BURN AT WORK: THE BURNOUT SYNDROME
human adjustment problems at work are extensively documented in the scientific literature of the past three decades been of special interest to the psychologist occupational health practicing in certain very specific professional groups, types of assistance.personal consequences for the company that generate the problems of coping with stress management and labor have led to increasingly transcend the popular colloquial terminology. Thus, "being stressed" or "burnt out" are two concepts that are part of the description that makes any person with respect to the characteristics of their work or perceived problems in their work. Not all slang definitions conform to reality, which is interesting to consider the present document.
Among the pathologies stress arising from the stands the so-called "burnout" or burnout. The burnout syndrome begins to investigate scientifically documented Feudenberger 1974 when a group of subjects with thoughts idealistic, optimistic and naive to give too much work to get good opinion of themselves and to achieve the common good. Despite this effort and commitment, these individuals fail, because they generate excessive involvement in work and just leaving.
1. Definition
From these studies, Maslach in 1977 first used the concept of burnout to define this process. This is a stress response chronic work long term and cumulative, with negative consequences for individual and organizational level. Burnout consists of three dimensions: (1) emotional exhaustion, (2) depersonalization, and (3) awareness of reduced personal accomplishment, which added stress and frustration by not getting the expected results for their work.
Other definitions of burnout, explain it as if it were a process of adaptation to stress, characterized by disorientation training, waste, feelings of guilt for lack of professional success, coldness or emotional distance and isolation. Among the different
definitions of burnout are some similar characteristics:
➠ more prevalent in all mental or behavioral symptoms than physical. Among them, mental or emotional fatigue, fatigue and depression, the most characteristic emotional exhaustion. ➠
burnout symptoms manifest themselves in people who did not and had not previously suffered any psychopathology. ➠
symptoms are classified as a clinical syndrome burnout and labor, and which is triggered by an inadequate adaptation to work, which leads to reduced performance at work with a sense of worthlessness.
Cherniss (1982) postulates that burnout occurs in a process of psychological adjustment between the subject stressed and a stressful job, in which the main precursor is the loss of commitment.
The process is described in three phases: Phase ➠
stress: this phase is an imbalance between job demands and the resources available to the individual to cope with these events. ➠
Exhaustion Phase: Refers to the subject's immediate emotional response to this imbalance, ie the worker submit feelings of apprehension, tension, anxiety, fatigue and exhaustion. ➠
coping Phase: This phase involves changes in behavior and attitude of the worker, characterized by an impersonal, cold and cynical towards the customers.
Farber (1991) describes successive stages: enthusiasm and dedication, response of anger and frustration of the worker to work stressors, there is a correspondence between effort and results and rewards, it leaves the commitment and involvement at work, increases the vulnerability of workers and physical symptoms, cognitive and emotional exhaustion and neglect final.
Currently, most stations work are becoming more demanding in what burnout is manifested not only in caring professions, but extends to other professional groups ranging from managers to unskilled occupations.
As shown in Figure 1, we can establish a relationship between the stages through which passes the subject's career, their performance levels and symptoms related to burnout. So, we joined a job with enthusiasm and dedication (phase 1), step by step we discover the problems insurmountable task and entered a plateau (phase 2) in which we are concerned about not being able to respond to the demands but we do nothing, then be developed responses of anger and frustration of working with the stressors of the job situation (phase 3), if there is a correspondence between effort and reward results and are entering the phase of apathy (stage 4) where cognitive symptoms appear and related emotional burnout.
