The factors associated with the burnout syndrome and fatigue in Cypriot nurses: a census report

BMC Public Health

Michael Talias³  Andreas Charalambous¹  Vasilios Raftopoulos² 

[1] Research Center for Oncology and Palliative Care, Cyprus University of Technology, 215 Paleos dromos lefkosias lemesou, Nicosia, Cyprus;Mediterranean Research Centre for Public Health and Quality of Care, Cyprus University of Technology, 215 Paleos dromos lefkosias lemesou, Nicosia, Cyprus;Open University of Cyprus, Nicosia, Cyprus

关键词: Maslach’s burnout scale;    Fatigue;    Nurses;    Burnout syndrome;   

Others  :  1163518
DOI  :  10.1186/1471-2458-12-457

 received in 2011-11-22, accepted in 2012-05-18,  发布年份 2012

【 摘 要 】

Background

Fatigue and burnout are two concepts often linked in the literature. However, regardless of their commonalities they should be approached as distinct concepts. The current and ever-growing reforms regarding the delivery of nursing care in Cyprus, stress for the development of ways to prevent burnout and effectively manage fatigue that can result from working in stressful clinical environments.

Methods

To explore the factors associated with the burnout syndrome in Cypriot nurses working in various clinical departments. A random sampling method taking into account geographical location, specialty and type of employment has been used.

Results

A total of 1,482 nurses (80.4% were females) working both in the private and public sectors completed and returned an anonymous questionnaire that included several aspects related to burnout; the MBI scale, questions related to occupational stress, and questions pertaining to self reported fatigue. Two-thirds (65.1%) of the nurses believed that their job is stressful with the majority reporting their job as stressful being female nurses (67.7%). Twelve point eight percent of the nurses met Maslach’s criteria for burnout. The prevalence of fatigue in nurses was found 91.9%. The prevalence of fatigue was higher in females (93%) than in males (87.5%) (p = 0.003). As opposed to the burnout prevalence, fatigue prevalence did not differ among the nursing departments (p = 0.166) and among nurses with a different marital status (p = 0.553). Burnout can be associated adequately knowing if nurses find their job stressful, their age, the level of emotional exhaustion and depersonalization. It has been shown that the fatigue may be thought of as a predictor of burnout, but its influence is already accounted by emotional exhaustion and depersonalization.

Conclusion

The clinical settings in Cyprus appear as stress generating environment for nurses. Nurses working both in the private and public sector appear to experience low to severe burnout. Self-reported fatigue interferes to the onset of emotional exhaustion and depersonalization.

