Burnout syndrome and related factors among health team employees

1 Introduction

Nowadays, the importance and the critical role of having jobs could clearly be seen in all aspects of human life. Due to the fact that besides fulfilling people’s needs in terms of cost of living, having a job directly leads to mental and physical health [1]. Furthermore, human resources would be the total capital of organizations and are considered the source of any evolution and innovation in them [2]. Studies have shown that there are different sources of occupational and professional stress, so the individual’s organizational role, professional development and relationships, organizational structure, and atmosphere may cause different psychological reactions, one of which is job burnout. They found it necessary to determine and diagnose the causes of job burnout [3–5]. Burnout is a major consequence of work-related stress and as long as that stress is not eliminated, it will continue [6]. Healthcare settings are always plagued by a wide range of stressors, such as severe illness and death of patients, high workloads, and role ambiguity [7].

In the late 1960 s, Herbert J. Freudenberger used the first time job burnout term [8] to describe human responses to work-related stress, and it includes the psychological reactions that individuals show when exposed to job stress [9]. This syndrome had three aspects and dimensions including emotional exhaustion (EE), personal accomplishment (PA), and depersonalization (DP). Burnout is more common in occupations where individuals spend many hours in close contact with other people [10].

Job burnout is not only related to the mental health of employees but also to their productivity [11]. A study showed that this syndrome is the product of prolonged stress at the workhouse [12]. It has several effects on a person’s social, physiological, and psychological life [13]. Since 1974, studies have shown burnout is a major problem in many organizations [14] so half of the individuals in organizations are affected by the effects of this syndrome [15].

In various studies, the complications of this syndrome are known at the individual, interpersonal, family, and social levels, which leads to great psychological damage to society, which can reduce a person’s mental health, increasing absence from work [16] dysfunction in interpersonal and family problems [17], decreased job satisfaction, service quality and client satisfaction [18]. Dargahi et al. [1] emphasized the need to pay attention to burnout due to its sensitivity. They suggested determination and pathology of the causes of job burnout are necessary. They also recommended using support mechanisms, given the considerable number of burnout among teachers and faculty members [1]. Therefore, reaching out to understand the effective strategies for coping with stress, recognizing, preventing, and overcoming burnout, while promoting psychological state, can play a crucial role in increasing human resource capacity and productivity and improving service levels [19]. Since job burnout has very important consequences for employees, this study aimed to investigate the burnout syndrome rate of health team employees.

2 Materials and methods

3 Results

The mean age of employees was 38.4±8.04, and the mean work experience was 12.45±7.6. The majority of participants were women (61.8%) and married (84%), and had an undergraduate degree (52.2%) (Table 1).

The results showed that EE and DP were higher in the majority of employees and PA is low at 88.33% of cases (Table 2).

The independent t-test demonstrated there was no significant difference between mean burnout and gender (P = 0.6). Moreover, it showed there was no statistically significant difference between marital status and burnout (P = 0.6). The results of the one-way ANOVA test showed there was a significant relationship between age groups and burnout score (P = 0.04), and the participants in the 35–40 age group had the highest scores. The one-way ANOVA test showed a significant relationship between educational level and burnout score (P = 0.001) and who those were professionals and Ph.D. degrees had the highest rate of burnout. Also, the results of the one-way ANOVA test indicated a significant relationship between employment status and burnout score (p≤0.001), and research and teaching staff had the highest rate of burnout, respectively (Table 3).

The findings showed that there was a significant relationship between work experience and burnout score (P = 0.04) and those who had more work experience had the highest rate of burnout. The Spearman correlation test shows a significant association between age groups and burnout score (P = 0.04) and employees 35–40 years had the highest rate of burnout.

The Pearson correlation coefficient test showed a positive and significant association between work experience and burnout score so the participants with a higher work experience had a higher burnout score (P = 0.002 and r = 0.95).

The results of this study provide information on burnout syndrome and related factors among health team employees of Mashhad University of Medical Sciences. Factors associated with health team employees’ burnout were determined by age, educational level, and employment status. All employees reported burnout; however, employees were 35–40 years old, participants had professional and Ph.D. degrees educational level, and research staff, were exposed to higher burnout levels.

