emotional burnout

Emotional Burnout

1Gnanavelu Panchasharam

A SURVEY OF BURNOUT OF THE MENTAL HEALTH OCCUPATIONAL THERAPY STAFF IN

THE PSYCHIATRIC HOSPITAL, BAHRAIN

Gnanavelu Panchasharam

Reference: Jahrami H. (2009) A Survey of Burnout of the Mental Health Occupational Therapy Staff in the Psychiatric

Hospital, Kingdom of Bahrain, British Journal of Occupational Therapy, 72(10), 458-464


Project Background

Zahra Al-Shuwaikh M.D.,

Haitham Jahrami Ph.D,Gnanavelu Panchasharam M.Sc.

Innovation in Psychiatry, The 2nd Psychiatric Conference, Arabian Gulf Psychiatric Association, Kingdom of Bahrain, Manama 24-27 November 2007


Project Continuation

This research was linked with Canadian Accreditation process as of evidence based.

We have under submission of Burnout among the Medical Doctors in the Psychiatric Hospital, Bahrain in British Journal of Psychiatry (Royal College of Psychiatrists)


The researcher conducted a computer search of peer-reviewed, English language

research studies published since 1970

PubMed (US Library of Medicine),PsycINFO (American Psychological Association),CINAHL (Cumulative Index of Nursing and Allied Health), BNI (British Nursing Index) ProQuest Medical.

The search used four lists of key terms and examined all possible combinations containing one term each from lists A, B, C and D:List A: mental health, psychiatryList B: clinical, clinician(s), professionalsList C: burnout, burn outList D: Arab, Arabic


Burnout

• Definition: Syndrome of emotional exhaustion, depersonalisation, and reduced personal accomplishment that can occur among people who do “people work” of some kind (Maslach, 1982).

• Burnout is therefore most frequently characterised as a syndrome of physical and emotional exhaustion resulting from the development of negative self-concept, negative job attitudes, and a loss of concern for clients (Maslach, 1976).


Burnout and Occupational Therapy

Occupational therapists are the healthcare professionals who, through the use of purposeful, goal oriented and scientifically guided occupation, attempt to make participation the key to the achievement of maximum levels of health, well-being and independence for the client.

The work conditions in which occupational therapists have to operate are varied. The Job stress is high in mental health rehabilitation, where the exposure of staff and patient contact is the most common determinants of Burnout.


Maslach Burnout Inventory (MBI)

The MBI is designed to asses the three components of the burnout syndrome:

Emotional Exhaustion, Depersonalisation,

Personal Accomplishment.

High degree of burnout is reflected in high scores on the emotional exhaustion and depersonalisation and low scores on personal accomplishment. Average degree of burnout is reflected in average scores on the three subscales. Low burnout is reflected in low score on emotional exhaustion and depersonalisation and high scores on personal accomplishment


Sub Scales

Emotional Exhaustion (9): feelings of being emotionally overextended and drained by others

Depersonalization (5): feelings of callous, cynical and detached responses toward clients

Reduced Personal Accomplishment (8): decline in one’s feelings of competence and successful achievement in work with people


Literature Review

No previous research has been conducted in Bahrain or any other Arab countries to study burnout among occupational therapy staff working in mental health.

Prosser et. al. (1996) NHS, UK ;Community staff scored significantly higher on burnout measures compared to Hospital-based staff


Harper and Minghella (1997): conducted a survey among community mental health staff to identify the pressures and rewards of working in mental health. Staff reported generally low levels of burnout on the MBI.


Maslach and Jackson (1981): This the first study on burnout and occupational therapy, reported lower levels of burnout on the three MBI subscales, indicating that burnout was not an issue for occupational therapists.

Recent study by Lloyd and King (2004) indicated that occupational therapists are experiencing high level of burnout.


Research Aim

To determine the extent of burnout experienced by occupational therapy staff in the Psychiatric Hospital, Kingdom of Bahrain.

To compare OT burnout score with other mental health professionals.


Research Design

Cross-Sectional Survey

Questionnaires were sent to all clinicians in the Psychiatric Hospital, Bahrain (N=261). Effective response rate of 58% (N=153) was achieved, 13 were from occupational therapy department.


Instrument

Maslach Burnout Inventory (MBI):

Self-administered tool

22 items divided into three subscales

7-point Scale (ranging from 0, "never" to 6, "every day").

