Research progress of nurses' job burnout

Job burnout is a state of physical, emotional and psychological exhaustion related to work situation, which mostly occurs among nurses. It will affect the physical and mental health of nurses, lead to the decline of service quality, easily lead nurses to leave the nursing team, and affect the stability of the nursing team. The study of nurses' job burnout can provide theoretical guidance and support for preventing and intervening nurses' job burnout, and also provide reference for improving nurses' physical and mental health, stabilizing nursing team and improving nurses' work quality.

Keywords: related factors of nurses' job burnout

American clinical and social psychologists Fredenberger, Masla Herr and Li Xiaomei found that nurses, as a professional group serving the crowd, are prone to job burnout in their work, which is characterized by inferiority, indifference, aversion to work and loss of sympathy, which leads to a decline in work efficiency, an increase in absenteeism tendency and even resignation. It can affect the physical and mental health of nurses, lead to the decline of service quality, easily lead nurses to leave the nursing team, and affect the stability of the nursing team [1]. Personally, job burnout has an impact on nurses' work and life. Nurses' apathy and increased turnover intention due to job burnout will indirectly affect the stability of nursing teams and cause patients' satisfaction with nursing work to decline [8]. It will also directly cause negative emotional and cognitive changes to nurses and bring physiological effects to nurses, including abnormal blood lipid, blood sugar, blood pressure and electrocardiogram [15].

1? The concept of job burnout

Job burnout, also called job burnout or job burnout. Mosby Dictionary points out that burnout refers to a state of mental or physical energy exhaustion, which is usually produced after a period of chronic stress, which is work-related and can not be alleviated, and sometimes causes physical diseases, and it is a psychological comprehensive disease related to the work situation. From three dimensions, job burnout is emotional exhaustion, disintegration of personality and disappearance of personal accomplishment. Among them, emotional exhaustion is the main aspect of a series of symptoms, which represents the personal stress dimension of job burnout and refers to an emotional feeling of over-dedication and resource exhaustion. The dehumanization tendency represents the interpersonal situation dimension of job burnout, which refers to the negative, indifferent and cynical attitude or emotion towards others at work. The disappearance of personal accomplishment represents the self-evaluation dimension of job burnout, that is, the sense of self-ability is reduced, and people tend to make negative comments on their work. Maslach and others think that these three dimensions promote the emergence of burnout, while some scholars think that the three dimensions appear in the opposite order, while others think that the three dimensions have no order, and they can appear independently or even at the same time [2]. The three concepts of job burnout, work stress and depression seem similar at first glance, but they are actually different. Among them, job stress is the antecedent of job burnout, and the existence of job stress may not necessarily develop into job burnout; However, depression has a universal orientation in many aspects such as life and work, which is different from the orientation of a single work situation of job burnout [17].

2? Causes of job burnout

2. 1 social factors

2. 1. 1 overwork? There is a serious shortage of nurses in China. Long-term overwork and "three-shift" work system make nurses' life irregular, which will lead to excessive mental consumption and long-term abnormal physical load in the long run, which is easy to cause mental fatigue.

2. 1.2 Role conflict and role ambiguity (also called role pressure) are the factors that affect nurses' job burnout. The higher the level of role stress, the higher the level of job burnout of nurses. Unclear clinical responsibilities lead nurses to engage in a lot of non-nursing work. Because nurses are mostly women, they should not only complete the role of good nurses, but also assume the role of wife and mother. Patients, patients' families, doctors and hospital administrators all put forward higher and higher requirements for the quality of nurses' work, which makes nurses feel too stressed in their roles. Multiple roles and excessive role requirements often make nurses feel overwhelmed and exhausted.

2.2 Personal characteristics factors

2.2. 1 demographic characteristics

Demographic variables include age, gender, marital status, education level, etc. Demographic variables are related to job burnout. Among them, the correlation between age and variables is the most stable. Nurses with low working years have higher job burnout, and young nurses with high academic qualifications have higher job burnout than nurses with low academic qualifications. Female medical staff are significantly higher than male medical staff in emotional exhaustion, single people are more likely to have job burnout than married people, and divorced people are more likely to have job burnout than single people. There is no significant difference between men and women in emotional alienation and personal accomplishment. Nurses in ICU, emergency department, pediatrics and other departments have a high proportion of job burnout, ranging from 4 to 5. Singles are more likely to feel job burnout than married people, and divorced people are more likely to feel job burnout than single people. Nursing managers should pay special attention to divorced, single groups and highly educated nurses. The job burnout of registered nurses is lower than that of contract nurses and nursing students.

