Coping strategies as mediators in the relation between perceived social support and job burnout among Chinese firefighters

Abstract

Perceived social support is a known factor in preventing job burnout in many professions. However, the influence of coping strategies on perceived social support and job burnout remains unclear. The current study investigated firefighters using data from a two-wave study to fill this gap in knowledge. Chinese firefighters (N = 340) participated in the study for 3-months. Results indicated that perceived social support at baseline predicted job burnout at the 3-month follow-up through coping strategies. We concluded that perceived social support acts through positive coping strategies to reduce job burnout in Chinese firefighters.

Keywords

coping strategies firefighters job burnout longitudinal design perceived social support

Introduction

Numerous studies have shown that firefighters face extremely stressful and traumatic challenges in their daily life (Boffa et al., 2017; Paulus et al., 2018). Firefighters are responsible for crucial rescue missions, such as fighting bush fires, rescuing survivors from accidents, and recovering the dead (Huang et al., 2019). Firefighter’s work in such cases poses not only physical but also significant psychological risks. Many studies on firefighters’ mental health have reported that they suffer from PTSD, depression, and burnout (Boffa et al., 2017; Smith et al., 2018; Straud et al., 2018). Firefighters are known to be vulnerable to burnout because they face intense work demands, heavy workloads, and hazardous working conditions (Bai and Li, 2015).

Job burnout is a common psychological syndrome seen among workers who cannot respond adequately to constant stress at their workplaces (Maslach et al., 2001). Job burnout consists of three aspects: emotional exhaustion, cynicism, and reduced personal accomplishment (Maslach, 2003), and tends to emerge when the workload is heavy, conflicts develop between personal, and job demands or workers lack motivation and resources (e.g. lack of efficacy, training, or critical information) to complete their tasks. Job burnout leads to physical fatigue and impairs workers’ creativity and passion (Alessandri et al. 2018). Even worse, the prolonged effects of job burnout could impact other life functions and result in negative mental health consequences, such as depression, anxiety, and dissatisfaction with life (Delgadillo et al., 2018; Hakanen and Schaufeli, 2012; Romswinkel et al., 2018).

Job Demands-Resources model (JD-R) developed by Bakker and Demerouti (2007) consider that every occupation has specific risk factors that might result in job stress and lead to job burnout (Ângelo and Chambel, 2014; Violanti et al., 2018), which were termed job demands. Job demands require employees to dedicate sustained physical and/or psychological effort or skills and mostly come from the outside world. They include a high workload, an unsatisfactory environment, and emotional interactions with clients, and workers are known to be relatively passive towards these situations. The authors also identified job resources, which are inclined to be subjectively exploited by employees and increase employees’ motivation (Hackman and Oldham, 1980), and positive work outcomes.

Social support, particularly from a partner, family, or friends, plays a vital role in strengthening people's ability and confidence in dealing with professional challenges (Underwood, 2000), and is known to be a significant job resource. Generally speaking, people with social support are more likely to manage better their challenges and stressors (Skaalvik and Skaalvik, 2007; Wegge et al., 2006). Many researchers have reported that social support played a critical role in alleviating job burnout (e.g. Ehring et al., 2011; Huynh et al., 2013). A meta-analysis conducted by Guilaran and colleagues (2018) revealed that social support is negatively associated with burnout. Moreover, Bai and Li (2015) demonstrated that social support significantly and negatively predicted firefighters’ job burnout. However, according to Isenhardt et al. (2019), support received from family and friends intensified jail employees’ burnout after stressful situations. Moreover, a 4-year longitudinal study conducted with school principals (Beausaert et al., 2016) reported that community support received at a previous time-point positively predicted burnout at the next time-point across four waves, indicating that principals receiving more support from the broader community are more likely to experience burnout. Such inconsistent results suggest the significance of investigating burnout from a longitudinal perspective, which allows examining causal relationships and the effect of different contextual and individual factors, including differences in measures, types of social support, job pressure, and motivation. Nevertheless, only a few longitudinal studies have been conducted on the relationship between social support and job burnout in firefighters. This study is one of few studies focusing on social support mechanisms in alleviating negative psychological consequences among Chinses firefighters, analyzed the effects of social support on burnout using a longitudinal research design to fill this knowledge gap.

