcare workers (HCWs) experiencing moral distress (MD). This study aimed to understand HCWs’ MD experiences during the COVID-19 pandemic and to identify HCWs’ preferred coping strategies. Based on a qualitative research methodology, three surveys were distributed at different stages of the pandemic response in British Columbia (BC), Canada. The thematic analysis of the data revealed common MD themes: concerns about ability to serve patients and about the risks intrinsic to the pandemic. Additionally, it revealed that COVID-19 fatigue and collateral impact of COVID-19 were important ethical challenges faced by the HCWs who completed the surveys. These experiences caused stress, anxiety, increased/decreased empathy, sleep disturbances, and feelings of helplessness. Respondents identified self-care and support provided by colleagues, family members, or friends as their main MD coping mechanisms. To a lesser extent, they also used formal sources of support provided by their employer and identified additional strategies they would like their employers to implement (e.g., improved access to mental health and wellness resources). These results may help inform pandemic policies for the future. Full article

(This article belongs to the Special Issue Worker Burnout: Evidence and Potential Solutions)

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15 pages, 689 KiB

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Buffering the Effects of Burnout on Healthcare Professionals’ Health—The Mediating Role of Compassionate Relationships at Work in the COVID Era

by Ilaria Buonomo, Paolo Emilio Santoro, Paula Benevene, Ivan Borrelli, Giacomo Angelini, Caterina Fiorilli, Maria Rosaria Gualano and Umberto Moscato

Int. J. Environ. Res. Public Health 2022, 19(15), 8966; https://doi.org/10.3390/ijerph19158966 - 23 Jul 2022

Cited by 21 | Viewed by 3903

Abstract

Managing the COVID-19 pandemic posed several challenges for healthcare professionals, which likely heightened their risk of burnout (Amanullah and Ramesh Shankar, 2020) and, consequently, their general physical and mental health. Although it may not be possible to address and eliminate the causes of burnout, current research informs healthcare organizations about protective strategies to reduce its detrimental consequences. The promotion of compassionate interactions among healthcare professionals may play such a role. Compassion within healthcare organizations positively affects individual performance and well-being. Building on these considerations and within the framework of the Conservation of Resources theory, this study explores the relationships among burnout dimensions, received compassion at work, and general health in 711 Italian healthcare professionals (68.5% female), aged between 21 and 73 years (M_age = 36.4, SD = 11.2). Analyses were conducted to investigate the association between burnout and general well-being (H1) and between burnout symptoms and perceived compassion at work (H2); and the mediational role of compassion in the relationship between burnout symptoms and general well-being. H1 and H2 were confirmed (r < 0.01 for both), and a SEM model showed the mediating role of compassion at work in the association between burnout symptoms and general well-being (RMSEA < 0.08, SRMR < 0.08, CFI and TLI > 0.90). Theoretical and practical implications of the findings are discussed in the paper. Full article

(This article belongs to the Special Issue Worker Burnout: Evidence and Potential Solutions)

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11 pages, 651 KiB

Open AccessArticle

The Importance of Effective Organizational Socialization for Preventing Stress, Strain, and Early Career Burnout: An Intensive Longitudinal Study of New Professionals

by Elin Frögéli, Stefan Annell, Ann Rudman, Miguel Inzunza and Petter Gustavsson

Int. J. Environ. Res. Public Health 2022, 19(12), 7356; https://doi.org/10.3390/ijerph19127356 - 15 Jun 2022

Cited by 5 | Viewed by 2743

Abstract

Burnout was originally conceptualized based on experiences of new professionals. Role clarity, task mastery, and social acceptance are recognized as key resources enabling new professionals’ management of the challenges of the new profession. However, relations between these resources and stress, strain, and burnout have not yet been thoroughly investigated at professional entry. Increased understanding of these relations could have implications for strategies to prevent burnout. The aim of the study was to investigate within- and between-individual effects over the first months and relations to burnout at one-year post-entry. Data (n = 322) was collected weekly over the first 13 weeks and again 9 months later. Relationships were modelled using a multilevel regression model and correlation analysis. Results showed that on weeks when participants experienced higher role clarity, task mastery, and social acceptance, they reported significantly less stress, and that participants who experienced higher levels of the resources in general, reported significantly less strain. Levels of the resources at three months were related to symptoms of burnout at 12 months. The study findings provide support of the role of task mastery, role clarity, and social acceptance as resources buffering the impact of demands at professional entry on experiences of stress, strain, and burnout. Full article