2.2.2 Personality characteristics

Personality is an influential factor of job burnout. In the same working environment, individuals with the same management, education and experience usually have different reactions to the same stressor. People who are stubborn, self-abased, extroverted, neurotic, type A personality, feeling, defensive coping style, lack of patience and avoidance of stress strategies show higher job burnout 12. Compared with the medical staff with type B personality, the medical staff with type A personality scored higher in the dimension of emotional exhaustion, lower in the dimension of personal accomplishment and higher in the degree of depersonalization (13). Compared with doctors, nurses' emotional control and sense of self-accomplishment are slightly lower than 14.

3. Related factors of nurses' job burnout

3. 1 Emotional exhaustion

Emotional exhaustion is a state of extreme exhaustion caused by the exhaustion of emotional resources. Because most of the work of nurses is done in contact with patients, heavy workload is bound to be accompanied by more emotional input to patients, which will lead to more serious emotional exhaustion. When the rescue fails and the patient dies, the nurse may be accused by her family members or criticized by doctors and leaders, and her efforts are not affirmed, which is more likely to lead to emotional exhaustion.

3.2 Personality disintegration

Depersonalization is the interpersonal situation dimension of job burnout, which shows that the client is treated as an object and the attitude is negative and indifferent. When the job satisfaction of nurses is low, the degree of dehumanization is also high, and the service attitude is relatively indifferent. Only by improving employees' satisfaction can the quality of work be improved. Managers should pay full attention to the importance of pre-job training for new nurses, and check whether new nurses are competent before they work independently, so as to avoid a high degree of dehumanization in their work and affect the quality and safety of nursing.

3.3 Loss of personal accomplishment

The loss of personal sense of accomplishment is manifested in the tendency to make negative comments on oneself, feeling the decline of work ability and self-esteem.

3.4 Coping Style and Job Burnout

Domestic studies have confirmed that positive or negative coping styles are related to job burnout, avoidance coping styles are positively related to emotional exhaustion, self-blaming coping styles are positively related to emotional exhaustion and depersonalization tendency, and problem-solving coping styles are positively related to personal accomplishment. Therefore, personality characteristics may be the deep reason why coping style affects the degree of individual emotional exhaustion.

4. The distribution of nurses' job burnout in different groups.

Studies have shown that emergency nurses have a relatively high degree of emotional exhaustion and a low tendency to depersonalize, while junior emergency nurses have a low sense of personal accomplishment [20]. Pediatric nurses are more prone to job burnout because they have to face the demands of a large number of children's families. Psychiatric nurses are prone to job burnout because most of the problems encountered in their work are difficult to solve [2 1]. In addition, single people are more likely to have job burnout than married people, while divorced people are more likely to have job burnout than single people. In terms of living environment, the residents in collective dormitory have a higher degree of job burnout. From the age point of view, nurses aged 26-30 are more likely to have job burnout [22].

5. Common measuring tools

1998, the Spanish school Moreno-Jim6nez compiled the Nursing Job Burnout Scale (NBS), which covers three factors: working environment, personality characteristics and different coping styles with stressors. Personality characteristics are the main factors to evaluate nurses' job burnout. The core scale includes the following five contents: stressors, job burnout, personality characteristics, coping styles, and physiological and psychological factors describing nurse burnout. The scale uses 1 to 4, and the higher the score, the higher the burnout [19].

6. Intervention measures of nurses' job burnout

6. 1 Rational allocation of nursing human resources to avoid long-term workload overload.

It is an effective measure to establish flexible scheduling system and cross-disciplinary flow mechanism of nurse resources. First of all, the scope of nursing work should be clarified, and the content that does not belong to nursing work should be handed over to people other than nurses; Secondly, nurses with different abilities, seniority and education should be arranged and used at different levels, so that individuals can give full play to their strengths in suitable positions; Finally, according to the distribution of work content in each time period, the nursing human resources are arranged, so as to define the responsibilities of each position in combination with the working procedures of each position.

