Exploring the meaning of job burnout beyond the Western context: A study of Salvadoran social workers

Abstract

This study explores the meaning of job burnout to social workers within the Salvadoran cultural context using qualitative data from 68 respondents. The themes that emerged during the study suggest that the most widely used three-dimensional conceptualization of job burnout developed by Maslach and colleagues (e.g. emotional exhaustion, depersonalization, and personal accomplishment) is applicable within the Salvadoran context.

Keywords

Depersonalization El Salvador emotional exhaustion job burnout Latin America personal accomplishment

Introduction

Job burnout has been widely studied among social work and human service employees since the 1970s (Lizano, 2015; Schaufeli et al., 2009). Interpersonal interactions and emotional investment are at the very core of human service work (Hasenfeld, 2010). Oftentimes, human service workers are required to work with clients facing a major crisis. The interpersonal nature of human service work (Hasenfeld, 2010), coupled with its requirement for an emotional investment, can subsequently lead to burnout (Maslach et al., 2001). Burnout research suggests that there is heterogeneity in levels of burnout between various countries and cultures (Carod-Artal and Vázquez-Cabrera, 2013; Maslach et al., 2001). Interest in burnout among researchers and practitioners has grown globally, but this growth has disproportionately been in Western countries. Burnout among non-Western social workers remains widely understudied. This may be a function of the fact that the concept of burnout was developed in a Western country, the United States (Schaufeli et al., 2009), or that burnout is thought to be a phenomenon relevant to the post-industrialized workplace (Leiter et al., 2014). While largely understudied in non-Western countries, the research that has been conducted outside of North America and other Western nations suggests that burnout is not just a Western phenomenon (Carod-Artal and Vázquez-Cabrera, 2013; Schaufeli et al., 2009).

The impetus to the study of burnout has largely fallen within two broad realms. The first is rooted in the understanding that the ‘burned out’ worker might not be as productive as the ‘non-burned out’ worker. Much of the research literature that examines the relationship between burnout and worker productivity has consistently found evidence to support the negative relationship that exists between burnout and work performance (Ford et al., 2011; Taris, 2006). The second major drive behind burnout research is the ethical responsibility that organizations have to protect the well-being of workers (Danna and Griffin, 1999; World Health Organization [WHO], 2010). The threat burnout poses to the well-being of workers has served to propel forward research that seeks to better understand the impact of this both on productivity and on the physical and psychological well-being of employees.

Though previous research findings suggest that burnout occurs globally, it cannot be assumed that it takes on the same meaning across languages, cultures, or countries (Schaufeli et al., 2009). Burnout as a term in many countries has a comparable translation in the local language, while in other countries the English word ‘burnout’ is the preferred term (Schaufeli et al., 2009). Findings from burnout research studies have significantly expanded what is known about the antecedents to and consequences of burnout. Nevertheless, the burnout research that has been conducted in non-Western regions of the world, such as Latin America, is limited. A Spanish language search of job burnout literature in the fields of human services using two databases (e.g. Proquest, Social Work Abstracts) and a search engine (Google Scholar) primarily yielded studies carried out in Spain, suggesting that studies specifically focused on exploring the experiences of burnout among social workers in Latin America are limited. Efforts to understand the burnout phenomenon, its consequences, and methods of combating it must not be isolated to Western countries given that our human service colleagues throughout the globe may also be grappling with experiences of burnout. Any efforts made to understand burnout experiences among social workers in Latin America should begin with an exploration of the meaning that is attributed to burnout as a concept among social workers in Latin America. This study aims to contribute to a greater understanding of the meaning of burnout within the sociocultural context of Latin America by exploring the meaning of this among social workers in El Salvador.

Literature review

Job burnout

The term ‘job burnout’ was coined within the field of humans services (Schaufeli et al., 2009). Freudenberger (1974) began using the term to describe the feelings of exhaustion and depersonalization that were being developed by workers in the field of substance abuse treatment. At the same time, Christina Maslach and colleagues were working on giving a name to the phenomenon of the once engaged human service worker who becomes overwhelmed and short-tempered toward clients and co-workers due to the emotional arousal experienced on the job (Maslach and Leiter, 2014; Schaufeli et al., 2009). Maslach and colleagues’ conceptualization of burnout is the most widely used in the burnout literature (Lee and Ashforth, 1996; Lizano, 2015; Schaufeli et al., 2009).