According to the “thriving through relationships” model (Feeney and Collins, 2015), social relationships can provide not only refuge but also sources of strength (SOS) for dealing with adverse circumstances. In this conceptual framework, SOS is a support function that promotes thriving in adversity through fortification. The fortification assists the development of individuals’ strengths and abilities for coping with adversity. Other empirical studies have also reported that exerting positive and effective coping strategies can increase an individual's psychological flexibility and help regulate emotional labor's influence on job burnout (Biron and Veldhoven, 2012). Therefore, it is very likely that the coping strategy plays a mediating role in the relationship between social support and job burnout.

Coping strategy used in the current study was adopted from Amirkhan’s concept (1990), which includes problem-solving, support seeking, and avoidance coping. Problem-solving to find effective ways of dealing with distressing situations (Shin et al., 2014) is a well-known adaptive strategy and usually reported to be a protective factor against burnout. It is known that training focusing on problem-focused coping strategies reduce burnout (Nevill and Havercamp, 2019). Support seeking represents contacts established with others for comfort and advice, which underlines the value of human contact. Human contact also has demonstrated value in preventing burnout (Judd et al., 2017).

On the contrary, it has been reported that avoidance coping, which is an emotion-focused response reflecting emotional withdrawal, is negatively related to coping with stress. Avoidance coping has been associated with higher burnout and work stress (Nevill and Havercamp, 2019). To summarize, job burnout might be alleviated by adopting positive coping strategies such as problem-solving and support seeking but could worsen when individuals tend to avoid by using avoidance coping.

Social support may influence the selection of coping strategies because of the strong relationship between social support and coping strategies, which is expected to impact the development of burnout further. No studies have investigated whether coping strategies mediate the relationship between perceived social support and job burnout in a longitudinal prospective study. Such studies are necessary to identify the causal relationship between personal and environmental resources and firefighters’ mental health (Bernabé and Botia, 2016). We assumed that coping strategy is a mediator in the association between perceived social support and burnout in firefighters, based on the theoretical models and empirical studies discussed above. We assessed social support and coping strategy at baseline and 3-month follow-up, and burnout at the 3-month follow-up to establish temporal precedence for a prospective mediation model (Cole and Maxwell, 2003). We examined the following hypotheses: (1) perceived social support at baseline negatively predicts job burnout at 3-month follow-up among firefighters; and (2) coping strategy at 3-month follow-up mediates the relationship between perceived social support at baseline and job burnout at 3-month follow-up.

Method

Participants and procedure

Participants were recruited from a training center for firefighters in Nanjing city of China. Firefighters with at least one year of professional firefighting experience were included in the study (N = 409). They completed the baseline assessment at T1, and 340 of them completed the second assessment three months later at T2. The dropout rate was 16.9% (69/409) and included firefighters assigned to emergency tasks and those who lost interest in the study and failed to participate in the follow-up. Data of the 340 firefighters that completed both assessments were analyzed (N = 340, Mean age, 21.3 years; SD = 1.67, Mean years of work experience 3.17 years, SD = 1.15 years). This study was approved by the ethics committees of all the authors’ universities. Written informed consent was obtained from the participants before they took part in either assessment. Each assessment consisted of responding to pencil and paper questionnaires that took approximately 30 minutes to complete in a quiet room where researchers were available to answer any questions.

Variation analysis were conducted to examine whether the dropouts (N = 69) differed significantly at baseline from the follow-up group (N = 340). Results indicated no significant differences in age (t = 0.91, p = 0.36), years of working (t = 1.48, p = 0.14), or education level (t = −0.85, p = 0.39) between the dropouts and the follow-up groups. However, the results indicated that the follow-up group perceived more social support (t = −2.71, p < 0.01) than the dropouts, whereas there were no significant difference in job burnout (t = 0.02, p = 0.98) or coping strategy (t = −0.25, p = 0.80) between the two groups.

