Abstract

     This study investigated the moderating effects of functional social support (emotional and instrumental support) on the relationship of job demand control with burnout and work engagement. In total, 297 frontline employees from a hotpot restaurant franchise in China were surveyed. The results indicated emotional support, such as caring and inspiration, mitigated the adverse effects of high demand/low control on burnout and work engagement. Instrumental support, such as giving suggestions and solving problems, only mitigated the adverse effects of burnout. Further, the high demand/low control/low emotional support work condition was the most unfavourable for work engagement and burnout; while high demand/low control/low instrumental support was the most unfavourable condition for burnout. The theoretical and managerial implications of this research have been provided to gain a deeper insight into functional social support in the job demand control model.

Introduction

     The service industry is one of the major economic sectors in developed countries. In this industry, frontline service employees play a critical role by offering services to customers and building strong customer relationships through direct and frequent interactions (Dong, Liao, Chuang, Zhou, & Campbell, 2015; Hülsheger & Schewe, 2011). Customer relationships and service quality have a substantial influence on organisational performance (Jung & Yoon, 2014; Wu, Yuan, & Yen, 2021). Thus, identifying effective ways of enhancing employees’ service with engagement is a key concern in the service industry, and in particular, an important consideration in the human resources management field (Buruck, Dorfel, Kugler, & Brom, 2016; Jung & Yoon, 2014; Wu et al., 2021). Further, due to the increasing levels of consumer demand in the service industry, the range of services that service employees provide has greatly expanded in recent years (Jung & Yoon, 2014; Karatepe & Karadas, 2015). Consequently, employees’ stress levels in the workplace have continued to increase, which can negatively affect their physical and psychological health (Dong et al., 2015; Jung & Yoon, 2014). In addition, to adapt to the exponential growth in various customer demands, organisational reform has resulted in employees feeling uncertain about their jobs, generating more work-related stress (Baum, Sattler, & Reimann, 2021).

Conclusions and discussion

Conclusions

     Based on the JDCS model, this study adopted the social support function as a moderator and investigated its effect on the relationships between two independent variables (job demand and job control) and outcome variables (burnout and work engagement). The results demonstrated that, with respect to emotional support, the situation of high demand/low control/low support leads to the most burnout and the least work engagement; however, emotional support can mitigate the adverse effects of high demand/low control on burnout and work engagement (H1.1a, H1.1b, H1.2a, and H1.2b were supported). With respect to instrumental support, the high demand/low control/low support condition leads to the greatest level of burnout; as with emotional support, instrumental support can mitigate the adverse effects of high demand/low control on burnout (H1.3a and H1.3b were supported). The above hypotheses (H1.1–H1.3) were consistent with previous studies (De Jonge & Dormann, 2006; H¨ ausser et al., 2010).

     However, this study uncovered that instrumental support did not contribute any benefit to the interaction effect of job demand and job control on work engagement (H1.4a and H1.4b are not supported). Further analysis showed that the combined effect of high instrumental support and high job demand would reduce employees’ work engagement (the product term of job demand and instrumental support on work engagement in Table 3: β = − 0.15, p < 0.05). This yields the question: Why can employees not take the advantage of instrumental support in some conditions?

 Abstract

Background

Methods

Results

Discussion

Conclusion

Availability of data and materials

Abbreviations

References

Acknowledgements

Funding

Author information

Ethics declarations

Additional information

Rights and permissions

About this article

Abstract

Background
The main aim of the present study was to examine the relationships among work environment, job satisfaction and burnout in dentists and to analyse the way in which certain sociodemographic variables, such as gender, professional experience and weekly working hours, predict the perception of the work environment.

Methods
A battery of online questionnaires was sent to 3876 dentists officially registered in the triple-province region of Valencia; the battery included the Survey of Organizational Attributes for Dental Care, the Warr–Cook–Wall Overall Job Satisfaction Scale, the Maslach Burnout Inventory and a series of sociodemographic questions formulated for the specific purpose of this study. To assess the relations with the independent variables, we calculated the Pearson correlation coefficient, the Z-scores were calculated to make effect sizes comparable, and the associations between the scales and the sociodemographic variables were investigated by adjusted multiple regression analysis.

