Understanding the burnout experience: recent research and its implications for psychiatry

The experience of burnout has been the focus of much research during the past few decades. Measures have been developed, as have various theoretical models, and research studies from many countries have contributed to a better understanding of the causes and consequences of this occupationally‐specific dysphoria. The majority of this work has focused on human service occupations, and particularly health care. Research on the burnout experience for psychiatrists mirrors much of the broader literature, in terms of both sources and outcomes of burnout. But it has also identified some of the unique stressors that mental health professionals face when they are dealing with especially difficult or violent clients. Current issues of particular relevance for psychiatry include the links between burnout and mental illness, the attempts to redefine burnout as simply exhaustion, and the relative dearth of evaluative research on potential interventions to treat and/or prevent burnout. Given that the treatment goal for burnout is usually to enable people to return to their job, and to be successful in their work, psychiatry could make an important contribution by identifying the treatment strategies that would be most effective in achieving that goal.     

Effects of an adjunctive,chronotype-based light therapy in hospitalized patients with severe burnout symptoms - a pilot study

Light therapy is a well-established treatment option for seasonal affective disorders and is effective in reducing sleep problems and daytime fatigue. Symptoms of severe burnout include feelings of exhaustion and impaired sleep and mood. Thus, light therapy seems promising for burnout treatment. So far, light therapy effects in burnout were investigated in outpatient settings only, with inconclusive results. The present study targeted light therapy effects in an inpatient setting. Participants with severe burnout were recruited in two psychosomatic clinics and randomly assigned to a control group with multimodal psychiatric treatment or an add-on light treatment group. Participants in the latter group were additionally exposed to morning bright light (illuminance: 4246 lux, irradiance: 1802.81 µW.cm^?2) for 3 weeks, 30 minutes a day, timed to their chronotypes. Light effects on burnout symptoms, depression, well-being, daytime sleepiness, sleep quality, and attentional performance were measured twice (pre-/postintervention design). Adjunctive chronotype-based bright light therapy was well tolerated and improved burnout symptoms and well-being without additional effect on severity of depression. Furthermore, reduced daytime sleepiness, improved nighttime sleep quality, a sleep phase advance of 25 minutes, shortened sleep latency, less sleep disturbances and increased sleep duration were observed in the light treatment group. No group differences were found in attentional performance. Chronotype-based bright light therapy seems to be effective in improving burnout symptoms and sleep problems in patients with severe burnout symptoms. Further studies with larger sample sizes and objective measures of sleep are necessary to confirm these preliminary results before practical recommendations can be made.     

El peor año de mi vida. Agotamiento emocional y burnout por la COVID-19 en profesionales de residencias. Estudio RESICOVID

IntroductionThe COVID-19 pandemic has led to major changes in the day-to-day operations of residential care facilities. Little is known about the impact it has had on professionals working in nursing homes in Spain. This research arose from the need to explore the situation experienced during the pandemic and to delve into the experiences as narrated by professionals working in nursing homes. The aim of the RESICOVID study was to analyze the effects on professionals of the measures taken in response to the COVID-19 pandemic in nursing homes.Material and method31 professionals (mean age: 32.9 years; 83.8% women, in various areas of care) were interviewed. Seventy-one percent of the sample presented a diagnosis of COVID-19. The analysis was performed with the Atlas-ti v8 program.ResultsFrom the analysis of the interviews, 128 quotations were extracted, coded in the following dimensions: 1. experience of confinement; 2. perception of changes; 3. health problems; 4. cognitive and functional changes; 5. loneliness.ConclusionsBurnout, overload, lack of resources and uncertainty caused by the COVID-19 pandemic have generated feelings of fear, exhaustion, anxiety, frustration and sadness in professionals who continue to this day without sufficient resources to face the situation. The design of contingency plans for future health crises should take into account this impact on care professionals.     

职业倦怠与性别的相关性及其生物学基础的研究*

从上个世纪七十年代开始,职业倦怠就引起了欧美发达国家相关学者的关注。在中国,对这方面的研究相对较少。近年来,随着我国社会经济的快速发展,人们的工作压力增大,而职业倦怠对人们工作和生活造成的影响也日趋严重,已经成为日常生活中一个不可回避的问题。男性和女性之间职业倦怠的表现和程度存在一定差异,本文从环境和生物学的角度分析男性和女性之间职业倦怠的表现和程度不同的原因。     

工作倦怠研究中的变量分析及进展

随着劳动力结构与工作特点的巨大变化,工作倦怠问题日益突出。国内外研究涉及到与之相关的多个变量。前因变量主要包括个体与工作特征层面,后果变量主要涉及身心健康、绩效与离职层面,以及未有明确因果关系的工作满意度和工作家庭冲突。在未来研究中,纵向研究与因果关系研究成为工作倦怠领域的最大挑战,而工作投入的引入又成为新的亮点。     

