Antecedents to Burnout Among Hospital Doctors: Can they cope?

Main Article Content

Aharon Tziner Or Shkoler Edna Rabenu Lior Oren

Abstract

With increasing stress and burnout accounting for depreciation in the physical and mental health of medical practitioners in hospital settings and the concomitant reduction in the level of their job performance, this paper reports on an attempt to tease out possible antecedents that give rise to burnout among 185 doctors practicing in a major hospital in the center of Israel. Based on the literature related to job performance and Hobfoll’s (2001) model of stress management – indicating that individuals cope with stress by replenishing both personal and work-related resources – we investigated the relationship between six possible input variables and burnout with a view to establishing the associations between them. The results indicated that all six possible antecedents associated with at least one of the three facets of burnout described by Maslach and Leiter (1997), namely, emotional exhaustion, depersonalization and reduced personal efficacy, with workload notably associating with all three criteria. The results are discussed with particular attention to practical suggestions whereby Human Resource Management in hospitals could adjust policy to ease the burden on their doctors and enhance the self- and public image of hospital practitioners.

Article Details

How to Cite
TZINER, Aharon et al. Antecedents to Burnout Among Hospital Doctors: Can they cope?. Medical Research Archives, [S.l.], v. 6, n. 10, oct. 2018. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/1859>. Date accessed: 21 nov. 2024. doi: https://doi.org/10.18103/mra.v6i10.1859.
Section
Research Articles

References

Ahola, K., Kivimäki, M., Honkonen, T., Virtanen, M., Koskinen, S., Vahtera, J., & Lönnqvist, J. (2008). Occupational burnout and medically certified sickness absence: a population-based study of Finnish employees. Journal of Psychosomatic Research, 64, 185-193.‏ https://doi.org/10.1016/j.jpsychores.2007.06.022
Amanullah, S., McNally, K., Zelin, J., Cole, J., & Cernovsky, Z. (2017). Are burnout prevention programs for hospital physicians needed?. Asian Journal of Psychiatry, 26, 66-69.‏ https://doi.org/10.1016/j.ajp.2017.01.009
Anthony‐McMann, P. E., Ellinger, A. D., Astakhova, M., & Halbesleben, J. R. (2017). Exploring different operationalizations of employee engagement and their relationships with workplace stress and burnout. Human Resource Development Quarterly, 28, 163-195.‏ https://doi.org/10.1002/hrdq.21276
Asuero, A. M., Queraltó, J. M., Pujol‐Ribera, E., Berenguera, A., Rodriguez‐Blanco, T., & Epstein, R. M. (2014). Effectiveness of a mindfulness education program in primary health care professionals: a pragmatic controlled trial. Journal of Continuing Education in the Health Professions, 34, 4-12.‏ https://doi.org/10.1002/chp.21211
Avolio, B. J., Yammarino, F. J., & Bass, B. M. (1991). Identifying common methods variance with data collected from a single source: An unresolved sticky issue. Journal of Management, 17, 571-587.‏ https://doi.org/10.1177/014920639101700303
Browne, M. W. (1975). Predictive validity of a linear regression equation. British Journal of Mathematical and Statistical Psychology, 28, 79-87. https://doi.org/10.1111/j.2044-8317.1975.tb00550.x
Caruso, C. C. (2006). Possible broad impacts of long work hours. Industrial Health, 44, 531-536.‏ https://doi.org/10.2486/indhealth.44.531
Caruso, C. C. (2014). Negative impacts of shiftwork and long work hours. Rehabilitation
Nursing, 39, 16-25. https://doi.org/10.1002/rnj.107
Chen, K.Y., Yang, C.M., Lien, C.H., Chiou, H.Y., Lin, M.R., Chang H.R., & Chiu, W.T. (2013). Burnout, job satisfaction, and medical malpractice among physicians. International Journal of Medical Sciences, 10, 1471-1478. http://dx.doi.org/10.7150/ijms.6743
Chernyak-Hai, L., & Tziner, A. (2016). The “I believe” and the “I invest” of Work-Family Balance: The indirect influences of personal values and work engagement via perceived organizational climate and workplace burnout. Revista de Psicología del Trabajo y de las Organizaciones, 32, 1-10. https://doi.org/10.1016/j.rpto.2015.11.004
Crawford, E. R., LePine, J. A., & Rich, B. L. (2010). Linking job demands and resources to employee engagement and burnout: A theoretical extension and meta-analytic test. Journal of Applied Psychology, 95, 834-848. http://dx.doi.org/10.1037/a0019364
