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Burnout

Student’s Name

Institutional Affiliation
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Literature Review

2.1 Burnout

Burnout is a psychological syndrome characterized by cynicism, exhaustion and

inefficacy among employees. It is as a result of the stress experience of a person that is

embedded in the context of intermingled social relationships where a person forms a sense of

both self and others in the workplace. Unlike other un-dimensional understanding of stress,

burnout is a multidimensional model explain burnout in three different core components:

exhaustion, cynicism and inefficacy. This means that burnout is characterized by many factors

and a single rough day at work not imply that a person is experiencing burnout. It occurs when

difference occurs between a certain job and the person responsible for carryout the job. The

greater the gap between the two parties, the greater the chances of suffering from burnout.

2.2 Measurement and diagnosis of burnout

The process of diagnosis, management and treatment of burnout begins with the

acknowledger of the existence of the problem followed by finding a solution. There are several

useful tools used to measure the extent of burnout. The most common tool is Maslach Burnout

Inventory (MBI) developed in 1983 by Jackson and Maslach. This tool has subtypes such as

Human Service Survey (MBI-HSS) which were developed primarily for human service-related

occupation such as health care (Firth, et al,. 1985).

MBI is used in occupational institution to determine and measure the risk and prevalence

of burnout in work places. Most of the material used in this research used MBI while measuring

burnout among nurses. This assessment tool comprises three parts/section, with part A and B,

having seven questions each, while part C has 8 questions. The first section uses physical
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symptoms to identify the presence of burnout. A score of 30 and above signify the presence of

high burnout level, while between 18 and 29 showing a moderate level of burnout. A score

below 18 shows low burnout level. In the second section, the tool measures a persons’ negative

attitude towards toward the work environment, such has feelings towards the colleagues and the

job itself. It also determines a person empathy level toward the patient’s r colleagues. The much

the nurse withdraw and shows a sign of low involvement the higher the level of burnout. Score

of 5 and below shows a lower level, above 12 shows a high level while score between 6 and 11

indicate a moderate burnout. The third section, section C, is determined by the first two parts of

the tool.

Maslach burnout inventory is a predominant instrument by the occupational companies in

examining and gauging the danger of burnout in workstations across the universe. In this section,

when the score is 30 or below, it signifies high level of burnout. At this point, a person is at a

‘low point’. This is point where a burnout is too great that it may hinder from performing as

expected. At this point, the patient experience may show emotional distress characterized by low

self-esteem. The score above 40 is indicating low levels of burnout. The score between 34 and 39

shows a moderate level of burnout.

2.3 Nursing and Burnout

The prevalence of stress and burnout among nurses is a common phenomenon because

nursing is a demanding and stressful profession. The high cases of burnout in the profession is a

big problem that threaten the health care system. Many studies reveal that there is high rate of

burnout among nurses, and more so among those serving the hospitals. Europe, Asia and North

America report high incidence of burnout.

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In a research done in Finland, where 723 nurses participated, half of the nurses indicated

experiencing burnout, frustration and job dissatisfaction. The highest level of burnout in the

investigation was among older nurses, secondary level nurses and those working in psychiatric

departments. In another research done in 2002 in Greek hospitals to determine and compare the

level of burnout in intensive care units, emergency hospitals and medicine ward. The study

showed that nurses in emergency units are more prune exhaustion resulting to burnout compared

to other groups. The study also revealed that environmental factors are instrumental in promoting

burnout among nurses.

Another research conducted in Iran public hospitals supported the Finland research. The

aim of study was to determine the impact of different clinical settings on burnout level among

nurses. The clinical settings user study was internal medicine, surgical, burnout and psychiatry

department. The results show that nurses in psychiatric department compared to other

department. Social factor also played important roles, with those nurses who were single, and

those working night shifts experiencing high level of burnout than others.

2.4 Consequences of burnout among nurses

The repercussions of burnout among nurses are alarming. Burnout is grouped into three

dimensions which are emotional suffering, depersonalization, and efficacy. When at least one of

the aspects are encountered by the nurses, then the overall job productivity will reduce. This has

resulted to serious repercussions of the welfare, safety of patients, quality of life and quality of

care offered.

