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Objective: Clinician burnout in healthcare is extensive and of growing concern. In mental health and rehabilitation settings, research on interventions to improve burnout and work engagement is limited and rarely addresses organizational drivers of burnout. This study sought to elaborate on the organizational influence of burnout and work engagement in mental health. Methods: We randomly selected 40 mental health clinicians and managers who were participating in a burnout intervention and conducted semi-structured interviews to understand their views of organizational conditions impacting burnout and work engagement. Data were analyzed using a thematic analytical approach. Results: Analyses yielded three major themes where organizational contexts might reduce burnout and increase work engagement: (a) a work culture that prioritizes person-centered care over productivity and other performance metrics, (b) robust management skills and practices to overcome bureaucracy, and (c) opportunities for employee professional development and self-care. Participants also referenced three levels of the organizational context that they believed influenced burnout and work engagement: front-line supervisors and program managers, organizational executive leadership, and the larger health system. Conclusions and Implications for Practice: Findings point to several possible targets of intervention at various organizational levels that could guide the field toward more effective ways to reduce burnout and improve work engagement. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Employed people ( N = 826) completed questionnaires including the Social Encounters Scale that assessed civility, incivility, and intimidation from supervisors, coworkers, and respondents on identical frequency scale. Factor analyses, correlations, and profile analysis addressed the first research question by demonstrating the benefits of assessing various dimensions of workplace social dynamics on a common rating scale. A subsample ( N = 275 completed a second survey, confirming consistency over time. To address the second research question a Latent Profile Analysis (LPA) identified five social profiles: Civil, Low Contact, Uncivil Coworkers, Uncivil Supervisor, and Uncivil. These profiles were associated with distinct perceptions of the work environment, addressing the third research question. To address the fourth research question, crosstabulation with a profile structure based on the Maslach Burnout Scale demonstrated close links of workplace social culture with psychological connections with work.

Journalists are at particular risk of work-related stress and burnout. The objective of this study is to describe and analyze the principal factors involved in the appearance of burnout in communication professionals, as well as the possible interactions between them and with self-reported health, and to observe whether the variables involved are the same in different types of environments. To achieve this objective, 292 participants answered the following measurement instruments: Demographic and labor datasheet; Maslach Burnout Inventory (MBI General survey); Areas of Worklife Scale (AWS); and General Health Questionnaire (GHQ -12). The results were the following: Emotional Exhaustion (EE) shows direct correlation and statistical significance with the other two burnout dimensions, Depersonalization (DP) and Personal Accomplishment (PA), also with health perception variables and inverse and statistical significance with the workload, control, rewards, community, fairness, and values. A multiple linear regression model shows workload and values as inverse EE predictors, which confirms a burnout process in which EE contributes as the main dimension in DP and is shown to be a precursor of PA, itself. When comparing different types of media, journalists who work in institutional press offices presented significantly lower scores in PA and higher in control, rewards, community, justice, and values. Therefore, further research should be carried out in order to analyze the protective role of these variables regarding PA and burnout.

In the Job Demand-Control-Support (JDCS) model, the combination of job demands, job control, and social support was hypothesized to lead to eight different constellations of job types. According to the model, these constellations are linked to wellbeing/health and learning outcomes. In the last three decades, these constellations of job types have been investigated by adopting a variable-centered perspective. However, latent profile analyses (LPA) enable a person-centered approach and empirically capture constellations of job types. In the present study, we used LPA to empirically identify distinct profiles of JDCS among Italian healthcare workers. Furthermore, we investigated the role of social stressors (workplace relationships and coworkers' incivility) as antecedents of these profiles and the association of these profiles with job burnout and work motivation. Results from LPA ( n = 1671) revealed four profiles: Isolated Prisoner, Participatory Leader, Moderate Strain, and Low Strain. Negative relationships at work and coworkers' incivility increased the chances of being included in both Isolated prisoner and Participatory Leader profiles. Finally, the Isolated Prisoner and Moderate Strain profiles showed the highest levels of emotional exhaustion and cynicism and the lower levels of intrinsic work motivation. This study extends previous JDCS research, highlighting that researchers should consider empirically identified profiles rather than theoretically defined subgroups. Implications for stress theory, future research, and practice are discussed.

