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HEALTH AND WELLNESS 1/2014 WELLNESS AND TEAM CHAPTER V Department of Psychiatric Nursing Faculty of Nursing and Health Sciences Medical University of Lublin Zakład Pielęgniarstwa Psychiatrycznego Uniwersytetu Medycznego w Lublinie RENATA MARKIEWICZ Professional burnout among psychiatric nurses - analysis of factors Wypalenie zawodowe wśród pielęgniarek psychiatrycznych - analiza czynników Key words: professional burnout, nursing, socio-demographic factors, the scale of professional burnout Słowa kluczowe: wypalenie zawodowe, pielęgniarki, czynniki socjodemograficzne, skala wypalenia zawodowego Professional burnout is a discomfort experienced in relation to work, it is the dif- ference between the resources available to the person and the costs which the work incurs during its execution [2]. The cause of loss of resources is the chronic stress and the lack of skills which could be used to alleviate the stress [1]. Significant scope of responsibilities at work, fatigue, high expectations, interpersonal conflicts are just some of the factors that contribute to the cascade of stress reactions which in turn lead to emotional problems and disorders in the daily functioning of an individ- ual [6]. And although every person has different personality traits, everyone experi- ences stress in a similar way when exposed to it. Stress in a greater or lesser extent limits our intellectual capacity and has an impact on our well-being, both mental and physical, causing a variety of disease states [11]. This adverse influence is present especially among employees performing medical professions [3]. It can cause a number of undesirable behaviors as a result of which mistakes, negligence, inade- quate assessment of patients and wrong perception of patients’ problems may occur. Staff employed in psychiatric wards is a particularly high-risk group [1,8]. It is in

Professional burnout among psychiatric nurses - analysis of factors · Wypalenie zawodowe wśród pielęgniarek psychiatrycznych -analiza czynników Key words: professional burnout,

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HEALTH AND WELLNESS 1/2014

WELLNESS AND TEAM

CHAPTER V

Department of Psychiatric Nursing Faculty of Nursing and Health Sciences

Medical University of Lublin

Zakład Pielęgniarstwa Psychiatrycznego

Uniwersytetu Medycznego w Lublinie

RENATA MARKIEWICZ

Professional burnout among psychiatric nurses

- analysis of factors

Wypalenie zawodowe wśród pielęgniarek psychiatrycznych

- analiza czynników

Key words: professional burnout, nursing, socio-demographic factors, the scale of

professional burnout

Słowa kluczowe: wypalenie zawodowe, pielęgniarki, czynniki socjodemograficzne,

skala wypalenia zawodowego

Professional burnout is a discomfort experienced in relation to work, it is the dif-

ference between the resources available to the person and the costs which the work

incurs during its execution [2]. The cause of loss of resources is the chronic stress

and the lack of skills which could be used to alleviate the stress [1]. Significant

scope of responsibilities at work, fatigue, high expectations, interpersonal conflicts

are just some of the factors that contribute to the cascade of stress reactions which in

turn lead to emotional problems and disorders in the daily functioning of an individ-

ual [6]. And although every person has different personality traits, everyone experi-

ences stress in a similar way when exposed to it. Stress in a greater or lesser extent

limits our intellectual capacity and has an impact on our well-being, both mental and

physical, causing a variety of disease states [11]. This adverse influence is present

especially among employees performing medical professions [3]. It can cause a

number of undesirable behaviors as a result of which mistakes, negligence, inade-

quate assessment of patients and wrong perception of patients’ problems may occur.

Staff employed in psychiatric wards is a particularly high-risk group [1,8]. It is in

HEALTH AND WELLNESS 1/2014

Wellness and team

54

such institutions where the (physical, psychological) burden is two times greater

than in other work contexts. In analyzing various factors it is worth identifying those

that have a negative impact and contribute to the development of burnout syndrome

as well as those that protect against it. Their recognition will allow executing both

measures reducing the occurrence of existing threats and promoting positive behav-

iors which decrease the risk of the development of the syndrome.