Burnout affects depression among patients leading to poor job turnover. At a 1999 survey

of more than ten thousand registered inpatient nurses, nearly 43% had high extent of emotional
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suffering. In another study, McHugh et al. (2011) documents that nearly 68, 000 registered

nurses in 2007 reported that 37%, 35%, and 22% of nursing home nurses, hospital nurses, and

nurses working in other environments encountered high levels of emotional suffering.

Burnout lowers the levels of patient satisfaction in the hospital. According to Vahey et al.

(2004), the patients nursed for units that nurses were defined as having sufficient employees,

proper management of nursing care, and good relationship between the nurses and physicians

were more than two times likely as other patients to document high patient contentment with

their care and the nurses articulated significantly lower exhaustion. In essence, the higher levels

of job burnout, the less the lower the patient satisfaction.

Burnout influences the level of job turnover among nurses. A study was conducted

among 667 Canadian nurses was instrumental to draw the association between burnout and its

motive to quit the profession. The result of the study is that some facets of the lives of nurses

contributed to burnout thus causing them to consider quitting the profession. The annual turnover

poses a stringent threat to both the welfare of patients and nurses. It is evident that turnover

would result to conducive nurse-patient ratio which is associated to adverse results.

It is vital to evaluate if individual stress is a more significant predictor of job satisfaction

and burnout. In a survey conducted by 1200 nurses, 895 of them agreed to complete six

questionnaires in a lifespan of three weeks. The result of the study was that individual stress is a

better predictor of burnout and general health than the level of job satisfaction, which is better

forecasted by occupational stress. The finding of the exploration is that timely solutions need to

be drafted to decrease the effect of individual and occupational stress on burnout.

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The emotional state of nurses is significant in evaluating the quality of care provided to

patients. In a Thai study, it was disclosed that 32% of nurses documented high emotional

suffering, 35% low personal attainment and 18% high depersonalization. Nonetheless, 16% of

the nurses considered the quality of care on the departments as poor or fair, 14% documented

infections, 11% reported medication errors, and 5% reported patient letdowns. The entire three

subscales of the MBI were linked with raising reporting of poor or fair quality of care,

medication mistakes, infections, and patient falls. Each unit of augmenting emotional exhaustion

score was linked with 2.63 times increase in documenting poor or fair quality of care, a 30%

increase in patient falls, a 32% rise in infection and 47% rise in medication errors. The finding of

the study is that nurse burnout is linked with the increased odds of documenting negative patient

results. In essence, enforcing interventions to decrease burnout among nurses is important in

enhancing patient care in Thai hospitals (Nantsupawat et al. 2016).

2.5. Theoretical Framework

The Maslach theory on burnout and the Job Demands-Resources model buttress the study

of the effect of burnout on the quality of care by nurses in England. These two theories have

been selected because they are suitable to illuminate the concept of nurse burnout at the

workplace. The Job demands-resource model forms a good base on demands and resources of

job. In addition, addresses how job resources and demand evaluate the frequency of job stress

and burnout. The Maslach theory on burnout is appropriate in this study as it emphasizes on the

frequency of burnout among persons delivering human services. T provides in-depth information

about the possible cause and risk factors of burnout.

3.1 Job Demands-Resources model

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Professor Arnord Bakker and Evangelia Demerouti are regarded as the brainchild behind

the Job Demands-Resources model. The latter drew inspiration from the earlier models such as

the Effort Reward Imbalance and Demand Control models. The theorists contended that the

already coexisting models were not relevant in all circumstances and jobs had an aspect of

simplicity in them. The Effort Reward Imbalance model emphasized on issues such as salary

while the Demand Control Model centered on autonomy. Majority of work organizations and

jobs are complicated and earlier research indicates lack of resources and high job demands which

demands timely solutions. The theorists deduced to come up with a model that would cover all

persons, companies, and jobs thus backing up the physical and emotional welfare which delivers

better results at the workplace. The model clarifies the phenomenon of burnout mental distancing

and decrease individual efficacy. After several years, the model was supplemented with work

engagement, commitment, and absorption at the workplace.

The model has garnered considerable empirical support from various scholars. Job

resources and demands are presumed to cause alienated psychological processes. Job resources

attain the fundamental psychological needs while job demands require more efforts and consume

a lot of resources. In essence, job demands are likely contributors to a health impairment process

while job resources enable the attainment of set objectives and therefore raise the level of

commitment and engagement via a motivational process. Latest examples have disclosed

interaction between these resources where the resources of the occupation have demonstrated to

buttress high demands of job and therefore safeguard the individual from health issues.

