Burnout, work environment, and coping in surgical hospital nurses

Master Thesis


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University of Cape Town

This study examined the extent of burnout (as conceptualized by Maslach and Jackson (1981): emotional exhaustion, depersonalization and diminished personal accomplishment) being experienced by nurses in a South African state hospital, and its associations with a range of work environment variables and the ways in which nurses generally cope with their stress. This exploratory study took the form of a cross-sectional, correlational field survey, in which both quantitative and qualitative data were collected from surgical hospital nurses by means of self-report questionnaires. Quantitative measures included were the Maslach Burnout Inventory (MBI; Maslach & Jackson, 1981), the Work Environment Scale (WES; Moos, 1986) and the Coping Orientations to Problems Experienced Scale (COPE; Carver, Scheier & Weintraub, 1989). Additional quantitative measures of personal control, support, sense of appreciation and job satisfaction were obtained from visual analogue rating scales. The qualitative data comprised a frequency analysis of themes evident in the content of subjects' written responses to four open-ended questions posed in the questionnaire. On each of the three burnout subscales, respondents' scores were categorized into low, moderate or high levels of burnout. Apart from correlational and ANOVA analyses, performed in order to examine relationships between variables and differences in terms of demographics, nursing categories, and nursing specialities, discriminant analyses were performed in order to identify those variables which were experienced differently by nurses reporting different levels of burnout. A number of significant predictors of burnout were identified. Of the work environment variables examined in the study, higher levels of work pressure, diminished physical comfort, and lack of peer cohesion predicted higher levels of emotional exhaustion. Lack of physical comfort and perceived lack of supervisor support were strongly associated with higher levels of depersonalization. Generally, lower levels of perceived autonomy and supervisor support were associated with a diminished sense of personal accomplishment. Regarding coping, frequent use of the problem-focused strategy of planning was found to be associated with lower levels of emotional exhaustion and depersonalization. Frequent use of the emotion-focused strategies of positive reinterpretation, seeking emotional social support, and acceptance were related to higher levels of personal accomplishment, whereas increased use of the emotion-focused strategy of denial was strongly associated with diminished personal accomplishment. Regarding palliative/avoidant coping strategies, frequent behavioural disengagement was associated with higher levels of emotional exhaustion and depersonalization, and mental disengagement and focusing/venting of emotions were related to higher levels of emotional exhaustion.

Summary in English.

Bibliography: leaves 145-152.