职业倦怠与焦虑的相关性及其生物学基础研究

职业倦怠作为当前社会从业人员普遍存在的心理现象,其生理机制主要与长期过度应激引起神经系统的紊乱相关,焦虑与职业倦怠关系密切,都受到神经系统和内分泌系统共同调节。神经系统中神经递质及其受体:如5-羟色胺,去甲肾上腺素和多巴胺的异常,导致焦虑的发生,可能诱发了职业倦怠。本文从激素水平、分子水平、基因水平三个方面分别阐述了职业倦怠发生和焦虑发生的机制以及两者之间相互作用的生物原理,为今后职业倦怠的心理预防以及基因治疗提供了生物医学研究相关的基础理论,也为职业倦怠易感人群,尤其是女性易感人群的焦虑情绪产生的机制研究奠定了详尽的生物医学方面的基础。     

工作倦怠研究中的变量分析及进展

随着劳动力结构与工作特点的巨大变化,工作倦怠问题日益突出。国内外研究涉及到与之相关的多个变量。前因变量主要包括个体与工作特征层面,后果变量主要涉及身心健康、绩效与离职层面,以及未有明确因果关系的工作满意度和工作家庭冲突。在未来研究中,纵向研究与因果关系研究成为工作倦怠领域的最大挑战,而工作投入的引入又成为新的亮点。     

心理疲劳的研究进展

心理疲劳是指重复单一作业或从事紧张程度较大的工作,神经系统紧张程度过高,从而出现的心理不安和疲乏感。心理疲劳会造成个体各种心理疾病以及重大事故的出现,但至今心理疲劳的概念还未有统一的标准,病因病机不明确,本文意在探讨其研究进展。笔者对于心理疲劳的国内外研究进展进行了文献整理,从心理疲劳的定义、表现、病因病机以及检测方法四个方面论述,发现心理疲劳由工作强度与持续时间、心理负荷、工作方法和熟练程度、环境因素以及体质、健康和营养状况等原因引起不同脑区的神经系统的变化以及相应物质代谢产生的疲劳。目前对心理疲劳的研究方法和手段有待改进,可将脑磁图、正电子发射断层扫描技术、功能核磁共振成像技术大量应用到研究中,探索其神经生理机制,为预防和治疗心理疲劳提供思路和方法。     

Fighting racism,battling burnout: causes of activist burnout in US racial justice activists

Social movement scholars have identified activist burnout – when the accumulation of stressors associated with activism become so overwhelming they compromise activists’ persistence in their activism – as a threat to movement viability. This phenomenological study on the causes of burnout among racial justice activists in the United States was designed to bolster understandings of burnout and inform strategies for sustaining racial justice movements. Thirty racial justice activists who had experienced burnout were interviewed. They described four primary burnout causes: emotional-dispositional causes, structural causes, backlash causes, and in-movement causes. Implications for activist and movement sustainability are discussed.     

Flexibilidad psicológica,burnout y satisfacción vital en profesionales que trabajan con personas afectadas de demencia

IntroductionThe clinical complexity of dementia, its physical burden, and the potential assaults associated with psychological and behavioral symptoms, could put healthcare workers working with dementia at high risk of burnout. Certain attitudes toward dementia and certain coping styles may be a protective factor against the stress experienced by these workers. On the other hand, it has been shown that a coping style based on psychological flexibility can prevent the development of burnout in the workplace. The present study analyzes the relationship between levels of burnout, psychological flexibility, attitudes towards dementia and life satisfaction in a sample of healthcare workers who work with people affected by dementia.MethodsA sample of 105 healthcare workers from the Ricard Fortuny Social Hospital was recruited (day hospital, hospitalization unit, and nursing home), and psychological flexibility (AAQII), burnout levels (MBI), life satisfaction (SWL), anxiety (STAI-R), and attitudes towards dementia (EAD) were assessed.ResultsPsychological inflexiblility showed a positive relationship with 2 dimensions of burnout (emotional exhaustion [r = .342, P < .01]; depersonalization [r = .328, P < .01]), and with anxiety (r = .723, P < .01), and also showed a negative relation with life satisfaction (r = ?.485, P < .01) and affect attitude (r = ?.209); p < .05). It was also found a negative relation between rejection attitude with emotional exhaustion (r = ?.328, P < .01) and with depersonalization (r = ?.328; P < .01).ConclusionsThose participants with greater psychological flexibility, in addition to feel more satisfaction with life, were found to be less likely to feel emotionally exhausted, to depersonalize patients with dementia, and felt more affection for them. On the other hand, no relationship was found between Burnout levels and the cognitive dimension of Attitudes towards dementia (the worker's knowledge of dementia). The results have significant implications regarding the type of training that is given to healthcare workers who work with people affected by dementia. Psychoeducational interventions promoting the psychological flexibility could help to reduce the risk of burnout in healthcare workers who work with dementia.