Background: Researchers have studied for decades workplace stress and burnout to identify their relationship to health and wellness. This research has focused on stress levels in people, as well as on environmental and personal factors that contribute to experiencing stress or burnout. In addition to the burnout measurement questionnaires (MBI-GS), Leiter and Maslach designed a model to evaluate the areas of work environment that relate to this construct (Areas of Worklife Scale-AWLS). The goal of the present research was to analyze the psychometric properties of a Spanish translation of the MBI (GS) and the AWLS with a Spanish-speaking population. This work makes a substantial contribution by addressing the need to use validated measures and methods when exploring the positive and negative aspects of organizations. These conditions provide a means to accurately evaluate the impact of interventions aimed to address stress and burnout., Method: Cross-sectional study with self-report measures. The sample was comprised of 452 managers and employees (hotels, restaurants, catering) of Aragón (Spain). There were approximately equal numbers of women and men (45,4% vs. 54,6%). The average age of participants was 36.6 years (SD = 10.03). A battery of questionnaires was used: Socio-demographic and work characteristics, Scale of stress and health symptoms, Maslach Burnout Inventory-General Survey (MBI-GS), Areas of Worklife Scale (AWLS)., Results: The results showed optimal psychometric properties in both questionnaires, especially in terms of the predictive capacity of the AWLS in each of the MBI-GS dimensions., Conclusions: The best explained dimension is that of emotional exhaustion. The manageable load variable is the one that most contributes to predicting burnout levels. For future interventions, the results confirm the need to verify the levels of each area of work, in order to focus on the most deteriorated ones.

Employees working in the hospitality industry are constantly exposed to occupational stressors that may lead employees into experiencing burnout syndrome. Research addressing the interactive effects of control, community and value congruence to alleviate the impact of workplace demands on experiencing burnout is relatively limited. The present study examined relationships among control, community and value congruence, workplace demands and the three components of burnout. A sample of 418 employees working in a variety of hospitality associations including restaurants and hotels in Spain were recruited. Moderation analyses and linear regressions analyzed the predictive power of control, community and value congruence as moderating variables. Results indicate that control, community and value congruence were successful buffers in the relationships between workplace demands and the burnout dimensions. The present findings offer suggestions for future research on potential moderating variables, as well as implications for reducing burnout among hospitality employees.

Objective: The study examined the relationship of occupational safety with job burnout., Design: The study used a cross-sectional survey design., Setting: The setting was Nova Scotia, Canada., Participants: Mobile health employees ( N = 156) completed surveys on road safety, workload, burnout and supervisor incivility., Main Outcome Measure: The main outcome measure was the Maslach Burnout Inventory., Results: Results found that safety concerns improved the prediction of exhaustion beyond that provided by workload concerns alone. Further, confidence in safety buffered the relationship of exhaustion with cynicism such that the exhaustion/cynicism relationship was stronger for employees who had lower confidence in road safety., Conclusions: Employees' confidence in occupational safety while addressing work responsibilities on the road has implications for their experience of job burnout.

Burnout has been disproportionally reported in child protection social work. This paper presents data from 162 child protection staff in Northern Ireland, assessed for burnout using the Maslach Burnout Inventory. Path models were estimated, based on an extension of the two-process demands and values model (Leiter, ) to include additional measures of resilience using the Resilience Scale-14, as well as perceived rewards and sense of community from the Areas of Work Life Scale (Leiter, ). Optimal model fit was achieved by modelling resilience as a mediator of the relationship between organizational factors of control and value congruence and burnout. Resilience also directly predicted emotional exhaustion (β = -.23, p < .005) and personal accomplishment (β = .46, p < .001). Workload was the strongest direct predictor of emotional exhaustion (β = -.54, p < .001). Adding perceived rewards to extend the two-process model resulted in moderate associations with control (β = .44, p < .001), workload (β = .26, p < .005), fairness (β = .40, p < .001), and values (β = .32, p < .001). In the final model, resilience is modelled as both an outcome of some organizational factors whilst also making a unique direct contribution to explaining burnout alongside other organizational factors. Other pathways and mediating relationships are reported and further research directions discussed., (Copyright © 2017 John Wiley & Sons, Ltd.)

