Emotional Exhaustion in Healthcare Workers: Moving Beyond Coping Skills to Improve Organizational Conditions.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Additional Information
    • Source:
      Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9504688 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1536-5948 (Electronic) Linking ISSN: 10762752 NLM ISO Abbreviation: J Occup Environ Med Subsets: MEDLINE
    • Publication Information:
      Publication: Hagerstown, MD : Lippincott Williams & Wilkins
      Original Publication: Baltimore, MD : Williams & Wilkins, c1995-
    • Subject Terms:
    • Abstract:
      Objective: Emotional exhaustion (EE)-the first stage of burnout-is related to preventable work environment exposures. We examined the understudied impact of organizational support for safety (OSS) and safety hazards (SH) on EE in a mixed licensed and unlicensed population of healthcare workers (HCWs).
      Methods: A work environment exposures survey was conducted in five US public healthcare facilities in 2018-2019. A total of 1059 questionnaires were collected from a predominantly female population of mixed HCWs.
      Results: Mean EE scores were higher among women, direct care workers, and younger subjects. In linear regression models, EE was positively associated with SH, emotional labor, psychological demands, physical demands, job strain, assault, and negative acts, while OSS was negatively associated. Safety hazard s both mediated and moderated the relationship between OSS and EE.
      Conclusions: When perception of SH is high, OSS has less impact on reducing EE, suggesting a need to effectively put safety policies to practice for improving EE in HCWS.
      Competing Interests: Conflicts of interest: None declared.
      (Copyright © 2024 American College of Occupational and Environmental Medicine.)
    • References:
      Burn-out an “occupational phenomenon”: International Classification of Diseases. 2019. Available at: https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases . Accessed October 10, 2023.
      Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol 2001;52:397–422.
      Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry 2016;15:103–111.
      Koinis A, Giannou V, Drantaki V, Angelaina S, Stratou E, Saridi M. The impact of healthcare workers job environment on their mental-emotional health. Coping strategies: the case of a local general hospital. Health Psychol Res 2015;3:1984.
      Reith TP. Burnout in United States healthcare professionals: a narrative review. Cureus 2018;10:e3681.
      Rotenstein LS, Torre M, Ramos MA, et al. Prevalence of burnout among physicians: a systematic review. JAMA 2018;320:1131–1150.
      Monsalve-Reyes CS, San Luis-Costas C, Gómez-Urquiza JL, Albendín-García L, Aguayo R. Burnout syndrome and its prevalence in primary care nursing: a systematic review and meta-analysis. BMC Fam Pract 2018;19:59.
      Sexton JB, Adair KC, Proulx J, et al. Emotional exhaustion among US health care workers before and during the COVID-19 pandemic, 2019–2021. JAMA Netw Open 2022;5:e2232748.
      World Health Organization. Global Health Workforce statistics database. 2022. Available at: https://www.who.int/data/gho/data/themes/topics/health-workforce . Accessed October 10, 2023.
      World Health Organization. World failing in ‘our duty of care’ to protect mental health and well-being of health and care workers, finds report on impact of COVID-19. 2022. Available at: https://www.who.int/news/item/05-10-2022-world-failing-in--our-duty-of-care--to-protect-mental-health-and-wellbeing-of-health-and-care-workers--finds-report-on-impact-of-covid-19#:~:text=The%20report%20found%20that%2023,52%20percent%20in%20pooled%20estim . Accessed October 10, 2023.
      World Health organization. Guidelines on mental health at work. 2022. Available at: https://www.who.int/publications/i/item/9789240053052 . Accessed October 10, 2023.
      Hall LH, Johnson J, Watt I, Tsipa A, O’Connor DB. Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PLoS One 2016;11:e0159015.
      Stehman CR, Testo Z, Gershaw RS, Kellogg AR. Burnout, drop out, suicide: physician loss in emergency medicine, part I. West J Emerg Med 2019;20:485–494.
      Han S, Shanafelt TD, Sinsky CA, et al. Estimating the attributable cost of physician burnout in the United States. Ann Intern Med 2019;170:784–790.
      Maslach C. Chapter: Burnout in health professionals. Ayers S, Baum A, McManus C, et al. (eds) In: Cambridge handbook of psychology, health and medicine. Cambridge University Press; 2007:427–430. doi: 10.1017/CBO9780511543579.094.
      Kim M-N, Yoo Y-S, Cho O-H, Hwang K-H. Emotional labor and burnout of public health nurses during the COVID-19 pandemic: mediating effects of perceived health status and perceived organizational support. Int J Environ Res Public Health 2022;19:549.
      Dall’Ora C, Ball J, Reinius M, Griffiths P. Burnout in nursing: a theoretical review. Hum Resour Health 2020;18:41.
      Shah MK, Gandrakota N, Cimiotti JP, Ghose N, Moore M, Ali MK. Prevalence of and factors associated with nurse burnout in the US. JAMA Netw Open 2021;4:–e2036469.
      Yang T, Lei R, Jin X, et al. Supervisor support, coworker support and presenteeism among healthcare workers in China: the mediating role of distributive justice. Int J Environ Res Public Health 2019;16:817.
      Punnett L, Nobrega S, Zhang Y, et al. The Healthy Workplace Participatory Program: stepped-wedge protocol for prospective, controlled evaluation using mixed methods. BMC Public Health 2020;20:1463.
