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Att bli eller inte bli utbränd: ett komplext fenomen bland vårdpersonal på samma arbetsplatser
Umeå University, Faculty of Medicine, Omvårdnad.
2009 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The thesis comprises four papers. The overall aim was to illuminate meanings of becoming and being burnt out respectively not becoming or being burnt out. The papers deal with two groups of healthcare personnel, one group on sick leave due to medically assessed burnout (n=20) and one group who showed no indications of burnout (n=20) from the same workplaces at psychiatric (n=7) and elderly (n=7) care units. A further aim was to describe personality traits and to elucidate perceptions of conscience (PCQ), stress of conscience (SCQ), moral sensitivity (MSQ-R), social support (SocIS) and resilience (RS) among the people in these two groups. Papers I and II are based on the text of narrative interviews interpreted using a phenomenological-hermeneutic method. Papers III and IV are based on data, pertaining to the same participants as in Papers I and II, derived from the following questionnaires; Cattell’s Sixteen Personality Factors Questionnaire (16PF) (III), ‘Perception of Conscience’ (PCQ), ‘Stress of Conscience’ (SCQ), ‘Moral Sensitivity Revised’ (MSQ-R), ‘Social Interactions Scale’ (SocIS) and ‘Resilience Scale’ (RS) (IV). Conventional statistical methods and Partial Least Square Regression (PLSR) were used to analyse the data (III, IV). In Paper I the aim was to illuminate meanings of becoming and being burnt out as narrated by healthcare personnel. The results show that meanings of becoming and being burnt out is to be torn between what one wants to manage and what one can actually manage. It is as if one’s ideals become more like demands for, regardless of the circumstances, one must be and show that one is capable and independent. It also means being dissatisfied with oneself for not living up to one’s own ideals as well as being disappointed in other people for not providing the confirmation one strives for. Feelings that one is a victim of circumstances emerge. Becoming and being burnt out leads to a futile struggle to live up to one’s ideals and when failing to unite one’s ideal picture with one’s reality one finally reaches an overwhelming feebleness. In Paper II the aim was to illuminate meanings of not becoming or being burnt out at workplaces where others developed burnout, as narrated by healthcare personnel. The results show that meanings of not becoming or being burnt out are to be rooted in an outlook on life which perceives its many-sidedness of prosperity, adversity, strength and weakness in oneself and others. An openness towards the circumstances of life emerges. Being able to judge the possibilities of influencing things, as well as being able to let go of injustice and look after oneself with a clear conscience are revealed as meanings of not becoming and being burnt out. In Paper III the aim was to describe personality traits among burnt out and non-burnt out healthcare personnel from the same workplaces. The results show, that the people in the burnt out group had lower scores regarding emotional stability and higher scores regarding anxiety than the people in the non-burnt out group but the results also showed a wide variation of personality traits within the groups. The most important indicators for belonging to the burnt out group were openness to changes and anxiety, and for belonging to the non-burnt out group, emotional stability, liveliness, privateness and tension. In Paper IV the aims were to elucidate perceptions of conscience, stress of conscience, moral sensitivity, social support and resilience among burnt out and non-burnt out healthcare personnel from the same workplaces. The results show that higher levels of stress of conscience and moral sensitivity, a perception of conscience as a burden, having to deaden one’s conscience in order to keep working in healthcare and perceiving a lack of support from those around them characterize the burnt out group. Those in the non-burnt out group are characterised by lower levels of stress of conscience, an out-look on life with a forbearing attitude, a perception of conscience as an asset, an ability to deal with one’s conscience in a constructive way and a perception of receiving support from those around them. The comprehensive understanding from the four papers (I-IV) is discussed in light of a theoretical framework derived from Emmy van Deurzens thoughts about the four life worlds: the natural world (the physical world), the public world (the social world), the private world (the psychological world) and the ideal world (the spiritual world). The result can be summarized in terms of the human condition in life and demonstrates the essential importance of reconciling the vita activa (the active life of labor, work and action), the vita contemplativa (thinking, willing and judging) and not least the vita regenerativa (rest and recovery) in order to avoid being burned out.

Place, publisher, year, edition, pages
Umeå: Institutionen för omvårdnad , 2009. , 88 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1243
Keyword [en]
burnt out/non-burnt out, conscience, healthcare personnel, phenomenological-hermeneutics, stress of conscience, PLSR, 16PF
National Category
Nursing
Research subject
Caring Sciences
Identifiers
URN: urn:nbn:se:umu:diva-19666ISBN: 978-91-7264-724-4 (print)OAI: oai:DiVA.org:umu-19666DiVA: diva2:202274
Public defence
2009-03-27, Aulan, Vårdvetarhuset, NUS, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Projects
Samvetsstress i vården
Available from: 2009-03-12 Created: 2009-03-09 Last updated: 2009-03-12Bibliographically approved
List of papers
1. Meanings of becoming and being burnout: phenomenological-hermeneutic interpretation of female healthcare personnel's narratives
Open this publication in new window or tab >>Meanings of becoming and being burnout: phenomenological-hermeneutic interpretation of female healthcare personnel's narratives
2008 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 4, 520-528 p.Article in journal (Refereed) Published
Abstract [en]