Toon Taris and his associates affirmed the interceding job of burnout in the uneasiness

procedure and investment in the persuasive procedure, while in whatever is left of the

investigations incomplete instead of full intervention was found for either burnout or support. As
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of late, eight longitudinal investigations among representatives of numerous countries and found

that the expectations of the model about the circumstances and logical results relationship of the

two factors which were bolstered by five examinations, in part upheld by couple thinks about,

while just a single investigation neglected to find any longitudinal examination.

The JD-R model is material to any sort of occupation as dangers and defending variables

depict the job. These two elements are assembled into assets and requests. Job demands are

portrayed as those mental, physical, social or authoritative qualities of the activity that require

supported mental or physical aptitudes and this connected with specific physiological and mental

costs. Employment assets are those social, physical, mental or hierarchical highlights of the

occupation that are either operational in achieving work objectives, decline work requests and

the connected mental costs, animate individual development, learning, and opportunities.

Job resources and demands are the two key sections of the model. Job demands are the

physical, psychological, and social organizations features of the job which span from workload,

work pressures, time management, conflicts, and uncertainty. Job resources formulate the

physical or social structures of the company that are positioned to help the staff perform better at

the workstation which are not restrained to proper leadership, management, working tools,

secure working environment, good working relationships and prospects of promotion. In this

model, when the demands increase and job resources decline, then an impact to both burnout and

stress among workers will be evident. In contrast, when there is high job resources and low job

demands, more positive results are bound to happen. Evidently, the model emphasizes the

significance of creating equilibrium between job demands and job resources. These two aspects

depend on one another to create a thriving working environment. Job resources might reverse the
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negative effect of job strains for example proper leadership, good supervision, and improved

relationship with supervisors that can assist decrease the strain form workload.

3.6 The Maslach theory of burnout

The earlier look into by the researcher did not include the information of an

authoritatively existing together speculation and underlines on burnout, fundamental interest had

been to consider 'feelings' which then later came to fruition to eagerness for occupation burnout.

The past assessments and research on burnout focused more on giving thought occupations

whereby the individual legitimizing care and the individual tolerating thought had a relationship.

The assessment has extended to involve various occupations other than human organization.

Burnout happens when there is a perplex between the individual wearing down completing the

movement and the action demands. It is proposed that the individual doing the duty and the

movement solicitations should facilitate each other to turn away burnout. In addition, burnout

contains three components of antagonism, energetic exhaustion, or depersonalization and

inefficacy.

Emotional suffering is the most obvious and discernable among the three estimations.

The vast majority experiencing burnout effectively highlight weariness. Burnout is connected

with energetic suffering signs including disillusionment, cantankerousness, fomentation which

may later reason the absence of capacity to persevere through the enthusiastic and physical

qualities of the action. Regardless, deficiency of sentiments unfavorably impacts physical ability.

This makes individuals act in a manner that does not agree with their work and sufferers are not

prepared to persevere through the action demands. Skepticism and depersonalization is the

second component of the hypothesis. Depersonalization causes people to end up far off to one

another and the activity which is related with adverse feelings. This every so often happens when
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the individual is unable to connect himself with the activity requests coming about to

nonparticipation in the work.

Passionate depletion impacts the subsequent measurement. Occupation disappointment

may occur in this measurement. People may be considered as items as opposed to individuals.

Finally, inefficacy is the third component of the hypothesis. This measurement is seen advanced

than enthusiastic misery and skepticism. A general feeling of inadequacy and disgracefulness is

experienced at this stage after self-assessment from the presentation of the activity. Because of

this, there is a decline of individual accomplishments. This hypothesis pinpoints that burnouts

adversely impacts execution of the activity, turnover and relationship among people. In such

manner, poor employment individual may be considered because of proceeded with work

regardless of experiencing burnout.

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References

Firth, H., McIntee, J., McKeown, P., & Britton, P. G. (1985). Maslach Burnout Inventory: Factor

structure and norms for British nursing staff. Psychological Reports, 57(1), 147-150.

Nantsupawat, A., Nantsupawat, R., Kunaviktikul, W., Turale, S., & Poghosyan, L. (2016). Nurse

burnout, nurse‐reported quality of care, and patient outcomes in Thai hospitals. Journal

of Nursing Scholarship, 48(1), 83-90.