Investigating the relationship between burnout and job support from the point of view of nurses in Rasht medical training centers in 2019

Dissertation for obtaining a master's degree in nursing education

(internal surgical orientation)

Abstract:                                  

Introduction: Job burnout is one of the problems of the nursing profession, which occurs if job stress is not dealt with correctly. It manifests as a feeling of emotional weakness, depersonalization, and lack of individual career success. One of the factors that reduce job stress is the support received by the working person in the work environment.  The purpose of this study was to determine the relationship between burnout and job support from the point of view of nurses in Rasht educational centers in 2019.   

Materials and methods: In this descriptive study, stratified random sampling was used. The sample size was 257 people from 8 medical training centers in Rasht in 2019. The tools used are Meslach's standard job burnout questionnaire and Spooner's job support questionnaire.  Data were analyzed using descriptive statistics and t-test, chi-square, Fisher's exact test and logistic regression model.                                   

Results: Among the dimensions of job burnout, emotional retardation was low in (51.4%) of the researched units and moderate to high in (48.6%) of them; Depersonalization was low in (94.2%) of the researched units and moderate to high in (5.8%) of them; Individual lack of job success was reported in (33.9%) of the researched units as low and in (66.1%) as medium to high. The support of colleagues in most cases (82.9%) was medium to high, and the support of officials was medium to low in (47%) of the researched units. There was an inverse correlation between official support and emotional distress, while there was a direct correlation between dialysis ward and depersonalization and an inverse correlation between age and depersonalization. 

    Conclusion: The results of this study show that by considering the factors affecting nurses' burnout and by increasing the support of officials, it is possible to prevent nurses' burnout;  Therefore, the quality of nursing care for patients increases and the job satisfaction of nurses also increases. Keywords: hospital nurses / social support / burnout Problem statement: Today, the healthcare sector is one of the most important areas of sustainable development in human societies due to its direct relationship with human health. is coming The realization of this requires the presence of a healthy, energetic and highly motivated group of therapists. Among the people of this group are the nursing staff of hospitals. In all hospital departments, we meet nurses who were regular, caring and interested people when they entered the nursing profession, but usually after working for a while and facing a lot of problems and job stress in the workplace, they feel tired and even want to quit their jobs. Among these, one of the common factors can be job burnout (1). About 50-80% of diseases are caused by stress or with the help of stress. There are various sources of stress, one of the most important sources of which is job (2). If job stress is not properly identified and properly dealt with, it may lead to job burnout (3).           

Job burnout syndrome is a response to job stress. The term burnout was first proposed by Freudenberg [1] in 1974 when he identified a state of growing fatigue and despair in people who provided care services (4). Burnout is not a symptom of job stress, but the end result of "unmanaged" job stress, which manifests as feeling of emotional exhaustion [2], depersonalization [3] and reduction of individual job achievements (individual lack of success in the job) [4]. Emotional exhaustion is a feeling of being overly emotional and helpless by a person who is working. Depersonalization refers to the development of lack of personality, apathy and indifference towards clients.A decrease in individual job achievement occurs when the sense of competition and achieving success in working with people decreases. Nurses are especially prone to burnout, because they are faced with illness, pain, suffering and death of clients (5).       

Equipment defects in some departments, lack or rarity of drugs, working hours and rotation that separates nurses from the daily life of society are factors that lead to increased tension in nurses. The insufficient number of nurses, the uncertainty of the situations they have to deal with and the responsibility towards patients (for example, during night work), the inconsistency of stressful situations, which is the result of the diversity of hospitals and, as a result, the difference in the type of work of nurses, have exposed the employees of this profession to considerable stress (6). Also, nurses are faced with various challenges in their work environment, which is the source of tension in them, including the fact that what nurses have learned during the nursing education program is in most cases contrary to the conditions that govern the workplace and usually puts them in an unfavorable situation that is not acceptable to them, so they have an internal conflict in daily decisions related to patient care and they do not know how to respond to the calls of their conscience. As a result, psychological stress symptoms may appear in them (7). According to the reports made in our country, the prevalence of burnout among nurses is high, so that in hospitals affiliated to Babol University of Medical Sciences, 68.6% of nurses have high burnout and 0.7% very high burnout. The most common causes of burnout include low salaries and benefits (93.9%), lack of support from managers (85%), lack of job security (84%) and long working hours (83.3%) (2). In private hospitals in Tehran, moderate to high emotional exhaustion has been reported in 87% of nurses in Tehran (1).

Job burnout has many harmful effects on the body, psychological and social status of a person, and job performance, which includes a lack of employee morale, defective work performance, reduced production, absenteeism, inappropriate personal behavior with caregivers, negative attitude toward the job, less job satisfaction, job change. More, lower quality of life and poor health and mental well-being (4). In a study conducted in 2010 by Hazel[5] in Florida with the aim of determining job stress, job burnout, job satisfaction and the tendency to leave work in public hospital nurses, the negative effect of emotional exhaustion and personal lack of job success on job satisfaction was also reported. Also, the results of this study confirmed the relationship between job stress, job burnout, lack of job satisfaction and the desire to leave work (8). When nurses experience burnout, they provide poorer care, which ultimately causes losses to the organization; So organizations also pay the price of job burnout (10 and 9). In addition to these, nurses themselves also suffer because burnout affects their lives as well (11).  In the management of occupational stress, some individual measures must be taken, so that each person should act on his own to control his nervous pressure. Managers can also be involved in the management of occupational stress by applying some measures such as fostering a favorable organizational culture, guiding and supporting employees, designing an appropriate and motivating salary system, paying attention to job adaptation and meritocracy, and improving organizational communication. Most nurses in stressful work environments do not have enough social support (13). If there is social support in the work environment, it will play a major role in a person's adaptation to stress (14). Abularab [6] also quoted Seliyeh [7] as saying that nurses who have to support patients themselves need support (15). There are two main sources of support for a working person: work-based support, which includes the two dimensions of support from officials and support from colleagues; Support based on non-work also includes the support of people such as spouse, family and friends of the working person. In the face of workplace stressors, organizational resources provide more support than support resources outside the workplace.