CHAPTER ONE: INTRODUCTION
1.1 Background to the Study
The term “burnout” was identified thirty years ago to describe a state of fatigue and frustration among health and service workers arising from excessive demands on their resources. According to Maslash & Leiter (2008) is a prolonged response to chronic emotional and interpersonal stressors on the job, and is defined by the three dimension of exhaustion, cynicism and inefficacy. Leiter & Maslash (2009) also saw it as a cumulative negative reaction to constant occupational stressors relating to the misfit between workers and their desired jobs. with this understanding it can be deciphered that burnout is a psychological syndrome response to chronic stressors in the work place that leads to, physical & emotional exhaustion, cynicism and detachment and feelings of ineffectiveness and lack of accomplishment. Exhaustion is mainly related to an individual’s experience of stress, which is in turn related to a decline in emotional and physical resources.
According to Leiter & Maslack (2003). “The experience of exhaustion reduces worker’s initiative while progressively limiting their capacity for demanding work” while cynicism refers to a detachment from work in reaction to the overload of exhaustion, and the burnout component perceived professional inefficacy refers to the feelings of ineffectiveness and lack of achievement productivity at work and also lack of confidence in one’s work. Most workers in the health sector have encountered occupational stressors in their working environment that often makes them care professionals such as the Doctors, Nurses, lab scientists, pharmacists, social workers and psychologists (Leiter & Malash 2009).
When an individual is psychologically burned out due to occupational stress and depression, frustration set in the working environment and this affects the individuals psychological, physical and mental wellbeing. The nation of wellbeing is examined in two aspects, those being subjective wellbeing and psychological well-being, subjective well-being corresponds to the hedonistic view predicting the individual’s elusion from pain and approach to pleasure, while psychological well-being corresponds to ensuring the individuals personal development and realizing one’s potentials, going beyond the search of pleasure which include psychological and spatial health (Shanhun, 2010).
In recent years increasing attention has been paid to the phenomenon of burnout particularly in human service professions, psychological burnout appears to be a response to interpersonal stressors on the job, in which an overload of contact with people result in changes in attitudes and behaviors towards them (Schaufeh, Leiter & Maslash 2008). Burnout can show up as poor job performance, impersonality with patients and lack of motivation. Health problems such as high blood pressure, insomnia, depression or addiction can also be sign of burnout and it’s as a result most people in the health care professions carry their job home with them; it’s good to really care about your patients. But if you don’t know how to distance yourself at times, it will be a problem “(Synder,2007).
Also burnout which is as a result of prolonged stress in the work place, is globally considered as a risk factor for worker’s health and safety. More specifically the health care, sector is a constantly changing environment, and the working conditions in the hospitals are increasingly becoming demanding and stressful .Several studies; studies focusing on the health sector have shown that health care professionals are exposed to a variety of severe occupational stressors, such as time pressure, low social support at work, a high work load, uncertainty concerning patient treatment and predisposition to emotional responses due to exposure to suffering, frustration, depression anxiety and anger, and in this case health care workers are at a high risk of experiencing severe distress, burnout and both mental and physical illness . (Peterson, Demerouts, Bergstom, Samielsson, Asbsg, & Nigren, 2008).
According to Demerouti, Bakker, Nachrainer & Schaufele (2001), the syndrome of burnout is more prevalent among human service providers. The two core dimensions of burnout can be distinguished as emotional exhaustion and depersonalization. Burnout is a syndrome characterized by emotional exhaustion that results in depersonalization and decreased personal accomplishment at work. The emotional exhaustion clinicians may develop a sense of cynical detachment from work and view people, especially patients as objects, such that clinicians no longer feel effective at work because they have lost sense of their ability to contribute meaningfully in the past few years, the growing prevalence of burnout syndrome among health care personal has gained attention as potential threat to health care quality and patient safety.
Burnout is common among health care workers and the characteristics of the health care environment contributing work processes, role conflict and poor relationship between groups and with leadership, when these are combined with leadership and personal disposing factors and the emotional intensity of clinical work, they put clinicians at risk. Burnout is viewed as a threat to patient’s safety because depersonalization is presumed to result in poorer interaction with patients, clinicians aremore likely to subjectively rate patient’s safety lower in their organization and to admit having mistaken or delivered standardized care at work.
Burnout complaints among nurses have not been consistently related to occupational species stressors such as confrontation with death and dying and interactions with difficult situations. More specifically, psychological burnout has three syndromes which are emotional, depolarization and a reduced sense of personal accomplishment that can occur among individuals who work with people in some capacity. As described above, burnout is studied in three different types, “emotional” this refers to over extended and drained by one’s contact with other people” depersonalization “this refers to an unfeeling and callous response towards people who are usually the recipients of one’s service or care and reduced personal accomplishment” this refers to a deadline in one’s feeling of competence and successful achievement in one’s work with people. These three aspect of syndrome have been the causes and outcomes.