2.
differential diagnosis for psychosocial intervention on burnout is critical to establish the differential diagnosis which to distinguish between burnout and other psychological constructs such as:
➠ Work stress burnout is different in that the former is the result of a temporary adaptation while burnout is a break in the adaptation of chronic type. The subject affected by the burnout can not return to normal levels or initial operation again. ➠
physical fatigue, like burnout, differ by a faster recovery of who has the first and may be accompanied by feelings of personal accomplishment and sometimes successfully, against suffering burnout. ➠
Depression shows significant correlation with the dimensions of burnout (emotional exhaustion), but not with the other two dimensions as it can arise in other contexts (personal, social, family) than labor. ➠
Boredom (or boredom) has been used interchangeably to explain the process that follows the burnout that, with increasing emotional exhaustion, boredom appears and decreases job satisfaction. ➠
job dissatisfaction is related to variables that are often little related to the nature of the task and the burnout, but with other external factors related to personal life.
Today, many authors argue that burnout is a syndrome with its own identity and multidimensional, with a process that develops gradually and continuously produced in the sequential interaction variables emotional, cognitive and attitudes within a work context (Ramos, 1999, Gil-Monte & Peiró, 1997).
3. Measurement of burnout
The "Maslach Burnout Inventory (MBI) is the most known and applied internationally to measure burnout in occupational health services and teaching. This scale has become the most used and therefore the most accepted to be used in various types of samples. MBI scale has had three revisions, and as a result of the latest revision has been replaced with the term "depersonalization" by "cynicism" to explain this factor in the type does not care professions (Maslach, Jackson and Leiter, 1996). The MBI is a 22-item questionnaire to collect the subject's responses regarding their work on their feelings, emotions, thoughts and behaviors. Measure the burnout from three subscales: emotional exhaustion (with 9 items), depersonalization (5-item) and reduced personal accomplishment (8-item). For each of these factors are obtained scores to assess levels of burnout that each worker in each subscale. This scale has been published by TEA in 1987 in Castilian. In 1996 he released a new version (the MBI-General Survey, or MBI-GS) which is adapted to the population Gil English and validated by Monte in 2002.
The MBI has been applied to these people getting high reliability and validity of the three factors. This has allowed to develop scales for different populations or occupational groups and interpret the results based on the occupation of the subject (for teachers, social workers, doctors, mental health professionals and other professionals).
The development of the MBI as a measurement tool enhanced the development of three lines of research:
➠ The first line focuses on a specific analysis of burnout: the subject affected have personality characteristics that make it vulnerable to the factors or stressors. The classification code of mental disorders (ICD 10) classified to burnout among the group of "problems concerning the difficulties to cope with life" and appears as a syndrome of exhaustion. The psychosocial phenomenon is thus simplified to individual differences and does not include interpersonal relationships.
➠ The second line focuses on the study of the job, work environment and the nature of the tasks being undertaken by the subject as the causes of burnout. It would be a pathology related to care type tasks where the relationship with people is the central feature of his position. Thus, people with whom they work, are a constant source of stress, since it is extremely difficult to forecast and plan the conduct of others. ➠
Finally, a last line of research explains the burnout as a result of the interaction of multiple factors: cultural, occupational, educational, individual or personality. In organizing certain problems can arise when workers experience these symptoms, as there is a deterioration in job performance and therefore can lead to a deterioration in service quality, absenteeism, high number of rotaciones y abandono del puesto de trabajo
Para el análisis y evaluación del burnout profesional se han desarrollado en castellano cuestionarios para poblaciones específicas. Señalamos por su importancia el Cuestionario de desgaste profesional en enfermería (CDPE) que desarrollan Moreno, Garrosa y Gonzalez desde el año 2000 o el cuestionario sobre el estrés en el lugar de trabajo Kompier y Levi publicado en el año 1995.
4. Consecuencias del burnout
Resulta importante establecer diferencias entre los síntomas cognitivos del burnout y sus consecuencias. Los síntomas son manifestaciones fisiológicas que se registran en el sujeto "quemado" such as headache, muscle aches, toothaches, nausea, hypertension, ulcers, loss of voice, loss of appetite, sexual dysfunction and sleep problems, but may be of a cognitive and emotional. The cognitive symptoms have been less studied, but are of great importance in the early development of burnout.