Results
A total of 336 participants (9.4%) correctly completed the survey in this study. The mean (M) age was 37.6 years old (standard deviation (SD) = 9.6, median (Me) = 34). Participants reported high scores on the work environment and job satisfaction scales, with only limited experiences of burnout (3.8%). Work environment and burnout were significantly and positively predicted by years of professional experience (β = .078; p = .000 and β = .107; p = .004, respectively), and job satisfaction was significantly and positively predicted by weekly hours of work (β = .022; p = .001), without significant differences according to gender.

Conclusions
Dentists who work over 20 hours a week and have more years of professional experience report having better perceptions of well-being at work, with no significant difference according to gender. It is important to highlight the aspects that improve well-being in dentistry to reduce burnout, which would lead to greater work engagement and better attention to patients.

Abstract

Keywords

1. Introduction

2. Method

3. Results

4. Discussion

CRediT author statement

Ethical approval

Conflict of interest

Funding

References

Abstract
Background
Previous studies on the effects of providing feedback about quality improvement measures to nurses show mixed results and the factors explaining the variance in effects are not yet well-understood. One of the factors that could explain the variance in outcomes is how nurses perceive the feedback. It is not the feedback per se that influences nurses, and consequently their performance, but rather the way the feedback is perceived.

Objectives
This article aims to enhance our understanding of Human Resource attributions and employee engagement and burnout in a feedback environment. An in-depth study of nurses’ attributions about the ‘why’ of feedback on quality measurements, and its relation to engagement and burnout, was performed.

Design and Methods
A convergent mixed-methods, multiple case study design was used. Evidence was drawn from four comparable surgical wards within three teaching hospitals in the Netherlands that volunteered to participate in this study. Nurses on each ward were provided with oral and written feedback on quality measurements every two weeks, over a four month period. After this period, an online survey was distributed to all the nurses (n = 184) on the four participating wards. Data were collected from 91 nurses. Parallel to the survey, individual, semi-structured face-to-face interviews were conducted with eight nurses and their ward manager in each ward, resulting in interview data from 32 nurses and four ward managers.

Results
Results show that nurses – both as a group and individually – make varying attributions about their managers’ purpose in providing feedback on quality measurements. The feedback environment is associated to nurses’ attributions and these attributions are related to nurses’ burnout.

Conclusions
By showing that feedback on quality measurements can be attributed differently by nurses and that the feedback environment plays a role in this, the study provides an interesting mechanism for explaining how feedback is related to performance. Implications for theory, practice and future research are discussed.

1- Introduction

1-1 Background

Providing feedback to nursing teams is an important and frequently used strategy for improving clinical performance after quality measurements in hospital care (De Vos et al., 2009). Feedback on performance is generally used to draw healthcare workers attention to gaps between desired and actual practice in patient care, and can be defined as “delivering information about clinical performance provided to patient populations over a specified period of time to professionals, practices or institutions, for the purpose of improving the team’s or clinician’s insight into the quality of care they provide and improving it when possible” (Ivers et al., 2020). The mechanisms of how providing feedback on performance would lead to improved performance are too often ignored in the literature on healthcare quality improvement (Tuti et al., 2017). However, from behaviour change literature we know that feedback is a basic change method that relates to several theories on learning and goal setting (Kok et al., 2016), with the most likely mechanisms being: 1) that feedback on performance triggers positive change through creating awareness of suboptimal performance; and 2) that positive feedback in case of improved performance over time can be rewarding and thus stimulate further improvement.

t Bipolar spectrum disorders are characterized by alternating intervals of extreme positive and negative affect. We performed a meta-analysis to test the hypothesis that such disorders would be related to dysregulated reinforcement sensitivity. First, we reviewed 23 studies that reported the correlation between self-report measures of (hypo)manic personality and measures of reinforcement sensitivity. A large relationship was found between (hypo)manic personality and BAS sensitivity (g = .74), but not with BIS sensitivity (g = -.08). This stands in contrast to self-reported depression which has a small, negative relationship with BAS sensitivity and a large positive one with BIS sensitivity (Katz et al., 2020). Next, we reviewed 33 studies that compared reinforcement sensitivity between euthymic, bipolar participants and healthy controls. There, bipolar disorder had a small, positive relationship with BAS sensitivity (g = .20) and a medium, positive relationship with BIS sensitivity (g = .64). These findings support a dualsystem theory of bipolar disorders, wherein BAS sensitivity is more closely related to mania and BIS sensitivity more closely to bipolar depression. Bipolar disorders show diatheses for both states with euthymic participants being BAS- and BIS- hypersensitive. Implications for further theory and research practice are expounded upon in the discussion.