Csikszentmihalyi, M., & LeFevre, J. (1989). Optimal experience in work and leisure. Journal of Personality and Social Psychology, 56, 815-822. http://dx.doi.org/10.1037/0022-3514.56.5.815
Diener, E., Suh, E., & Oishi, S. (1997). Recent findings on subjective well-being. Indian Journal of Clinical Psychology, 24, 25-41.‏ Retrieved from: https://intranet.newriver.edu/images/stories/library/Stennett_Psychology_Articles/Recent%20Findings%20on%20Subjective%20Well-Being.pdf
Dunford, B. B., Shipp, A. J., Boss, R. W., Angermeier, I., & Boss, A. D. (2012). Is burnout static or dynamic? A career transition perspective of employee burnout trajectories. Journal of Applied Psychology, 97, 637-650.‏ http://dx.doi.org/10.1037/a0027060
Schilling, E. J., Randolph, M., & Boan-Lenzo, C. (2017). Job burnout in school psychology: How big Is the problem?. Contemporary School Psychology, 22, 1-8. https://doi.org/10.1007/s40688-017-0138-x
Goodman, A., Mazerolle, S. M., & Eason, C. M. (2017). Organizational infrastructure in the collegiate athletic training setting, part II: Benefits of and barriers in the athletics model. Journal of Athletic Training, 52, 23-34.‏ https://doi.org/10.4085/1062-6050-51.12.24
Green, F. (2008). Work effort and worker well-being in the age of affluence. In R. J.,
Burke, and C. L., Cooper (Eds.), The long work hours culture: Causes, consequences
and choices (pp. 115-36). London, UK: Emerald Group Publishing.
Hakanen, J. J., & Schaufeli, W. B. (2012). Do burnout and work engagement predict depressive symptoms and life satisfaction? A three-wave seven-year prospective study. Journal of Affective Disorders, 141, 415-424.‏ https://doi.org/10.1016/j.jad.2012.02.043
Halbesleben, J. R., & Rathert, C. (2008). Linking physician burnout and patient outcomes: exploring the dyadic relationship between physicians and patients. Health Care Management Review, 33, 29-39.‏ http://dx.doi.org/10.1097/01.HMR.0000304493.87898.72
Hansen, A., Buitendach, J. H., & Kanengoni, H. (2015). Psychological capital, subjective well-being, burnout and job satisfaction amongst educators in the Umlazi region in South Africa. SA Journal of Human Resource Management, 13, 1-9. http://hdl.handle.net/10520/EJC177943
Hobfoll, S.E. (1989). Conservation of resources: A new attempt at conceptualizing stress. American Psychologist, 44, 513-524. http://dx.doi.org/10.1037/0003-066X.44.3.513
Hobfoll, S. E. (2001). The influence of culture community and the nested-self in the stress process: Advancing conservation of resources theory. Applied Psychology, 50, 337-421. https://doi.org/10.1111/1464-0597.00062
Imo, U. O. (2017). Burnout and psychiatric morbidity among doctors in the UK: a systematic literature review of prevalence and associated factors. BJPsych Bulletin, 41, 197-204.‏
https://doi.org/10.1192/pb.bp.116.054247
Kelly, L. A., & Lefton, C. (2017). Effect of meaningful recognition on critical care nurses' compassion fatigue. American Journal of Critical Care, 26, 438-444. https://doi.org/10.4037/ajcc2017471
Kristof, A. L. (1996). Person-organization fit: An integrative review of its conceptualizations,
measurement, and implications. Personnel Psychology, 49, 1-49. https://doi.org/10.1111/j.1744-6570.1996.tb01790.x
Kristof-Brown, A. L., Zimmerman, R. D., & Johnson, E. C. (2005). Consequences of
individuals’ fit at work: A meta-analysis of person-job, person-organization, person-
group, and person-supervisor fit. Personnel Psychology, 58, 281-342. https://doi.org/10.1111/j.1744-6570.2005.00672.x
Kushnir, T., & Cohen A.H. (2006). Job structure and burnout among primary care pediatricians. Work: A Journal of Prevention, Assessment and Rehabilitation, 27, 67-74. Retrieved from: https://www.researchgate.net/profile/Talma_Kushnir/publication/6912488_Job_structure_and_burnout_among_primary_care_pediatricians/links/0046351e6d9085d8f3000000/Job-structure-and-burnout-among-primary-care-pediatricians.pdf
Kushnir, T., Levhar, C., & Cohen A.H. (2004). Are burnout levels increasing? The experience of Israeli primary care physicians. Israel Medical Association Journal, 6, 451-455. Retrieved from: https://www.ima.org.il/FilesUpload/IMAJ/0/52/26177.pdf
Leiter, M. P., & Maslach, C. (2002). Areas of worklife survey manual. Wolfville, NS: Centre
for Organizational Research & Development.