This paper presents an analysis of socio-demographic variables and analysis of

the relationships between professional burnout scales which may have an impact on

the development of burnout syndrome.

MATERIAL AND METHODS

The study presents an analysis of the socio-demographic variables and the analy-

sis of the relationship between the scales of professional burnout in nurses working

in the Mazowieckie Specialistyczne Centrum Zdrowia w Pruszkowie. Participation

in the study was voluntary. The survey was conducted in July 2012, based on the list

which contained closed-ended questions. The obtained data were analyzed quantita-

tively and statistically basing on the Spearman's rank correlation coefficient, Mann–

Whitney U test and a chi-squared test.

RESULTS

The analysis of the results were divided into two parts. The first part examined

the relationship between socio-demographic variables and the level of the individual

scales of burnout, that is:

1) active professional burnout: emotional involvement in work, stigmatizing the

mentally ill, overload of responsibilities at work, experiencing negative emo-

tions related to work, supererogation, a need to be perfect, the assessment of

the employer;

2) warning signals of passive professional burnout in the sphere of: psychologi-

cal activity, activity, somatic disorders, interpersonal relations;

3) passive full-blown professional burnout in the sphere of: psychological activ-

ity, activity, somatic disorders, interpersonal relations. The second part exam-

ines the relationship between the individual scales of professional burnout.

CHARACTERISTICS OF RESPONDENTS

The study involved 60 people. The vast majority were women (95%), most of

them aged 35 to 49 years. 53.3% of the nurses surveyed had secondary vocational

education while 6.7% had higher education with specialization. Married individuals

accounted for 68.3% of the respondents while the nurses having children constituted

81.7% of all the people surveyed. 66.7% of the nurses evaluated the relationships in

their families as good. 70% of respondents rated their financial situation as good.

The vast majority of nurses indicated that they like their job (88.3%). Permanent

employees constituted 90% of the people. The biggest share in the group of re-

Renata Markiewicz

Professional burnout among psychiatric nurses - analysis of factors

55

spondents were people with job seniority in the psychiatric ward exceeding 22 years

(70%) while the smallest share was formed by the individuals with job seniority in

the range of 0-4 years (17%). 70% respondents answered that the place they work in

was the place of their own choice. Only for 16.67% of the people surveyed the

choice of their workplace was arbitrary. 78.3% of nurses were those who quickly

adapted to working in the psychiatric ward (up to 1 month) and only 11.67% said

they had difficulty with adaptation (up to 3 months). Most of the nurses surveyed

took basic training regarding the applicable safety rules in the workplace (51.7%).

Professional training related to the introduction to work in the psychiatric ward was

attended by 43.3% of the nurses.

I. ANALYSIS OF SOCIO-DEMOGRAPHIC VARIABLES

To determine whether the age of the respondents is related to the level of profes-

sional burnout, Spearman's correlation analysis was performed. The analyses re-

vealed no statistically significant relationships. It was also examined whether wom-

en differ from men in terms of the levels of individual scales of professional burn-

out. For this purpose, the analysis was carried out with the use of the Mann–Whitney

U test. The analysis showed that women (M = 1.8) had a higher level of emotional

involvement in their work in comparison with men (M = 1.1): Z = 2.02; p = 0.043

(tab.1).

Table 1. Descriptive statistics for the level of emotional involvement in work, grou-

ped by gender Gender Average Standard deviation

Women 1,84 0,68

Men 1,05 0,27

Chart 1. The level of emotional involvement in work, grouped by gender

0

0,2

0,4

0,6

0,8

1

1,2

1,4

1,6

1,8

2

Women Men

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56

For the remaining professional burnout scales no statistically significant differ-

ences between men and women were noticed. It was verified if among people of

different marital status there are differences in the level of their professional burn-

out in different scales. The analysis was performed with the use of Kruskal-Wallis

test, which showed no statistically significant differences between the analyzed

groups. Using the Spearman's rank correlation, the relationship between the place of

residence and the financial situation of respondents on one hand and professional

burnout level on the other hand was analyzed (tab. 2).

