Les stades du burnout selon une perspective temporelle : revue narrative

Abstract

Due to the increasing number of burnout cases, prevention and management of burnout have become major concerns, underscoring the importance of further research to better delineate this phenomenon. To provide a contemporary understanding rooted in the experiences of workers, this article introduces a qualitative approach to the experience of burnout as a temporal process. Some authors emphasize burnout as a state, while others identify it as a process integrating symptomatology alone or associating it with changes in the work context. According to a temporal perspective focused on both symptomatology and the professional context, a narrative review of the literature was conducted to investigate the evolution of burnout. The bibliographic databases Medline (Ovid) and Psycinfo (Ovid), as well as Google Scholar, were consulted. Inclusion and exclusion criteria were defined to select relevant studies, including thematic relevance, adult population, qualitative or descriptive methodology while excluding papers lacking full-text availability and irrelevant contexts. A narrative analysis was conducted, involving a thorough examination of the methodologies, findings, and limitations of the chosen studies. Results were synthesized and classified to discern common themes concerning the temporal progression of burnout. This research identified four stages that depict this temporal process: engagement and enthusiasm with a high job ideal (stage 0), weakening of the ideal (stage 1), protective withdrawal (stage 2) and confirmed burnout (stage 3). At stage 0, individuals are fully engaged in their work, driven by idealistic enthusiasm. They invest a lot of energy in their tasks, considering work as a major source of personal accomplishment. At this stage, signs of burnout are rare. In stage 1, professional ideal begins to show signs of weakness. Work hindrance stressors and conflicting events start to diminish initial enthusiasm. Despite efforts exerted to exhaustion, individuals are confronted with obstacles that question their progress and professional fulfillment, resulting in a feeling of stagnation and doubt. At stage 2, a protective withdrawal occurs. What was once a source of work satisfaction is now perceived as a threat. Individuals develop strategies to protect themselves from harmful situations and begin to adopt an increasing cynicism towards organizational values. Work-related issues also start to impact their personal lives. Finally, in stage 3, burnout is confirmed. The ideal of a fulfilling job has completely disappeared, and individuals find themselves unable to maintain their usual functioning. Often triggered by a critical event, burnout manifests as intense emotional and physical distress, potentially leading to sick leave and an increased risk of depression. Doubts arise about their identity and personal worth, marking the beginning of an awareness and a reassessment of their relationship with work. Without being prescriptive or exhaustive, the study offers a model outlining a clinical framework for the evolution from a positive work engagement situation to an untenable suffering state for the worker, aiming to facilitate the translation between theory and practice while considering the evolution of the professional context and symptomatology. This model also prompts reflection on prevention. Primary prevention is referred to the stage 0, secondary prevention at stages 1 and 2, and tertiary prevention for stage 3. Practitioners can thus use this model earlier to assess environmental and individual factors contributing to burnout, raise awareness of early signs of burnout, or plan personalized follow-up based on the worker's journey and the evolution of their suffering.