14. Definition A psychological complex phenomenon related to stressful working environment, long-term exhaustion and diminished interest. First coined by Herbert Freudenbergerin his 1974 Staff burnout, based on the 1960 novel A Burnt-Out Caseby Graham Greene. According to Maslach; Burnout syndrome is characterized by three dimensions: 1) Emotional exhaustion (depletion of emotional resources to contact with other people, feelings of frustration, anger and dissatisfaction). 2) Depersonalization (negative feelings and dehumanization of the relationships with the persons who expect personal “investment”). 3) Reduced personal accomplishment (a tendency to evaluate oneself negatively, particularly with regard to work).
15. Outcome of Burnout Syndrome On organizational level: Reduced job performance and organizational commitment. Higher intention to leave the job. On individual level: Health related outcomes (increases in stress hormones, coronary heart disease, circulatory issues). Mental health problems (depression, etc.). Excessive absenteeism, inordinate use of sick leave, wish to leave the job and decrease to overall well-being.
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17. How does burnout develop? Herbert Freudenberger “12 phases” theory A compulsion to prove oneself. Working harder. Neglecting one's own needs. Displacement of conflicts (person does not realize the root of the distress). Revision of values (friends or hobbies are completely dismissed). Denial of emerging problems (cynicism and aggression become apparent). Withdrawal (reducing social contacts to a minimum; alcohol or other substance abuse may occur). Behavioral changes become obvious to others. Depersonalization (life becomes a series of mechanical functions). Inner emptiness. Depression. Burnout syndrome.
18. Biological aspect: HPA axis dysfunction: Some studies found elevated levels of cortisol after awakening in burnout participants. However, results have so far been inconclusive. Failure of adult hippocampal neurogenesis: Elevated HPA-axis activityin reaction to stress can lead to the suppression of hippocampal neurogenesis, which is assumed to be one of the pathways for depression and other neuropsychiatric disorders. Brain-derived neurotrophic factor “BDNF”: Neurotrophic factors are critical regulators of the formation and plasticity of neuronal networks Stress reduces BDNF gene expression in the hippocampus and this reduction can also be prevented by antidepressant drug treatment. Also more recently Mitoma et al. (2007) found a negative correlation between job stress levels and sBDNF levels.
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20. Signs & Symptoms The burnout process can be resumed in the following stage: Stage 1: High workload, high level of job stress, high job expectations Job demands exceed job resources. The job does not fulfill one’s expectations. Stage 2: Physical / emotional exhaustion Chronic exhaustion, sleep disturbances, susceptibility to physical pain. Emotional exhaustion; fatigue even when work comes only back to mind Stage 3: Depersonalization / Cynicism / Indifference Apathy, depression, boredom A negative attitude toward the job, the colleagues and service recipients . Withdrawal from the job, the problems; a reduced work effort Stage 4: Despair / Helplessness / Aversion Aversion to oneself, to other people, to everything Feelings of guilt and insufficiency
21. What is not burnout? Stress: Can intensify burnout but is not the main cause. Symptoms may be more physical rather than emotional. Produces urgency and hyperactivity, while, Burnout produces helplessness. Emotions associated with stress are over-reactive, those of burnout are more blunted. Depression: Extends to every life domain (e.g., work, family, leisure), while, Burnout is specific to work context. Post traumatic stress disorder (PTSD): Caused by the exposure to a traumatic event or extreme stressor.
36. Prevention of Burnout syndrome At the organizational level: Eliminating, reducing or counteracting stress factors of working environment. Development of values in organizational culture. Development of attitudes and rewarding relationships. Development of effective social support. Modeling, programming and resource planning. Consultation with employees. Employee participation in decisions making concerning changes. Custom fitting and comfortable workplace.
37. Prevention of Burnout syndrome “cont.” Prevention of Burnout syndrome “Cont.” At the individual level: Relaxation techniques. Cognitive restructuring. Social skills training, Didactical stress management. Attitude change.
38. Intervention programs on Burnout Syndrome Person directed intervention programs : Psychotherapy: “cognitive-behavioral measures”. Counseling Adaptive skill training. Communication skill training. Social support. Exercises for relaxation.
41. Change shift work systems & introduce vacations.Increasing participation on making decisions. Training supervisors & managers. Training for better coping “stress management intervention”. Counseling & therapy.