Didier Truchot

Comparative symptomatology of burnout and depression.

The link between burnout and depression remains unclear. In this study, we compared depressive symptoms in 46 burned-out workers, 46 outpatients experiencing a major depressive episode, and 453 burnout-free workers to test the distinctiveness of burnout as a clinical entity. Participants with burnout and major depressive episode reported similar, severe levels of overall depressive symptoms. The between-syndrome overlap was further verified for eight of the nine major depressive episode diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). Our findings do not support the view hypothesizing that burnout and depression are separate entities and question the nosological added value of the burnout construct.

Épuisement professionnel chez les médecins généralistes

Resume Objectif Evaluer le degre d’epuisement professionnel (ou burn out ) de medecins generalistes liberaux du departement de la Loire. Methodes Un questionnaire en 3 parties a ete envoye a 480 medecins generalistes : la premiere partie concernait les variables sociodemographiques telles qu’âge des medecins, statut matrimonial, date d’installation, mode d’exercice, quantification de l’activite professionnelle ; la seconde partie correspondait a la version francaise du Maslach Burn out Inventory (MBI) ; la troisieme partie envisageait des consequences eventuelles de l’epuisement professionnel, telles que desir de reconversion, usage de psychotropes, ou pensees de suicide ; les medecins etaient invites a indiquer les causes de l’epuisement professionnel telles qu’ils les percevaient, en reponse a une question ouverte. Les reponses etaient anonymes. Resultats Trois cent six medecins ont repondu (taux de reponse de 64 %). Les scores moyens pour les 3 dimensions du burn out (epuisement emotionnel, depersonnalisation et diminution de l’accomplissement personnel) etaient similaires a ceux d’autres enquetes utilisant le meme instrument. Cinq pour cent des medecins avaient un niveau eleve de burn out pour les 3 composantes, mais la plupart des medecins avaient un niveau eleve d’accomplissement personnel dans leur metier. Plus d’un medecin sur 2 a envisage une reconversion ; 5,5 % avouaient boire de l’alcool de facon excessive ; 30 % avaient pris des psychotropes et 13 % ont envisage le suicide. La composante d’epuisement emotionnel etait statistiquement associee au sexe feminin, a une charge de travail importante, au desir de reconversion, a la consommation d’alcool, de psychotropes, aux ideations suicidaires. Les causes d’epuisement professionnel invoquees par les praticiens etaient organisationnelles et administratives (charge de travail elevee, poids de l’administration, conflit avec les organismes sociaux) mais aussi relationnelles (demandes jugees excessives des patients et de leurs familles). Conclusion L’epuisement professionnel des medecins generalistes apparait comme une realite. La qualite de vie des praticiens qui en sont victimes semble significativement alteree et la litterature indique que des consequences nefastes sur la sante de leurs patients pourraient en decouler.

Perceived inequity, communal orientation and burnout: The role of helping models

A large amount of empirical evidence has shown that professional helpers who perceive inequity in their relationships with their clients experience burnout. However, in such a situation, communal orientation (a desire to give benefits in response to the perceived needs of others), has been found to buffer burnout. In the present study, this buffering effect was investigated from the perspective of helping models. French nurses ( n =60) and social workers ( n =68) completed a questionnaire designed to evaluate perceived inequity, communal orientation and burnout. The results showed that, as expected, the buffering effect of communal orientation greatly depends on the helping model. Among professionals who endorsed a medical model of helping (wherein recipients are expected to be relatively passive to get better), those high on communal orientation experienced a low level of burnout when they perceived inequity. However, among professionals with a compensatory helping model (wherein recipients are expected to be active to get better), not only had perceived imbalance no buffering effect but also it reduced personal accomplishment. It was speculated that with a medical model, a perceived imbalance in the relationships does not hinder the desire to respond to the perceived needs of others. However, within a compensatory model, a perceived imbalance probably impedes the self efficacy of professionals high in communal orientation, that is who desire to respond to the perceived needs of others.

Is burnout solely job-related? A critical comment

Within the field-dominating, multidimensional theory of burnout, burnout is viewed as a work-specific condition. As a consequence, the burnout syndrome cannot be investigated outside of the occupational domain. In the present paper, this restrictive view of burnouts scope is criticized and a rationale to decide between a work-specific and a generic approach to burnout is presented. First, the idea that a multidimensional conception of burnout implies a work-restricted scope is deconstructed. Second, it is shown that the burnout phenomenon cannot be confined to work because chronic, unresolvable stress - the putative cause of burnout - is not limited to work. In support of an integrative view of health, it is concluded that the field-dominating, multidimensional theory of burnout should abandon as groundless the idea that burnout is a specifically job-related phenomenon and define burnout as a multi-domain syndrome. The shift from a work-specific to a generic approach would allow both finer analysis and wider synthesis in research on chronic stress and burnout.

COMMUNAL ORIENTATION MAY NOT BUFFER BURNOUT

Communal orientation (a desire to give and receive benefits in response to the needs of and out of concern for others) has had a buffer effect on burnout, in particular when the helping relationship is perceived by the helper as inequitable. This result, however, comes from research involving a specific professional group, medical personnel, that is, a group with a medical helping model wherein recipients are neither held responsible for their problem nor for the solution. We hypothesized that among professional helpers with a compensatory model wherein recipients are not held responsible for their problem but for the solution, and who perceive the relationship as inequitable, not only will a communal orientation not have effect on burnout, but it will reduce personal accomplishment. We present some results supporting this hypothesis.