The consequences of burnout can be analyzed from a multilevel perspective:
➠ The individually produced are characterized by the affected party has difficulty concentrating or making decisions, behave in a cynical way, performs a self-oriented self-devaluation, self-sabotage, distrust and low regard for his own work.
➠ Those that occur on the conduct of the worker and the organization where they work, and that the person concerned will want to isolate themselves and avoid social interaction. The company also pays a high cost for workers to have "burned" because they cause delays, reduced productivity, increased absenteeism ratios, ask to be shifted, reduced work performance and commitment to the organization, performing work low quality, are involved in incidents and accidents, show publicly their intentions to quit work and claim complain constantly.
➠ Those produced on a personal level and marital violence. Thus, we have observed that people with high levels of burnout are less satisfaction with the couple and the behavior in the home are of irritation, anger and tension. This situation particularly affects the deterioration of personal interactions and feeds the consequences of the other levels.
Figure 2 shows schematically a summary level the impact of burnout on three levels.
5.
intervention strategies All psychosocial intervention should be aimed at trying to break the momentum generated with burnout, that is, search the subject any responses to break the cycle of a process of disillusionment which surrounds the subject "burned." Psychology has developed a set of techniques called "coping" with the aim of developing skills to cope and manage stress. Most techniques are grouped in preventive programs that are articulated in previous training on specific aspects (process, stress, coping, cognitive restructuring, time management, lifestyle, etc.) To raise awareness among workers of the importance of preventing risk factors. Also develop strategies to address social and organizational aspects of burnout. Thus, work to strengthen relationships and social support networks and, if possible, eliminating organizational stressors.
individual intervention strategies on burnout focused on the acquisition and improvement of the ways of coping. The burnout intervention should occur from a number of strategies that aim to alter the cognitive processes of self-evaluation (coping skills training, mainly task-oriented and problem solving) that serve to develop cognitive-behavioral strategies neutralize the negative arguments (training in problem-solving techniques, stress inoculation, personal organization ...) and to develop interpersonal communication skills, social skills and assertiveness.
these techniques can be divided into two groups of strategy: The ➠
aimed at achieving an improvement in instrumental strategies that focus on solving problems, for example, training in the acquisition of problem-solving skills, assertiveness, organization and time management, improved communication, improved relationships and lifestyle. The ➠
aimed at ensuring that the individual develops mitigation strategies to learn and develop skills to manage emotions associated managed properly relax and know the feelings of guilt.
Recommended strategies seek to increase the professional competence, redesign enforcement personnel, personal organization, planning, leisure, taking breaks-breaks at work, effective use of time, pose real and achievable objectives and skills communication.
Most studies point to the importance of relaxation techniques and decreased activation, exercise and improved physical fitness, biofeedback techniques or techniques cognitive behavioral and stress inoculation, thought stopping, or autogenic training and technical problem solving that should be used on individual programs to intervene preventively burnout.
individual intervention is important for the employee in jobs "at risk" to develop coping strategies to help reduce and control the internal and external demands in a work situation. Coping strategies allow reasoning (cognitive) problems and prevent the development of burnout and emotion-focused responses such as avoidance and escape.
Strategies social intervention on burnout focused on the acquisition and development of social skills such as preventing or treating burnout.
Social support is the main factor to promote, as it has been shown that it diminishes the impact of chronic stressors related to work, increasing levels of personal accomplishment, emotional exhaustion and decrease the negative attitudes and behaviors toward others. It is recommended to enhance social support from peers, supervisors, managers, friends and family, so that the worker receives personal support, information on their job performance and how you can improve it realistically.
is important to note that social intervention strategies, usually as part of intervention programs, individual and organizational variables as their overlapping and complementary.
organizational intervention strategies on burnout act on the elements of the organization over which they can act individually or social skills. Often complemented by the redesign of the elements that contribute to stress, to eliminate or reduce, but be careful because the intervention may worsen the situation. Any changes we make in an organization is a potential source of stress and can bring out other underlying problems in it.