(This article belongs to the Special Issue Worker Burnout: Evidence and Potential Solutions)

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14 pages, 2027 KiB

Open AccessArticle

How Much Burnout and Coping Influence Quality of Life among Young Oncology Providers in Romania during the COVID-19 Pandemic

by Cristian-Virgil Lungulescu, Adina Turcu-Stiolica, Cristina Lungulescu, Elena-Adriana Dumitrescu, Razvan-Aurelian Turcu-Stiolica, Vlad-Mihai Croitoru, Irina-Mihaela Cazacu, Adelina-Silvana Gheorghe, Dana-Lucia Stanculeanu and Daniel Sur

Int. J. Environ. Res. Public Health 2022, 19(9), 5508; https://doi.org/10.3390/ijerph19095508 - 1 May 2022

Cited by 4 | Viewed by 2295

Abstract

This study aims to investigate the correlations between burnout, coping strategies, and quality of life among young oncology healthcare workers in Romania during the COVID-19 pandemic. We collected the data using an online questionnaire consisting of sociodemographic questions, the Maslach Burnout Inventory, the COPE questionnaire, and the 15D instrument. A total of 122 healthcare providers responded to our survey. We evaluated the differences in the scores among the three groups of healthcare workers in oncology under 40 years old: medical oncologists (n = 87), radiation oncologists (n = 11), and oncology nurses (n = 24). Finally, we conducted a correlation analysis between the dimensions of burnout, coping, and quality of life. Overall, the medical oncologists exhibited much higher burnout levels than nurses in the COVID-19 pandemic outbreak, having statistically significant higher levels of emotional exhaustion, depersonalization, and lack of personal achievement. Some factors were inversely associated with burnout: active approach, planning, positive interpretation and growth, and acceptance. Our findings illustrated a very good level of health-related quality of life (average = 0.93, SD = 0.06), and no statistically significant differences were found in the quality of life between the three groups. This study was the first to identify the profile of young oncology providers in Romania. Our findings may be relevant in creating preventive strategies for burnout and increasing the quality of life in Romanian young oncology providers in future crises. Full article

(This article belongs to the Special Issue Worker Burnout: Evidence and Potential Solutions)

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14 pages, 840 KiB

Open AccessArticle

Striking a Balance between Work and Play: The Effects of Work–Life Interference and Burnout on Faculty Turnover Intentions and Career Satisfaction

by Sheila A. Boamah, Hanadi Y. Hamadi, Farinaz Havaei, Hailey Smith and Fern Webb

Int. J. Environ. Res. Public Health 2022, 19(2), 809; https://doi.org/10.3390/ijerph19020809 - 12 Jan 2022

Cited by 45 | Viewed by 18800

Abstract

Background: The interactions between work and personal life are important for ensuring well-being, especially during COVID-19 where the lines between work and home are blurred. Work–life interference/imbalance can result in work-related burnout, which has been shown to have negative effects on faculty members’ physical and psychological health. Although our understanding of burnout has advanced considerably in recent years, little is known about the effects of burnout on nursing faculty turnover intentions and career satisfaction. Objective: To test a hypothesized model examining the effects of work–life interference on nursing faculty burnout (emotional exhaustion and cynicism), turnover intentions and, ultimately, career satisfaction. Design: A predictive cross-sectional design was used. Settings: An online national survey of nursing faculty members was administered throughout Canada in summer 2021. Participants: Nursing faculty who held full-time or part-time positions in Canadian academic settings were invited via email to participate in the study. Methods: Data were collected from an anonymous survey housed on Qualtrics. Descriptive statistics and reliability estimates were computed. The hypothesized model was tested using structural equation modeling. Results: Data suggest that work–life interference significantly increases burnout which contributes to both higher turnover intentions and lower career satisfaction. Turnover intentions, in turn, decrease career satisfaction. Conclusions: The findings add to the growing body of literature linking burnout to turnover and dissatisfaction, highlighting key antecedents and/or drivers of burnout among nurse academics. These results provide suggestions for suitable areas for the development of interventions and policies within the organizational structure to reduce the risk of burnout during and post-COVID-19 and improve faculty retention. Full article

