Browsing by Subject "burnout"

Healthcare workers (HCW) have historically suffered from high rates of burnout, and these rates have continued to rise during the pandemic (Sexton et al., 2022). Burnout among healthcare workers carries significant consequences for both HCWs (Davidson et al., 2018; Stathopoulou et al., 2011) and patients (Schlak et al., 2021). National organizations have focused their attention on this issue of improving HCW well-being. Greater clarity is needed to understand how best to optimize HCW well-being and to address the challenges of HCW burnout. The purpose of this dissertation was to generate knowledge on HCW burnout and resilience. Specifically, this dissertation used existing data from the Web-based Implementation of the Science for Enhancing Resilience (WISER) data set and encompasses three studies whose purpose was: (1) to describe the stressors that HCWs experience using a summative content analysis to determine the types and total numbers of stressors; (2) to identify subgroups of nurses with distinct profiles of well-being using a latent profile analysis to identify profiles of burnout (emotional exhaustion) and resilience (emotional thriving and emotional recovery); bivariate statistics were used to identify profile differences in nurse characteristics; and (3) to identify types of well-being behaviors and the total number of well-being behaviors associated with resilience among HCWs. Bivariate statistics were used to identify the relationship of each type of well-being behavior with emotional thriving and emotional recovery, and to identify the total number of well-being behaviors with emotional thriving and emotional recovery. General Linear Models using analysis of covariance was used to examine the relationships between the well-being behaviors and the total number of well-being behaviors, respectively, with emotional thriving and emotional recovery, after adjusting for covariates. The main findings of this dissertation included those regarding stressors, the co-occurrence of burnout and resilience, and findings related to well-being behaviors. First, stressors are experienced in HCWs’ work, personal life, and in ways that intersect both work and personal life. Second, we found that nurses experienced a combination of burnout (emotional exhaustion) and resilience (emotional thriving and emotional recovery) in four distinct profiles of “exhausted,” “exhausted with thriving,” “exhausted with thriving and recovery,” and “thriving and recovery.” Each profile was associated with unique nurse characteristics. Finally, we found that the well-being behaviors of exercise, yoga, meditation, spending time with a close friend, and going on a vacation were all significantly associated with greater emotional thriving while only exercise, and spending time with a close friend were significantly associated with greater emotional recovery (Rink et al., 2021). Findings from this dissertation will inform the development and testing of interventions to reduce burnout and strengthen resilience for HCWs. Specifically, understanding the full breadth of stressors experienced by HCWs can inform the strategies used in interventions to address stress and burnout among HCWs. Additionally, this dissertation identified the co-occurrence of burnout and resilience that extend beyond the previously known dichotomous relationship and underscored the importance of increasing resilience. Finally, findings also can inform future work on enhancing HCW resilience through well-being behaviors.

After the committing of an error or transgression, some people are prone to experience shame (they feel badly about themselves) and some are prone to experience guilt (they tend to feel badly about their action or inaction). Although a sizable number of researchers have examined how shame and guilt relate to distress or health, the field knows very little about whether persons are more prone to shame or whether shame is more strongly associated with distress when the error is particularly relevant to the offender's sense of self. The current research aims to address this significant gap in the literature.

One domain in which people's self-view and sense of worth is often heightened is their work or vocation. Clergy have been shown to collapse who they are with what they do or are called to do in their role as pastor. Therefore, a measure that uses failures that clergy may experience in their role was created to examine how this domain specific shame and guilt relate to general shame and guilt, positive and negative affect, and clergy burnout.

Student pastors generated items for the new scale of domain specific shame and guilt. Seminary students completed questionnaires online and were asked to complete the new measure again one month later to establish test-retest reliability. Factor analyses were run to examine the structure of the shame and guilt scales. A secondary factor analysis found that the four guilt factors all loaded onto one second-order factor and the three shame factors all loaded onto another second-order factor. Cronbach's alpha and test-retest reliability were strong. Construct validity was established. Next, United Methodist clergy completed measure by pen and paper or online.

Overall the data demonstrate that higher shame, both in ministry situations and in secular situations, was significantly associated with higher negative affect among seminarians and less satisfaction and more emotional exhaustion in ministry among clergy. Contrary to expectations, seminarians and clergy were not more prone to ministry shame nor was ministry shame more strongly associated with clergy burnout than was general proneness to shame.

In response to God’s call to love neighbors, some Christians in the United States enter the social work profession. Yet, within a severely curtailed welfare system and the asymmetries of the professional helping relationship, moral hazards abound in discerning the shape of this love. Charged with supporting individuals and families meet their basic needs, social workers decide and act in conditions of insufficient recourses and unmanageable caseloads. Moreover, they frequently serve as gatekeepers to medical treatment, housing, or, paradigmatically, another’s children. Paternalism and exhaustion threaten. Drawing upon interviews with thirty-five Christian social workers in the American southeast, this dissertation traces their reasons for the work, their moral deliberations and judgments, their confessions of uncertainty and regret, and their prayers. In doing so, I offer a theological anthropology and phenomenology of moral agency pressed to its limits. I contend that at these limits, the human agent finds herself to be a creature dependent on God’s care for herself and for others, a confession often mediated by prayer. As a corollary, I illustrate how a properly Christian account of the moral life depends upon reconstituting a version of divine command theory situated in close relation with a prayer-infused practical reason.