Burnout individuals simultaneously experience high levels of chronic fatigue, and distance themselves emotionally and cognitively from their work activities employees with higher levels of burnout are more likely to experience a hold range of psychological and physical health problems including anxiety, depression, sleep disturbance, memory impairment (Peterson, Demerouts, Bergstom, Samielsson, Asbsg, & Nigren, 2008). Consequently, burnout employees are likely to display one or more withdrawal behaviours such as lateness, absence or turnover according to (Maslach, Schaufeli & Leiter 2001). Clinically, burnout employees may get justified absence leaves from work. However other burnout employees remain at work which leads to a form, existence more psychological and physical health problems, and this influences their behavior at work in a significant way.
(Picco, 2017) emphasizes on occupational burnout which is characterized by exhaustion, lack of enthusiasm and motivation, feeling of ineffectiveness which may also have the dimension of frustration or cynicism, and as a result reduces efficacy within the workplace. Bakker, Demerouti & Sanzvergel (2014), emphasizes on the antithesis of burnout engagement which is characterized by energy involvement and efficacy, (the opposite of exhaustion, cynicism and inefficacy). According to Bakker et al (2014), the causes of burnout are generally divided into two categories situational factors and individual factor situational factors include job demands and lack of job resources. Job demands are aspects of the job demands and lack of job resources. Job demands are aspects of the job that requires strenuous effort, (Demerouti et al, 2001). Therefore, job demands are associated with psychological and physical costs, such as an increased heart rate and fatigue such symptoms may set the ground for the experience of burnout, because job demands lead to employees to feel exhausted and to psychologically distance themselves from work (Bakker Schaufeli, Sixma, Bosvveld & Van Dierendonck, 2000).
Role ambiguity, role conflict, role stress, stressful events, workload and work pressure are among the most important job demands that cause burnout (Akercon, 2011). Individual factors which are concerned with both socio-economic status and personality variables have been analyzed as creating a predisposition to suffer from burnout symptoms.
Also (Leiter & Maslach, 2005) maintained that the sources of burnout at work are lack of control which entails that there is high job demands in combination with low control and that there is a disconnection between the workers care value and the care values of the organization, the next sources of burnout is insufficient reward which entails that the workers may feel being taken for granted not recognized and under compensated, this entails demanding employees to engage in more work activities, one employee can carry out the work in which three or more people are supposed to carry out and they are not properly rewarded for, this can lead to burnout, work overload is another source of burnout which entails that the workers workload is too much, too complex or too important to be ignored. Maslach, Schaufeli, & Leiter (2001), burnout can be caused by stressors in which a person is unable to cope with fully. Occupational burnout often develops slowly and may not recognized until it has become severe, when one’s expectation about a job and its reality differs burnout can begin, how pressure is dealt with, determine how much stress someone feels and how close they are to burnout. One individual can experience few stressors, but be unable to handle the pressure well and thus experience burnout. Another person however can experience a far greater number of stressors but affectively deal with them and avoid burnout. According to Sorenson & German (2013), the most recent Gallup survey on employee engagement entails that 50% of worker’s report being not engaged, while another 20% report being actively disengaged. Another source of burnout is unfairness which entails that employees are treated unfairly, that there is a culture of favoritism, assignment fashion and discussed behind closed doors.
Breakdown of community is a source of burnout which entails that workers have to work with patronizing colleagues, and that there is no mechanism or conflict resolution and that feed-back is non-existence (MC Pherson, Smith-Lovin & Brashears, 2006). The perception of an inequitable work environment might also lead to burnout, in addition to the work environment in the industries ,some personal characteristics or individual differences also, appear to predict burnout, these include both demographical and dispositional variables.
Alarcon, Eschleman, & Bowling (2009), found out that four of the big five factors of personality, which are emotional stability, extraversion, conscientiousness and agreeableness were consistently negatively related to each of the three dimensions of burnout. Further, individuals high in self-efficacy, optimism and self-esteem were better able to deal with job demands, most likely because they believe they have control over their work environment, and therefore are more likely to proactively solve problems and seek resources when facing job demands, one possible explanation for the negative link between burnout and performance is that exhausted employees lack the concentration needed to perform well, and therefore make more mistake. One problem that is evident from the literature and follows logically from observation is that burnout coincides with impaired job performance and that burnout predicts increased job demands overtime (Bakka et al, 2014). Several studies have been attributed to psychological burnout such as expectation, self-concept, self-esteem and self-actualization (Den, 2001).
This study considers variables such as personal functioning and behavior among health workers. Due to high rate of health workers encountering psychological burnout arising from occupational stress, anger, frustration, depression and sadness in the health sectors, the purpose of this study is focusing on how to cope and function maximally so that it would not lead to burnout. One of the variables of interest that can influence psychological burnout is personal functioning. It has to do with adaptive coping strategies and healthy way of dealing with stress. The subjective assessment of personal functioning is that some people believed that it is best not to think about a troublesome issue, thought, feelings as getting upset about it may only make the issue worse. In some instances, this will be true depending on how you react to situations, inability to deal with stress, anxiety, or troubling issues as it arises to feel a whole range of emotions about any given situations is healthy but it is what you do in reaction to this emotion however can be unhealthy.
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