Burnout is theorized to develop as a result of chronic exposure to work stressors and is conceptualized as a phenomenon comprised of three dimensions: emotional exhaustion, depersonalization, and personal accomplishment (Maslach and Jackson, 1981; Maslach and Leiter, 2014). Emotional exhaustion is purported to be the central quality of burnout that results from the worker feeling emotionally depleted as a result of having his or her personal resources overtaxed in the workplace. Furthermore, the person develops an irritability toward both clients and co-workers. The once engaged worker is thought to reach a point of cynicism toward the clients for whom he or she once cared. Finally, the person experiencing burnout will experience reduced feelings of personal accomplishment. These feelings are postulated to result in the worker feeling that no matter the effort put forward, no real progress will be made in the work that he or she is carrying out. It can be described as feeling that one is simply spinning one’s wheels when no real change or progress will come from the effort.

Job burnout within the Salvadoran context

While Maslach’s development of the definition and measurement of burnout is well established, the social and cultural context in which this construct is understood must be considered. Burnout research has seen exponential growth on a global scale, suggesting that it is not just a Western phenomenon and that it does have global implications (Leiter and Maslach, 2014). Leiter and colleagues (2014), all scholars who have spearheaded much of the seminal work on burnout, purport that the social and economic context of work in the post-industrialized world is largely to blame for the increase of burnout as a phenomenon. The growth in the study of and interest in burnout is largely attributed to an ever-growing service economy throughout the world (Leiter and Maslach, 2014). Employment within the service sector has several benefits, including increased interpersonal interaction and fewer physical demands, but it also inevitably increases the risk of experiencing distress as a result of interpersonal interactions (Leiter and Maslach, 2014).

As the Salvadoran economic landscape has shifted, so has the field of social work in the country. Over the last 50 years, El Salvador has transitioned from a largely agricultural economy to a ‘neo-liberal’ economic system that relies heavily on the service sector and utilizes the US dollar as its national currency (Rubalcaba, 2013; Seelke, 2013). The human service sector has expanded in many countries around the world into a highly bureaucratized and professionalized field, which is postulated to be a central reason why burnout has increasingly become a salient issue in more and more countries across the globe (Schaufeli et al., 2009). Similarly, El Salvador has also seen an increase in the professionalization of the field of social work in the last 60 years. The first efforts to establish the field of social work as a bona fide field of practice took place in El Salvador during the 1950s (Silva, 2005). More recently, in the 1990s the field of social work was increasingly professionalized in El Salvador as universities across the country adopted baccalaureate degree programs of social work (Silva, 2005). The development of the field of social work in El Salvador is noted as being influenced largely by models of social work practice established in the United States (Silva, 2005). Although the field of social work in El Salvador is increasingly professionalized and modeled after the United States’ social work field, it cannot be assumed that the experiences of burnout among Salvadoran social workers are similar to those of social workers in Western countries. The aim of this study is to better understand the meaning of burnout within the Salvadoran context.

Methods

Study procedure

This study makes use of data drawn from an availability sample of 68 individuals who identified as social workers from various regions of El Salvador. One hundred social workers were contacted via email for the purposes of study recruitment, yielding an estimated response rate of 68 percent. The recruitment email was disseminated by a professional social work association in El Salvador to its members. Although participants were recruited nationwide by email, data were only collected in the departments of San Salvador, Usulután, and San Miguel.

Data collection was conducted between June and August 2015 by the principal investigator. The study was conducted with the approval of the Institutional Review Board. All study participants gave informed consent and volunteered to participate in the study. Open-ended questions were administered to participants in a local coffee shop at a convenient time for the participants. A US$15 gift card for a local supermarket was offered as a token of gratitude for participation in the study. The informed consent forms and the study questionnaire were both available in Spanish. Study participants completed a questionnaire where they self-reported their demographic characteristics and answered several questions designed to explore their multifaceted experience of burnout and the meanings and implications these experiences have for them. The following open-ended questions were put to all participants to elicit the personal and nuanced narratives of the respondents: ‘How would you define burnout?’ and ‘How would you describe job burnout symptoms?’ These questions were expected to be sufficiently flexible to enable participants to answer in a way that would be relevant to their personal experiences.