Leiter, M. P., & Maslach, C. (2003). Areas of worklife: A structured approach to
organizational predictors of job burnout. In P. L., Perrewe, and D. C., Ganster
(Eds.), Emotional and physiological processes and positive intervention strategies
(Research in Occupational Stress and Well-being, Vol. 3) (pp. 91-134). Oxford, UK:
Elsevier.
Lim, V. K., & Yuen, E. C. (1998). Doctors, patients, and perceived job image: an empirical study of stress and nurses in Singapore. Journal of Behavioral Medicine, 21, 269-282.‏ https://doi.org/10.1023/A:1018769000750
Marchand, A., Durand, P., Haines, V., & Harvey, S. (2015). The multilevel determinants of workers’ mental health: results from the SALVEO study. Social Psychiatry and Psychiatric Epidemiology, 50, 445-459. https://doi.org/10.1007/s00127-014-0932-y
Marek, T., Schaufeli, W. B., & Maslach, C. (2017). Professional burnout: Recent developments in theory and research. NY, New York: Routledge.‏
Maslach, C. (2003). Job burnout: New directions in research and intervention. Current Directions in Psychological Science, 12, 189-192. http://dx.doi.org/10.1111/1467-8721.01258
Maslach, C. (2011). Burnout and engagement in the workplace: New perspectives. The
European Health Psychologist, 13, 44-47. Retrieved from: http://www.ehps.net/ehp/index.php/contents/article/viewFile/ehp.v13.i3.p44/997
Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of
Organizational Behavior, 2, 99-113. https://doi.org/10.1002/job.4030020205
Maslach, C., & Leiter, M. P. (1997). The truth about burnout. San Francisco, CA:
Jossey-Bass
Nahrgang, J. D., Morgeson, F. P., & Hofmann, D. A. (2011). Safety at work: a meta-analytic investigation of the link between job demands, job resources, burnout, engagement, and safety outcomes. Journal of Applied Psychology, 96, 71-95.‏ http://dx.doi.org/10.1037/a0021484
Nguyen, H. T. T., Kitaoka, K., Sukigara, M., & Thai, A. L. (2018). Burnout study of clinical nurses in Vietnam: Development of job burnout model based on Leiter and Maslach's theory. Asian Nursing Research, 12, 42-49.‏ https://doi.org/10.1016/j.anr.2018.01.003
Nirel, N., Shirom, A., & Ismail, S. (2003). Consultant doctors in Israel: Employment characteristics and implications to their work life [in Hebrew]. Joint Israel: Brookdale Institute.