Burnout was associated socio-economic status of the participants. Similar to this study, in other studies [23–25] there was no significant difference between burnout scores and gender, while Farsi et al. [26], Umutoni [27] and Oliveira et al. [28] presented a connection between gender and burnout. In various Iranian studies, socioeconomic factors were associated with burnout [29–31].

The findings did not show a significant difference between burnout scores and marital status. while Umutoni [27] indicated single nurses are more exposed to job burnout than married nurses. Okwaraji and Aguwa [32] also obtained a similar result in Nigeria. Alber Marin and Garcia-Ramirez [23] also found that being single had a significant positive relationship with burnout. We did not observe a significant difference between the severity and frequency of burnout dimensions with age, while in other studies [1, 33] a significant difference was observed between age and burnout [34]. For example, Farsi et al. [26] and Lafaver et al. [35] suggested one of the risk factors for job burnout is age, and young people have higher job burnout compared to older people. Although young age may have a greater effect on job burnout than old age.

We observed there was a significant relationship between burnout score and educational level. Participants with high education had more burnout scores. This result in other studies confirmed [36–38]. While in previous studies, there was no correlation between education level and job burnout [31, 39]. Moreover, Demir et al. [40] and Yeh et al. [41] reported as the level of education increases, the job burnout rate decreases. In the present study, work experience was associated with increased burnout. Similar to the present research other studies in Iran reported there was an association between work experience and burnout score [1, 31, 34, 42]. In contrast, Dargahi et al. [1] and Roganizadeh et al. [43] reported that work experience was not related to job burnout. Work experience may not have a direct influence on burnout, but could be a mediator of the other sociodemographic factors [44]. In addition, those who had higher work experience may change their perceptions and experience due to the multi-purpose nature of executive responsibilities. It seems that professors and people with academic education are subjects to job burnout due to occupational stress [45].

In the current study, occupational depression was high among the teaching staff, which was also confirmed in other studies [1, 24]. Employee depression can affect the training of employees and faculty members [46]. Iran has a different healthcare system; healthcare employees tend to have lower-income and longer hours than their American and European counterparts [29]. In Iran, physicians often spend afternoons and late nights in the workplace, which decreases their rest and recovery and limits their social interactions. In addition, it can be said that economic inflation and sanctions increased financial pressure on people and doctors. These situations can reduce society’s tolerance and lead to individual and interpersonal tensions.

The results showed frequency and severity of EE, and DP dimension were at a high level and experienced reduced PA. In the study by Dargahi et al. [1], 90% of the subjects had a decrease in the PA [1], which is almost the same as the present study. Qari Alavijeh et al. [47] reported the frequency of DP (29%), EE (61%), and decreased PA (67%) and they were moderate or severe compared to the present study. They reported the three subscales of occupational burnout were higher. Abdi Masuleh et al. [48] reported the rate of DP (20%), PA (14.9%), and EE (37%) that the intensity these rates were moderate. In the present study, burnout in the teaching and research staff was more than in the medical staff, which were considered hard jobs. It seems the reason for this can be the multi-functions of the task in the research field and education, which need members of the academic staff to be active in education, research, and implementation.

One of the strengths of this study was the measurement of job burnout in Mashhad health team employees. The results of this study may be considered in planning related to health promotion in the workplace. However, this study is not without limitations. The cross-sectional design of this study limits obtaining information about causal relationships. Therefore, cohort studies are suggested for more accurate measurements. It should be noted that this issue can be investigated and fully analyzed by developing qualitative studies.

5 Conclusion

Job burnout and its subscale levels were high among the employees of the Mashhad University of Medical Sciences. Job burnout is associated with socioeconomic status that can be affected by individual, organizational, management, and environmental factors. Therefore, this study suggests employees need to get out of EE and DP conditions for higher job performance. Therefore, for analyzing, diagnosing, and supporting the employees’ point of view, it is suggested to hold face-to-face meetings in the field of eliminating job burnout. In this regard, it is possible to identify individual, organizational, management, and environmental factors affecting job burnout. Thus, by modifying strategies and processes and reviewing organizational plans and goals, effective measures can be taken to improve the dimensions of the physical, mental, and social health of employees. Additionally, further research is required to examine the long-term effects of workplace burnout.