|Year : 2016 | Volume
| Issue : 2 | Page : 144-148
Prevalence and pattern of burnout syndrome among healthcare professionals in a university teaching hospital
Peter O Ibikunle1, Emmanuel Amah2, U Useh3
1 School of Research and Postgraduate Studies, Science and Technology, Northwest University Mafikeng Campus, Mmabatho, South Africa; Department of Medical Rehabilitation, Nnamdi Azikiwe University, Awka, Nigeria
2 Department of Medical Rehabilitation, Nnamdi Azikiwe University, Awka, Nigeria
3 School of Research and Postgraduate Studies, Science and Technology, Northwest University Mafikeng Campus, Mmabatho, South Africa
|Date of Web Publication||5-Jul-2016|
Peter O Ibikunle
School of Research and Postgraduate Studies, Faculty of Agriculture, Science and Technology, Northwest University Mafikeng Campus, PMB X 2046, Mmabatho 2735
Background: Burnout syndrome in health care workers is a state of physical, emotional and mental exhaustion caused by long-term involvement in high-stress situations. Burnout is regarded as the result of chronic stress that has not been successfully addressed. The purpose of this study was to determine the prevalence, patterns and comparison of the different stages of burnout syndrome amongst various health care professionals. Materials and Methods: Total of 280 health care professionals comprising 55 doctors, 165 nurses, three physiotherapists, five radiographers and 52 medical laboratory scientists participated in the survey. Participants were chosen using a proportionate stratified random sampling technique. The instrument used for data collection was the Maslach Burnout Inventory (MBI) .The data were analysed using descriptive statistics such as means and standard deviations, and inferential statistics (ANOVA). Significance was set at 95%. Results: The results reveals that burnout (EE-emotional exhaustion, DP-depersonalisation, PA-personal accomplishment) occurred in the following order, medical lab scientist (EE 33.85, DP:14.83, PA:21.77), nurses (EE:30.81, DP:12.80,PA:27.81), doctors (EE:25.47, DP:9.87, PA:31.64), radiographers (EE:16.8, DP:7.6, PA:36.2), physiotherapist (EE:8.67, DP:4.33, PA:37.68). There was significant difference in all the stages of burnout (P<0.05). Conclusion: Health care organisations need to acknowledge that those who work in the health care profession may need help to cope with the stress and burnout that are often associated with such practice. Efforts to alleviate burnout among health care professionals will have positive effect on health care service delivery.
Keywords: Burnout, depersonalization, emotional exhaustion, personal accomplishment, professionals
|How to cite this article:|
Ibikunle PO, Amah E, Useh U. Prevalence and pattern of burnout syndrome among healthcare professionals in a university teaching hospital. Trop J Med Res 2016;19:144-8
|How to cite this URL:|
Ibikunle PO, Amah E, Useh U. Prevalence and pattern of burnout syndrome among healthcare professionals in a university teaching hospital. Trop J Med Res [serial online] 2016 [cited 2020 Aug 8];19:144-8. Available from: http://www.tjmrjournal.org/text.asp?2016/19/2/144/185443
| Introduction|| |
The term "burnout" was first introduced by Freudenberger, a clinical psychologist who used it to describe the physical and emotional exhaustion (EE) he observed in employees of healthcare facilities.  Burnout is a worldwide phenomenon that has a detrimental impact on employees at all organizational levels and on organizations in their entirety, which translates into substantial human and economic costs. ,,
A healthcare professional is an individual who provides preventive, curative, promotional, or rehabilitative healthcare services in a systematic way to individuals, families, or communities. He or she may be in a medicine, nursing, or rehabilitation team, or in a field of allied health care. Healthcare providers may also be public/community health professionals. Health institutions or facilities include hospitals, clinics, primary healthcare centers, and other service delivery points. Healthcare professionals and healthcare facilities together form part of an overall healthcare system. 
According to the American psychologist Christina Maslach, burnout is a syndrome of EE, depersonalization (DP), and reduced personal accomplishment (PA). It is a psychological concept, and describes the experience of long-term exhaustion and diminished interest (DP or cynicism), usually in the work context. Burnout syndrome in healthcare workers is a state of physical, emotional, and mental exhaustion caused by long-term involvement in situations that are emotionally demanding.  It is regarded as the result of chronic stress that has not been successfully addressed. 
Burnout describes the relationships that people have with their jobs, especially people working in the service and healthcare industries. ,,, It occurs more frequently among those who do "people work," such as police work, social work, teaching, and, of course, health care.  The onset of burnout syndrome is characterized by a gradual loss of idealism, energy, enterprise, and future aim, resulting in emotional overload and exhaustion.  Burnout syndrome may predispose healthcare professionals to EE, DP, and having a reduced sense of PA, resulting in a decline in their professional output and results. Patients too, may feel unsatisfied, which may reduce the respect and esteem they have for healthcare professionals.
