Burnout and Resilience in Psychiatric Hospital Care-givers: A Cross-Sectional Study Using Mediation and Path Analyses
DOI:
https://doi.org/10.17140/PHOJ-3-126Keywords:
Burnout resilience; Mediation analysis; Path analysis.Abstract
Background The role of resilience in mediating burnout in psychiatric hospital care-givers has not been well established in the published research. This study attempted to identify the salient factors associated with the development of burnout, specifically resilience, through a secondary analysis of data collected in a study of post-traumatic stress symptoms in a sample of hospital employees. MethodsAn analysis of data collected in a correlational study with a convenience sample of 149 care-givers in a psychiatric hospital was performed, comparing the rate of traumatic events (TEs), resilience, confidence, PTSD symptoms (PTSS), secondary traumatic stress, compassion satisfaction, and life events to burnout. The analysis employed multiple linear regression, mediation analysis and path analysis. ResultsIt was observed that episodes of trauma stress, resilience and compassion satisfaction, combined, robustly predict burnout (explained variance=65%), but that each variable is a weak predictor. In addition, resilience was not related to trauma and stress and did not mediate burnout. This finding presents a paradigm suggesting that there may be two distinctly separate pathways affecting burnout, one involving traumatic stress and the other–resilience and compassion satisfaction. ConclusionThe effect of resilience in the development of burnout may be limited to its relationship to role satisfaction (compassion satisfaction) and unrelated to traumatic stress.
References
Zerach G, Shalev T. The relations between violence exposure, posttraumatic stress symptoms, secondary traumatization, vicarious post traumatic growth and illness attribution among psychiatric nurses. Arch Psychiatr Nurs. 2015; 29(3): 135-142. doi: 10.1016/J.APNU.2015.01.002
Jacobowitz W, Moran C, Best C, Mensah L. Post-traumatic stress, trauma-informed care, and compassion fatigue in psychiatric hospital staff: A correlational study. Issues Ment Health Nurs. 2015; 36(11): 890-899. doi: 10.3109/01612840.2015.1055020
Cieslak R, Shoji K, Douglas A, Melville E, Luszczynska A, Benight C. A meta-analysis of the relationship between job burnout and secondary traumatic stress among workers with indirect exposure to trauma. Psychol Serv. 2014; 11(1): 75-86. doi: 10.1037/a0033798
Aronsson G, Theorell T, Grape T, et al. A systematic review including meta-analysis of work environment and burnout symptoms. BMC Public Health. 2017; 17(1): 264. doi: 10.1186/ s12889-017-4153-7
Poghosyan L, Aiken L, Sloane D. Factor structure of the Maslach burnout inventory: An analysis of data from large scale cross-sectional surveys of nurses from eight countries. Int J Nurs Stud. 2009; 46(7): 894-902. doi: 10.1016/j.ijnurstu.2009.03.004
MaslachC, Jackson S. The measurement of experienced burnout. Journal of Organizational Behavior. 1981; 2(2): 99-113. doi: 10.1002/ job.4030020205
Lopez A. Posttraumatic stress disorder and occupational performance: Building resilience and fostering occupational adaptation. Work. 2011; 38(1): 33-38. doi: 10.3233/WOR-2011-
Lim N, Kim EK, Kim H, Lee SM. Individual and work-related factors influencing burnout of mental health professionals: A meta-analysis. 2010; 47(2): 86-96. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission .
Guo Y, Luo Y, Lam L, Cross W, Plummer V, Zhang J. Burnout and its association with resilience in nurses: A cross-sectional study. J Clin Nurs. 2018; 27(1-2): 441-449. doi: 10.1111/jocn.13952
Kutluturkan S, Sozeri E, Uysal N, Bay F. Resilience and burnout 27 Jacobowitz W status among nurses working in oncology. Ann Gen Psychiatry. 2016; 15(1): 33. doi: 10.1186/s12991-016-0121-3
Magtibay D, Chesak S, Coughlin K, Sood A. Decreasing stress and burnout in nurses: Efficacy of blended learning with stress management and resilience training program. J Nurs Adm. 2017; 47(7-8): 391-395. doi: 10.1097/NNA.0000000000000501
Simpkin A, Khan A, West D, et al. Stress from uncertainty and resilience among depressed and burned out residents: A cross-sectional Sstudy. Acad Pediatr. 2018; 18(6): 698-704. doi: 10.1016/j. acap.2018.03.002
Colville G, Dalia C, Brierley J, Abbas K, Morgan H, Perkins-Porras L. Burnout and traumatic stress in staff working in paediatric intensive care: associations with resilience and coping strategies. Intensive Care Med. 2014; 41(2): 364-365. doi: 10.1007/ s00134-014-3559-2
Harker R, Pidgeon A, Klaassen F, KingS. Exploring resilience and mindfulness as preventative factors for psychological distress burnout and secondary traumatic stress among human service professionals. Work. 2016; 54(3): 631-637. doi: 10.3233/WOR-
Mealer M, Jones J, Meek P. Factors affecting resilience and development of posttraumatic stress disorder in critical care nurses. Am J Crit Care. 2017; 26(3): 184-192. doi: 10.4037/ajcc2017798
Rodríguez-Rey R, Palacios A, Alonso-Tapia J, et al. Burnout and posttraumatic stress in paediatric critical care personnel: Prediction from resilience and coping styles. Aust Crit Care. 2018; pii: S1036- 7314(17)30322-30323. doi: 10.1016/j.aucc.2018.02.003
Treglown L, Palaiou K, Zarola A, Furnham A. The dark side of resilience and burnout: A moderation-mediation model. PLoS One. 2016; 11(6): e0156279. doi: 10.1371/journal.pone.0156279
Arrogante O, Aparicio-Zaldivar E. Burnout and health among critical care professionals: The mediational role of resilience. Intensive Crit Care Nurs. 2017; 42: 110-115. doi: 10.1016/j. iccn.2017.04.010
García-Izquierdo M, Meseguer de Pedro M, Ríos-Risquez M, Sánchez M. Resilience as a moderator of psychological health in situations of chronic stress (burnout) in a sample of hospital nurses. J Nurs Scholarsh. 2018; 50(2): 228-236. doi: 10.1111/jnu.12367
Shi Y, Guo H, Zhang S, et al. Impact of workplace incivility against new nurses on job burn-out: A cross-sectional study in China. BMJ Open. 2018; 8(4): e020461. doi: 10.1136/ bmjopen-2017-020461
Tian X, Liu C, Zou G, Li G, Kong L, Li P. Positive resources for combating job burnout among Chinese telephone operators: Resilience and psychological empowerment. Psychiatry Res. 2015; 228(3): 411-415. doi: 10.1016/j.psychres.2015.05.073
Meyers L, Gamst G, Guarino A. Applied Multivariate Research: Design and Interpretation. Los Angeles, US: SAGE Publications Inc. 2017.
Stamm B. The Concise ProQOL Manual. Pocatello, ID: ProQOL. Org, 78; Web site: http://proqol.org/uploads/ ProQOL_Concise_2ndEd_12-2010.pdf. 2010.
Wagnild G. A review of the resilience scale. J Nurs Meas. 2009; 17(2): 105-113. doi: 10.1891/1061-3749.17.2.105
Hemsworth D, Baregheh A, Aoun S, Kazanjian A. A critical enquiry into the psychometric properties of the professional quality of life scale (ProQol-5) instrument. Appl Nurs Res. 2018; 39: 81-88. doi: 10.1016/J.APNR.2017.09.006
Thackrey M. Clinician confidence in coping with patient aggression: Assessment and enhancement. Professional Psychology Research and Practice. 1987; 18(1): 57-60. doi.: 10.1037/0735- 7028.18.1.57
Aggarwal S, Prabhu C, Anand L, Kotwal L. Stressful life events among adolescents: The development of a new measure. Indian J Psychiatry. 2007; 49(2): 96-102. doi: 10.4103/0019-5545.33255
Weathers F, Blake D, Kaloupek D, Marx B, Kean TM. Life Events Checklist for DSM-5 (LEC-5)-Standard Version-Fillable Form. https://www.ptsd.va.gov/professional/assess. 2004.