Measures

Maslach Burnout Inventory - General Survey

Job burnout was assessed by using Maslach Burnout Inventory-General Survey (MBI-GS; Schaufeli et al., 1996), which was revised by Li and Shi (2003) for the Chinese culture. MBI-GS is a 16-item scale consisting of three subscales: emotional exhaustion, cynicism, and reduced personal accomplishment. The participants evaluate their degree of burnout on a 7-point Likert scale, ranging from 0 (never) to 6 (every day). MBI-GS exhibited good reliability (Cronbach’s α = 0.86), and acceptable validity [χ² / df = 4.666, CFI = 0.914, NFI = 0.894, TLI = 0.887, RMSEA (90% CI) = 0.095 (0.086–0.104)] in this study.

Perceived Social Support Scale

Perceived social support scale (PSSS) was used to assess social support (Huang et al., 1996). PSSS contains 12 items, including two subscales: family endogenous support (4 items) and family exogenous support (8 items). Responses to the PSSS are made on a 7-point Likert scale ranging from 1 (extremely disagree) to 7 (extremely agree). The questionnaire had good internal reliability (Cronbach’s α = 0.91) and validity [χ² / df = 3.776, CFI = 0.961, NFI = 0.948, TLI = 0.937, RMSEA (90% CI) = 0.082 (0.069–0.097)] in the current study.

Coping Strategy Indicator

The coping strategy was assessed by the Coping Strategy Indicator (CSI; Amirkhan, 1990), which has been revised for the Chinese culture and language (Hou et al., 2014). The CSI constitutes three subscales including problem-solving (e.g. “I try various ways to solve the problem”), support seeking (e.g. “I will tell my relatives and friends about my fears and worries”), and avoidance coping (e.g. “I prevent to face the problem directly”), with each subscale containing 11 items. Responses to CSI are made on a 3-point Likert scale ranging from 0 (not at all) to 2 (a lot). The total score for each subscale is calculated. The scale had good reliability (Cronbach’s α = 0.84 to 0.89) and acceptable validity [χ² / df = 1.947, CFI = 0.880, NFI = 0.784, TLI = 0.868, RMSEA (90% CI) = 0.048 (0.044–0.053)] in the current study.

Data analysis

Descriptive statistics of all the measures were described, and Pearson correlations were calculated to examine relationships between main variables using SPSS 20.0. We also evaluated two structural equation models (SEMs) by using AMOS 24.0: (1) a direct model, and (2) a structural model to examine the role of coping strategy in the relationship between PSS at the baseline and job burnout at the 3-month follow-up. We inserted the coping strategy at the 3-month follow-up to the structural model as mediators to assess the indirect effect model. PSS at the 3-month follow-up could also affect job burnout at the 3-month follow-up due to the cross-time measurement and mix with PSS's effect at baseline. Therefore, we controlled for PSS at the 3-month follow-up in the analyses. Model-data fit was presented through chi-square values, the comparative fit index (CFI), the Normed fit index (NFI), the Tucker–Lewis index (TLI), and RMSEA. We also conducted bias-corrected bootstrap tests with a 95% confidence interval to examine the indirect paths' significance.

Results

We conducted Harman’s single-factor test to examine common method bias (Podsakoff et al., 2003). Exploratory factor analysis was conducted on all the variables of this study, and the unrotated factor solution was examined to determine the factor number that accounted for the overall variance. This procedure suggested 14 factors, while no single factor accounted for over 40% of the covariance among the variables, which fitted the standard prescribed by the common method bias (Zhou and Long, 2004). Therefore, we concluded that no sign of any severe common method bias existed in the current study.

Descriptive statistics and correlations among main measures

The means, standard deviations (SD), and correlations between main variables are listed in Table 1. Results suggested that PSS at baseline had a significant and positive correlation with PSS at the 3-month follow-up, and the level of PSS at the baseline was more reliable than the level of PSS at the 3-month follow-up. Both PSS at baseline and 3-month follow-up were negatively correlated with avoidance coping and job burnout at the 3-month follow-up and were positively correlated with support seeking and problem-solving at the 3-month follow-up. Moreover, support seeking had a significant and positive correlation with avoidance coping and problem-solving. However, support seeking was not significantly correlated with job burnout. Furthermore, there was a significantly negative correlation between avoidance coping and problem-solving, whereas there was a significant positive correlation between avoidance coping and job burnout. Also, there was a significantly negative correlation between problem-solving and job burnout. Table 1 also shows Cronbach's alpha coefficients of the measures. It can be seen from the table that all the measures have excellent reliability.