The incidence of burnout has increased in many industrialized countries. Burnout is mainly studied among people still at work and with quantitative methods. The present study aimed to illuminate the meanings of becoming and being burnout as narrated by healthcare personnel on sick leave because of symptoms of burnout. Interviews with 20 female healthcare personnel were performed, tape-recorded and transcribed verbatim and a phenomenological-hermeneutic method was used to interpret the text. The result shows that the meanings of becoming and being burnout are to be torn between what one wants to be and what one manages. It is as one's ideals have become more like demands and no matter the circumstances, one must be and show oneself as being capable and independent. It is also to be dissatisfied with oneself for not living up to one's ideals as well as disappointed with other people for not giving the confirmation one strives for. Feelings of being a victim of circumstances emerge. Thus, becoming and being burnout is leading a futile struggle to live up to one's ideal, failing to unite one's ideal picture with one's reality and experiencing an overwhelming feebleness. This is interpreted in the light of Buber's philosophy as well as relevant empirical studies about burnout. One conclusion is that it seems important to reflect on as well as discuss between one another about our everyday reality; what are reasonable vs. unreasonable demands. Hopefully, such reflections will increase our tolerance of ourselves and others and our insightfulness of what is possible to achieve in work as well as in private life. This study is ethically approved.

Place, publisher, year, edition, pages
Umeå: Institutione för omvårdnad, 2008
Keyword
Buber, burnout, conscience, healthcare personnel, phenomenological-hermeneutics, sick leave
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-19654 (URN)10.1111/j.1471-6712.2007.00559.x (DOI)
Projects
Samvetsstress i vården
Available from: 2009-03-09 Created: 2009-03-09 Last updated: 2017-12-13Bibliographically approved
2. Meanings of staying healthy in a context where others developed burnout: phenomenological-hermeneutic interpretation of healthcare personnel's narratives
Open this publication in new window or tab >>Meanings of staying healthy in a context where others developed burnout: phenomenological-hermeneutic interpretation of healthcare personnel's narratives
2009 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 2Article in journal (Refereed) Published
Abstract [en]

Burnout has become a major problem in many industrialized countries, but not everyone at the same work place develops burnout. The present paper aimed to illuminate meanings of staying healthy in a context where others developed burnout as narrated by healthcare personnel. Interviews were conducted with 20 healthcare personnel and were interpreted using a phenomenological-hermeneutic method. The result shows that the meanings of staying healthy are to be rooted in an outlook on life perceiving its many-sidedness and the strengths and weaknesses of oneself and others with forbearance. One is striving to shoulder responsibility for oneself and for others and is also receptive towards the circumstances of life, striving to judge the possibilities of being and acting in order to attempt to influence things in what is believed to be the right direction. Being able to let go of injustice and look after oneself with a clear conscience is also revealed as meanings of staying healthy. In conclusion, forbearance with life's many-sidedness seems to pervade one's experiences, judgements and actions in life when dealing with one's reality, and thus, it is interpreted as essential for staying healthy in a context where others developed burnout. This study is ethically approved.

Place, publisher, year, edition, pages
Umeå: Institutionen för omvårdnad, 2009
Keyword
burnout, conscience, healthcare personnel, inner strength, phenomenological-hermeneutics, sense of coherence, staying healthy
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-19660 (URN)10.1111/j.1471-6712.2008.00641.x (DOI)
Projects
Samvetsstress i vården
Available from: 2009-03-09 Created: 2009-03-09 Last updated: 2017-12-13Bibliographically approved
3. Personality traits among burnt out and non-burnt out healthcare personnel from the same workplaces: a pilotstudy
Open this publication in new window or tab >>Personality traits among burnt out and non-burnt out healthcare personnel from the same workplaces: a pilotstudy
Show others...
(English)Article in journal (Refereed) Submitted
Identifiers
urn:nbn:se:umu:diva-19661 (URN)
Available from: 2009-03-09 Created: 2009-03-09 Last updated: 2009-03-12Bibliographically approved
4. Perceptions of conscience, stress of conscience, moral sensitivity, social support and resilience among burnt out and non-burnt out healthcare personnel from the same workplaces: a pilotstudy
Open this publication in new window or tab >>Perceptions of conscience, stress of conscience, moral sensitivity, social support and resilience among burnt out and non-burnt out healthcare personnel from the same workplaces: a pilotstudy
(English)Article in journal (Refereed) Submitted
Identifiers
urn:nbn:se:umu:diva-19663 (URN)
Available from: 2009-03-09 Created: 2009-03-09 Last updated: 2009-03-12Bibliographically approved

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