6. Burnout intervention programs
intervention for burnout is advisable to direct our efforts towards prevention, but without focusing on one level (which is usually the personal or individual level). Given the relationship between the person and the multiple environments in which they interact (work, family, friends, etc.) We must consider that they can all affect one way or another about the person and the burnout effects (positive or negative) directly or indirectly. This will lead to work with multi-intervention programs that attempt to achieve a person-environment fit. There are many programs
contrasting intervention that allow multi-level action are classified based on two criteria: according to the level at which the program is geared to the impact that seeks its preventive action.
If we consider the criterion of priority level of the program, we find:
➠ programs that focus their work on an individual level intervention, action oriented toward the person, seeking to redesign their perceptions of inequality, and changed for others can reduce their levels of burnout. Some of these programs have extensive clinical work to develop in the affected burnout, cognitive behavioral strategies to facilitate development (and mantener) habilidades laborales para afrontar su trabajo con "herramientas o recursos cognitivos" distintos de los que le habían llevado a padecer burnout.
➠ Los programas centrados en la intervención sobre la organización están centrados en el puesto de trabajo y buscan identificar y resolver los problemas que los empleados tienen con el trabajo y la relación de dichos problemas con su vida personal. Se busca la reducción de la tensión que genera el desajuste del individuo al puesto de trabajo reorganizando los puestos en busca de la percepción de "control" sobre ellos de sus ocupantes. Dicha dimensión es básica para determinar la salubridad o insalubridad de un job.
If we look at the impact of preventive action to classify intervention programs:
➠ for primary prevention programs that seek to eliminate unfavorable factors (risk) before they generate burnout. ➠
secondary prevention programs, which seek to address burnout in the early stages through rapid intervention for those affected. ➠
tertiary prevention programs, which try to reduce disability or consequences associated with the disorder following the burnout.
The programs implemented in companies are integrators, which are custom designed for a specific organization in a given situation to meet the needs of one or several levels. These programs consist of intervention strategies that perform various types of training plans and training (communication, problem solving, supervisory skills, stress management ,...) between the employees concerned or not.
7. In conclusion
burnout to intervene in various strategies we can choose the most appropriate and although used is the development of an organizational intervention program. The program should start from an objective and comprehensive development of jobs and workers to define the different areas of further action and to conduct a preliminary analysis of the objectives to be achieved, the resources of the organization, emergency intervention, number of people involving in the operation, cost, resources, involvement of management, etc.
Initially, the program should support workers who have detected a high burnout dimension (if we use in MBI) to explain the situation and get informed about the changes they need, provide consultation to managers to improve the problems encountered by employees and provide a rapid response to problem situations. In
caso que se vea necesario el tratamiento psicoterapéutico, se deberá remitir al individuo afectado a servicios especializados. También pueden ofrecer psicoterapia ocasional, el desarrollo de técnicas de dirección, el seguimiento del impacto de decisiones directivas sobre el estrés, el apoyo y formación para la realización de formación de equipos y la resolución de problemas o realización de planes de cambio organizacional. Este tipo de programas sólo han sido aplicados en organizaciones policiales y han surgido tras un periodo de situaciones negativas
En síntesis, la intervención organizacional tendría que ser aplicada desde la perspectiva de un sistema integral que consiga:
✗ improve workplace conditions
✗ job redesign. ✗
enrich the job. ✗
redefine job roles. ✗
Rearrange schedules. ✗ Design
career plans. ✗
develop teams. ✗
use participative management styles
✗ Improve internal and external communication.
investigacion@psicosociologia.org
Dr. Jordi Tous Pallarès. Professor at the Universitat Rovira i Virgili. Department of Psychology. Social Psychology Area Coordinator. Director of Human Resources Management Master of
FURV President of "Congress (annual) Pathogen derived from the stress", held in Tarragona each November.
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APESSLA
Strengthening the Quality of Life of its Associates.
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