Study participants

Only four respondents did not have a Bachelor’s degree, and approximately 44 percent of the study sample reported having a graduate degree. The mean age of study participants was 46 years, with an age range of 20–60 years. The study sample was largely female (N = 54). The current employment setting reported by participants varied widely. Table 1 presents the various employment settings reported by study participants. Among those who reported the organizational setting in which they work (N = 64), the majority worked for a governmental institution (N = 51), while the remaining participants worked in either a private/non-governmental (N = 13) or hybrid organization (N = 3). Of the 66 respondents who provided information on their organizational position, only a small number held a management or supervisory position (N = 5). The sample mean for tenure in the field of social work was 15 years, and the sample mean for tenure in the respondents’ current organizations was 12 years.

Table 1.

Employment settings of study sample

Employment setting	N	%
Health	23	36
Academic	16	25
Criminal justice, judicial system	9	14
Clinical (work with individuals)	4	6
Children, youth, and families	6	9
Community and human rights	4	6
Rehabilitation	1	2
Public policy	1	2

Data for employment setting are only provided for 64 respondents. Four respondents did not provide information about their employment setting.

Data management and analysis

The responses from participating social workers were handwritten by the social workers and anonymously submitted to the primary investigator. Once all data were collected, the responses were translated by the principal investigator and a bilingual research assistant from Spanish to English, and then back-translated to Spanish for accuracy. Transcriptions were reviewed and checked for accuracy by both the principal investigator and the research assistant. By use of methodology that is rooted in both content and thematic analysis, data were first reviewed by the investigators to develop a broad understanding of content as it connected to the aims of the study (Creswell and Plano Clark, 2007). This understanding was used to identify themes and subthemes. Based on these themes, a codebook was built by the principal investigator and co-investigator. The responses were then categorized and organized according to the common themes that best described how the social workers understood the construct of burnout. The material from the interviews was coded to condense the data into analyzable units; this involved assigning codes based on a priori themes from the codebook to words, phrases, and paragraphs in the interviewees’ responses. The principal investigator and co-investigator served as the two coders who assigned codes to the text using QSR NVivo 11 (QSR International, 2015). Using NVivo 11, a taxonomy of themes was established and represented in a series of categories arranged in a tree-like structure (nodes) to connect texts for analysis (Krueger and Casey, 2009).

Results

The meaning that each worker attributed to the concept of burnout was unique, yet there were several themes that emerged regarding experiences of burnout that connected many of the narratives together. The central themes that emerged from the study included exhaustion and fatigue, depersonalization, and reduced efficacy (see Table 2). As the investigators initially reviewed that data for general understanding, it was clear that the emerging content was connected to the existing three-dimensional conceptualization of burnout put forward by Christina Maslach and colleagues. See Table 3 for a comparison of the themes that emerged from the present study and the conceptualization of burnout by Maslach and colleagues. The core conceptualization of burnout according to Maslach and Jackson (1981) involves emotional exhaustion, depersonalization, and personal accomplishment. Thus, the study findings suggest that the definition of burnout as a construct is applicable within the Salvadoran social work context. Within the three central themes, several subthemes emerged, each of which are described in the following.

Table 2.

Examples of coded text responses provided by study participants

Code	Text
Exhaustion	‘I understand this syndrome to be worn out emotionally, physically, and psychologically.’ ‘Emotional depletion and physical or mental suffering that a person experiences as a result of the tension that occurs in the workplace because of the problems they have to face.’
Fatigue	‘[Burnout is] the suffering that some professionals go through as a result of the high degree of stress because of work overload that results in physical and mental fatigue.’
Depersonalization	‘People who have lost the interest to carry out their work with efficiency and effectiveness, their work then becomes boring, tedious, and monotonous, they blame others for their mistakes … they do not enjoy what they do.’
Loss of efficacy	‘[Burnout is] a negative state that affects the areas of emotional and mental health due to feeling worn out making it very difficult to reach effectiveness on the job and in one’s personal life.’

Table 3.