【 授权许可】

   
2012 Raftopoulos et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Pavlakis A: Mood Disturbances among nurses. Noseleutike 1996, 35(3):173-179. article in Greek
• [2]Payne N: Occupational Stressors and Coping as Determinants of Burnout in Female Hospice Nurses. J Adv Nurs 2001, 33(3):396-405.
• [3]Escot C, Artero S, Gandubert C, Boulenger JP, Ritchie K: Stress Levels in Nursing Staff Working in Oncology. Stress Heal 2001, 17:273-279.
• [4]Steenkamp WC, van der Merwe AE: The Psychosocial Functioning of Nurses in a Burn Unit. Burns 1998, 24:253-258.
• [5]Freudenberger HJ: Staff burn-out. J Social Issues 1974, 30(1):159-185.
• [6]Daley MR: Preventing worker burnout in child welfare. Child Welfare 1979, 58:443-450.
• [7]Cherniss C: “Job Burnout”: Growing Worry for Workers, Bosses. U.S. News & World Report 1980, 88(6):71-72.
• [8]Maslach C, Jackson SE: Maslach Burnout Inventory Manual. 2nd edition. Palo Alto, CA: Consulting Psychologists Press; 1986.
• [9]Maslach C, Jackson SE: Burnout in health professions: a social psychological analysis. In Social psychology of health and illness. Edited by Sanders GS, Suls J. Hillsdale, NJ: Lawrence Erlbaum Associates; 1982:227-251.
• [10]Sabo BM: Adverse psychosocial consequences: Compassion fatigue, burnout and vicarious traumatization: Are nurses who provide palliative and hematological cancer care vulnerable? Indian J Palliat Care 2008, 14:23-29.
• [11]Patrick K: Burnout in nursing. Aust J Adv Nurs 2007, 24(3):43-48.
• [12]Duquette A, Kerouac S, Sandhu B, et al.: Factors related to nursing burnout: a review of empirical knowledge. Issues Ment Health Nurs 1994, 15:337-358.
• [13]Melchior MEW, Bours GJJW, Schmitz P, Wittich Y: Burnout in psychiatric nursing: a meta-analysis of related variables. J Psychiatr Ment Health Nurs 1997, 4:193-201.
• [14]Schaufeli W: Opgebrand: Over de Achtergronden van Werkstress: Het Burnout-Syndroom (Burnout: About the Background of Work Stress: The Burnout Syndrome). the Netherlands: Donker, Rotterdam; 1990.
• [15]Duquette A, Sandhu BK, Beaudet L: Factors related to nursing burnout: a review of empirical knowledge. Issues Ment Health Nurs 1994, 15:337-358.
• [16]Devereux JM, Hastings RP, Noone S: Staff stress and burnout in intellectual disability services: work stress theory and its application. J Appl Res Intellect Disabil 2009, 22:561-573.
• [17]Devereux JM, Hastings RP, Noone S, Firth A, Totsika V: Special support and coping as mediators or moderators of the impact of work stressors on burnout in intellectual disability support staff. Res Dev Disabil 2009, 30(2):367-377.
• [18]Maslach C, Schaufeli WB, Leiter MP, Maslach C, Schaufeli WB, Leiter MP: Job burnout. Edited by S. T. Fiske, D. L. Schacter, & C. Zahn-Waxler. Annu Rev Psychol 2001, 52:397-422.
• [19]Valent P: Diagnosis and treatment of helper stresses, traumas, and illnesses. In Treating Compassion Fatigue. Edited by Figley C. New York: Routledge; 2002.
• [20]Shen J, Barbera J, Shapiro CM: Distinguishing sleepiness and fatigue: focus on definition and measurement. Sleep Rev 2006, 10(1):63-76.
• [21]Joinson C: Coping with compassion fatigue. Nursing 1992, 22(4):118-121.
• [22]Yoder EA: Compassion fatigue in nurses. Appl Nurs Res 2010, 23:191-197.
• [23]Janssen N, Kant IJ, Swaen GMH, Janssen PPM, Schroer CAP: Fatigue as a predictor of sickness absence: results from the Maastricht cohort study on fatigue at work. Occup Environ Med 2003, 60:71-76.
• [24]Van Amelsvoort LG, Kant IJ, Beurskens AJ, Schroer CA, Swaen GM: Fatigue as a predictor of work disability. Occup Environ Med 2002, 59:712-713.
• [25]Flin R, Fletcher G, McGeorge P, Sutherland A, Patey R: Anaesthetists’ attitudes to teamwork and safety. Anaesthesia 2003, 58:233-242.