Background: Incivility has negative consequences in the workplace and remains a prevalent issue in nursing. Research has consistently linked incivility to nurse burnout and, in turn, to poor mental health and turnover intentions. To retain high-quality nurses, it is important to understand what factors might protect nurses from the negative effects of workplace mistreatment., Purpose: The aim of the study was to investigate the role of relational occupational coping self-efficacy in protecting nurses from workplace incivility and related burnout and turnover intentions., Methodology: A two-wave national sample of 596 Canadian nurses completed mail surveys both at Time 1 and one year later at Time 2. Structural equation modeling was used to test the hypothesized model., Results: The model showed a good fit, and most of the hypothesized paths were significant. Overall, the results supported the hypothesized protective effect of relational occupational coping self-efficacy against incivility and later burnout, mental health, and turnover intentions., Conclusion: Relational occupational coping self-efficacy is an important protective factor against negative work behavior., Practice Implications: Organizations should provide nurses with opportunities to build their coping strategies for managing job demands and difficult interpersonal interactions. Similarly, providing exposure to effective role models and providing meaningful verbal encouragement are other sources of efficacy information for building nurses' relational coping self-efficacy.

What do we know about burnout, and what can we do about it? This article will provide an overview of what has been learned from current research on burnout, and what are the implications of the key themes that have emerged. One theme involves the critical significance of the social environment in health care settings. A second theme is the challenge of how to take what we know, and apply it to what we can do about burnout. What we need are new ideas about potential interventions, and clear evidence of their effectiveness. One example of this perspective addresses burnout by improving the balance of civil, respectful social encounters occurring during a workday. Research has demonstrated that not only can civility be increased at work but that doing so leads to an enduring reduction in burnout among health care providers. Lessons learned from this extensive research form the basis of recommendations for medical education. Specifically, the effectiveness of both the academic content and supervised practice would be enhanced by giving a greater emphasis to the social dynamics of healthcare teams. This perspective can help new physicians in avoiding potential pitfalls and recovering from unavoidable strains.

Objectives: Prior research found preliminary effectiveness for Burnout Reduction: Enhanced Awareness, Tools, Handouts, and Education (BREATHE), a daylong workshop for reducing burnout among behavioral health providers. Using a longer follow-up compared with prior research, this study compared the effectiveness of BREATHE and a control condition., Methods: Behavioral health providers (N=145) from three U.S. Department of Veterans Affairs facilities and two social service agencies were randomly assigned to BREATHE or person-centered treatment planning. Burnout and other outcomes were compared across groups over time., Results: Analyses yielded no significant differences between groups. However, BREATHE participants showed small but statistically significant improvements in cynicism (six weeks) and in emotional exhaustion and positive expectations for clients (six months). Participants in the control condition showed no significant changes over time., Conclusions: Although it did not demonstrate comparative effectiveness versus a control condition, BREATHE could be strengthened and targeted toward both distressed providers and their organizations.

Aim: The aim of this study was to examine whether participant views of job resources (i.e. trust and civility) towards their co-workers and supervisors were longitudinally predictive of workplace cynicism, an aspect of burnout., Background: Cynicism is a significant predictor of intention to quit among nurses. Social supports are hypothesized to protect workers from becoming increasingly cynical., Method: Measures of cynicism, and trust and civility in both co-workers and supervisors were part of a survey completed by a sample of 323 Canadian nurses whose responses were matched across two time-points, 1 year apart., Results: Hierarchical multiple linear regression analyses revealed that co-worker civility enhanced the ability of our regression models to predict cynicism by explaining 1.1% of the variance in cynicism. The addition of co-worker trust, supervisor civility and supervisor trust did not enhance the ability of the models to predict cynicism., Conclusion: The results indicated the importance of workgroup civility in diminishing workplace cynicism., Implications for Nursing Management: Efforts to reduce burnout may be improved by decreasing cynicism through interventions aimed at increasing workgroup civility., (© 2013 John Wiley & Sons Ltd.)