Conceptual comparison of the definitions of burnout

Salvadoran social workers	Maslach and colleagues
Themes	Dimensions
Exhaustion and fatigue	Emotional exhaustion
Depersonalization	Depersonalization
Loss of efficacy	Reduced personal accomplishment

Exhaustion and fatigue

The theme of exhaustion and fatigue was the most common theme to emerge among the responses from participants. Although the primary method of analysis in this study is not a content analysis, the frequency with which exhaustion was mentioned as a defining characteristic of burnout is worthy of note, with 30 respondents naming exhaustion in their definition of it. This theme, which is embodied in the following quote, primarily explored definitions of burnout as a state in which all personal resources have been expended to the point of exhaustion:

… it [burnout] is a state of exhaustion that pushes the human limit, where you can’t produce what is expected.

Study participants further elaborated on the various forms of exhaustion they perceived to constitute burnout. Some respondents identified burnout as either constituting complete depletion, while others specified that burnout meant emotional, psychological, and/or physical exhaustion experienced as a result of stress in the workplace or work conditions. Below, a respondent describes burnout as exhaustion that impacts the person mentally and physically:

… it [burnout] is a real syndrome in our Salvadoran society, it’s the mental and physical exhaustion due to working conditions.

In addition to describing the burned-out worker as exhausted, several participants described burnout as a condition where a worker experiences fatigue. The second most common theme to emerge from the data was fatigue. Several respondents described burnout as a state of fatigue. While some referred to burnout as fatigue in general, some respondents elaborated and described it as chronic fatigue, as well as mental and physical fatigue. One respondent described it as follows:

Definitely all us who are exposed to the pressure that our clients exert on us with their emotional burden, […] fall into emotional depletion and fatigue after each workday.

Depersonalization

A second major theme that emerged was coded as depersonalization. Respondents described the burned-out worker as someone who has reached a point of apathy due to workplace stress or work conditions. Furthermore, some respondents described a burned-out worker as someone who has lost the zeal for the work he or she does. One respondent said the following about social workers reaching a point of cynicism or depersonalization:

I would describe it [burnout] as not knowing how to cope with the profession and as such social workers do not do their work with passion and care.

A worker experiencing depersonalization was described by respondents as someone who disconnected from the work they did and from the clients about whom they once cared. Similarly, depersonalization is described by Maslach and Jackson (1981) as the feelings of callousness and cynicism that develop toward clients and colleagues as a result of extended exposure to workplace stress. The process of reaching depersonalization is described by one of the respondents in the quote below:

Burnout is the response or result of our bodies being exposed to situations of prolonged stress, it leads us to lose empathy toward our clients.

Reduced efficacy

In their descriptions of burnout, participants noted it as a state in which the worker is ‘spinning’ his or her wheels while at work. Participants described workers experiencing burnout as those who are putting forward a strong effort to ensure services are provided to clients but the said efforts are fruitless. Similarly, some participants further described burned-out workers as people who have reached a point of inefficiency in their work:

It [burnout] is the condition that professionals face after having been subjected to conditions of occupational stress and it’s reflected in the loss of motivation and inefficiency in their work.

The study participants also described burnout as a state in which a worker has lost motivation and as a result faces a lack of feelings of achievement in the workplace. One participant described this loss of motivation among burned-out social workers as follows:

You have a life without motivation or goals for the short, medium, and long-term, feeling frustrated, bitter, feeling unaccomplished professionally.

Discussion

The goal of this study was to examine the meaning that Salvadoran social workers attribute to burnout, using qualitative research methods. The three central themes that emerged from our study were exhaustion and fatigue, depersonalization, and reduced efficacy. Based on the qualitative responses of the 68 participants in our study, we conclude that there is a connection between the meaning associated with the concept of burnout among Salvadoran social workers and the most widely used three-dimensional conceptualization of burnout put forward by Maslach and Jackson (1981), which includes emotional exhaustion, depersonalization, and reduced personal accomplishment.

The most notable theme that emerged in the study was exhaustion and fatigue. The definition of burnout as a form of exhaustion aligns closely, though not exactly, with what Maslach et al. (2001) describe as the central dimension of burnout: emotional exhaustion. The definitions of burnout posited by the study participants went beyond emotional exhaustion, to include physical and psychological exhaustion and fatigue. As previously noted, exhaustion was the most noted definition of burnout among study participants, with close to half of the respondents mentioning a form of exhaustion in their burnout definitions. The definition of burnout among Salvadoran social workers as feelings of exhaustion aligns well with Maslach’s burnout construct and expands upon it further in its inclusion of exhaustion and fatigue of the body and mind (e.g. physical and psychological exhaustion).