Emerging changes in health care reform have further accelerated the need for brief and cost-effective interventions. As such, the current study tested the efficacy of two brief, phone-administered, behavioral interventions derived from behavioral activation (BA) in reducing burnout among graduate students. 66 adults currently enrolled in a doctoral program in the state of North Carolina and demonstrating current burnout were randomly assigned to one of three intervention conditions: 1) Reward: a brief intervention to help participants increase pleasant, rewarding behaviors, 2) Approach: a brief intervention to help participants approach important goals that they have been avoiding due to emotion (fear, stress, sadness) or 3) Control: a condition that involves monitoring only. All participants completed three days of daily monitoring, conducted through an online survey platform, in order to attain baseline indices of mood and activities. They then received a brief intervention over the phone and completed 7 days of additional online self-monitoring while completing the intervention. Participants completed a self-report packet assessing burnout, perceived stress, behavioral activation, experiential avoidance, mastery, anxiety and depression symptoms, quality of life, and functional impairment at baseline, post-intervention, and a 1-week follow-up assessment.

The study found that individuals in the Approach condition showed significant reductions in burnout post-intervention and at a one-week follow-up assessment, compared to individuals in the Control condition. In addition, individuals in the Approach condition showed significant improvements in well-being and significant increases in behavioral activation, compared to individuals in the Control condition. These findings suggest that a one-time intervention designed to help individuals approach challenging, avoided tasks may significantly improve indices of distress and dysfunction among doctoral-level graduate students.

Objective: Though the role of negative mental health has been investigated, positive mental health in medical students remains an under-investigated topic. This study sought to describe and explore mental well-being in a population of medical students in Sri Lanka, by investigating the range and level of both positive and negative mental health and covariates and by comparing the results with those of US studies. Methods: Students at University of Ruhuna Faculty of Medicine completed paper-based, cross-sectional questionnaires that included demographic items, the Mental Health Continuum-Short Form (MHC-SF), the Kessler 10 Psychological Distress Scale (K10), and the Oldenburg Burnout Inventory (OLBI). Analysis took place in Stata and RStudio. Results: Most students were categorized with moderate positive mental health (64.8%) and severe psychological distress (40.4%). Negative and positive mental health outcomes were moderately associated. None of the demographic factors was a significant predictor of positive mental health nor academic performance, and none of the mental health outcomes predicted academic performance. Females reported significantly higher levels of burnout. Conclusions: Medical students in Sri Lanka may experience different levels of positive and negative mental health by year in school. In the current study, final year students reported significantly higher levels of psychological distress and burnout than first year students. Males and older students were significantly more likely to have poor academic performance. Institutions should monitor medical student well-being and direct resources toward evidence-based activities, allowing students to continue along the upward spiral of well-being and flourish into successful medical practitioners.

ABSTRACT

This thesis explores the issue of burnout in congregational settings. Unmanaged stress in a system is a cause of burnout. Individuals can feel burnout, but a systemic approach is needed to prevent and address burnout. Christina Maslach and Michael P. Leiter believe burnout is a relationship problem. Requiring a relational solution This thesis will examine a congregation’s relationship to the world, work, and church. A relationship reset is needed to prevent and address burnout.

The thesis unfolds in five moves. The first move explores the relationship between burnout and the world. It seeks to answer the question, what cultural realities contribute to the experience of burnout? In conversation with Charles Taylor, Andy Root believes we live in a secular age when the drive to seek a distorted idea of the good life “the good life” is constant and overwhelming. Root contends that the problem arises from the constant drive to seek the good life and from the speeding up of time itself. Root builds upon Taylor’s theory of the secular age using the work of Hartmut Rosa; he claims congregations are living in an age of acceleration which produces an epidemic of “time-famine” in modernity. Rosa concludes that acceleration causes alienation, experienced as isolation in many forms. Root concludes that the time-sickness of modernity causes depression. I conclude that times-sickness additionally causes burnout identified by exhaustion, disengagement, and ineffectiveness. The second move of the thesis explores burnout as a mismatch of relationships between people and their work. Christina Maslach and Michael P. Leiter suggest burnout is a systemic problem, not a personal one. Maslach and Leiter’s research defines burnout as a mismatch between people and work. The cost of caring can lead to exhaustion, disengagement, and ineffectiveness. Maslach and Leiter not only diagnose the problem of burnout but suggest how organizations can prevent burnout through engagement and empathy. The third movement of the thesis explores burnout as a systemic issue in which better matches can be made between people and their relationship to work. The fourth move explores the relationship between burnout and the church. Hartmut Rosa suggests resonance is the only antidote to the problem of the accelerated pace of modern life. Rosa defines resonance as a connection involving meaning and transformation. Andrew Root concludes that a theological understanding of resonance involves waiting as action, as the church waits for an encounter with God. I challenge Root's call for waiting and instead call for a current deepening of relationships in a congregational setting. The fifth and final move explores the need to reclaim relationships in the church as canopies of community through resonant leadership to manage burnout in a congregation. Sociologist Peter Burger wrote that religion provided a sacred canopy in the reality of a chaotic and secular world. How can congregations reclaim resonant relationships to prevent burnout as they work in the world? The Bible never uses the word burnout, though scripture offers examples of congregations facing exhaustion, disengagement, and perhaps feeling ineffective. The Apostle Paul writes to the church at Rome, facing divisions and obstacles in a chaotic world. Paul appeals to the church at Rome to create new relationships with each other and the world. He points to the image of a body working in tandem, believing each part is vital for the work of the system. Ultimately, the Apostle Paul, called by God, knows the church's work is too exhausting to do solo. In the 16th chapter of Romans, Paul names parts of the body like Phoebe and Junia who assist him in the work of God. How can the church reclaim the necessity and importance of relational leadership to prevent burnout in congregations? How can congregations move from burnout to engagement?