Ruggiero K, Del Ben K, Scotti J, Rabalais A. Psychometric properties of the PTSD checklist-civilian version. J Trauma Stress. 2003; 16(5): 495-502. doi: 10.1023/A:1025714729117
Weathers L, Huska K. PCL-C for DSM-IV. National Center for PTSD-Behavioral Science Division. http://library.niwap.org/ wp-content/uploads/2015/PTSDChecklist.pdf. 1994.
Cohen J, Cohen P, West S, Aiken L. Applied Multiple Regression/ Correlation Analysis for the Behavioral Sciences. New York, US: Routledge. 2002.
Chatzea V, Sifaki-Pistolla D, Vlachaki S, Melidoniotis E, Submit your article to this journal | https://openventio.org/submit-manuscript/ Jacobowitz W Pistolla G. PTSD, burnout and well-being among rescue workers: Seeking to understand the impact of the European refugee crisis on rescuers. Psychiatry Res. 2018; 262: 446-451. doi: 10.1016/J. PSYCHRES.2017.09.022
Czaja AS, Moss M, Mealer M. Symptoms of posttraumatic stress disorder among pediatric acute care nurses. J Pediatr Nurs. 2012; 27(4): 357-365. doi: 10.1016/j.pedn.2011.04.024
Gascon S, Leiter M, Andrés E, et al. The role of aggressions suffered by healthcare workers as predictors of burnout. J Clin Nurs. 2013; 22(21-22): 3120-3129. doi: 10.1111/j.1365- 2702.2012.04255.x
Sheen K, Spiby H, Slade P. Exposure to traumatic perinatal experiences and posttraumatic stress symptoms in midwives: Prevalence and association with burnout. Int J Nurs Stud. 2015; 52(2): 578-87. doi: 10.1016/j.ijnurstu.2014.11.006
Burnett H, Willis K, Burnett H. The power of stress: Perceived stress and its relationship with rumination, self-concept clarity, and resilience. North American Journal of Psychology. 2016; 18(3): 483-498.
Fortney L, Luchterhand C, Zakletskaia L, Zgierska A, Rakel, D. Abbreviated mindfulness intervention for job satisfaction, quality of life, and compassion in primary care clinicians: A pilot study. Ann Fam Med. 2013; 11(5): 412-420. doi: 10.1370/afm.1511
Aiena BJ, Baczwaski BJ, Schulenberg SE, Buchanan EM. Measuring resilience with the RS-14: A tale of two samples. J Pers Assess. 2015; 97(3): 291-300. doi: 10.1080/00223891.2014.951445
Pritzker S, Minter A. Measuring adolescent resilience: An examination of the cross-ethnic validity of the RS-14. Children and Youth Services Review. 2014; 44: 328-333. doi: 10.1016/J. CHILDYOUTH.2014.06.022
Mangoulia P, Koukia E, Alevizopoulos G, Fildissis G, Katostaras, T. Prevalence of secondary traumatic stress among psychiatric nurses in greece. Arch Psychiatr Nurs. 2015; 29(5): 333- 338. doi: 10.1016/j.apnu.2015.06.001
Lauvrud C, Nonstad K, Palmstierna T. Occurrence of post traumatic stress symptoms and their relationship to professional quality of life (ProQoL) in nursing staff at a forensic psychiatric security unit: A cross-sectional study. Health and Qual Life Outcomes. 2009; 7: 31. doi: 10.1186/1477-7525-7-31
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Public Health - Open Journal (PHOJ) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.