The bipolar spectrum contains a set of related disorders characterized by the periodic experiencing of emotional extremes (American Psychiatric Association, 2013). Those who suffer from a bipolar spectrum disorder have typically experienced periods of abnormally elevated, energetic or irritable moods as well as periods of lethargy and anhedonia – sometimes rapidly cycling between both, and sometimes experiencing both simultaneously. Although a diagnosis of Bipolar I disorder (BP-I) requires only a manic episode (American Psychiatric Association, 2013), a recent, large-scale survey of those diagnosed with BP-I found that the vast majority have experienced at least one depressive episode as well (e.g., 94.2%; Karanti et al., 2020). A diagnosis of Bipolar II (BP-II), on the other hand, entails the history of a less severe manic episode along with a depressive episode (American Psychiatric Association, 2013). Cyclothymic disorder involves numerous cycles of subthreshold manic and depressive episodes. Final diagnosis often reflects the relative severity of each bipolar episode. Severe impairment due to mania/hypomania is somewhat more common among those with BP-I than with BP-II (e.g., 73.1% vs 64.6%), while severe impairment due to a depressive episode is slightly more likely among those with BP-II than in BP-I (e.g., 91.4% vs 89.3%; Merikangas et al., 2007). While the relative severities of each bipolar episode may shift based on disorder, bipolar spectrum disorders typically share the primary experience of alternating between extremes.

This paper used moderator analysis to test whether emotional intelligence and resilience moderated the relationship between the Dark Triad variables and burnout. 232 adults completed measures of all variables. Primary Psychopathy was found to reduce an individual’s level of burnout. However, Secondary Psychopathy and Machiavellianism were expected to increase burnout, and although the correlation results supported this, the regression models did not. Narcissism, unexpectedly, had no significant relationship with burnout. As predicted, emotional intelligence provides a buffer against negative effects of the Dark Triad traits but also amplifies the positive effects, such as reducing burnout. Implication and limitations are considered.

Introduction

The Dark Triad comprises of three personality traits, psychopathy, Machiavellianism and narcissism, which are believed to share a common core but have aspects that are unique to each trait (Paulhus & Williams, 2002). Derived from clinical research, psychopathy is made up of 2 factors: Factor 1 representing the core personality traits of a psychopath: selfishness, callousness and lack of empathy and remorse, whereas Factor 2 encompasses the chronic antisocial behaviour that is associated with a psychopath: the chronically unstable and antisocial lifestyle (Hare et al., 1990; Harpur, Hakstian, & Hare, 1988). Machiavellianism is characterized by behaviour that is amoral and manipulative. Individuals scoring high on Machiavellianism are cynical of the individuals around them and willing to adopt the necessary tactics to achieve their goal (Christie & Geis, 1970). The core of Narcissism is an inflated view of self and a sense of entitlement. Consequently, individuals high on this trait display behaviour that exaggerates their abilities and they are not receptive of criticism. As expected, others view high narcissists as egotistical and arrogant (O’Boyle, Forsyth, Banks, & McDaniel, 2012). Recent meta-analyses of the Dark Triad have examined several outcomes such as intelligence (O’Boyle, Forsyth, Banks, & Story, 2013), job performance (O’Boyle et al., 2012), and counter productive work behaviours (CWB; Grijalva & Newman, 2015). They have all shown there is considerable heterogeneity in effect sizes to warrant moderator investigation. However, only a few studies have examined what moderates the Dark Triad and whether those moderating effects are consistent across Dark Triad traits (notable exceptions are Palmer, Komarraju, Carter, & Karau, 2017; Smith, Wallace, & Jordan, 2015). This study attempts just that. Furthermore, this study examines whether there are potential benefits to the individual or an “upside” to these traits that have traditionally been investigated as detrimental to individuals and wider society. Moderator research is important to identify situational or dispositional factors that not only reduce the negative influence of the Dark Triad on work outcomes but also potentially amplify, and therefore illuminate, the positive influence the Dark Triad traits may have in the workplace.

