Discussion
The overall goal of this study is to understand the relationship between different personality profiles and the degree of occupational stress exhibited by nursing staff working in palliative care units. The results can be divided into 3 MBI categories. Of all individuals interviewed, more than half exhibited a medium-high level of emotional fatigue that negatively affected their professional performance in working with sick, elderly patients. Half of the sample exhibited moderate levels of depersonalization, which also negatively affected the performance of nursing staff. Similar results were found for the reduced personal achievement variable, with more than half of the population experiencing a substantial reduction in personal achievement and one quarter of these individuals exhibiting very low values.
Stress, burnout, and workplace satisfaction have emerged as important topics in the nursing profession over the past 20 years. Intensive care unit nursing staff work in very stressful environments, and even those who are well trained are affected by this stress. Work place satisfaction causes moderate degrees of stress, high degrees of emotional fatigue, and negative attitudes toward patients (depersonalization) among nursing staff. Similar trends were found in our study, which detected medium-high degrees of emotional fatigue and depersonalization among palliative care unit nursing staff.
Intervention programs applied to workplaces can have long-term benefits with respect to staff burnout. Interventions directed toward individuals can also reduce burnout symptoms in the short term, although data on this issue are limited.
It is also important to note that occupational satisfaction levels are influenced by social and professional relationships in the workplace, and as worker burnout levels increase, occupational satisfaction levels decrease. Occupational satisfaction is negatively associated with emotional fatigue and depersonalization and positively related to personal achievement on the job.
Grau-Arberola et al conducted a study to determine burnout levels among nursing staff of a particular hospital at a particular time and conducted the same test 1 year later. The study revealed that a significant increase in emotional fatigue levels had occurred over time even though no significant changes occurred with respect to depersonalization or personal achievement levels. Our findings contrast with the results obtained by Grau-Arbeloa et al in that our results clearly showed a high level of emotional fatigue and depersonalization among the palliative care nursing staff interviewed.
Our study obtained results similar to those of Garrosa et al, which show that nursing staff exhibited higher risks of increased stress.
The analysis of variance for personality effects on burnout levels raised several issues: Individuals who were not very extroverted exhibited moderate levels of depersonalization. Extroverted individuals do not tend to exhibit stress in any of the 3 areas.
Our data regarding extroversion also complement those of Swider and Zimmermann, who found that interviewees with lower scores exhibited higher levels of burnout.
Less sociable individuals also presented low levels of emotional fatigue. As sociability increased, the degree of emotional fatigue increased to a moderate level. These results disagree with the work of Swider and Zimmerman, who arrived at the conclusion that interviewees exhibiting lower sociability scores were more likely to experience increased emotional fatigue on the job.
Overall, nursing staff were found to experience a certain degree of stress irrespective of their professional responsibilities, although in this study the data were not assessed in terms of type of tasks undertaken by nursing staff. In contrast, Swider and Zimmermann found that interviewees exhibiting lower responsibility scores were more susceptible to experiencing burnout on the job.
In this study, interviewees with low levels of neuroticism also exhibited low degrees of emotional fatigue, while those with high levels of neuroticism exhibited moderate levels of emotional fatigue. The study of Swider and Zimmermann also show that individuals with high neuroticism scores tended to experience emotional fatigue on the job.
Interviewees who exhibited low openness to change presented moderate levels of reduced personal achievement. High openness to change increased one's personal achievement score, thus resulting in a higher sense of success on the job.
Nursing staff exhibiting insecure attachment styles experienced higher degrees of stress than less insecure staff did. Palliative care nursing staff exhibiting fearful attachment styles seemed to present a lower tendency to seek out social emotional support to cope with stress than those palliative care staff with insecure or worried attachment styles. These data complement ours in that exhibiting an ideal professional profile caused professionals to experience less stress as long as the following traits were present: extroverted, unsociable, responsible, stable (not neurotic), and very open to change.