Table 2. The Spearman's rank correlation coefficient between the age of respondents

and the level of professional burnout

Professional burnout scale Spearman's rank correlation

coefficient

Statistical

significance

Overload of duties at work 0,26 0,044

Warning signals of passive professional

burnout in the sphere of activity 0,29 0,027

The analyses showed that there was a relationship between the place of residence

of the nurses surveyed and a predisposition to develop the professional burnout

syndrome. People who live in smaller towns were more overburdened with duties at

work and had a higher level of warning signals of passive professional burnout in

the sphere of activity.

Also, the Spearman's correlation analysis showed a statistically significant rela-

tionship between the financial situation of respondents and the degree to which they

are overburdened with duties at work: rho = 0,44; p < 0,001. As the research

shows, an individual’s worse evaluation of their material situation has an impact on

the overload of duties at work.

It was examined whether the level of education of respondents was significantly

connected with the level of professional burnout. The Spearman's rank correlation

showed a significant relationship: rho = -0,37; p < 0,001. This means that the level

of education of nurses surveyed has an impact on their work with the mentally ill.

Individuals with higher education show respect and understanding towards those

people and therefore run a lower risk of developing the burnout syndrome. On the

other hand, the analysis by means of the Mann–Whitney U test showed no statisti-

cally significant differences between respondents having and not having children in

terms of professional burnout level in the individual scales and the respondents’

perceived relationships in the family.

It was studied whether the persons employed on the basis of permanent con-

tracts differ in terms of professional burnout from those employed on the basis of

fixed-term contracts (tab.3).

Renata Markiewicz

Professional burnout among psychiatric nurses - analysis of factors

57

Table 3. Descriptive statistics for the level of warning signals and passive full-blown

professional burnout in the sphere of interpersonal relations, divided according to

the type of employment

Sphere of interpersonal

relations Employment Average

Standard

deviation

Warning signals of pro-

fessional burnout

Permanent 0,98 0,61

Fixed-term 0,48 0,41

Fullblown professional

burnout.

Permanent 0,69 0,52

Fixed-term 0,31 0,51

The analysis by means of the Mann–Whitney U test showed that persons em-

ployed for an indefinite period had higher levels of warning signals and a greater

degree of full-blown professional burnout in the sphere of interpersonal relations,

respectively: Z = 2,10; p = 0,036 and Z = 2,07; p = 0,038 in comparison with indi-

viduals employed on the basis of fixed-term contracts.

Chart 2. The level of warning signals and passive full-blown professional burnout

in the sphere of interpersonal relations, divided according to the type of employment

This was followed by the Spearman's correlation analyses between the level of

burnout in respondents, their total work experience and job seniority in the psychiat-

ric ward. The analyzes showed that the longer (total) work experience of respond-

ents, the higher their level of emotional involvement in work (rho = 0.27, p = 0.037)

and the higher their level of responsibilities overload at work (rho = 0.31, p = 0.016

). Similar results were obtained in relation to persons employed in psychiatric wards

(rho = 0.28, p = 0.031).

0

0,1

0,2

0,3

0,4

0,5

0,6

0,7

0,8

0,9

1

Permanent Fixed term Permanent

Fixed term

Warning signals of professional burnout

Full-blown professional

burnout

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58

Also, the analysis conducted with the use of the Kruskal-Wallis test showed sta-

tistically significant differences between the individuals who deliberately chose their

place of employment and the level of passive full-blown professional burnout in the

sphere of interpersonal relations: chi2(2) = 7,06; p = 0,029 (tab.4).

Table 4. The average level of passive full-blown professional burnout in the sphere

of interpersonal relations, divided according to the reason for choosing a place of

work Reason Average Standard deviation

Person’s own choice 0,58 0,55

Arbitrary 1,01 0,41

Other reasons 0,57 0,37

The individuals who began working in the psychiatric ward “by accident” had

higher levels of passive full-blown professional burnout in the sphere of

interpersonal relations compared to those who consciously made the choice concern-

ing their place of work.