• [26]Howard SK, Rosekind MR, Katz JD, Berry AJ: Fatigue in anesthesiology. Implications and strategies for patient and provider safety. Anesthesiology 2002, 97(5):1281-1294.
• [27]Parker PA, Kulik JA: Burnout, self- and supervisor-related job performance, and absenteeism among nurses. J Behav Med 1995, 18:581-599.
• [28]Leiter M, Harvie P, Frizzell C: The correspondence of patient satisfaction and nurse burnout. Soc Sci Med 1998, 47:1611-1617.
• [29]Wolf DM, Lehman L, Quinlin R, Zullo T, Hoffman L: Effect of patient-centered care on patient satisfaction and quality of care. J Nurs Care Qual 2008, 23(4):316-321.
• [30]Bergeson SC, Dean JD: A systems approach to patient-centered care. J Am Med Assoc 2006, 296(23):2848-2851.
• [31]Charalambous A, Papadopoulos I, Beadsmoore A: Listening to the voices of patients with cancer, their advocates and their nurses: a hermeneutic-phenomenological study of quality nursing care. Eur J Oncol Nurs 2008, 12(5):436-442.
• [32]Roupa Z, Raftopoulos V, Tzavelas G, Sapountzi-Krepia D, Kotrotsiou E: Correlation of burnout syndrome and life satisfaction in the oncology nurses. Noseleutike 2008, 47(2):247-255. in Greek
• [33]Raftopoulos V, Savva N, Papadopoulou M: Safety culture in the maternity units: a census survey using the Safety Attitudes Questionnaire. BMC Health Serv Res 2011, 11:238. BioMed Central Full Text
• [34]Brown LK, Shulz JR, Forsberg AD, King G, Kocik SM, Butler RB: Predictors of Retention among HIV/hemophilia Health Care Professionals. Gen Hosp Psychiatr 2002, 24:48-54.
• [35]Provan H, Raftopoulos V, Soteriades E: Use of occupational health services in a Cyprus oncology center. AAOHN J 2009, 57(5):198-201.
• [36]Lynn MR: Determination and quantification of content validity. Nurs Res 1986, 35:382-385.
• [37]Cohen J: Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychol Bull 1968, 70(4):213-220.
• [38]Pines A, Burnout AE: From tedium to personal growth. New York: The Free Press; 1981.
• [39]Jones WJ: The staff burnout scale for health professionals (SBS-HP). Park Ridge, IL: London House; 1980.
• [40]Matthiesen S: Ildsjeler brenner ikke evig - om utbrenthet i arbeidslivet [Enthusiasm does not last forever - about burnout in working life]. In Det Gode arbeidsmiljø: Krav og utfordringer [The good work environment: Demands and challenges]. 3rd edition. Edited by Einarsen S, Skogstad A. Bergen: Fagbokforl; 2000:287-312.
• [41]Papadatou D, Anagnostopoulos F, Monos D: Factors contributing to the development of burnout in oncology nursing. Br J Med Psychol 1994, 67:187-199.
• [42]Pavlakis A, Raftopoulos V, Theodorou M: Burnout syndrome in Cypriot physiotherapists: a national survey. BMC Health Serv Res 2010, 10:63. BioMed Central Full Text
• [43]Maslach C, Jackson SE, Leiter MP: Maslach Burnout Inventory. 3rd edition. Palo Alto, California: Consulting Psychologists Press Inc; 1996.
• [44]Soler JK, Yaman H, Esteva M, Dodds F, Spiridonova Asenova R, Katic M, Ozavacic Z, Desgranges JP, Moreau A, Lionis C, Kotanyi P, Carelli F, Nowak PR, de Aguiar Sa Azeredo Z, Marklund E, Churchill D, Ungan M: Burnout in European family doctors: the EGPRN Study. Fam Pract 2008, 25:245-265.
• [45]Molassiotis A, Haberman M: Evaluation of Burnout and Job Satisfaction in Marrow Transplant Nurses. Cancer Nurs 1996, 19(5):360-367.
• [46]Hannigan B, Edwards D, Coyle D, Fothergill A, Burnard P: Burnout in Community Mental Health Nurses: Findings From the All-Wales Stress Study. J Psychiatr Ment Health Nurs 2000, 7(2):127-134.
• [47]Coffey M, Coleman M: The Relationship between Support and Stress in Forensic Community Health Nursing. J Adv Nurs 2001, 34(3):397-407.