(This article belongs to the Special Issue Worker Burnout: Evidence and Potential Solutions)

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21 pages, 1074 KiB

Open AccessReview

Holistic Assessment of Factors Associated with Exhaustion, the Main Symptom of Burnout: A Meta-Analysis of Longitudinal Studies

by Yara Shoman, Valentin Rousson, Renzo Bianchi and Irina Guseva Canu

Int. J. Environ. Res. Public Health 2022, 19(20), 13037; https://doi.org/10.3390/ijerph192013037 - 11 Oct 2022

Cited by 6 | Viewed by 2721

Abstract

Background: This meta-analysis summarized longitudinal findings pertaining to exhaustion’s predictors. In so doing, our aim was ultimately to identify target factors for the prevention of burnout. Methods: We searched for studies that (a) examined predictors of exhaustion longitudinally and (b) reported correlation coefficients as an effect estimate. We conducted our literature search in three databases: MEDLINE, PsycINFO, and Embase. We focused on studies published between January 1990 and November 2020. Predictors were grouped into families, subfamilies, and subgroups. A meta-analysis of z-transformed correlation coefficients (rho) was performed. The results were scrutinized in relation to studies’ follow-up length. Results: We included 65 studies assessing 242 predictors of different types captured across different occupations. Our findings highlighted mostly weak associations (rho < 0.30). For six predictors—Job control, Job resources, Interactions at work, Communication and leadership, Job attitudes, and Work-family interface—longer length of follow-up involved weaker associations with exhaustion. The quality of the evidence available was generally low. Conclusions: The evidence available does not point to clear target factors for preventing burnout. The decrease in associations as the follow-up length increases may suggest a relatively short latency period, followed by recovery. Higher-quality cohorts should be conducted to better understand the etiology and course of burnout. Full article

(This article belongs to the Special Issue Worker Burnout: Evidence and Potential Solutions)

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9 pages, 306 KiB

Open AccessEssay

The Critical Need for a Meaning-Centered Team-Level Intervention to Address Healthcare Provider Distress Now

by William E. Rosa, Kailey E. Roberts, Amelia E. Schlak, Allison J. Applebaum, William S. Breitbart, Emily H. Kantoff, Hayley Pessin and Wendy G. Lichtenthal

Int. J. Environ. Res. Public Health 2022, 19(13), 7801; https://doi.org/10.3390/ijerph19137801 - 25 Jun 2022

Cited by 7 | Viewed by 2807

Abstract

COVID-19 has unveiled and amplified the burnout, grief, and other forms of distress among healthcare providers (HCPs) that long preceded the pandemic. The suffering of the healthcare workforce cannot be simply and sufficiently addressed with a single psychotherapeutic intervention. Nevertheless, the National Academies of Sciences, Engineering, and Medicine Studies recommended prioritizing interventions that generate an increased sense of meaning in life and in work to reduce burnout and cultivate clinician wellbeing. Despite their guidance, there is a dearth of interventions for HCPs specifically targeting meaning and purpose as an avenue to reduce HCP distress. In a time when such an intervention has never been more essential, Meaning-Centered Pyschotherapy (MCP), a brief, evidence-based intervention designed for patients with advanced cancer may be key. This piece describes the principles underlying MCP and how it might be adapted and applied to ameliorate burnout among HCPs while providing a rationale to support future empirical studies in this area. Importantly, the systemic factors that contribute to the emotional and mental health burdens of HCPs are discussed, emphasizing the need for systems-level changes that are needed to leverage the potential outcomes of MCP for HCPs. Full article

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