Demographic Sheet


Data Collection

All 261 clinicians (September 2007)of the Psychiatric Hospital, Bahrain were surveyed using the MBI and a basic demographic sheet.

The survey pack was dispatched with an accompanying letter, instruction sheet, and a self-addressed envelope for the return of information.


Ethical Approval

Ethical approvals were sought and granted from the appropriate research authorities in the hospital

Dr. Charllotte Kamel (Chair, Research Committee) approved on 2007.

MOH approval been sought through the Chairman Office.


Data Analysis

Statistical Package for Social Science (SPSS) Version 16.0 for windows.

Descriptive Statistics of the MBI Analysis of Variance (ANOVA)-One Way


Results

Effective response rate 58% (N=153) Most of them fall in Age groups of 26~31 and the 32~37

years Males (48%) , Females (52%) 78.5% being nurses, 9.2% being medical doctors, and 12.3%

being other healthcare professionals Bahraini clinicians accounted for approximately 56%. 13 Occupational Therapy staff which includes four

therapists and nine technicians.


Descriptive Values

Total Population (N=153)

Mean (S.D) Burnout Level

Emotional Exhaustion

Depersonalisation

Personal Achievement

18.96 (13.81)

6.69 (5.26

34.28 (8.05 )


Medical Doctors

(N=14)



Depersonalisation


18.78 (9.08)

4.64 (2.95)

39.21 (4.44 )


Nurses (N=120) Mean (S.D) Burnout Level


Depersonalisation


18.14 (14.34)

6.40 (5.14)

33.49 (8.55 )


Occupational Therapy Staff (N=13)



Depersonalisation


28.14 (10.67)

11.92 (5.67)

36.49 (5.72 )


Social Workers (N=2) Mean (S.D) Burnout Level


Depersonalisation


5.50 (0.70)

5.00 (1.41)

31.50 (0.70 )


Psychologists (N=4) Mean (S.D) Burnout Level


Depersonalisation


21.25 (13.59)

6.75 (6.65)

36.50 (2.51 )


One-Way ANOVA

MBI means were to compare between occupational therapy staff and the other professional background

MBI Sub Scales *Significant

P<0.05Emotional Exhaustion Depersonalisation Personal Achievement

0.08

0.01*

0.10


Discussion

Occupational therapy staff experienced high level of emotional exhaustion, moderate depersonalisation, and high personal accomplishment.

Occupational therapy staff differed from other groups on the depersonalisation scale with occupational therapy staff scoring higher than any other job group.


Maslach et. al. (1996), emotional exhaustion dimension is the scale that is most responsive to the organisational environment and social interactions that characterise human service work (Ex: Mental health care).

Emotional exhaustion is seen as mediating the environment’s relationships with depersonalisation.

Personal accomplishment is less closely associated to emotional exhaustion in structural ways.

This is contrastingly evident in this study by observing that a sense of achievement or competence operate as indistinct from emotional exhaustion with both being high rates.


Limitations

To the author’s best knowledge, this is the first study that has examined the burnout levels of the mental health occupational therapy staff in the Arab World.

1. the design was limited to participants working in a single hospital

2. the sample sizes of medical doctors, nurses and other

healthcare professionals were not equally distributed. 3.the sample size of the occupational therapy staff is very

small N=13


Implications

It is very important to establish why occupational therapy staffs have different burnout profile than other professional groups.

It is expected that the occupational therapy staff work environment can be improved, because greater knowledge about the levels of burnout should facilitate the prevention or early recognition and treatment of burnout.

Generalising these findings to other Arab countries where psychiatric morbidity, organisation of mental health services and staff make up may be different.


Conclusions

Stress and fatigue in the form of burnout will continue to be a critical area for research for all clinicians working in mental health.

The burnout profile of occupational therapy staff showed that occupational therapy staff statistically differs from other groups in the depersonalisation scale and experiencing high level of burnout.

This perspective provides in-depth analysis of how perceptive factors and objectives related to family, organisational, community and cultural contexts interact to have an impact on professionals' psychological output.


Thank you

Happy New Year 2010

http://www.jahrami.weebly.com


Further Readings

http://www.jahrami.weebly.com


emotional burnout

Documents

emotional burnout

burnout syndrome

low burnout

submission of burnout

high degree of burnout

average degree of burnout

common determinants

psychiatric hospital