The vulnerability to burn out in healthcare personnel according to the Stoyanov-Cloninger model: evidence from a pilot study
Keywords:Burn out, personality, psychological climate, resilience, vulnerability
AbstractBackground: The vulnerability to burn out is determined by the specific interaction of the two domains – personality disposition and complementary anomalies in the psychological climate of the work place. Our basic hypotheses include inferences in 3 different, but strongly associated dimensions: specific personality traits as measured by the Temperament and Character Inventory (TCI-R) will reveal profiles of vulnerability vs. resilience to burn out; dimensions of the psychological climate will elicit the relevant precipitating factors determining burn out and dimensions where significant relations between personality structure, psychological climate and burn out are anticipated.Aim: To design a complex person-centered model (battery of assessment tools) for early detection of burn out in populations of healthcare employees at risk and to determine the profile of the individual vulnerability to burn out both in terms of personality and psychological climate.Methods: Based on a literature research, 5 healthcare personnel risk groups were identified as being highly affected by burn out syndrome: (i) general practitioners; (ii) palliative care physicians and nurses; (iii) psychiatrists; (iv) oncologists & (v) emergency and intensive care personnel. The battery was tested on 73 randomly selected healthcare professionals from the above-mentioned groups.The following methods were employed in our cross-sectional study in order to construct the assessment battery: Personality Profile Inventory: TCI-R – 240 items; Inductive Measurement of Psychological Climate - 40 items Psychological Climate Inventory (courtesy of Koys and DeCotiis); Measurements of burn out as control condition – 22 items Maslach Burn Out Inventory.Results: Temperamental traits (harm avoidance and persistence) and Character dimensions (self-directedness and cooperativeness) have been largely correlated with burn out performance, mostly represented by emotional exhaustion, de-personalization and reduced personal accomplishment and result from psychological climate impact, mediated by 8 basic criteria: independence, unity, confidence, pressure, support, recognition, honesty and innovation.Conclusion: We have identified so far two groups of vulnerability (proneness) and protective (resilience) factors in relevance with the emergence of burn out syndrome in healthcare personnel. The vulnerability is defined with the following constellations: (i) high levels of harm avoidance in combination with pressure leads to high emotional exhaustion; (ii) high persistence in combination with low autonomy leads to low personal accomplishment and high emotional exhaustion. The resilience is outlined with the following constellations: (i) high persistence with high autonomy determines high personal accomplishment and low emotional exhaustion; (ii) self-directedness is an independent indicator of resilience: (iii) high personal accomplishment and low emotional exhaustion (i.e. protects from burn out regardless of the psychological climate at workplace) & (iv) cooperativeness in combination with high cohesion determines a low level of de-personalization. Also, cohesion and fairness from the Psychological Climate Inventory define resilience to burn out as independent indicators.
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