Influence of gender, working field and psychosocial factors on the vulnerability for burnout in mental hospital staff: results of an Austrian cross‐sectional study

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Employees suffer stress when demands exceed the possibilities to cope with them 1. Prolonged occupational stress caused by interpersonal demands may result in symptoms of burnout 2 such as emotional exhaustion, depersonalisation and reduced personal accomplishment 3.
An ageing workforce faces challenges related to pressure of time, understaffing and increased demands on quality and quantity of work – a trend that especially impacts hospital work. Therefore, the healthcare sector is considered as a setting with particularly high prevalence of burnout and relatively short length of stay on job. Occupational stress and psychosocial conditions are considered as the most important factors affecting employee's health and well‐being 4.
Due to socio‐demographic and economic changes, new forms of employment contracts, job insecurity, high workload and work pressure, high emotional demands at work and poor work–life balance belong to the main emerging risks in mental hospital staff 5. Such burdens may result in a decreasing ability to cope with demands of job and of family life, in poor work performance 7, in ‘presenteeism’ (employees continue to work although they are sick or unable to do their job effectively) and finally in increased absenteeism and in elevated injury rates 8. As a consequence, costs for enterprises and for the society are rising significantly 9. Therefore, the Austrian Social Insurance considers the identification of vulnerable groups of employees for burnout and an early diagnosis as a main preventive measurement for improvement of health and well‐being 10.
Although numerous investigations about stress and strains in nursing have been published, little research focused on differences between occupational groups in hospitals and gender‐specific vulnerability for burnout.
Since 2007, the American Psychological Association annually examines the gender‐specific perception of stress among the working population across the United States. They report a widening gap in stress level between women and men with a higher stress perception in women and a lower stress perception in older employees, but did not provide information about stress perception within different professional groups working in the healthcare sector 11.
In Europe, recent research dealing with burnout in hospital staff is scarce; it mainly focuses on employees working directly with patients and predominantly includes nurses and physicians 12.
An Italian study assessed interpersonal strain at work and vulnerability for burnout in hospital staff with direct patient contact 14. Emotional dissonance and exhaustion were confirmed as risk factors for adverse health effects, especially in women. A second study conducted in Italy investigated occupational and environmental factors of burnout among nurses 15. A strong buffering effect of communication within teams on exhaustion was described and underlines the importance of personal relationships among staff members on efficacy and quality of patient care.
Results of a study conducted in Greece, Bulgaria, Romania, Turkey, Croatia and the Republic of Macedonia showed an impact of negative evaluative talk about an absent third person on organisational function, engagement, quality of care and vulnerability for burnout in nurses and physicians 16.
In Sweden, the MONICA study (Monitoring of Trends and Determinants in Cardiovascular Disease) investigated vulnerability for burnout involving the general working population 17. Interactions between sex and working field were reported as well as lower levels of burnout with increasing age. The Swedish Karolinska Institute analysed the extent of work‐related strains in healthcare workers 18 and reported an association between higher levels of occupational strains and emotional exhaustion.
Furthermore, the NEXT study (nurses' early exit study) investigated well‐being at work in nurses in ten European countries and found an increasing tendency to leave the profession as a consequence of burnout 19.
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