Abstract and Introduction
Abstract
Burnout syndrome was defined in 1976 by Maslach and Jackson, and there is evidence of its high impact on nursing personnel. The syndrome manifests most intensely among palliative care unit employees who assist elderly patients, owing to their constant exposure to patient deaths. The aim of this study is to determine whether palliative care unit nursing staff who treat terminal gerontology patients and who have certain personality traits are more susceptible to occupational stress. The study also determines the personality type that most significantly reduced vulnerability to occupational stress. Two questionnaires, the Maslach Burnout Inventory and Big Five Inventory, were applied to 162 nursing professionals working in Spain. The most relevant study findings are the following: Extroverted nurses tend to not express stress; the more sociable the caregiver is, the greater the degree of emotional fatigue he/she experiences; nurses who exhibit a higher degree of neuroticism show an average degree of emotional fatigue; and caregivers who exhibit high openness to change have low stress levels while experiencing a strong sense of success. From these results, an ideal personality profile for selecting palliative care unit nursing staff was developed.
Introduction
The primary responsibility of health care professionals has traditionally involved recovering the health of patients. However, in recent years, palliative care has grown more prominent, and its objective is to provide patients with serious, progressive, and incurable illnesses with a higher quality of life.
Palliative care is unique in its holistic approach to care. It involves treating not only pain and physical symptoms but also the psychological, social, and spiritual needs of patients. Given the characteristics of their profession, nursing staff are more heavily involved in the direct care of these patients, both in residential and hospital settings.
When a patient dies in a hospital or residential center, the emotional burden that comes with exposure to death that had previously fallen primarily on families is now also assumed by health care staff. When one is exposed to such events repeatedly, the phenomenon generates stress, anxiety, depression, and emotional fatigue among nursing professionals and changes in personality variables, as detected by applying key tests that measure personality factors, such as the "Big Five".
These stimuli may also trigger the burnout syndrome, which was defined in 1976 by Maslach and Jackson. Burnout syndrome is identified as "a syndrome of emotional exhaustion, depersonalization, and reduced personal achievement that can develop in individuals who carry out activities oriented toward working with other people." Burnout syndrome is associated with, among other aspects, increased risk of employee absenteeism and increased intention to quit their employment; the syndrome is also associated with reduced efficacy and efficiency among nursing staff in work-related settings. This can affect workplace environments by increasing levels of dissatisfaction and rates of absenteeism and by promoting low productivity, conflict between coworkers, and higher turnover rates.
Symptoms of emotional exhaustion may also create distance between professionals and patients, thus affecting communication between both parties and negatively impacting 1 of the basic principles of palliative care. However, in other cases, this may cause professionals to identify with patient problems, which may negatively affect both parties by affecting interpersonal relationships.
However, besides patient characteristics and the complex situations that arise over the course of the patient's care, other factors can trigger burnout syndrome in professionals. Among these factors are insufficient training and particularly communication skills that the caretaker uses while engaging with patients and families. Work conditions also may exhaust staff, especially those who perform shift work with low salary and low levels of autonomy. In addition, teamwork, while potentially acting as a protective factor, may also at times generate stress, especially when tensions exist between team members. In short, the factors contributing to burnout are multifactorial, but this study was restricted to the phenomenon and incidence in the personality type of nursing staff.
In addition to external factors that promote burnout, internal factors may also explain why certain employees experience burnout while others do not develop these symptoms when subjected to the same stress conditions. A number of authors propose that stressful situations affect individuals to a greater degree if they possess few psychological resources necessary to face these situations or if they have lost access to such resources.
These mediating factors include personality variables, which may be defined as the "set of characteristics or biological and learning traits that are reflected in the way each individual perceives, feels, thinks, copes, and behaves." Most definitions of personality agree that an individual's behavioral tendencies in different situations can be predicted. Whereas there are personal factors that depend solely on the individual, one's environment and organizational setting can facilitate other positive traits such as maturity, the ability to access personal resources, self-care habits, the ability to establish a healthy working environment, self-esteem, humor, engagement in leisure activities, and engagement in interests outside of work. All of these factors play a role in reducing stress levels.
Regarding stress responses, personality serves as a survival mechanism that can allow one to cope with certain situations. Thus, extroverted, friendly, open, and emotionally stable individuals exhibit lower levels of stress because they are able to manage the demands of their surroundings.
Swider and Zimmermann believe that there is a relationship between Big Five Inventory results, the 3 dimensions of burnout in the workplace (emotional fatigue, depersonalization, and personal achievement), absenteeism, turnover, and worker job performance.
Given the negative effects that burnout can have on the quality of care, it is worth analyzing the personalities of health care workers and determining how personality traits may affect the ways that these employees cope with work-related stress. Personality profile tests of nursing staff may contribute to the design of prevention programs aimed at improving mental health and averting the impact of burnout, which in turn will lead to improved quality in patient care.