Burnout is not a symptom of work stress. It is, rather, an end product or a result of unmanaged chronic work stress.  Symptoms of burnout have been classified as physical (exhaustion/fatigue, depression, insomnia, headaches, gastrointestinal problems/ulcers, weight loss or gain, hypertension, and high cholesterol levels); psychological (loss of concern and feelings of anger/bitterness); and behavioral (low job performance/low job satisfaction, decreased communication/withdrawal, increased absenteeism, loss of enthusiasm for job, and increased drug use and alcohol use). These symptoms apply to both managerial and nonmanagerial employees. 
The measurement of burnout syndrome commonly used in published research is the Maslach Burnout Inventory (MBI). This is a 22-item self-assessment tool that measures three burnout elements (EE, DP, and reduced PA). The EE scale measures how frequently an individual feels emotionally overextended at his/her work environment. The second scale, DP, evaluates how an individual responds to colleagues and one's attitude toward recipients of one's services. The PA scale assesses how frequently the respondent experiences positive feelings from success and accomplishments at work.  This inventory has become the standard tool for measuring burnout syndrome in research globally. Maslach's criterion for burnout syndrome is a high DP score (>31).  Maslach and Jackson reported a reliability coefficient of 0.90 for EE, 0.79 for DP, and 0.71 for decreased feeling of PA.  Most of the research on burnout syndrome has been conducted in developed countries. Burnout can be measured by EE, DP, and PA.  Due to the fact that the Nigerian environment and other working factors are different from those of developed countries, the values for EE, DP, and decreased sense of PA may not be the same for people working in different countries. Apart from the studies conducted by Olley et al. (2003) and Lasebiken et al. on healthcare professionals, physiotherapists, and nurses in Nigeria, there is a dearth of information on burnout syndrome among health workers in developing countries. ,, This study provides some information on the various levels of burnout syndrome among various healthcare professionals, which may help identify the symptoms. Burnout syndrome is a common problem among healthcare professionals, with high levels affecting mostly nurses, doctors, and medical lab scientists. This may be due to different factors affecting healthcare professionals in different environments and contexts, which may vary from institution to institution as the case may be.
The objective of this study was to compare the prevalence and patterns of presentation of the three different elements of burnout syndrome among various healthcare professionals.
| Materials and Methods|| |
A survey was conducted in a University Teaching Hospital in one of the South-Eastern States of Nigeria. The study population consisted of all the healthcare professionals employed by the Hospital as of January 2013 (n = 907).
The sample size for the study was 305 healthcare professionals; this was estimated using the Yaro Yamane formula:
where n = sample size, 1 = unity, N = total population of healthcare professionals, e = level of significance (0.05).
The sampling technique that was used was proportionate stratified random sampling.
Ethical approval for the survey was obtained from the Ethical Committee of a University Teaching Hospital in South-East Nigeria.
The procedure was explained to the participants in detail. The questionnaires were self-administered. The participants completed the questionnaires at their own convenience, after which the filled-in questionnaires were collected at an agreed-on time.
The subscales of the questionnaires were scored based on a numerical rating scale (0-6 for MBI) and scores were analyzed using descriptive statistics such as mean, frequency, percentage, and standard deviation (SD). Inferential statistics [analysis of variance (ANOVA)] were employed to test the hypotheses.
The burnout element scores as described by Maslach are interpreted as follows: EE is considered high when ≥31, moderate when 21-30, and low when ≤20. DP is high when ≥11, moderate when 6-10, and low when ≤5. PA is high when ≤35, moderate when 36-41, and low when ≥42. Maslach and Leiter stated that individuals with scores greater than or equal to 31 on EE, 11 on DP, and less than or equal to 35 on the PA subscales have high levels of burnout syndrome. Moderate levels are indicated by scores of 21-30 on the EE, 6-10 on the DP, and 36-41 on the PA subscales, while low levels are indicated by ≤20, ≤5, and ≥42 on the EE, DP, and PA subscales respectively. 
| Results and Discussion|| |
The total number of questionnaires administered was 305; 280 (91.8%) were completed and returned.
The mean age of the study participants was 35.20 ± 6.82 years and the range was 24-55 years.
[Table 1] shows the demographic characteristics of the healthcare professionals.
Prevalence and pattern of burnout syndrome among healthcare professionals.
The prevalence and pattern of burnout syndrome as found in this study are shown in [Table 2].
|Table 2: Prevalence and patterns of the stages of burnout syndrome among health professionals |
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Differences in the scores of burnout syndrome among healthcare professionals.
Significant differences in the scores of burnout among the healthcare professionals are revealed in [Table 3] [Table 4] [Table 5].
| Discussion|| |
Differences were found in the stages of burnout syndrome among the different healthcare professionals.
