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Abstract
Objectives: The purpose of the study was to investigate the role of Type D personality in perceiving stress at work and the
development of adverse effects of experienced stress, i.e. mental health disorders and burnout syndrome. Materials and
Methods: A sample of 79 healthcare professionals (51 psychiatrists and 28 nurses) of a mental hospital in d was eligible
for the study. The mean age of the subjects was 39.71 (SD = 8.02) and their work experience was 11.20 (SD = 5.45). The
DS-14 self-report to measure Type D personality, the Subjective Work Evaluation Questionnaire, the Maslach Burnout
Inventory, and the General Health Questionnaire (GHQ-28) were used in the study. Results: The results of the study
conrm a signicant role of Type D personality in perceiving job stress and the development of its adverse effects reected
especially in the worsening health condition. Type D subjects perceive their workplace as more stressful than non-Type Ds
and manifest more symptoms of mental health disorders and a higher level of burnout, expressed mainly in the form
of emotional exhaustion and lower personal accomplishment. Conclusion: Modication of Type D personality aimed at
reducing tendency to experience negative emotions and enhancing skills to express them combined with improving social
relations is desired to prevent healthcare professionals from adverse health outcomes.
Key words:
Type D personality, Job stress, Burnout, Health status, Healthcare professionals
INTRODUCTION
work. This stress may result from work overload, high de-
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to inhibit self-expression in social interactions. Experiencing negative emotions and not expressing them outwardly
expose individuals to chronic stress [26]. Type D personality is a risk factor of somatic diseases, mainly cardiovascular diseases. The role of experienced negative emotions
combined with their inhibited expression is underlined in
the development of diseases [25,26].
Type D personality indicates some similarities to Type A
behavior pattern, Type C personality, and rst of all to
two personality traits, neuroticism and introversion, wellknown from the Five-Factor Model of personality. Those
similarities (and differences) are presented elsewhere
[27,28].
Type D individuals are at increased risk for a wide range
of adverse health outcomes [25,26,29]. They are also at
risk for posttraumatic stress [30] and vital exhaustion [31].
Type D personality is also related to job stress and its negative outcomes. Balog [32] in a Hungarian study revealed
the positive relationship between type D personality and
experience of occupational stress, mostly in women. Abraham [33] found that high negative affectivity individuals
reported lower job satisfaction and greater intention to
look for another job.
One can assume that high-NA and high-SI workers will
perceive their workplace as more stressful and that they
will experience more negative consequences of stress,
manifested by mental health disorders and burnout syndrome.
Figure 1 presents the hypothesized model of the study.
The major objective of this study was to conrm this assumption by making an attempt to answer the following
questions:
whether Type D subjects differ in perceiving stress
and its consequences from non-Type Ds,
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RESULTS
Descriptive analyses
The means of all the analyzed variables are presented in Table 1. The study group of healthcare workers revealed a high
level of experienced stress at work (sten 8 according to normative data by Dudek et al. [34]). In the analyzed variables,
the differences between psychiatrists and nurses and between men and women were also checked (but not presented
in Tables). The nurses did not differ from psychiatrists in the
level of perceived job stress, but the gender differentiated
the level of this variable. Women revealed a higher level of
stress (M = 122.02; SD = 27.14) than men (M = 101.76;
SD = 20.36; p < 0.002). The most stressful factors at work
for the whole group comprised: work overload, lack of rewards, and threat expressed by being at risk of conicts at
work, worsening or loss of health. Nurses yielded a higher
level of physical burdens, unpleasant work conditions, and
lack of control. Psychiatrists in turn revealed a higher sense
of work overload. Compared with men, women yielded
stronger sense of lack of rewards and control, stronger stress
related to social relations, higher level of physical burdens
and stronger feelings of responsibility.
The level of both dimensions of Type D personality in
the study group of healthcare workers may be regarded
as average (5 sten for NA and 6 sten for SI). The nurses
did not differ from psychiatrists in the level of experienced
negative emotions, but revealed a higher tendency to inhibit those emotions (M = 13.36; SD = 4.94; M = 11.25;
SD = 3.85; p < 0.03). The gender differentiated the level
of negative affectivity, but not social inhibition. A tendency to experience negative emotions was found higher in
women than in men (M = 12.07; SD = 5.20; M = 6.36;
SD = 4.11; p < 0.000).
The obtained results indicate that the examined group of
healthcare professionals suffer from burnout syndrome.
