Burnout and Resilience in Psychiatric Hospital Care-givers: A Cross-Sectional Study Using Mediation and Path Analyses

Abstract

Original Research | Volume 3 | Issue 1| 20 Copyright 2018 by Jacobowitz W. This is an open-access article distributed under Creative Commons Attribution 4.0 International License (CC BY 4.0), which allows to copy, redistribute, remix, transform, and reproduce in any medium or format, even commercially, provided the original work is properly cited. cc INTRODUCTION P providers working in psychiatric hospitals are frequently exposed to verbal threats of violence and at times experience physical attacks resulting in post-traumatic stress.1,2 In addition, it is not uncommon for them to witness violence between patients or towards other staff members. The stress associated with the latter is known as secondary traumatic stress.3 Aside from these types of traumatic stress; emotional exhaustion, cynicism, and a reduced experience of personal accomplishment have also been observed in individuals working in stressful environments over a significant period of time. These symptoms are often referred to as burnout.4,5 This study is a re-analysis of the data from an earlier study to examine the predictors of burnout in psychiatric hospital patient care providers.2 The research question in the original study was related to the prevalence of post-traumatic stress symptoms (PTSS) in psychiatric hospital care workers and their relationships to resilience, compassion satisfaction, secondary traumatic stress and burnout.2 PTSS are symptoms of post-traumatic stress disorder (PTSD) that may or may not reach the level of a clinical Background The role of resilience in mediating burnout in psychiatric hospital care-givers has not been well established in the published research. This study attempted to identify the salient factors associated with the development of burnout, specifically resilience, through a secondary analysis of data collected in a study of post-traumatic stress symptoms in a sample of hospital employees. Methods An analysis of data collected in a correlational study with a convenience sample of 149 care-givers in a psychiatric hospital was performed, comparing the rate of traumatic events (TEs), resilience, confidence, PTSD symptoms (PTSS), secondary traumatic stress, compassion satisfaction, and life events to burnout. The analysis employed multiple linear regression, mediation analysis and path analysis. Results It was observed that episodes of trauma stress, resilience and compassion satisfaction, combined, robustly predict burnout (explained variance=65%), but that each variable is a weak predictor. In addition, resilience was not related to trauma and stress and did not mediate burnout. This finding presents a paradigm suggesting that there may be two distinctly separate pathways affecting burnout, one involving traumatic stress and the other–resilience and compassion satisfaction. Conclusion The effect of resilience in the development of burnout may be limited to its relationship to role satisfaction (compassion satisfaction) and unrelated to traumatic stress.