Maslach and colleague’s definition of depersonalization and cynicism as dimensions of burnout makes reference to the interpersonal dimension of the phenomenon. In Maslach and colleagues’ (Maslach and Jackson, 1981; Maslach and Leiter, 2014; Maslach et al., 2001) conceptualization of burnout, depersonalization is the manifestation of burnout in interpersonal relationships. A person experiencing long periods of job stress is subsequently thought to experience emotional exhaustion, which leads to the development of cynicism toward clients and colleagues (Maslach and Goldberg, 1998). Similarly, several participants in the study describe a detrimental change in the quality of interpersonal relationships between burned-out social workers and clients. The study participants described the burned-out social worker as someone who has lost empathy for their clients.

The burned-out worker is further described by the study participants as having lost their zeal for work. More specifically, burnout was described in the qualitative data as a loss of passion for and efficacy in one’s work. The description of the loss of passion and efficacy provided by study participants is congruent with Maslach and Jackson’s third dimension of burnout: reduced personal accomplishment. Maslach and colleagues (Maslach and Jackson, 1981; Maslach et al., 2001) postulate that as a result of emotional exhaustion and depersonalization, the worker feels ineffective in the workplace. The Salvadoran social workers in our study describe a similar burnout experience as they elaborated on burnout being a loss of efficiency and passion for the work in addition to being in a state of ‘goalessness’, which alludes to a lack of professional drive.

The findings of the present study have several implications for the field of social work. These findings suggest that the conceptual definition that Maslach and colleagues have given to burnout aligns with the definitions of burnout from the perspective of Salvadoran social workers. Although the work context of social workers in El Salvador might differ from that of their counterparts in Western countries, the emotional investment required of social workers, which is explained to be at the crux of burnout development, is very likely the same. This would then imply that the findings previously developed in research studies on burnout among social workers in other parts of the globe might be applicable within the Latin American context, more specifically within El Salvador.

Although findings from this study lend support to the applicability of Maslach’s conceptualization of burnout within the Salvadoran context, additional research should be conducted to examine this further. Some next steps should include efforts to test the generalizability of the Maslach Burnout Inventory (MBI; Maslach and Jackson, 1981) among Salvadoran social workers. Furthermore, if efforts are carried out to by researchers to test a measure of burnout among a Salvadoran sample, they should be sure to measure exhaustion beyond emotional exhaustion to include physical and psychological exhaustion and fatigue.

Given the risk that burnout poses to the well-being of human service workers, it is important to begin examining the etiology of burnout within the Salvadoran and Latin American context and its consequences. Job burnout has been found to be a risk to the psychological and physical well-being of human service workers and has been linked to reduced job satisfaction, life satisfaction, and mental and physical health (Lizano, 2015). In addition to the need for empirical research on the predictors and consequences of burnout in Latin America, it will be necessary to examine levels of burnout among this worker population. One central tenet of the social work workforce holds true across countries and cultures: social workers are the single most important asset to the field of social work. An examination of the levels of burnout among Salvadoran and Latin American social workers, coupled with an understanding of burnout’s predictors and consequences, will better inform the development of interventions to prevent or ameliorate burnout among this highly important worker population.

Although this study makes a unique contribution to the burnout literature in Latin America, it is important to interpret the study findings while taking into consideration the study’s limitations. The use of an availability sample in this study limits the study’s generalizability. Additionally, study participants were recruited via email, potentially excluding participants with limited access to technology (e.g. computers and the Internet). The use of an open-ended questionnaire may limit the richness of qualitative data by precluding the investigators from being able to probe further into the definition of job burnout.

Footnotes

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author biographies

Erica L. Lizano is an Assistant Professor at California State University, San Bernardino School of Social Work.

Brooklyn Levine Sapozhnikov is an Adjunct Lecturer at the University of Southern California School of Social Work.

References

Carod-Artal

F.J.

Vázquez-Cabrera

(2013) ‘Burnout Syndrome in an International Setting’, in Bährer-Kohler

(ed.) Burnout for Experts, pp. 15–35. London: Springer.