Chart 3. The level of passive full-blown professional burnout in the sphere of inter-

personal relations, divided according to the reason for choosing a place of work

Correlation analysis showed no statistically significant relationship between the

level of professional burnout and the length of the period of adaptation to work in a

psychiatric ward.

0

0,2

0,4

0,6

0,8

1

1,2

Person’s own choice Arbitrary Other reasons

Reason for choosing a place of work

Renata Markiewicz

Professional burnout among psychiatric nurses - analysis of factors

59

In order to check whether there is a relationship between the respondents’ appre-

ciation of the their own job and the level of professional burnout, the Spearman's

correlation analyses were performed(tab.5).

Table 5. Spearman's rank correlation coefficient between the persons’ liking their

own job and the level of professional burnout

Passive full-blown profes-

sional burnout

Spearman's rank

correlation

coefficient

Statistical

significance

In the sphere of psychological

activity 0,29 0,024

In the sphere of activity 0,33 0,011

The analyzes showed that the less the respondents appreciated their job (no satis-

faction) the higher was their level of the passive full-blown professional burnout in

the sphere of psychological activity and in the sphere of activity.

In order to check whether there is a relationship between the level of training

which the respondents have attended before starting to work on the ward and the

level of professional burnout, the Spearman's correlation analyses were performed

(tab.6).

Table 6. Spearman's rank correlation coefficients between the level of training

which the respondents attended before starting to work on the ward and the level of

professional burnout

Professional burnout scale Spearman's rank

correlation coefficient

Statistical

significance

Active professional burnout

Emotional involvement in work 0,04 0,736

Stigmatizing the mentally ill -0,28 0,033

Overload of responsibilities at work -0,04 0,757

Experiencing negative emotions related to work -0,27 0,041

Supererogation, a need to be perfect 0,06 0,651

Assessment of the employer 0,24 0,062

Warning signals of passive professional burnout

In the sphere of psychological activity -0,31 0,019

In the sphere of activity -0,25 0,059

In the sphere of somatic disorders -0,32 0,013

In the sphere of interpersonal relations -0,31 0,017

Passive full-blown professional burnout

In the sphere of psychological activity -0,31 0,016

In the sphere of activity -0,31 0,015

In the sphere of somatic disorders -0,37 0,004

In the sphere of interpersonal relations -0,28 0,030

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The analyses showed that the individuals who received professional training be-

fore starting to work on the ward showed more understanding towards mentally ill

people, had a lower level of experiencing negative emotions associated with the

work, lower level of warning signals of passive professional burnout (in the spheres

of psychological activity, somatic disorders and interpersonal relations) and lower

level of passive full-blown professional burnout in each of the studied spheres.

II. THE ANALYSIS OF RELATIONSHIP BETWEEN PROFESSIONAL

BURNOUT SCALES

In the remaining part of the paper it was examined whether there are connections

between the active burnout scales and passive burnout scales, both with regard to

warning signs and a full blown burnout (tab.7)

Tab. 7. Spearman's rank correlation coefficients between the active burnout scales

and passive burnout scales

Passive professional burnout Sphere Active professional burnout

WA1 WA2 WA3 WA4 WA5 WA6

Warning signs

Psychological activity 0,51* 0,39* 0,20 0,47* 0,11 -0,20

Activity 0,53* 0,32* 0,29* 0,49* 0,06 -0,19

Somatic disorders 0,45* 0,30* 0,17 0,48* 0,14 -0,17

Interpersonal relations 0,45* 0,31* 0,14 0,46* 0,17 -0,20

Full-blown

professional burnout

Psychological activity 0,44* 0,31* 0,19 0,56* 0,21 -0,28*

Activity 0,37* 0,26* 0,16 0,60* 0,12 -0,24

Somatic disorders 0,44* 0,44* 0,31* 0,57* 0,04 -0,13

Interpersonal relations 0,42* 0,25* 0,13 0,50* 0,19 -0,18

* p < 0,05

WA1 Emotional involvement in work, WA2 Stigmatizing the mentally ill, WA3

Overload of responsibilities at work, WA4 Experiencing negative emotions related

to work , WA5 Supererogation, a need to be perfect, WA6 Assessment of the em-

ployer

The correlation analyses showed positive connections between emotional in-

volvement in work, the level of warning signals and the level of full-blown profes-

sional burnout in all analyzed spheres. As can be seen from the analysis, the burden

related to stigmatizing the mentally ill in the environment as well as the negative