6.2 Provide social support for nurses

Social support is the material and spiritual support that individuals get from the outside when facing pressure events, which mainly refers to the emotional and material help and assistance from family, relatives and friends and all aspects of society. Emotional social support includes talking, listening and expressing concern and sympathy [12]. Some surveys show that support from superiors is more important than that from colleagues, and informal support from family and friends can reduce the occurrence of job burnout [7]. Managers can organize collective activities, increase nurses' social interaction, create a collective culture of solidarity and mutual assistance, help coordinate the relationship between nurses and their families and colleagues, and try their best to help nurses when they encounter material difficulties. At the same time, nurses should also feel the friendly and helpful side of managers, so that nurses can actively seek support when they need help.

6.3 Let nurses participate in the decision-making process of management

Nurses are the most basic medical workers in hospitals and have the most contact with patients. It is a shortcut to realize this by paying attention to the working conditions and needs of nurses and letting them participate in the decision-making process of management. In the management of hospitals and wards, especially in the process of formulating policies and systems related to nursing work, managers should listen to the opinions and suggestions of nurses and get their approval. Therefore, the needs of nurses are met, their working conditions are improved, and they can feel the respect and support from leaders. Their job burnout will be alleviated to some extent, and their work quality will be improved.

6.4 Ensure the normal rest of nurses.

Vacation relieves physical and mental fatigue caused by work pressure to a certain extent, and helps employees maintain efficient working conditions. But in practice, nurses are often deprived of rest time and normal vacation. Therefore, relevant measures must be taken to ensure the normal rest and vacation of nurses. In addition, nurses can be helped to relax themselves in a short time by reasonably arranging the commuting time, optimizing the working environment and organizing various recreational activities.

6.5 Maintain good medical relations

Good doctor-nurse relationship and tacit understanding of doctor-nurse cooperation have a significant impact on nurses' personal accomplishment. All departments should arrange more communication between doctors and nurses. Head nurses should try their best to take time to participate in doctors' rounds and case discussions, and may invite attending doctors to participate in nurses' case discussions. At the same time, departments can also arrange more doctors and nurses to participate in group activities, so that doctors and nurses can understand each other's professional content and ideas in a relaxed atmosphere, and understand each other's role expectations, so as to understand each other in their work and reduce contradictions.

6.6 Train nurses in communication skills and maintain a good nurse-patient relationship.

Good communication skills can reduce the degree of job burnout, and it is very necessary to learn communication skills. Frequent use of civilized language in work can avoid or alleviate the contradiction between nurses and patients to a certain extent. Good nurse-patient relationship can also relieve the work pressure of nurses, thus effectively avoiding job burnout.

6.7 to carry out coping style guidance for nurses

Providing nurses with guidance on coping styles can effectively eliminate stressors. For example, guide nurses to carry out relaxation training and control unconsciousness caused by work pressure; Or instruct nurses to divert personal attention from work stress through appropriate activities and relieve various negative emotions.

6.8 Personal strategy

In order to prevent and improve job burnout, nurses should not only objectively understand the factors that cause job burnout, but also actively change their lifestyle. First of all, we should pay attention to cultivate extroverted personality, learn to control their negative emotions in work and life, and avoid stubbornness [17]. Secondly, we should correctly understand and evaluate ourselves, pay attention to learning interpersonal skills and establish good interpersonal relationships. Thirdly, nurses should learn and maintain effective coping skills [26] to improve their sense of internal control in the face of setbacks, and must continue to learn, improve their ability, overcome prejudice and find positive ones.

At present, China is in a period of rapid economic development and social change. The speed of organizational change is accelerating, and the occupational instability is intensifying, which makes people feel unprecedented work pressure. For nurses, job burnout is an important occupational risk factor, which directly affects nurses' work efficiency. With the sharp increase of people's concern about job burnout, it is particularly important to conduct in-depth research on nurse job burnout in order to ensure the quality of nursing service and maintain the stability of nursing team. Only by solving related problems can we prevent and reduce job burnout.

refer to

Kodbehe HJ Journal of Social Issues,1974,30 (1):159—165.