The present study aims to explain why research thus far has found only low to moderate associations between burnout and performance. We argue that employees use adaptive strategies that help them to maintain their performance (i.e., task performance, adaptivity to change) at acceptable levels despite experiencing burnout (i.e., exhaustion, disengagement). We focus on the strategies included in the selective optimization with compensation model. Using a sample of 294 employees and their supervisors, we found that compensation is the most successful strategy in buffering the negative associations of disengagement with supervisor-rated task performance and both disengagement and exhaustion with supervisor-rated adaptivity to change. In contrast, selection exacerbates the negative relationship of exhaustion with supervisor-rated adaptivity to change. In total, 42% of the hypothesized interactions proved to be significant. Our study uncovers successful and unsuccessful strategies that people use to deal with their burnout symptoms in order to achieve satisfactory job performance., (PsycINFO Database Record (c) 2014 APA, all rights reserved.)

Aims and Objectives: To examine the prevalence of aggression against healthcare professionals and to determine the possible impact that violent episodes have on healthcare professionals in terms of loss of enthusiasm and involvement towards work. The objective was to analyse the percentage of occupational assault against professionals' aggression in different types of healthcare services, differentiating between physical and verbal aggression as a possible variable in detecting burnout in doctors and nursing professionals., Background: Leiter and Maslach have explored a double process model of burnout not only based on exhaustion by overload, but also based on personal and organisational value conflicts (community, rewards or values). Moreover, Whittington has obtained conclusive results about the possible relationship between violence and burnout in mental health nurses., Design: A retrospective study was performed in three hospitals and 22 primary care centres in Spain (n = 1·826)., Methods: Through different questionnaires, we have explored the relationship between aggression suffered by healthcare workers and burnout., Results: Eleven percent of respondents had been physically assaulted on at least one occasion, whilst 34·4% had suffered threats and intimidation on at least one occasion and 36·6% had been subjected to insults. Both forms of violence, physical and non-physical aggression, showed significant correlations with symptoms of burnout (emotional exhaustion, depersonalisation and inefficacy)., Conclusions: The survey showed evidence of a double process: (1) by which excess workload helps predict burnout, and (2) by which a mismatch in the congruence of values, or interpersonal conflict, contributes in a meaningful way to each of the dimensions of burnout, adding overhead to the process of exhaustion-cynicism-lack of realisation. Relevance to clinical practice.  Studies indicate that health professionals are some of the most exposed to disorders steaming from psychosocial risks and a high comorbidity: anxiety, depression, etc. There is a clear need for accurate instruments of evaluation to detect not only the burnout but also the areas that cause it. Professional exhaustion caused by aggression or other factors can reflect a deterioration in the healthcare relationship., (© 2012 Blackwell Publishing Ltd.)

Although incivility has been identified as an important issue in workplaces, little research has focused on reducing incivility and improving employee outcomes. Health care workers (N = 1,173, Time 1; N = 907, Time 2) working in 41 units completed a survey of social relationships, burnout, turnover intention, attitudes, and management trust before and after a 6-month intervention, CREW (Civility, Respect, and Engagement at Work). Most measures significantly improved for the 8 intervention units, and these improvements were significantly greater than changes in the 33 contrast units. Specifically, significant interactions indicating greater improvements in the intervention groups than in the contrast groups were found for coworker civility, supervisor incivility, respect, cynicism, job satisfaction, management trust, and absences. Improvements in civility mediated improvements in attitudes. The results suggest that this employee-based civility intervention can improve collegiality and enhance health care provider outcomes., ((c) 2011 APA, all rights reserved.)

Aim: We used Kanter's (1977) structural empowerment theory to examine the influence of structural empowerment and emotional exhaustion on healthcare professionals' use of organizational citizenship behaviours directed at the organization (OCBO) and peers (OCBI)., Background: Organizational citizenship behaviours (OCB) are discretionary behaviours that are not rewarded directly by the organization but have been linked to positive outcomes, such as increased job satisfaction and lower turnover intentions. Promoting OCB can help employees and organizations flourish despite current challenges in the healthcare system. Structural empowerment may influence the frequency and type of OCB by reducing burnout., Method: We conducted multiple mediated regression analyses to test two hypothesized models about relationships between empowerment, emotional exhaustion and two types of OCB (OCBI and OCBO) in a sample of 897 healthcare professionals in five Canadian hospitals., Results: Emotional exhaustion was found to be a significant mediator of the relationship between empowerment and OCBO. The predicted mediation of the empowerment/OCBI relationship by emotional exhaustion was not supported., Conclusions: Exhaustion was an important mediator of empowering working conditions and OCBO, but was not significantly related to OCBI. Empowerment was significantly related to both OCBO and OCBI., Implications for Nursing Management: Promoting empowerment among healthcare workers may decrease burnout and promote OCB. Specific managerial strategies are discussed in the present study.