Renata Markiewicz

Professional burnout among psychiatric nurses - analysis of factors

61

emotions felt in connection with work have an impact on the development of profes-

sional burnout syndrome, both in terms of warning signs and symptoms associated

with the full-blown burnout syndrome.

Positive attitude of employers to employees substantially reduces the develop-

ment of this syndrome (mainly in the sphere of psychological activity). This was

followed by the Spearman's correlation analyses between the level of warning sig-

nals and passive full-blown professional burnout in different spheres (tab. 8).

Table 8. The correlation coefficients between the level of warning signals of passive

professional burnout and the passive full-blown professional burnout in different

spheres Full-blown pro-

fessional burnouts

in the spheres

Warning signs in the spheres

Psychological activ-

ity Activity

Somatic disor-

ders

Interpersonal

relations

Psychological

activity - 0,92* 0,85* 0,86*

Activity 0,92* - 0,77* 0,80*

Somatic disorders 0,85* 0,77* - 0,82*

Interpersonal

relations 0,86* 0,80* 0,82* -

* p < 0,05

The correlation analyses have shown a statistically significant relationship be-

tween the level of the warning signals and the level of full-blown professional burn-

out in all analyzed spheres. This means that the warning signals of professional

burnout syndrome in different spheres of life essentially contribute to the develop-

ment of the full-blown-syndrome.

CONCLUSIONS

1. Gender, place of residence, financial situation and the level of education have an

impact on the development of burnout syndrome among the nurses surveyed.

Marital status and having children do not have this type of impact.

2. Stigmatizing the mentally ill, experiencing negative emotions at work, overload

of responsibilities at work, many-years’ job seniority and arbitrary selection of

the place of employment are the cause of burnout syndrome among nurses work-

ing in psychiatric wards.

3. Positive attitude of employers to employees, nurses’ performing official duties

with passion as well as professional training prevent the development of burnout

syndrome. The employer’s goodwill and providing employees with opportunities

of personal development, improving the employees’ professional skills and

broadening their professional qualifications are undoubtedly the elements which

are strongly recommended to be continued.

4. The analysis of negative factors is the basis for the conclusion that there is a need

to provide personnel with training courses on the techniques of reducing stress,

HEALTH AND WELLNESS 1/2014

Wellness and team

62

educate the public in respect of mental health, and adequately determine re-

quirements for particular job positions, taking into consideration personal pre-

dispositions of employees. Some of the alternative activities worth considering

are: self-diagnosis, psychological support for staff and the introduction of de-

briefing procedures.

DISCUSSION

The paper presents an analysis of the socio-demographic situation and an analy-

sis of the factors of individual scales of occupational burnout that may affect the

development of occupational burnout among nurses. The work is divided into two

parts. The first one examines relationships between socio-demographic variables and

the level of individual scales of occupational burnout which are related to:

1) active occupational burnout: emotional involvement in work, stigmatization

of the mentally ill, being overburdened with duties, experiencing negative

emotions related to work, excessive sense of duty, sense of perfection, the as-

sessment of the employer;

2) warning signs of passive occupational burnout and a full-blown burnout syn-

drome in the above-mentioned areas.

The second part examines relationships between individual scales.

The study has been conducted among 60 nurses working in psychiatric wards in

Mazowieckie Specjalistyczne Centrum Zdrowia1 in Pruszków.