Table 1.

Means, standard deviations, and correlations among the main variables.

	M	SD	1	2	3	4	5	6	7	8	9
1 T1 PSS	63.14	11.75	1
2 T2 PSS	61.10	12.50	0.53***	1
3 T2 Problem Solving	16.25	4.37	0.32***	0.51***	1
4 T2 Support Seeking	11.54	4.40	0.31***	0.39***	0.40***	1
5 T2 Avoidance Coping	7.32	4.30	−0.20***	−0.28***	−0.12*	0.32***	1
6 T2 Job Burnout	27.39	15.01	−0.33***	−0.50***	−0.52***	−0.02	0.50***	1
7 T2 Emotional Exhaustion	7.54	5.06	−0.27***	−0.39***	−0.31***	0.01	0.49***	0.72***	1
8 T2 Cynicism	5.81	4.71	−0.26***	−0.45***	−0.45***	0.04	0.49***	0.66***	0.65***	1
9 T2 Reduced Personal Accomplishment	14.04	8.44	−0.28***	−0.40***	−0.49***	−0.07	0.33***	0.86***	0.31***	0.61***	1

Note: ^***p < 0.001, ^*p < 0.05. PSS, Perceived Social Support.

Mediating effects of coping strategies

We first built a direct effect model that demonstrated the effects of PSS at baseline on job burnout at 3-month follow-up. This model fitted the data well [χ² / df = 3.180, CFI = 0.993, NFI = 0.989, TLI = 0.963, RMSEA (90% CI) = 0.080 (0.014–0.154)]. Path analyses revealed that PSS significantly and negatively predicted job burnout (β = −.21, p < 0.01).

Then we inserted three coping strategies as mediators between PSS at baseline and job burnout at the 3-month follow-up. We controlled PSS at the 3-month follow-up by considering the significant correlation between PSS at 3-month follow-up and job burnout at the 3-month follow-up and explored this indirect model. The final model is presented in Figure 1. Results indicated that this indirect effect model also fitted the data well [χ² / df = 2.349, CFI = 0.980, NFI = 0.965, TLI = 0.962, RMSEA (90% CI) = 0.063 (0.042–0.085)]. Path analyses revealed that PSS at baseline could not significantly predict job burnout at the 3-month follow-up after controlling for PSS at the 3-month follow-up, suggesting that coping strategies fully mediated the relationship between PSS at baseline and job burnout at 3-month follow-up. (insert Figure 1.)

Figure 1.

The model of mediating roles of coping strategies at T2 in the relationship between perceived social support at T1 and job burnout at T2.

We conducted bias-corrected bootstrap tests with a 95% confidence interval to evaluate the significance of the direct effects shown in Table 2. Five thousand bootstrap samples were created from the original data. In this situation, if the 95% confidence interval of the direct path coefficient does not include 0, it is suggested that the direct path is indeed significant. Table 2 shows the bias-corrected bootstrap test results. The indirect effect was calculated by multiplying PSS's direct effect on coping strategies and coping strategies with job burnout. Results confirmed that the indirect paths from perceived social support at baseline to job burnout at the 3-month follow-up through three coping strategies indicated that the three indirect paths in Figure 1 were significant.

Table 2.

Bias-corrected bootstrap test of mediating effects.

Paths	Standardized β (SE)	Standardized 95% CI
Paths	Standardized β (SE)	Low	High
Direct paths
T1 PSS—T2 Problem Solving	0.60*** (0.05)	0.52	0.68
T1 PSS—T2 Support Seeking	0.50** (0.05)	0.40	0.58
T1 PSS—T2 Avoidance Coping	−0.32*** (0.06)	−0.42	−0.22
T1 PSS—T2 Job burnout	−0.41 (0.49)	−1.21	0.42
T2 Problem Solving—T2 Job burnout	−0.44*** (0.10)	−0.60	−0.27
T2 Support Seeking —T2 Job burnout	0.30* (0.13)	0.08	0.51
T2 Avoidance Coping—T2 Job burnout	0.40** (0.12)	0.21	0.59
Indirect paths
T1 PSS—T2 Problem Solving—T2 Job burnout	−0.26***
T1 PSS—T2 Support Seeking —T2 Job burnout	0.15*
T1 PSS—T2 Avoidance Coping—T2 Job burnout	−0.13**

Note: ^***p < 0.001, ^**p < 0.01, ^*p < 0.05. PSS, Perceived Social Support.