Objective: T o explore the interaction between workload and values congruence (personal values with health care system values) in the context of burnout and physician engagement and to explore the relative importance of these factors by sex, given the distinct work patterns of male and female physicians., Design: National mailed survey., Setting: Canada., Participants: A random sample of 8100 Canadian physicians (response rate 40%, N = 3213); 2536 responses (from physicians working more than 35 hours per week) were analyzed., Main Outcome Measures: Levels of burnout, values congruence, and workload, by sex, measured by the Maslach Burnout Inventory-General Scale and the Areas of Worklife Scale., Results: Results showed a moderate level of burnout among Canadian physicians, with relatively positive scores on exhaustion, average scores on cynicism, and mildly negative scores on professional efficacy. A series of multiple regression analyses confirmed parallel main effect contributions from manageable workload and values congruence. Both workload and values congruence predicted exhaustion and cynicism for men and women (P = .001). Only values congruence provided a significant prediction of professional efficacy for both men and women (P = .001) These predictors interacted for women on all 3 aspects of burnout (exhaustion, cynicism, and diminished efficacy). Howevever, overall levels of the burnout indicators departed only modestly from normative levels., Conclusion: W orkload and values congruence make distinct contributions to physician burnout. Work overload contributes to predicting exhaustion and cynicism; professional values crises contribute to predicting exhaustion, cynicism, and low professional efficacy. The interaction of values and workload for women in particular has implications for the distinct work-life patterns of male and female physicians. Specifically, the congruence of individual values with values inherent in the health care system appeared to be of greater consequence for women than for men.

Aim: The aim of this study was to examine the influence of empowering work conditions and workplace incivility on nurses' experiences of burnout and important nurse retention factors identified in the literature., Background: A major cause of turnover among nurses is related to unsatisfying workplaces. Recently, there have been numerous anecdotal reports of uncivil behaviour in health care settings., Method: We examined the impact of workplace empowerment, supervisor and coworker incivility, and burnout on three employee retention outcomes: job satisfaction, organizational commitment, and turnover intentions in a sample of 612 Canadian staff nurses., Results: Hierarchical multiple linear regression analyses revealed that empowerment, workplace incivility, and burnout explained significant variance in all three retention factors: job satisfaction (R(2) = 0.46), organizational commitment (R(2) = 0.29) and turnover intentions (R(2) = 0.28). Empowerment, supervisor incivility, and cynicism most strongly predicted job dissatisfaction and low commitment (P < 0.001), whereas emotional exhaustion, cynicism, and supervisor incivility most strongly predicted turnover intentions., Conclusions: In our study, nurses' perceptions of empowerment, supervisor incivility, and cynicism were strongly related to job satisfaction, organizational commitment, and turnover intentions., Implications for Nursing Management: Managerial strategies that empower nurses for professional practice may be helpful in preventing workplace incivility, and ultimately, burnout.

Aim: This study tested whether the mediation model of burnout could predict nurses' turnover intentions., Background: A better understanding of what factors support a commitment to a nursing career could inform both policies and workplace practices. The mediation model of burnout provides a way of linking the quality of a nurse's worklife to various outcomes, such as turnover., Method: Data on areas of worklife, burnout, and turnover intentions were collected by surveying 667 Canadian nurses in the Atlantic Provinces., Results: The findings supported the mediation model of burnout, in which areas of worklife predicted burnout, which in turn predicted turnover intentions. Cynicism was the key burnout dimension for turnover, and the most critical areas of worklife were value conflicts and inadequate rewards., Conclusions: The results of this study provide some new insights into how the intention of nurses to leave their job is related to particular aspects of their worklife and to burnout., Implications for Nursing Management: These results suggest what may be the most appropriate areas to target for interventions to reduce the risk of nurses exiting early from their chosen career.