Oh, I. S., Guay, R. P., Kim, K., Harold, C. M., Lee, J. H., Heo, C. G., & Shin, K. H. (2014). Fit happens globally: A meta‐analytic comparison of the relationships of person–environment fit dimensions with work attitudes and performance across East Asia, Europe, and North America. Personnel Psychology, 67, 99-152.‏ https://doi.org/10.1111/peps.12026
Olafsen, A. H. (2017). The implications of need-satisfying work climates on state mindfulness in a longitudinal analysis of work outcomes. Motivation and Emotion, 41, 22-37.‏ https://doi.org/10.1007/s11031-016-9592-4
Podsakoff, P. M., MacKenzie, S. B., Lee, J. Y., & Podsakoff, N. P. (2003). Common method biases in behavioral research: A critical review of the literature and recommended remedies. Journal of Applied Psychology, 88, 879-903.‏ http://dx.doi.org/10.1037/0021-9010.88.5.879
Regehr, C., Glancy, D., Pitts, A., & LeBlanc, V. R. (2014). Interventions to reduce the consequences of stress in physicians: a review and meta-analysis. The Journal of Nervous and Mental Disease, 202, 353-359. https://doi.org/10.1097/NMD.0000000000000130 ‏
Richter, A., Kostova, P., Baur, X., & Wegner, R. (2014). Less work: more burnout? A comparison of working conditions and the risk of burnout by German physicians before and after the implementation of the EU Working Time Directive. International Archives of Occupational and Environmental Health, 87, 205-215.‏ https://doi.org/10.1007/s00420-013-0849-x
Salgado, J. F. (1998). Sample size in validity studies of personnel selection. Journal of Occupational and Organizational Psychology, 71, 161-164. https://doi.org/10.1111/j.2044-8325.1998.tb00669.x
Shamai, O., Harpaz, I., & Snir, R. (2012, August). Would you be happier if you worked
harder? A comparison of life satisfaction in workers’ types. Academy of Management
Meeting, Boston, MA.
Shamai, O. (2015). The relationship between heavy work investment and employees’
happiness. In I., Harpaz, and R., Snir (Eds.), Heavy work investment: Its nature,
sources, outcomes, and future directions (pp. 204-222). New York, NY: Routledge.
Shanafelt, T. D., Boone, S., Tan, L., Dyrbye, L. N., Sotile, W., Satele, D., West, C. P., Sloan, J., & Oreskovich, M. R. (2012). Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Archives of Internal Medicine, 172, 1377-1385.‏ https://doi.org/10.1001/archinternmed.2012.3199
Schaufeli, W. B., Shimazu, A., & Taris, T. W. (2009). Being driven to work excessively hard: The evaluation of a two-factor measure of workaholism in the Netherlands and Japan. Cross-Cultural Research, 43, 320-348.‏ https://doi.org/10.1177/1069397109337239
Schaufeli, W. B., Taris, T. W., & Van Rhenen, W. (2008). Workaholism, burnout, and work engagement: Three of a kind or three different kinds of employee well‐being?. Applied Psychology, 57, 173-203.‏ https://doi.org/10.1111/j.1464-0597.2007.00285.x
Shkoler, O., Rabenu, E., & Tziner, A. (2017). The dimensionality of workaholism and its relations with internal and external factors. Revista de Psicología del Trabajo y de las Organizaciones, 33, 193-203.‏ https://doi.org/10.1016/j.rpto.2017.09.002
Shkoler, O., Rabenu, E., Vasiliu, C., Sharoni, G., & Tziner, A. (2017). Organizing the confusion surrounding workaholism: New structure, measure, and validation. Frontiers in Psychology, 8, 1803. https://doi.org/10.3389/fpsyg.2017.01803
Shkoler, O., & Tziner, A. (2015). Job engagement: Antecedents and outcomes. Journal of Organizational Psychology, 15, 34-48. Retrieved from: http://t.www.na-businesspress.com/JOP/TzinerA_Web15_1_.pdf
Shkoler, O., & Tziner, A. (2017). The mediating and moderating role of burnout and emotional intelligence in the relationship between organizational justice and work misbehavior. Revista de Psicologia del Trabajo y de las Organizaciones, 33, 157-164.‏ https://doi.org/10.1016/j.rpto.2017.05.002
Shimizu, T., Feng, Q., & Nagata, S. (2005). Relationship between turnover and burnout among Japanese hospital nurses. Journal of Occupational Health, 47, 334-336. https://doi.org/10.1539/joh.47.334
Shirom, A., Nirel, N., & Vinokur, A. D. (2010). Work hours and caseload as predictors of physician burnout: the mediating effects by perceived workload and by autonomy. Applied Psychology, 59, 539-565. https://doi.org/10.1111/j.1464-0597.2009.00411.x
Snir, R., & Harpaz, I. (2012). Beyond workaholism: Towards a general model of heavy work
investment. Human Resource Management Review, 22, 232-243.‏ https://doi.org/10.1016/j.hrmr.2011.11.011
Snir, R., & Harpaz, I. (2013). The Challenge of Heavy Work Investment. In R. Burke, S. Fox, & C. Cooper (Eds.), Human Frailties: Wrong Turns on the Road to Success (pp. 165–79). Farnham: Gower Publishing.