      Demerouti E, Bakker AB. The Oldenburg Burnout Inventory: A Good Alternative to Measure Burnout and Engagement. Halbesleben J (ed) In Handbook of Stress and Burnout in Health Care. Nova Science Publishers, Hauppauge, NY; 2008: 65–78.
      Kines P, Lappalainen J, Mikkelsen KL, et al. Nordic Safety Climate Questionnaire (NOSACQ-50): a new tool for diagnosing occupational safety climate. Int J Ind Ergon 2011;41:634–646.
      Karasek R, Pieper C, Schwartz J. Job Content Questionnaire and User's Guide. Revision 1.1 . USCLA: Los Angeles; 1985.
      Brotheridge CM, Lee RT. Development and validation of the Emotional Labour Scale. J Occup Organ Psych 2003;76:365–379.
      Sliter KA, Sliter MT. The concise PHYSICAL ACTIVITY QUESTIONNAIRE (CPAQ): its development, validation, and application to firefighter occupational health. Int J Stress Manag 2014;21:283–305.
      Walsh BM, Magley VJ, Reeves DW, Davies-Schrils KA, Marmet MD, Gallus JA. Assessing workgroup norms for civility: the development of the Civility Norms Questionnaire-Brief. J Bus Psychol 2012;27:407–420.
      SAS Institute Inc. 2023. SAS/STAT® 15.3 User’s Guide. Cary, NC: SAS Institute Inc.
      Yung Y-F, Lamm M, Zhang W. Causal Mediation Analysis With the CAUSALMED Procedure . Cary, NC: SAS Institute Inc; 2018:1991–2018.
      VanderWeele TJ. A unification of mediation and interaction: a 4-way decomposition. Epidemiology 2014;25:749–761.
      Valeri L, VanderWeele TJ. Mediation analysis allowing for exposure–mediator interactions and causal interpretation: theoretical assumptions and implementation with SAS and SPSS macros. Psychol Methods 2013;18:137–150.
      VanderWeele TJ. Mediation analysis: a practitioner's guide. Annu Rev Public Health 2016;37:17–32.
      Robins JM, Greenland S. Identifiability and exchangeability for direct and indirect effects. Epidemiology 1992;3:143–155.
      Pearl J. The foundations of causal inference. Sociol Methodol, 2010;40:75–149.
      West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet 2016;388:2272–2281.
      Westermann C, Kozak A, Harling M, Nienhaus A. Burnout intervention studies for inpatient elderly care nursing staff: systematic literature review. Int J Nurs Stud 2014;51:63–71.
      Panagioti M, Panagopoulou E, Bower P, et al. Controlled interventions to reduce burnout in physicians: a systematic review and meta-analysis. JAMA Intern Med 2017;177:195–205.
      Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol 1986;51:1173–1182.
      Rothman KJ, Greenland S, Walker AM. Concepts of interaction. Am J Epidemiol 1980;112:467–470.
      Pearl J. Interpretation and identification of causal mediation. Psychol Methods 2014;19:459–481.
      Corraini P, Olsen M, Pedersen L, Dekkers OM, Vandenbroucke JP. Effect modification, interaction and mediation: an overview of theoretical insights for clinical investigators. Clin Epidemiol 2017;9:331–338.
      Richiardi L, Bellocco R, Zugna D. Mediation analysis in epidemiology: methods, interpretation and bias. Int J Epidemiol 2013;42:1511–1519.
      VanderWeele TJ, Tchetgen Tchetgen EJ. Rejoinder: interacting on Interactions. Epidemiology 2014;25:727–728.
      Sjölander A, Chapter2: The Language of Potential Outcomes. Book Editor(s): Berzuini C, Dawid P, Bernardinelli L. Published: 25 June 2012. Book Series: Wiley Series in Probability and Statistics, Series Editor(s): Walter A, Shewhart, Samuel S. Wilks. Available at: https://doi.org/10.1002/9781119945710 . Accessed October 10, 2023.
      Boakye-Dankwa E, Teeple E, Gore R, Punnett L; Procare Research Team. Associations among health care workplace safety, resident satisfaction, and quality of care in long-term care facilities. J Occup Environ Med 2017;59:1127–1134.
      Plaku-Alakbarova B, Punnett L, Gore RJ; Procare Research Team. Nursing home employee and resident satisfaction and resident care outcomes. Saf Health Work 2018;9:408–415.
      International Labor Organization. Workplace Stress: A collective challenge. 2022. Available at: https://www.ilo.org/safework/info/publications/WCMS_466547/lang--en/index.htm . Accessed October 10, 2023.
      Halbesleben JR, Demerouti E. The construct validity of an alternative measure of burnout: investigating the English translation of the Oldenburg Burnout Inventory. Work & Stress 2005;19:208–220.
      Ahola K, Honkonen T, Kivimäki M, et al. Contribution of burnout to the association between job strain and depression: the health 2000 study. J Occup Environ Med 2006;48:1023–1030.
    • Grant Information:
      U19 OH012299 United States OH NIOSH CDC HHS
    • Publication Date:
      Date Created: 20240213 Date Completed: 20240409 Latest Revision: 20240409
    • Publication Date:
      20240409
    • Accession Number:
      10.1097/JOM.0000000000003063
    • Accession Number:
      38349324