This study aimed to find out the correlations between in-service teachers’ emotional, burnout and job satisfaction in Turkey. To this end, the Teacher Emotion Inventory (TEI), Job Satisfaction Questionnaire and Maslach Burnout Inventory were administered to 564 in-service teachers in a wide range of disciplines. According to confirmatory factor analysis, the five-factor model of TEI was successfully confirmed within the current study. In addition, joy and love dimensions exhibited positive correlations with job satisfaction. The love and fear dimensions significantly predicted job satisfaction with a medium effect. Love, sadness, and fear dimensions significantly predicted teachers’ burnout with a medium effect.

Introduction

Teacher emotion is an interrelated and intermediating term among several variables such as job satisfaction, burnout, identity, cognition and competencies in that the more the teacher becomes aware of his/her emotional experience, the more rapport s/he can build with colleagues and the more s/he can cope with the dehumanization of teaching career in some contexts (Shapiro, 2010). Despite these interrelationships, emotions in educational research have been disregarded for a long time. The reasons for the dearth of research in this area might be the difficulty in defining and assessing the subjective emotional aspects of learning compared to the more objective and relatively more observable cognitive aspects such as thinking, motivation, metacognition and professional aspects like identity formation (Karlsson, 2013; Shapiro, 2010; Timostsuk & Ugaste, 2012), professional development (Golombek & Doran, 2014), burnout (Fiorilli, Albanese, Gabola, & Pepe, 2017), and self-efficacy (Penrose, Perry, & Ball, 2007). In a nutshell, Frenzel and Stephens (2013, p. 5) acknowledge the complexity of emotions and define them as “multidimensional constructs comprising affective, psychological, cognitive, expressive, and motivational components”. Teachers are involved in different social interactions in classroom settings and it is important for them to establish a good relationship with their students and understand their students’ mental states through mentalization (Swan & Riley, 2015).

The 2011–12 Schools and Staffing Survey (SASS) was used to examine occupational stress, occupational commitment, and intention to remain in teaching in a nationally representative sample of U.S. kindergarten teachers (n = 744). Teachers who perceived classroom resources as sufficient to meet demands, tended to report they would become a teacher again (86.5%) and reported intentions to remain in the profession (87.6%). However, of teachers who perceived classroom resources as insufficient to meet classroom demands, only 50.2% reported they would become teachers again, and only 61.4% reported they intended to remain in the profession. Logistic regression was used to examine teacher responses to these items while controlling for school- and teacher-level covariates. Teachers perceiving sufficient resources were more likely to report they would become teachers again and intended to remain in teaching (odds ratios = 2.612, 1.863) while teachers perceiving insufficient resources were much less likely (odds ratios = 0.324, 0.327).

Occupational stress among U.S. kindergarten teachers

Teacher attrition, a phenomenon describing teachers who voluntarily exit the field, has emerged as a major concern for both policy makers and researchers within the United States. The exceedingly high rate of pre-retirement teacher attrition in the U.S. – approximately 5.3% of the workforce – has been well documented over the past several decades, as have the associated financial, organizational, and educational costs (Borman & Maritza, 2008; Kelly & Northrop, 2015; Sutcher, Darling-Hammond, & Carver-Thomas, 2016). Schools, school systems, and state education agencies spend large sums of scarce resources on teacher induction and initial training, on-going professional development of new teachers, and materials for recruitment and hiring. All of these costs increase as teacher turnover grows. Teacher turnover is also disruptive to the educational process and harmful to student developmental progress and achievement of instructional goals. When teachers have a more positive experience with their jobs and are less stressed, they are much more effective at supporting the growth and development of young children. Conversely, when teachers experience greater stress, they create more stressful learning environments for their students (Pakarinen et al., 2010). Recent studies have focused on the affective dimensions of young learners, suggesting that students learning under less stressful environs are more educationally productive. A growing body of evidence has shown that mindfulness training for young students can have positive benefits related to enhanced attention, self-regulation, executive functioning, and social skills (Frank, Jennings, & Greenberg, 2013; Roeser, 2013).