Discussion

This two-wave study investigated job burnout and its relationship with social support and coping strategies among Chinese firefighters and also explored the mediating role of coping strategies in this relationship. The results confirmed the first study hypothesis that perceived social support at the baseline, and the 3-month follow-up was significantly and negatively correlated with job burnout at the 3-month follow-up. This finding is consistent with the results of previous cross-sectional studies on social support and burnout (Ehring et al., 2011; Wang et al., 2018), indicating that higher perceived social support is associated with reduced experiences of job burnout (Wang et al., 2018). This study also indicated that the effect of perceived social support on alleviating job burnout among firefighters was stable over the long-term. This could be because Chinese firefighters believe that adequate support from families and friends is beneficial to them. Moreover, the work of firefighters is a collective activity. Therefore, increased collaboration and support from peers and supervisors might be especially helpful to firefighters.

We examined Hypothesis 2 of the study using structural equation modeling. Results demonstrated that the coping strategy mediated between perceived social support at the baseline and job burnout at the 3-month follow-up, with coping strategies, including problem-solving, support seeking, and avoidance coping, acting as mediators. This finding supported the theoretical model of thriving through relationships described by Feeney and Collins (2015). The model postulates that the feeling of being supported by others motivates people experiencing stress to seek help from significant others and rely on personal strengths to explore new stress coping strategies such as promoting positive coping with adversity by acting, instead of indulging in unchangeable adverse circumstances. As a result, people might adopt adaptive methods of alleviating job burnout. Social support might also inhibit maladaptive responses, such as avoidance coping, which is less adoptive than adaptive coping.

Moreover, results indicated that the perceived social support at baseline negatively predicted avoidance coping and positively predicted job burnout at the 3-month follow-up, suggesting that firefighters are unlikely to maintain mental distress they had experienced if they cope with problems rather than avoid them, which is consistent with previous research (Steiner et al., 2002). Other studies have shown that social support, which is positively related to stress coping, is vital for fire departments (Smith et al., 2011), possibly because it offers care and empathy to firefighters and reminds them of their self-esteem and social companionships (Cohen and Wills, 1985). Also, firefighters might feel more confident about managing their work-related problems instead of avoiding them if they have adequate social support.

The mediating effect indicated that perceived social support at the baseline predicted job burnout at the 3-month follow-up through problem-solving and support seeking, which suggests that social support might facilitate adaptive responses. Path analysis showed that perceived social support at baseline positively predicted problem-solving at 3-month follow-up, and negatively predicted job burnout. That means firefighters might develop the courage to deal with their problems once they know that people support them emotionally and instrumentally, and directly face problems and solve them, which alleviates job burnout. Individuals tend to maintain and accumulate job resources, which could gain motivational potential in demanding jobs. Firefighters undertake highly demanding jobs, and the more resources they have, the less likely they are to suffer from burnout (Bakker and Demerouti, 2007). Unexpectedly, however, support seeking, which is also an adaptive coping strategy, did not decrease firefighters' job burnout, which is inconsistent with previous studies that have emphasized the mitigating role of support seeking on job burnout (Yip et al., 2008). The concept of social undermining (Vinokur et al., 1996) explains the adverse effects and behaviors initiated by interactions between individuals and social relationships (Vinokur and Van Ryn, 1993). Specifically, firefighters that perceived a high degree of support from their family and other people at the last time point (the baseline) might take it for granted that they can quickly receive help and support. As a result, they might tend to ask for more help when encountering problems during the period from the baseline to 3-month follow-up. Then, the habit of excessive help-seeking and identifying with seeking others’ support might make them passive about solving daily work-related problems, resulting in cynicism and a reduced sense of accomplishment (Santa Maria et al., 2018). Moreover, the positive correlation between support seeking and avoidance coping suggests that even if firefighters ask others for help, others might not always support them for coping with their problems. Therefore, they might perceive less support and consider avoidance. These results emphasize the need for rational support seeking. Furthermore, the received support is crucial because it influences perceived social support (Prati and Pietrantoni, 2010).