Creswell

J.W.

Plano Clark

V.L.

(2007) Designing and Conducting Mixed Methods Research. Thousand Oaks, CA: SAGE.

Danna

Griffin

R.W.

(1999) ‘Health and Well-being in the Workplace: A Review and Synthesis of the Literature’, Journal of Management 25: 357–84.

Ford

M.T.

Cerasoli

C.P.

Higgins

J.A.

DeCesare

A.L.

(2011) ‘Relationships between Psychological, Physical, and Behavioural Health and Work Performance: A Review and Meta-analysis’, Work & Stress 25(3): 185–204.

Freudenberger

H.J.

(1974) ‘Staff Burn-out’, Journal of Social Issues 30(1): 159–65.

Hasenfeld

(2010) Human Services as Complex Organizations, 2nd edn. Thousand Oaks, CA: SAGE.

Krueger

R.A.

Casey

M.A.

(2009) Focus Groups: A Practical Guide for Applied Research, 4th edn. Thousand Oaks, CA: SAGE.

Lee

R.T.

Ashforth

B.E.

(1996) ‘A Meta-analytic Examination of the Correlates of the Three Dimensions of Job Burnout’, Journal of Applied Psychology 81(2): 123–33.

Leiter

M.P.

Maslach

(2014) ‘Interventions to Prevent and Alleviate Burnout’, in Leiter

M.P.

Bakker

A.B.

Maslach

(eds) Burnout at Work: A Psychological Perspective, pp. 145–67. London: Psychology Press.

10.

Leiter

M.P.

Bakker

A.B.

Maslach

(2014) Burnout at Work: A Psychological Perspective. London: Psychology Press.

11.

Lizano

E.L.

(2015) ‘Examining the Impact of Job Burnout on the Health and Well-being of Human Service Workers: A Systematic Review and Synthesis’, Human Service Organizations: Management, Leadership & Governance, 39(3): 167–181.

12.

Maslach

Goldberg

(1998) ‘Prevention of Burnout: New Perspectives’, Applied & Preventive Psychology 7(1): 63–74.

13.

Maslach

Jackson

S.E.

(1981) ‘The Measurement of Experienced Burnout’, Journal of Organizational Behavior 2(2): 99–113.

14.

Maslach

Leiter

M.P.

(2014) ‘Burnout in the Workplace: A Global Problem in Need of Solution’, in Cooper

Ratele

(eds) Proceedings of the 30th International Congress of Psychology, Volume 2: Western Psychology, pp. 116–26. New York: Psychology Press.

15.

Maslach

Schaufeli

W.B.

Leiter

M.P.

(2001) ‘Job Burnout’, Annual Review of Psychology 52(1): 397–422.

16.

QSR International (2015) ‘NVivo Qualitative Analysis Software’, Pty Ltd. Version 11. Burlington, MA: QSR International.

17.

Rubalcaba

(2013) ‘Innovation and the New Service Economy in Latin America and the Caribbean’. Available online at: https://publications.iadb.org/handle/11319/5747 (accessed 20 January 2016).

18.

Schaufeli

W.B.

Leiter

M.P.

Maslach

(2009) ‘Burnout: 35 Years of Research and Practice’, Career Development International 14(3): 204–20.

19.

Seelke

C.R.

(2013) ‘El Salvador: Political and Economic Conditions and US Relations: Congressional Research Service’, Current Politics and Economics of South and Central America 6(1): 53–84.

20.

Silva

(2005) ‘Reconceptualización en trabajo social y su historia en El Salvador’ [Reconceptualization of Social Work and History in El Salvador], in Alayón

(ed.) Trabajo Social Latinoamericano: A 40 Años de la Reconceptualización, pp. 163–75. Buenos Aires, Argentina: Espacio Editorial.

21.

Taris

T.W.

(2006) ‘Is There a Relationship between Burnout and Objective Performance? A Critical Review of 16 Studies’, Work & Stress 20(4): 316–34.

22.

World Health Organization (WHO) (2010) ‘Healthy Workplaces: A Model for Action for Employers, Workers, Policy-makers and Practitioners’. Available online at: http://www.who.int/occupational_health/publications/healthy_workplaces_model.pdf (accessed 14 September 2016).