• [48]Nunnally JC, Bernstein IH: Psychometric Theory. 3rd edition. New York: McGraw-Hill; 1994.
• [49]Carayon P, Gurses AP: A human factors engineering conceptual framework of nursing workload and patient safety in intensive care units. Intensive Crit Care Nurs 2005, 21:284-301.
• [50]Edwards D, Burnard P, Coyle D, Fothergill A, Hannigan B: Stress and Burnout in Community Mental Health Nursing: A Review of the Literature. J Psychiatr Ment Health Nurs 2000, 7(1):7-14.
• [51]Maytum J, Heiman H, Garwick A: Compassion fatigue and burnout in nurses who work with chronic conditions and their families. J Pediatr Health Care 2004, 18(4):172-179.
• [52]Buunk BP, Ybema JF, Van Der Zee K, Schaufeli WB, Gibbons FX: Affect generated by social comparisons among nurses high and low in Burnout. J Appl Psychol 2001, 31(7):1500-1520.
• [53]Hall L: Burnout: Results of an Empirical Study of New Zealand Nurses. Contemp Nurse 2001, 11(1):71-83.
• [54]Keane A, DuCette J, Adler C: Stress in I.C.U and non I.C.U nurses. Nurs Res 1985, 34:231-236.
• [55]Schmitz N, Neumann W, Oppermann R: Stress, burnout and locus of control in German nurses. Int J Nurs Stud 2000, 37:95-99.
• [56]Kelly JG, Cross DG: Stress, Coping Behaviors and Recommendations for Intensive Care and Medical Surgical Ward Registered Nurses. Res Nurs Health 1985, 8:321-328.
• [57]Maloney J: Job Stress and it Consequences in a Group of Intensive Care and Non-Intensive Care Nurses. Adv Nurs Sci 1982, 4(2):31-42.
• [58]Van Servellen G, Leake B: Burn-out in Hospital Nurses: A Comparison of Acquired Immune Deficiency Syndrome, Oncology, General Medical and Intensive Care Unit Nurse Samples. J Prof Nurs 1993, 9(3):169-177.
• [59]Giovannetti P, Estabrooks CA, Hesketh KL: Alberta Nurse Survey Final Report. (Report No. 02-01-TR). Alberta: Edmonton University of Alberta, Faculty of Nursing; 2002.
• [60]Jaracz K, Górna K, Konieczna J: Burnout, stress and styles of coping among hospital nurses. Roczniki Akademii Medycznej w Białymstoku 2005, 50(1):216-219.
• [61]Bartz C, Maloney JP: Burnout among Intensive Care Nurses. Res Nurs Health 1986, 9(2):147-153.
• [62]Chiriboga DA, Bailey J: Stress and burnout among critical care and medical surgical nurses: A comparative study. Crit Care Quart 1986, 9(3):84-92.
• [63]Foxall MJ, Zimmerman L, Standley R, Bene B: A comparison of frequency and sources of nursing job stress perceived by Intensive Care, Hospice and Medical-surgical Nurses. J Adv Nurs 1990, 15(5):577-584.
• [64]Soupios MA, Lawry K: Stress on personnel working in a critical care unit. Psychiatr Med 1987, 5:187-198.
• [65]Donchin Y, Seagull FJ: The hostile environment of the intensive care unit. Curr Opin Crit Care 2002, 8:316-320.
• [66]Sexton JB, Thomas EJ, Helmreich RL: Error, stress, and teamwork in medicine and aviation: Cross sectional surveys. BMJ 2000, 320(7237):745-749.
• [67]Ruggiero J: Correlates of fatigue in critical care nurses [PhD dissertation]. Newark, NJ: Rutgers, the State University of New Jersey; 2002. UMI no. 3043635
• [68]Zboril-Benson LR: Why nurses are calling in sick: The impact of health-care restructuring. Can J Nurs Res 2002, 33(4):89-107.
• [69]Schaffner MJ: Antecedents and consequences of work-related nurse fatigue: A preliminary evidence-based model [PhD dissertation]. Charleston, SC, UMI no: Medical University of South Carolina; 2006. 3254253
• [70]Yates K, Usher K, Kelly J: The dual roles of rural midwives: the potential for role conflict and impact on retention. Collegian 2011, 18(3):107-113.
• [71]Karsh B, Holden RJ, Alper SJ, Or CK: A human factors engineering paradigm for patient safety designing to support the performance of the health care professional. Qual Saf Healthcare 2006, 15(suppl 1):i59-i65.