Finally, our findings were consistent with a previous study showing that job resources had a weak negative impact on burnout over three years (Hakanen et al., 2008). Moreover, we found a significant mediation effect of coping strategies, which corroborated previous studies (Ben-Zur and Michael, 2007; Ma, 2015). Ma’s (2015) investigation on job burnout in Chinese judges indicated that positive coping strategies partially mediated the relationship between social support and emotional exhaustion and reduced personal accomplishments. The results imply that greater use of primary control coping (e.g. problem-solving) and less use of disengagement coping (e.g. avoidance coping) might be more adaptive when dealing with a broader array of life stressors.

This study has several strengths. It is a two-wave, theory-based study, and used two assessments to investigate the mediators of different coping strategies on the relationship between social support and job burnout. However, the findings of this study are constrained by specific limitations. Firstly, the measures of burnout, social support, and coping were based on firefighters’ self-reports, and therefore, the correlations between them might have been inflated by the shared method variance. Future studies should combine self- and other-evaluation. Secondly, there were limits on the personal variables related to the sample, such as their characteristics and job positions. Nearly all the firefighters in this study had worked as firefighters for less than five years, even though they had experienced considerable training and rescue work after employment. Therefore, the level of job burnout experienced by this sample might not represent firefighters in China in general, but only young firefighters. Nevertheless, we hope that this study would inspire future studies using larger samples based on the length of work experience and further explore the impact of employment length and other personal characteristics on job burnout.

These findings have implications for the management and psychological interventions of firefighters. The results indicated that social support is crucial for alleviating job burnout. Therefore, the military school for firefighters could provide more vacations to firefighters for visiting parents and friends. Also, interpersonal communication skills should be taught to firefighters in school to help them get along well with their supervisors and colleagues. Moreover, coping strategies are a significant personal resource for firefighters. Therefore, we suggest that group counseling, focusing on instructing firefighters to cope appropriately with work stressors, should be developed.

Footnotes

Acknowledgements

The authors gratefully acknowledge Jiali HUANG for her work on the investigation and data collection. We also wish to thank Wenchao WANG for his work on reviewing the manuscript.

Author contributions

Qi HUANG assisted in the investigation and wrote the original draft;

Yuanyuan AN contributed to the data curation, and in charge of project administration;

Xiaohui LI assisted in review and editing.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Funding

The author(s) disclosed the receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Natural Science Foundation of Jiangsu Province (grant number BK20190702) and the Philosophy and Social Science Foundation of Jiangsu Province (grant number 18SHC004).

ORCID iDs

Qi Huang

Yuanyuan An

References

Alessandri

Perinelli

De Longis

, et al. (2018). Job burnout: The contribution of emotional stability and emotional self-efficacy beliefs. Journal of Occupational and Organizational Psychology 91: 823–851.

Amirkhan

(1990) A factor analytically derived measure of coping: The coping strategy indicator. Journal of Personality and Social Psychology 59(5): 1066–1074.

Ângelo

Chambel

(2014) The role of proactive coping in the Job Demands–Resources Model: A cross-section study with firefighters. European Journal of Work and Organizational Psychology 23(2): 203–216.

Bai

(2015) The relationship between social support, work burnout and PTSD in Chinese firefighters. Modern Preventive Medicine 42(13): 2329–2333. (in Chinese)

Bakker

Demerouti

(2007) The job demands-resources model: State of the art. Journal of Managerial Psychology 22(3): 309–328.

Ben-Zur

Michael

(2007) Burnout, social support, and coping at work among social workers, psychologists, and nurses. Social Work in Health Care 45(4): 63–82.

Beausaert

Froehlich

Devos

, et al. (2016) Effects of support on stress and burnout in school principals. Educational Research 58(4): 347–365.

Bernabé

Botia

(2016) Resilience as a mediator in emotional social support’s relationship with occupational psychology health in firefighters. Journal of Health Psychology 21(8): 1778–1786.