Aim(s): This paper examines the contrasting role of work values for nurses from two generations: Baby Boomers and Generation X., Background: Differences among nurses regarding core values pertaining to their work has a potential to influence the quality of their work life. These differences may have implications for their vulnerability to job burnout., Evaluation: The analysis is based upon questionnaire surveys of nurses representing Generation X (n = 255) and Baby Boomers (n = 193) that contrasted their responses on job burnout, areas of work life, knowledge transfer and intention to quit., Key Issue(s): The analysis identified a greater person/organization value mismatch for Generation X nurses than for Baby Boomer nurses. Their greater value mismatch was associated with a greater susceptibility to burnout and a stronger intention to quit for Generation X nurses., Conclusion(s): The article notes the influence of Baby Boomer nurses in the structure of work and the application of new knowledge in health care work settings. Implications for recruitment and retention are discussed with a focus on knowledge transfer activities associated with distinct learning styles., Implications for Nursing Management: Understanding value differences between generations will help nursing managers to develop more responsive work settings for nurses of all ages.

A longitudinal study predicted changes in burnout or engagement a year later by identifying 2 types of early indicators at the initial assessment. Organizational employees (N = 466) completed measures of burnout and 6 areas of worklife at 2 times with a 1-year interval. Those people who showed an inconsistent pattern at Time 1 were more likely to change over the year than were those who did not. Among this group, those who also displayed a workplace incongruity in the area of fairness moved to burnout at Time 2, while those without this incongruity moved toward engagement. The implications of these 2 predictive indicators are discussed in terms of the enhanced ability to customize interventions for targeted groups within the workplace., (PsycINFO Database Record (c) 2008 APA, all rights reserved.)

Objective: To test a theoretical model of professional nurse work environments linking conditions for professional nursing practice to burnout and, subsequently, patient safety outcomes., Background: The 2004 Institute of Medicine report raised serious concerns about the impact of hospital restructuring on nursing work environments and patient safety outcomes. Few studies have used a theoretical framework to study the nature of the relationships between nursing work environments and patient safety outcomes., Methods: Hospital-based nurses in Canada (N = 8,597) completed measures of worklife (Practice Environment Scale of the Nursing Work Index), burnout (Maslach Burnout Inventory-Human Service Scale), and their report of frequency of adverse patient events., Results: Structural equation modeling analysis supported an extension of Leiter and Laschinger's Nursing Worklife Model. Nursing leadership played a fundamental role in the quality of worklife regarding policy involvement, staffing levels, support for a nursing model of care (vs medical), and nurse/physician relationships. Staffing adequacy directly affected emotional exhaustion, and use of a nursing model of care had a direct effect on nurses' personal accomplishment. Both directly affected patient safety outcomes., Conclusions: The results suggest that patient safety outcomes are related to the quality of the nursing practice work environment and nursing leadership's role in changing the work environment to decrease nurse burnout.

Background: Research has established clear links between nurses' experience of professional burnout and many qualities of work environments but more work is needed to clarify interrelationships among aspects of complex organizational settings., Objective: To test a nursing worklife model that defined structured relationships among professional practice environment qualities and burnout., Methods: Hospital-based nurses in Canada (N = 8,597) completed an assessment of worklife (Nursing Work Index, NWI) and burnout (Maslach Burnout Inventory-Human Service Scale, MBI-HSS)., Results: A causal model was used to confirm the factor structure of the Professional Environment Scale (NWI-PES) on a subset of NWI items and the factor structure of the MBI-HSS. The analysis provided support for a structural model (nursing worklife model) linking the five worklife factors used to define a fundamental role for nursing leadership in determining the quality of worklife regarding policy involvement, staffing levels, support for a nursing model of care, and physician-nurse relationships. The analysis supported a direct path (negatively weighted) from staffing to emotional exhaustion and a direct path (positively weighted) from nursing model of care to personal accomplishment., Discussion: Implications for refining a model of worklife are discussed. Implications for enhancing the quality of worklife and supporting engagement with work are considered.