Emotional exhaustion, which concerns the feeling of being
overextended and depleted of emotional and physical re-
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SD
116.61
27.02
Work overload
20.92
6.80
Lack of rewards
18.44
6.41
Uncertainty in workplace
15.56
3.91
9.47
1.79
12.34
3.95
Physical burdens
7.68
3.47
5.53
2.43
Lack of control
7.65
1.84
Lack of support
4.78
2.16
Social relations
Threat
Responsibility
8.65
2.87
Negative affectivity
10.27
5.54
Social inhibition
12.00
4.35
Emotional exhaustion
21.67
12.84
4.54
5.21
Personal accomplishment
29.77
9.01
Depersonalization
24.10
10.46
Somatic complaints
7.00
4.11
Anxiety/insomnia
7.89
4.31
Functioning disorders
7.48
1.82
Depression symptoms
1.73
2.90
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DISCUSSION
The study group of healthcare workers suffered from extensive job stress, which was more manifested among women
than in men; 60.7% of them experienced high level of stress
at work; 34.2% average and only 5.1% low level of stress.
The level of stress suffered in this occupational group is
Table 2. Means (M) and standard deviations (SD) of perceived stress, burnout syndrome, and general health status in Type D and non-Type D subjects
Type D
(n = 22)
Variables
General work stress
Work overload
Non-Type D
(n = 57)
25.86
-3.87
0.000
6.26
-1.54
NS
SD
SD
134.89
21.34
109.50
23.00
8.10
20.27
Lack of rewards
23.37
6.88
16.88
5.44
-4.23
0.000
Uncertainty in workplace
17.05
4.72
15.08
3.53
-1.98
0.05
Social relations
10.32
1.89
9.20
1.69
-2.44
0.01
Threat
13.89
3.49
11.85
3.98
-2.05
0.05
Physical burdens
9.16
3.45
7.22
3.37
-2.19
0.03
7.00
1.89
5.07
2.41
-3.19
0.01
Lack of control
9.37
2.19
7.10
1.32
-5.48
0.000
Lack of support
5.26
2.70
4.63
1.96
-1.10
NS
Responsibility
10.95
2.39
7.92
2.63
-4.46
0.000
Emotional exhaustion
26.42
14.84
20.17
12.01
-2.40
0.05
5.26
4.76
4.32
3.84
-0.78
NS
Personal accomplishment
24.58
8.38
31.42
8.62
3.03
0.003
31.37
9.41
21.80
9.76
-3.76
0.000
9.32
4.27
6.27
3.81
-2.96
0.01
0.01
Depersonalization
Somatic complaints
Anxiety/insomnia
10.01
3.54
7.22
4.35
-2.54
Functioning disorders
7.42
0.96
7.50
2.02
0.16
NS
Depression symptoms
4.64
4.26
0.82
1.41
-6.02
0.000
t test value;
P level of signicance;
NS not signicant.
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SEB
Beta
SE Beta
EMOTIONAL EXHAUSTION
Work overload
1.22
0.14
0.65
0.08
8.42
0.000
Negative affectivity
0.61
0.18
0.26
0.08
3.46
0.000
-10.16
3.02
-3.36
0.001
Constant
0.54
0.07
0.67
0.09
7.23
0.00
Physical burdens
0.56
0.14
0.37
0.09
4.06
0.000
Constant
-1.13
1.51
-0.74
NS
0.79
0.39
-0.21
0.10
-3.84
0.000
Negative affectivity
-0.70
0.18
-0.43
0.11
-3.84
0.000
-1.99
0.99
-0.22
0.11
-2.01
0.05
Constant
40.97
2.51
16.31
0.000
t test value;
NS not signicant.
SE B
Beta
SE Beta
Lack of support
Predictors
0.78
0.33
0.16
0.07
2.40
0.01
Negative affectivity
1.57
0.14
0.83
0.07
11.38
0.000
Social inhibition
0.55
0.17
0.23
0.07
3.17
0.002
18.80
2.54
4.25
0.000
Constant
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t test value;
NS not signicant.
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CONCLUSIONS
The results of the study indicated the need to develop preventive programs aimed at reducing stress experienced at work
and protecting health of healthcare workers. The programs
should be addressed to organizations with the aim to change
the system of rewards, to improve social relations between
both employees and employers and employees and co-workers, and to reduce workload and the sense of threat.
Modication of personality traits (aimed at both reducing
tendency to experience negative feelings and enhancing
skills to express them) is also desired. Assertiveness and
training of conversation skills may equip healthcare employees with a reportoire of interpersonal behaviors, which
may be helpful in coping with job stressors. Social support
also seems to be very important in protecting healthcare
workers from negative consequences of job stress, especially emotional exhaustion. As Maslach [43] noticed,
burnout rate is lower in individuals who actively express
and share their personal feelings with their colleagues.
In addition, support groups can defuse tension and assist
in problem solving, and workers with large networks may
possess greater skills to cope with job stressors.
There are some limitations of the presented study. The research was focused on self-report measures. The adopted
cross-sectional research design provides no information
on the job stress process and does not allow for afrmative
causal explanations. Therefore, further research, including
measurements of other personality variables, is required.
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