Background: Minimal research exists on how engagement, burnout, work-family balance, and job stressors impact advanced practice nurses and physician assistants, collectively referred to advanced practice providers (APPs). Purpose: To investigate the interrelationships among burnout, job stressors, workfamily balance, and engagement with APPs. Methods: An online questionnaire was distributed to APPs working in four healthcare systems. A total of 1,216 APPs completed the survey. A hypothesized model was tested using structural equation modeling. Findings: There was a high correlation of job stressors with development of burnout. A significant negative effect between job stress and work engagement was supported; however, indirect effects of stress through job burnout had a stronger impact on work engagement. Higher levels of work-family balance contributed to a lower level of stress experienced by providers. Discussion: Organizational leaders desiring to improve employee engagement and reduce burnout need to focus on the significance of work-family balance to job stressors.

Introduction

Burnout as a phenomenon has been well documented in nurses who provide direct care and its prevalence has been established (Aiken et al., 2001; McHugh, Kutney-Lee, Cimiotti, Sloane, & Aiken, 2011). Advanced practice providers (APPs) is a term used to describe advanced practice registered nurses (APRNs) and physician assistants (PAs) who work collaboratively with physicians. The rising concern for burnout among nurses and physicians globally (Linzer et al., 2001; Shanafelt et al., 2015) has prompted a need for a closer investigation of its possible existence in APPs who are expected to help address the projected shortage of 23,640 primary care physicians by 2025 within the United States of America (USA) (Health Resources Services Administration, 2016). However, there is very little research on the construct of burnout among APPs. The consequences of burnout within the healthcare professions include stress-related health problems, shorter careers, and turnover (Aiken et al., 2001; Bianchi, Mayor, Schonfield, & Laurent, 2018; Shanafelt et al., 2015; West, Dyrbye, & Shanafelt, 2018). It is difficult to know the degree to which burnout exists among different professionals (Helfrich et al., 2017). Retention of all providers is necessary to enhance the delivery and quality of care as access to care, particularly in rural areas, remains challenging. Emerging models of care that allow all healthcare professionals to work at the full scope and extent of their licensure are recommended as ways to improve efficiency, quality, and to meet healthcare needs; yet considerable challenges to full practice expansion of APRNs persist (Altman, Butler, & Shern, 2015). The expectations for APPs working within these new models suggest a need for consideration of their impact on job stressors. Fortney, Luchterhand, Zakletskaia, Zgierska, and Rakel (2013) proposed addressing elements of the work environment and self-care to avoid alienation and depersonalization, which are viewed as possible effects associated with an increasingly complex healthcare system.

Cross-sectional studies suggest that Type D personality is a risk factor for work-related exhaustion and engagement, but longitudinal evidence is lacking. The present 3-wave study examined its longitudinal effects, taking into account existing job demands and resources, exhaustion, engagement, and neuroticism. Data were extracted from the LISS-panel, based on a random sample of the Dutch population. Hierarchical multiple regression analyses were conducted among respondents (N = 2273) who were employed during the 7-month study. Respondents worked in sectors varying from healthcare to industry. In the longitudinal analyses Type D personality was not a significant predictor for exhaustion/engagement over and above existing exhaustion/ engagement, neuroticism, job demands and resources, in contrast to cross-sectional analyses. Job demands and resources explained a trivial proportion of variance of exhaustion and engagement in longitudinal analyses. Using the two elements of Type D personality (negative affectivity and social inhibition) did not change main findings. Existing exhaustion and engagement were significant and dominant predictors. We found no evidence to prove that Type D personality is relevant in the development of emotional exhaustion and engagement. Findings stress the necessity of longitudinal studies controlling for corresponding variables assessed earlier to prevent overestimations of effects.