[2] Wang Xiaochun, Gan Yiqun. A Review of Job Burnout Research Abroad [J]. advances in psychological science, 2003, 1 1 (5): 567-572.

[3] Luo Hong, Ye Zhihong, Feng Ying. Study on the correlation between nurses' job burnout and psychosocial factors in the workplace [J]. China Journal of Nursing, 2005,40 (1):12 ~14.

[4] Li Xiaomei, Liu Yanjun. Investigation on job stressors and job burnout of nurses [J]. Chinese Journal of Nursing, 2000,35 (11): 645-649.

[5] Feng Ying, Luo Hong, Ye Zhihong. The test. MBI. Study on nurses' job burnout [J]. China Journal of Mental Health, 2004,8 (7): 477-479.

[6] Wang Shuzhen, Zhao Qi. Investigation on job burnout of clinical nurses in FJ. Nursing Research, 2008,22 (9): 2292

[7] Jing Li. Research progress of exhaustion. Journal of Peking University (Natural Science Edition), 2003,39 (2): 286-290.

Chen Xiao. Study on the relationship among social support, job burnout and organizational commitment of clinical nurses. Nursing Practice and Research, 2008,5 (2): 6 ~ 8.

[9] Bo, Li Jun. Study on the correlation between nurses' job burnout and personality, self-esteem and social support [J]. Journal of Nursing Science. 2006.2 1(5):3—5

[10] Li Chaoping. Shi Kan, Luo, et al. Investigation on job burnout of medical staff [Tao]. China Journal of Clinical Psychology, 2003.11(3):170-172.

[1 1] Zaohuo Cheng, Tan Linxiang. Factor analysis of the theoretical structure of Eysenck personality questionnaire [J]. China Journal of Clinical Psychology, 2004, 12 (1), 9- 12.

[12]Zellars KL, press rewe pl. The content of emotional personality and emotional support: copy-in organization. Journal of Applied Psychology, 200 1, 86 (3): 459-467.

[13] Jiang, Hu. Study on the Relationship between Job Burnout of Medical Staff and Type A Personality and Locus of Control [J]. Psychological Science, 2004,27 (2): 364-366

Chen, Wang. Investigation on nurses' occupational stress and psychological adaptation [J]. China Journal of Nursing, 2002,37 (9): 659-662.

[15] Wang Wei, Zhou, Wang Peixi, et al. Study on the correlation between clinical nurses' fatigue, job stressors and coping styles. Journal of Henan University (Medical Edition), 2009,8

Wang Xiaohui, Sun Zhihua. On the intervention of nurses' job burnout [J]. China Community Physician, 2007,9 (16):140.

Li Yongxin. Job burnout and its measurement. Psychological Science, 2003,26 (3): 556-557.

Chen. Clinical psychological nursing guidance. Beijing: Science and Technology Literature Publishing House.2000.207-219.

[19] Tang Ying, Eva Garrosa, Lei Ling, etc. Brief introduction of nurse job burnout scale NBS. China occupational medicine,

2007,34(2): 15 1- 153.

[20] Song Shuang. Reliability and validity of Chinese version of Nurse Job Burnout Scale. Guangdong medical 20 10/0,31(4): 501-502.

Week or. Research progress of nurses' job burnout. Modern Nursing, 2005,11(10): 769-770.

22 Zhao Wendaogang. Causes and prevention of nurse psychosomatic exhaustion syndrome. Foreign medical nursing fascicle,

199 1,2:53—55.

[23] Burisch-M. Longitudinal study on burnout: the relative importance of burnout

Personality and experience. Work and stress. 2002， 16( 1): 1- 17。

[24] Le Yan, Liu Xiaohong. Research progress on coping strategies of nurses' job burnout-Journal of Nursing 2006, 13( 1)

[25] Shine Wong, Min Yang, Gao Wei, Wang Chaoxia. Correlation analysis between emotional labor performance strategies and job burnout of nurses-Journal of Nursing 2008,23 (3)

[26] Chen and Wang. Investigation on occupational stress and psychological adaptation of nurses. China Journal of Nursing,

2002,37(9):659—662.

[27] Li Xiaomei. Investigation on job stressors and job burnout of nurses. China Journal of Nursing, 2000,

35( 1 1):645—6495.