Biron

Van Veldhoven

(2012) Emotional labour in service work: Psychological flexibility and emotion regulation. Human Relations 65(10): 1259–1282.

10.

Boffa

Stanley

Hom

, et al. (2017) PTSD symptoms and suicidal thoughts and behaviors among firefighters. Journal of Psychiatric Research 84: 277–283.

11.

Cohen

Wills

(1985) Stress, social support, and the buffering hypothesis. Psychological Bulletin 98(2): 310–357.

12.

Cole

Maxwell

(2003) Testing mediational models with longitudinal data: Questions and tips in the use of structural equation modeling. Journal of Abnormal Psychology 112(4): 558–577.

13.

Delgadillo

Saxon

Barkham

(2018) Associations between therapists’ occupational burnout and their patients’ depression and anxiety treatment outcomes. Depression and Anxiety 35(9): 844–850.

14.

Ehring

Razik

Emmelkamp

(2011) Prevalence and predictors of posttraumatic stress disorder, anxiety, depression, and burnout in Pakistani earthquake recovery workers. Psychiatry Research 185(1–2): 161–166.

15.

Feeney

Collins

(2015) A new look at social support: A theoretical perspective on thriving through relationships. Personality and Social Psychology Review 19(2): 113–147.

16.

Guilaran

de Terte

Kaniasty

, et al. (2018) Psychological outcomes in disaster responders: A systematic review and meta-analysis on the effect of social support. International Journal of Disaster Risk Science 9(3): 344–358.

17.

Hackman

Oldham

(1980) Work Redesign. Reading, MA: Addison Wesley.

18.

Hakanen

Schaufeli

(2012) Do burnout and work engagement predict depressive symptoms and life satisfaction? A three-wave seven-year prospective study. Journal of Affective Disorders 141(2–3): 415–424.

19.

Hakanen

Schaufeli

Ahola

(2008) The job demands-resources model: A three-year cross-lagged study of burnout, depression, commitment, and work engagement. Work & Stress 22(3): 224–241.

20.

Hou

Zhou

Chen

, et al. (2014) The influencing factors of PTSD and PTG among teachers after Wenchuan earthquake: Perspectives from before, during and after disaster. Psychological Development and Education 30(1): 82–89. (In Chinese).

21.

Huang

Wang

, et al. (2019) The relationship between conscientiousness and posttraumatic stress disorder among young Chinese firefighters: The mediating effect of perceived social support. Psychiatry Research 273: 450–455.

22.

Huang

Jiang

Ren

(1996) Correlation between coping style, social support and psychosomatic symptoms of cancer patients. Chinese Mental Health Journal 10(4): 160–161. (In Chinese).

23.

Huynh

Xanthopoulou

Winefield

(2013) Social support moderates the impact of demands on burnout and organizational connectedness: A two-wave study of volunteer firefighters. Journal of Occupational Health Psychology 18(1): 9–15.

24.

Isenhardt

Hostettler

Ramseier

(2019) Effects of social relations at work and support from family and friends on the consequences of inmate violence on correctional staff burnout. Criminal Justice and Behavior 46(10): 1405–1426.

25.

Judd

Dorozenko

Breen

(2017) Workplace stress, burnout and coping: a qualitative study of the experiences of Australian disability support workers. Health & Social Care in the Community 25(3): 1109–1117.

26.

Shi

(2003) The influence of distributive justice and procedural justice on job burnout. Acta Psychologica Sinica 35(5) : 677–684. (In Chinese)

27.

(2015) Influence of social support on job burnout of Chinese judges: Coping style as a mediator. Chinese Journal of Clinical Psychology 23(3): 552–554. (In Chinese)

28.

Maslach

(2003) Job burnout: New directions in research and intervention. Current Directions in Psychological Science 12(5): 189–192.

29.

Maslach

Schaufeli

Leiter

(2001) Job burnout. Annual Review of Psychology 52(1): 397–422.

30.

Nevill

Havercamp

(2019) Effects of mindfulness, coping strategies and resilience on job retention and burnout in caregivers supporting aggressive adults with developmental disabilities. Journal of Intellectual Disability Research 63(5): 441–453.