Introduction

The Job Demands-Resources (JD-R) model (Bakker & Demerouti, 2007) is the most popular framework in occupational health psychology to investigate the relationships between these job characteristics and employee well-being (Lesener, Gusy, & Wolter, 2019). It distinguishes two broad categories of antecedent factors, namely job demands and job resources. The model represents an all-encompassing theoretical framework that may be applied to all occupational environments and is used to explain both positive and negative work outcomes. The most important of these work outcomes are burnout and work engagement, which are investigated most often by the JD-R approach (Schaufeli & Taris, 2014). The present research will focus on emotional exhaustion and work engagement. Emotional exhaustion is characterized by the feeling of being emotionally overextended and worn out by one’s work. It can be considered as the core component of burnout since the other dimensions (i.e., cynicism and reduced personal accomplishment) develop as a consequence from this state of exhaustion (Taris, Le Blanc, Schaufeli, & Schreurs, 2005). Work engagement is defined as “a positive, fulfilling, work-related state of mind that is characterized by vigour dedication, and absorption” (Schaufeli, Salanova, GonzálezRomá, & Bakker, 2002, p.74).

Introduction

Nurses fulfill an essential role within the intensive care unit (ICU) team. They contribute to improved clinical outcomes, fewer complications as well as errors and hence to reduced morbidity and mortality. ICU nurses co-operate closely with physicians as well as with colleagues and interact with the family of the patient (Blot et al., 2011, 2014; Brock et al., 2013; Coburn and Gage-Croll, 2011; Courtenay et al., 2013; Liu et al., 2015). These collaborations can lead to ethical conflicts, in particular when nurses feel insufficiently involved in medical decisions (Falco-Pegueroles et al., 2016). ICU nurses have unique working conditions, characterised by a high technical environment and the continuous handling of seriously ill patients requiring highly specialised training and education (Endacott et al., 2015). In this regard, the ICU differs from many other departments (Cartledge, 2001; van Dam et al., 2013). The specific working conditions of ICU nurses render them vulnerable for burnout. Similar to nurses in other departments, night shifts, work-related stress, the number of days off, conflicts with colleagues or patients, the relationship with their supervisors and the organisation influence the risk on burnout among ICU nurses. For nursing staff, poorly organised services are associated with higher stress levels. Stress triggers burnout, moderated by the way nurses cope with stressors (Cartledge, 2001; Embriaco et al., 2007; Ntantana et al., 2017; Ramirez et al., 1996; Vifladt et al., 2016). Besides overall stress, anxiety and depressive symptoms seems to play a role as well. In a survey among 370 ICU nurses and 121 general ward nurses, Mealer et al. (2007) found anxiety and depressive symptoms to be common in both groups. ICU nurses, however, had an increased prevalence of post-traumatic stress disorder (PTSD) symptoms as compared with general ward nurses (Mealer et al., 2007). The experience of stress has been repeatedly demonstrated as a major determinant for burnout (Embriaco et al., 2007; McHugh et al., 2011). Burnout has a negative impact on mental health, especially when resilience is low (Arrogante and Aparicio-Zaldivar, 2017). Burnout reduces the quality of ICU team communication, leading to lower quality of care (Galletta et al., 2016). In addition, staff rotation and absenteeism become significantly more common inflicting higher costs to health care organisations (Cartledge, 2001; Embriaco et al., 2007). Besides the risk for burnout, stress and poor job satisfaction also contribute to increased turnover intention among ICU nurses. Factors associated with the intention to leave the ICU include high workload, stress-related health problems and night shifts (Cartledge, 2001; Courtenay et al., 2013; Embriaco et al., 2007; van Dam et al., 2013). The issues of burnout, absenteeism and turnover intention also have important socio-economic consequences as it threatens the availability of ICU nurses (Dessy, 2009; Embriaco et al., 2007). The key issue in these challenges is job satisfaction. High levels of job satisfaction are associated with lower intention to leave, burnout, and absenteeism among health care staff (Castle et al., 2007; Gardulf et al., 2008).