The mean EE of medical laboratory scientists was the highest, followed by those of nurses, doctors, radiographers, and physiotherapists. These scores revealed that the medical laboratory scientists were possibly the most overworked in the hospital studied, followed by the nurses, medical doctors, and lastly the physiotherapists. There was significance difference in the scores of burnout among the healthcare professionals, and this showed that the values were indeed higher across the board when compared with each other. It was evident from the results of this study in South-East Nigeria that burnout syndrome was prevalent in this health facility. The medical laboratory scientists were extremely burned out, with high DP and low PA, while the least burned out were the physiotherapists, with very low DP and the highest PA. These findings are slightly similar to those of previous works, which revealed that psychiatrists, nurses, and radiographers consistently report high scores of EE, PA, and DP when compared with other healthcare providers. ,,, The pattern of burnout as revealed for every healthcare professional in this health facility studied only helps to confirm the level of intervention that will be needed to address the productivity of the professionals concerned. Given that the authors would not want to generalize the results of this study across the whole of Nigeria, a developing nation, it may not be out of place to suggest that its healthcare professionals are undergoing burnout and that this should be addressed by relevant supervising bodies in order to get quality service for patients who will be treated in those health facilities. Factors contributing to burnout syndrome have been identified to be staff shortages, compassion fatigue, work environment, job satisfaction, and also some personality characteristics such as being committed, being compulsive, and perfectionism. ,, With these factors, there is a possibility that burnout among healthcare professionals can lead to compromised standards of care and decreased job satisfaction, and ultimately have a negative impact on the effectiveness and product of the healthcare facility and system.
| Conclusion|| |
Ultimately, hospitals will pay the price for high levels of employee burnout, via the quality of the services they offer. Although developing individual coping skills may be quicker or easier, organizational improvements involving the individual in their workplace may have a more pervasive and longer-lasting impact on burnout. Providing employees with techniques to reduce job stress is helpful, but such methods can be more effective if the organization also seeks to make the job less stressful.
An organization or department must respond to burnout and recognize it as a legitimate workplace problem. Healthcare organizations need to acknowledge that those who work in those professions may need help to cope with the stress and burnout that is often associated with their practice. Genuine efforts to alleviate burnout, such as increasing the workforce of healthcare professionals, providing training, and adequately equipping healthcare facilities would have positive effects such as improved quality of patient care, improved quality of work life, and higher levels of job satisfaction, commitment and staff turnover.
| References|| |
Freudenberger HJ. Staff burnout. J Soc Issues 1974;30:159-65.
Grivia K, Graney B, Kilpatrick K. Mood and emotions while working. J Organ Behav 1999;121:185-202.
Leiter PM, Maslach C. Burnout and quality in a sped-up world. J Quality Participation 2001;24:48-51.
Mirvis DM, Graney MJ, Kilpatrick DP. Trends in burnout and related measures of organizational stress among leader of department veteran affairs medical centre. J Healthc Manag 1999;44:353-66.
The world Health report 2003: Shaping the Future. Geneva, Switzerland: World Health Organization; 2003. p. 105-35.
Pavlakis A. Mood disturbance among nurses. Noseleutike 1996;35:173-9.
Griva K, Joekes K. UK teachers under stress: Can we predict wellness on the basis of characteristics of the teaching job? Psychol Health 2003;18:457-71.
Goldberg R, Boss RW, Chan L, Goldberg J, Mallon WK, Moradzadeh D, et al
. Burnout and its correlates in emergency physician: Four years' experience with a wellness booth. Acad Emerg Med 1966;3:1156-64.
Maslach C, Jackson SE. Burnout in organization setting. Appl Soc Psychol Annu 1986;5:133-53.
Leiter MP, Schaufeli WB. Consistency of the burnout construct across occupations. Anxiety Stress Coping 1996;9:229-43.
Price D, Murphy P. Staff burnout in the perspective of grief history. Death Educ 1984;8:47-58.
Altun I. Burnout and nurses' Personal and Professional values. Nurs Ethics 2002;9:269-78.
Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory Manual. 3 rd
ed. Palo Alto, CA: Consulting Psychological Press; 1996. p. 1-10.
Olley BO. Burnout syndrome among healthcare professionals in a Nigerian teaching hospital. Afr J Med Med Sci 2003;32:297-302.
Ibikunle P, Umeadi O, Akosile C. Prevalence and pattern of burnout syndrome among Nigerian Physiotherapists. Internet J Chiropract 2012;1;1-4.
Lasebikan VO, Olusola MO. Burnout among nurses in a Nigerian general hospital. ISRN Nurs 2012;40:21-57.
Papadatou D, Anagnostopoulos F, Monos D. Factors contributing to the development of burnout in Oncology nursing. Br J Med Psychol 1994;67:187-99.
Bressi C, Porcellana M, Gambini O, Madia L, Muffatti R, Peirone A, et al
. Burnout among psychiatrics in Milan: A multicentre survey. Psychiatr Serv 2009;60:985-8.
Maslach C, Leiter MP. Early predictors of job burnout and engagement. J Appl Psychol 2008;93:498-512.
Ibikunle PO, Umeadi O, Umunnah JO. Predictors of Burnout syndrome among Nigerian physiotherapists. African Journal of Physiotherapy and Rehabilitation Science 2012;4:1-2.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]