abstract

Background: Among healthcare professions, critical care healthcare workers (HCWs) have one of the most stressful jobs. This study was conducted to determine the relationship between job stress and burnout syndrome (BOS) among nurses and healthcare technicians at the surgical emergency department and intensive care unit of Critical Care department at the Alexandria University Hospital. Methods: A cross-sectional approach was conducted from October 2014 to March 2015. Eighty-two nurses and healthcare technicians participated in the research (response rate = 80.39%). Data was collected by an interview questionnaire using selected subscales of NIOSH Generic job stress Questionnaire and Maslach Burnout Inventory of Health and human service Questionnaire. The relationship between BOS and job stress was examined using bivariate and multivariate analyses. Results: Although majority of participants reported variation of workload (84.15%), quantitative overload (76.8%), responsibility for peoples’ life (69.5%) and lack of perceived control (63.41%), yet, 85.4% were satisfied with their job. Moreover, high levels of emotional exhaustion was reported by the majority of participants (80%), while less than one third reported either high levels of depersonalization or low levels of personal accomplishment domains of BOS. In multiple regression analysis, skill underutilization, variation in workload, and intragroup conflicts were negatively associated with BOS domains. While, job satisfaction and responsibility for peoples’ life were positively associated with personal accomplishment domain of BOS. Conclusion: Critical care HCWs had high BOS. The study concluded that reducing intragroup conflict, improving skills utilization, and raising job satisfaction are crucial to reduce BOS among critical care HCWs. More attention and psychological support is recommended to critical care HCWs.

Introduction

Burnout syndrome (BOS) has been defined as the experience of long-term exhaustion and diminished interest, usually in the work context. It comes across as the result of a period of expending too much effort at work while having too little recovery.1,2 BOS may affect workers of any kind, however, high stress jobs can lead to more BOS than lower stress jobs.1 Healthcare workers (HCWs) are often prone to BOS, however, wide variations in the prevalence of BOS have been reported3,4; higher levels were reported among HCWs working in emergency department (ED)5 and intensive care units (ICUs) as they are exposed to a high level of job stress6 ; a factor known to increase the risk of BOS,7 which could be attributed to critical patient care, high mortality rates, improper working circumstances, and shortage of time to meet patients’ needs, therefore, they experience stress levels beyond their coping capacities that may result in burnout.8,9 BOS has been associated with decreased quality of care, and high rate of absenteeism and turnover among HCWs, all of which have consequences in the healthcare sector.1,7 Maslach Burnout Inventory (MBI) has been the gold standard for the diagnosis of BOS in clinical settings. MBI measures three dimensions of BOS; emotional exhaustion, depersonalization (negative or cynical attitudes toward patients), and reduced sense of personal accomplishment.10,11 Emotional exhaustion has been identified as the hallmark of burnout. People who experience all three symptoms have the greatest degree of BOS.1 Despite the plenty of studies conducted globally to investigate job stress and BOS, only few have been carried out in the Middle East.12,13 Moreover, the need to study BOS and job stress in the Middle-Eastern region has become more important with the new wave of Arabic Spring due to higher rates of trauma patients, increased healthcare demands and disturbed working conditions.14 Therefore, this research aimed at studying the relationship between BOS and job stress among nurses and healthcare technicians at the surgical ED and ICU of Critical Care department at the Alexandria University Hospital (AUH); one of the largest referral and trauma centers in the country.