With the development of technology and changes in medical care, the requirements of the medical service have been steadily increasing. In particular, the role of nurses has increased as the medical community recognizes the importance of patient care. Nurses are commonly the main point of contact between patients and medical staff, and therefore need to have enthusiasm, patience, and diligence in the treatment of each patient. In many cases, this must be accomplished in high-pressure environments under severe workloads, resulting in huge psychological stress and increased likelihood of anxiety, depression and insomnia (Cheung and Yip, 2015, Eldevik et al., 2013, Song, 2013). Anxiety is a common psychological condition(Cole, 2014). Onset can occur due to a variety of reasons, but is usually associated with stress-related either physical or mental challenges, or a combination of both. Anxiety is therefore an adaptive emotional response which has been shown to have protective functions(Cole, 2014). However, if the anxiety states become systematic, the response can be detrimental, producing anxiety disorder(Association, 2013). In China, compared to other medical professions, nurses have been shown to be more prone to anxiety(Gao et al., 2012, Wei et al., 2009). A recent Chinese study examined the prevalence of anxiety in 7071 nurses from 460 hospitals and found that 39.12% of these nurses suffered from anxiety(Jiang, 2012). Furthermore, another cross-sectional study conducted in seven Chinese cities indicated that the prevalence of anxiety symptoms among Chinese nurses was 43.4%(Gao et al., 2012). Studies have also shown that Chinese nurses suffer more from anxiety than those from some other countries. In particular, the prevalence of anxiety symptoms among Chinese nurses was greater than those in Japan(7%)(Kawano, 2008), the U.S.(20%)(Kawano, 2008), and Singapore (21%)(Chan and Huak, 2004). Finally, the level of anxiety among Chinese nurses (44.48 ± 11.32) has also been shown to be prominently higher than the general population (33.8 ± 5.9)(Wei et al., 2009). The question arises: Why would Chinese nurses suffer so many symptoms of anxiety? The answers are complex. First, China is a country with a large population base, and the ratio of nurses to the general population is 1:1750, which is significantly lower than other developed countries where the ranges are from 1:140 to 1:320(Wu et al., 2010). Chinese nurses tend to work overtime, experience long working hours, and have an enormous workload (Wang et al., 2012). In addition, the social status of Chinese nurses is relatively low and therefore there is a large imbalance in effort and reward(Gao et al., 2012).

Burnout is an occupational hazard that continues to draw immense attention as it relates to significant costs for employees and organizations (e.g. Bakker, Demerouti & Verbeke, 2014; Schaufeli, Bakker & VanRhenen, 2009). It has become a major problem in most countries, not only in the lowest socioeconomic groups, but at all societal levels (Albertsen et al., 2010). Majority of the burnout studies exist in the context of psychosocial professions of physicians, nurses and teachers. However, burnout may pertain to any occupation where there is an imbalance between demands and possible renewal of resources (Bakker & Demerouti, 2014). Such aspects are evident in many careers within fast-paced firms, where work is varied, complex, deadline driven and competitive, with long workdays, and where it is difficult to separate work from home life (Hetland, Sandal & Johnsen, 2007). This study is based on data from knowledge workers belonging to the IT services, which typically carries all of these characteristics. Knowledge work, often characterized by a „boundaryless‟ work environment stresses the potential endless demands and performance pressures in these kinds of jobs that lead to stress and burnout (Benson & Brown, 2007; Lee, Blackman & Hurst, 2007). The way people cope with burnout is very important to determine its impact (Chen & Cunradi, 2008). Consequently, the relationship between burnout and coping has been the focus of major research over the past few decades (Angelo & Chambel, 2014; Van Rhenen, Schaufeli, Van Dijk, & Blonk, 2008). Traditionally, the burnout literature has considered coping as a reactive mechanism in diminishing distress (Schwarzer & Knoll, 2003). However, the conceptualization of coping has changed in the context of the positive psychology movement (Peiró, 2007) to include proactive coping that involves a confirmatory and positive approach to dealing with burnout (Greenglass, 2002). Hence, several researchers have proposed a change in emphasis, investigating whether coping strategies are associated with decreased distress, as well as higher levels of positive outcomes (Angelo & Chambel, 2014; Crant, 2000). Such emphasis is reflected in the concept of job crafting, which constitutes self-driven work related changes through a proactive balance of job demands and job resources (Tims & Bakker, 2010; Wrzesniewski & Dutton, 2001). The conservation of resources (COR) theory (Hobfoll, 1988, 2001, 2002) and the job demands-resources (JD-R) model (Demerouti, Bakker, Nachreiner & Schaufeli, 2001) also suggest that resources play a dual role in enhancing positive and reducing negative outcomes. Hence, given the individual level resourcefulness, job crafting can play an effective role as a proactive coping mechanism in decreasing negative or detrimental outcomes as well as increasing positive outcomes.