Development and validation of the Work Stressor Inventory for Nurses in Oncology: preliminary findings

AIM This study is a report of the development and testing of the Work Stressor Inventory for Nurses in Oncology. BACKGROUND Stressors in oncology nursing are generally assessed using generic stress scales like the Nursing Stress Scale or the Health Professions Stress Inventory. However, qualitative investigations have highlighted the specific nature of the stress to which nurses are exposed. DESIGN The Work Stressor Inventory for Nurses in Oncology was developed using both qualitative and quantitative methodologies. METHOD For the item generation phase, a semi-structured interview was conducted with 59 nurses working in oncology units during 2007. A total of 51 work-related items were retained for the final survey. A convenience sample of 582 nurses working in oncology completed the survey between January 2008-June 2008. They also completed the General Health Questionnaire and the Maslach Burnout Inventory. The Work Stressor Inventory for Nurses in Oncology was further tested for theoretically supported constructs, internal consistency reliability and concurrent validity. FINDINGS The exploratory results revealed five factors: workload, dealing with death and dying, dealing with suffering, interpersonal conflicts, dealing with patients and relatives. The internal consistency of the five subscales was satisfactory. Correlation patterns between the Work Stressor Inventory for Nurses in Oncology dimensions and both mental health and burnout variables support the criterion-related validity of the scale. CONCLUSION Future quantitative or qualitative studies using this scale could add knowledge about the experiences of emotional and organizational stressors related to this area of nursing.

Suicidal tendency, physical health problems and addictive behaviours among general practitioners: their relationship with burnout

ABSTRACT The aim of this article is to analyse further the association of burnout with (poor) physical health, addictive behaviours and suicidal tendency among general practitioners (GPs). Four hypotheses were studied: (H1): burnout (i.e. emotional exhaustion, EE, and depersonalization, DP) will be positively associated with suicidal tendency; (H2): will be negatively related to physical health (i.e. large number of physical symptoms and long-lasting impairment); and (H3): positively linked to addictive behaviours (i.e. addiction to alcohol and psychotropic medication) of GPs. Based on the “spiral of losses” depicted by the conservation of resources theory, we also considered whether physical health mediates the relationships of burnout/suicidal tendency and burnout/addictive behaviours (H4). 1890 French GPs completed a questionnaire administered by phone. Information was collected on burnout, three physical health indicators (BMI, number of physical symptoms and lasting physical health problems), four health behaviours (consumption of tobacco, alcohol, anxiolytics and antidepressants) and suicidal tendency (ideation, plan and attempt). Concerning EE, the results supported the hypotheses, except for alcohol consumption. However, the findings showed that DP was associated with more positive outcomes when controlling for exhaustion. The difference in findings for EE and DP are discussed, together with the need for GPs to develop strategies for resilience.

Emotional Dissonance and Burnout: The Moderating Role of Team Reflexivity and Re‐Evaluation

The aim of the present study was to better understand the relationship between emotional dissonance and burnout by exploring the buffering effects of re-evaluation and team reflexivity. The study was conducted with a sample of 445 nurses and healthcare assistants from a general hospital. Team reflexivity was evaluated with the validation of the French version of the team reflexivity scale (Facchin, Tschan, Gurtner, Cohen, & Dupuis, 2006). Burnout was measured with the MBI General Survey (Schaufeli, Leiter, Maslach, & Jackson, 1996). Emotional dissonance and re-evaluation were measured with the scale developed by Andela, Truchot, & Borteyrou (2015). With reference to Rimés theoretical model (2009), we suggested that both dimensions of team reflexivity (task and social reflexivity) respond to both psychological necessities induced by dissonance (cognitive clarification and socio-affective necessities). Firstly, results indicated that emotional dissonance was related to burnout. Secondly, regression analysis confirmed the buffering role of re-evaluation and social reflexivity on the emotional exhaustion of emotional dissonance. Overall, results contribute to the literature by highlighting the moderating effect of re-evaluation and team reflexivity in analysing the relationship between emotional dissonance and burnout. Copyright

Career Orientation and Burnout in French General Practitioners

This study among 259 French general practitioners examined how Chernisss four career orientations, Artisan, Social Activist, Careerist, and Self-investor, as recalled by these physicians, are related to their burnout scores. Data were collected using anonymous questionnaires. Initial and present career orientations were related to depersonalization and personal accomplishment. Those whose career orientation changed to Self-investor reported the highest despersonalization, while those who changed to the Artisan orientation reported the lowest depersonalization. Results are discussed regarding the fit between career orientation and the work setting of general practitioners, a professional group with high burnout.

An exploratory study of self-consciousness and emotion-regulation strategies in health care workers.

The goal of this study was to assess relations between public self-consciousness, private self-consciousness (self-reflectiveness and internal state awareness), and two emotion-regulation strategies: cognitive reappraisal and expressive suppression. 59 employees of a public hospital completed a survey. Public self-consciousness was not associated with either emotion-regulation strategy, while both dimensions of private self-consciousness were related to the strategies. While self-reflectiveness was correlated with expressive suppression, internal states awareness was associated with cognitive reappraisal.