31.

Paulus

Gallagher

Bartlett

, et al. (2018) The unique and interactive effects of anxiety sensitivity and emotion dysregulation in relation to posttraumatic stress, depressive, and anxiety symptoms among trauma-exposed firefighters. Comprehensive Psychiatry 84: 54–61.

32.

Podsakoff

MacKenzie

Lee

, et al. (2003) Common method biases in behavioral research: A critical review of the literature and recommended remedies. Journal of Applied Psychology 88(5): 879–903.

33.

Prati

Pietrantoni

(2010) The relation of perceived and received social support to mental health among first responders: A meta-analytic review. Journal of Community Psychology 38(3): 403–417.

34.

Romswinkel

König

Hajek

(2018) The role of optimism in the relationship between job stress and depressive symptoms. Longitudinal findings from the German ageing survey. Journal of Affective Disorders 241: 249–255.

35.

Santa Maria

Wörfel

Wolter

, et al. (2018) The role of job demands and job resources in the development of emotional exhaustion, depression, and anxiety among police officers. Police Quarterly 21(1): 109–134.

36.

Schaufeli

Leiter

Maslach

, et al. (1996) The Maslach burnout inventory: General survey (MBI-GS). In: Maslach

Jackson

Leiter

(eds) Maslach Burnout Inventory Manual (3rd edn). Palo Alto, California: Consulting Psychologists Press, pp. 19–26.

37.

Shin

Park

Ying

, et al. (2014) Relationships between coping strategies and burnout symptoms: A meta-analytic approach. Professional Psychology: Research and Practice 45(1): 44–56.

38.

Skaalvik

(2007) Dimensions of teacher self-efficacy and relations with strain factors, perceived collective teacher efficacy, and teacher burnout. Journal of Educational Psychology 99(3): 611–625.

39.

Smith

Hughes

DeJoy

, et al. (2018) Assessment of relationships between work stress, work-family conflict, burnout and firefighter safety behavior outcomes. Safety Science 103: 287–292.

40.

Smith

Ortiz

Steffen

, et al. (2011) Mindfulness is associated with fewer PTSD symptoms, depressive symptoms, physical symptoms, and alcohol problems in urban firefighters. Journal of Consulting and Clinical Psychology 79(5): 613–617.

41.

Steiner

Erickson

Hernandez

, et al. (2002) Coping styles as correlates of health in high school students. Journal of Adolescent Health 30(5): 326–335.

42.

Straud

Henderson

Vega

, et al. (2018) Resiliency and posttraumatic stress symptoms in firefighter paramedics: The mediating role of depression, anxiety, and sleep. Traumatology 24(2): 140–147.

43.

Underwood

(2000) Social support: The promise and reality. In: Rice

(ed.) Handbook of Stress, Coping, and Health: Implications for Nursing Research, Theory, and Practice. Newbury Park, CA: Sage, pp. 367–391.

44.

Vinokur

Price

Caplan

(1996) Hard times and hurtful partners: How financial strain affects depression and relationship satisfaction of unemployed persons and their spouses. Journal of Personality and Social Psychology 71(1): 166–179.

45.

Vinokur

Van Ryn

(1993) Social support and undermining in close relationships: Their independent effects on the mental health of unemployed persons. Journal of Personality and Social Psychology 65(2): 350–359.

46.

Violanti

Mnatsakanova

Andrew

, et al. (2018) Effort–reward imbalance and overcommitment at work: Associations with police burnout. Police Quarterly 21(4): 440–460.

47.

Wang

Zhuang

Chiou

, et al. (2018) Exploring factors influencing the work-related morale for certified nursing assistants in hospice care: A structural equation modeling study. PLoS One 13(10).

48.

Wegge

Van Dick

Fisher

, et al. (2006) Work motivation, organizational identification, and well-being in call centre work. Work & Stress 20(1): 60–83.

49.

Yip

Rowlinson

Siu

(2008) Coping strategies as moderators in the relationship between role overload and burnout. Construction Management and Economics 26(8): 871–882.

50.

Zhou

Long

(2004) Statistical remedies for common method biases. Advances in Psychological Science 12(6): 942–950. (In Chinese).