| Abstract |
Background: The first approach to the term «burnout», was made by the American psychiatrist Freudenberger (1974), who defined it as the exhaustion of the individual, due to the continued use of energy reserves. In 1984, the most accepted definition was formulated by the American Psychologist Christine Maslach and her colleague Susan E. Jackson, after being first studied by many other researchers. It is defined as a psychosomatic developmental process syndrome, which consists of three components a) emotional exhaustion, b) depersonalization and c) lack of personal accomplishments.
Nursing staff working in hospital emergency departments (EDs), belong to a high risk group for the manifestation of burnout syndrome. Everyday contact with patients and a variety of negative work-related factors and personal characteristics lead nurses working in the field of emergency departments to exhibit significant levels of burnout, thereby endangering their physical and mental health and negatively affecting the quality of health care services but alsο the quality of their personal lives.
Objective: The purpose of this research is to record the levels of burnout syndrome, in the nursing staff of two major hospitals’ emergency departments (EDs) located in Heraklion and to evaluate the impact of the syndrome on the life satisfaction of employees.
Methods: The type of research carried out is a cross-sectional observational study. The research was carried out in Heraklion, Heraklion University General Hospital and Venizelio - Pananeio General Hospital of Heraklion. Questionnaires on demographic characteristics, occupational characteristics, habits, occupational difficulties were given. For the evaluation of burnout syndrome, the nurses of ΕDs were given the “Maslach Burnout Inventory - Human Services Survey (MBI-HSS)”, consisting of 22 questions. The Greek version of Maslach's questionnaire, evaluates the three dimensions of burnout syndrome:
- Emotional exhaustion (9 questions)
- Depersonalization (5 questions)
- Lack of personal accomplishments (8 questions)
Burnout of ΕDs nurses was classified, in frequencies and percentages, by three categories per burnout component (low or nonexistent, moderate, high).
Burnout of ΕDs nurses was recorded in relation to the characteristics of the sample, by calculating the mean value (mean), the standard deviation (SD) as well as the p-values for each characteristic of the sample. To assess the degree of life satisfaction, the nursing staff of the EDs were given the questionnaire "Life Satisfaction Inventory", which consists of 13 questions, which concern the current situation and the degree of life satisfaction. The degree of life satisfaction of the nurses was classified in percentages (%). The questionnaires were given from June to July 2019. All participants were asked to consent to their voluntary participation to the research.
The statistical models One way-ANOVA, Kruskal-Wallis and Mann-Whitney U were used for continuous parameters, as well as the χ2 test (Chi-Square test) and Fisher exact test for categorical parameters.
The Kruskal-Wallis statistical model was used to test the correlation between the three dimensions of burnout syndrome and the life satisfaction levels of EDs nurses.
All the tests of this study were performed at a statistical significance level of 5% while the processing and analysis of the data was carried out through the statistical program SPSS 26.0.
Results: 56 ED nurses participated and this was the final sample of the study, of which 88% were women (49 individuals) and 12% men (7 individuals). Their average age was about 43 years.
Regarding the professional characteristics, 75% (42 nurses) belong to the higher educational level, that is, graduates of Universities and Technological Institutes, while 25% (14 nurses) belong to the secondary education (graduates of 2-year Nursing School). The average number of years of work the study nurses have is about 17 years, while the average time spent in ΕDs is about 10 years.
In most areas, EDs nurses showed moderate life satisfaction rates (total Life Satisfaction score: 37.1%).
The dimension of emotional exhaustion was positively correlated to the levels of life satisfaction of the nurses (p-value=0.02). The dimension of depersonalization was positively correlated to the levels of life satisfaction of the nurses (p-value=0.05). The dimension of personal accomplishments was positively correlated to the levels of life satisfaction of the nurses (p-value=0.03). The three dimensions of burnout syndrome were associated with low levels of life satisfaction in EDs nurses.
The majority of EDs nurses suffer from moderate to high emotional exhaustion (n=40, 71.4%), moderate to high feelings of personal accomplishments (n=42, 75%) and moderate to high depersonalization (n=34, 58,9%). Burnout levels of the nursing staff of the EDs were found to be moderate to high because all three of its components were at moderate to high levels. The years of work in EDs were positively correlated to the dimension of emotional exhaustion (p-value=0.04). The frequency of alcohol consumption was positively related to the dimension of depersonalization and the dimension of personal accomplishments (p-value=0.03). The thought of quitting work in the past was positively related to the dimension of emotional exhaustion and depersonalization (p-value=0.01) while the thought of quitting work in the near future was positively related to the dimension of emotional exhaustion (p- value=0.02) and the dimension of depersonalization (p-value=0.01).
Conclusion: Βurnout levels for the majority of nurses in the present study, were moderate to high as it was found that they suffer from moderate to high emotional exhaustion, moderate to high sense of personal accomplishments and moderate to high depersonalization, a result consistent with the findings of many other studies of the Greek bibliography.
It is urgent to take measures to prevent, locate and deal with incidents that show signs and symptoms of burnout. It is considered imperative to periodically and internally evaluate the burnout levels of EDs nurses.
The development of a program for the development, support and empowerment of the nursing staff of the EDs is required. Development of guidelines for the prevention and treatment of burnout is proposed and the creation of a line of communication that will provide support to the nursing staff of the EDs and coping techniques.
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