Snir, R., & Harpaz, I. (2015). A general model of heavy work investment. In I., Harpaz & R.,
Snir (Eds.), Heavy work investment: Its nature, sources, outcomes, and future
directions (pp. 3-30). New York, NY: Routledge.
Singh, P., Suar, D., & Leiter, M. P. (2012). Antecedents, work-related consequences, and buffers of job burnout among Indian software developers. Journal of Leadership & Organizational Studies, 19, 83-109. https://doi.org/10.1177/1548051811429572
Spearman, C. (1904). The proof and measurement of association between two things. The American Journal of Psychology, 15, 72-101.‏ https://www.jstor.org/stable/1412159
Spearman, C. (1910). Correlation calculated from faulty data. British Journal of Psychology, 3, 271-295.‏ https://doi.org/10.1111/j.2044-8295.1910.tb00206.x
Stimpfel, A. W., Sloane, D. M., & Aiken, L. H. (2012). The longer the shifts for hospital
nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs, 31,
2501-2509. https://doi.org/10.1377/hlthaff.2011.1377
Taris, T. W. (2006). Is there a relationship between burnout and objective performance? A critical review of 16 studies. Work & Stress, 20, 316-334. https://doi.org/10.1080/02678370601065893
Trépanier, S. G., Fernet, C., Austin, S., Forest, J., & Vallerand, R. J. (2014). Linking job demands and resources to burnout and work engagement: Does passion underlie these differential relationships?. Motivation and Emotion, 38, 353-366. https://doi.org/10.1007/s11031-013-9384-z
Tziner, A., Buzea, C., Rabenu, E., Truta, C., & Shkoler, O. (under review). Understanding the relationship between antecedents of heavy work investment (HWI) and burnout.
Tziner, A., Meir, E. I., & Segal, H. (2002). Occupational congruence and personal task-related attributes: how do they relate to work performance?. Journal of Career Assessment, 10, 401-412.‏ https://doi.org/10.1177/1069072702238403
Van Der Hulst, M., & Geurts, S. (2001). Associations between overtime and psychological health in high and low reward jobs. Work and Stress, 15 (3), 227–240. https://doi.org/10.1080/026783701110.1080/02678370110066580
Ventrice, C. (2003). Make Their Day!: Employee Recognition that Works. San Francisco, CA: Berrett-Koehler Publishers.
Watson, D. (1988). Intraindividual and interindividual analyses of positive and negative affect: their relation to health complaints, perceived stress, and daily activities. Journal of Personality and Social Psychology, 54, 1020-1030. http://dx.doi.org/10.1037/0022-3514.54.6.1020
Watson, D., & Clark, L. A. (1984). Negative affectivity: The disposition to experience aversive emotional states. Psychological Bulletin, 96, 465-490. http://dx.doi.org/10.1037/0033-2909.96.3.465‏
Westerman, J. W., & Vanka, S. (2005). A cross-cultural empirical analysis of
person-organization fit measures as predictors of student performance in business
education: Comparing students in the United States and India. Academy of
Management Learning & Education, 4, 409-420. https://doi.org/10.5465/amle.2005.19086783
Williams, E. S., Manwell, L. B., Konrad, T. R., & Linzer, M. (2007). The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: results from the MEMO study. Health Care Management Review, 32, 203-212.‏ https://doi.org/10.1097/01.HMR.0000281626.28363.59
Williams, E. S., Savage, G. T., & Linzer, M. (2006). A proposed physician–patient cycle model. Stress and Health, 22, 131-137.‏ https://doi.org/10.1002/smi.1088