The analysis shows that sex, place of residence, financial situation and education

influence the development of burnout syndrome in the studied group of nurses. Neg-

ative impact is also exerted by the following factors: stigmatizing the mentally ill

and, as a result, perceiving care providers (nurses) in a similar way, experiencing

negative emotions, being overburdened with duties, considerable job seniority and

choosing the place of employment in a random way. These negative factors may be

transferred to the relationships in family and atmosphere at home. These assump-

tions are confirmed in the study by Lewandowska, who states that 25% of nurses

experience problems in family relationships due to the situation in the workplace

[5].

On the other hand, in their studies Płotka et al [7] agree that the most over-

whelming factors related to the risk are: personal security - 71.7%, barely visible

effects of work - 68.3%, inadequate remuneration system - 63.3%, helplessness and

limited possibilities to help some patients - 56.7%, as well as working at nights -

56.7%.

1 The center does not have an official English name but its Polish name could be translated as Ma-

zowiecki Specialist Health Center.

Renata Markiewicz

Professional burnout among psychiatric nurses - analysis of factors

63

The mentioned factors undoubtedly influence the health condition (both mental

and physical) of the nursing staff and sometimes contribute to serious health prob-

lems.

The research conducted by Markiewicz [7] shows that in the studied group of

nurses, the most common warning signs in the psychological sphere include the

sense of overwork - 35%, in the sphere of activity: lack of eagerness to work - 25%

and the overall feeling of fatigue - 20%, in the field of somatic disorders: sleep prob-

lems - 22% while in the sphere of interpersonal relationships: lack of patience - 12

%. Similar results have been obtained in the studies by Lewandowska et al, who

mention the following physical symptoms of occupational burnout: fatigue and

overwork - 79%, pain in the spine - 57% and the following mental symptoms: irrita-

bility - 46%, worse mood - 46 %, lack of motivation to work - 35% and sleep disor-

ders - 16% (Lewandowska 2009). Grzywa et al mention also headache - 47%, pain

in the spine - 44% and irritability - 17% [4].

The analysis of negative factors is the basis for the conclusion that there is a need

of: personnel training courses aiming at the reduction of stress, education of the

public in the field of mental disorders and adequate determination of the require-

ments for particular job positions taking into account personality predispositions of

employees. From among a variety of alternative activities it is worth considering

psychological support and assistance in crisis situations related to work. Undoubted-

ly, favorable attitude of the employer, providing employees with opportunities of

personal development, improvement and development of professional qualifications

are the elements that should be strongly encouraged.

REFERENCES

1. Anczewska M. Stres i wypalenie zawodowe u pracowników psychiatrycznej

opieki zdrowotnej. Instytut Psychiatrii i Neurologii, Warszawa 2006.

2. Dudek B., Koniarek J., Szymczak W. Stres związany z pracą a teoria zachowania

zasobów Stevana Hobfolla. Medycyna nr 58 (4),317-325, 2007.

3. Fengler J. Pomaganie męczy, Gdańskie Wydawnictwo Psychologiczne, Gdańsk

2001.

4. Grzywa T., Cieślik A. Praca pielęgniarki w oddziale psychiatrycznym zamknię-

tym a zespół wypalenia zawodowego, Ann UMCS nr 58 (13), 2003.

5. Lewandowska A., Litwin B. Wypalenie zawodowe jako zagrożenie w pracy

pielęgniarki. Roczniki Pomorskiej Akademii Medycznej, Szczecin 2009.

6. Litzke S., Schuh H. Stres, mobing i wypalenie zawodowe. Gdańskie Wydawnic-

two Psychologiczne, Gdańsk 2006.

7. Markiewicz R. The symptoms of burnout syndrome among nurses working in

psychiatric wards. Health and Wellness, Wydawnictwo NeuroCentrum, Lublin,

nr 3,101-113, 2013.

8. Maslach C. Wypalenie w perspektywie wielowymiarowej. [in:] Sęk H.(ed.) Wy-

palenie zawodowe. Przyczyny i zapobieganie, PWN, Warszawa 2004.

HEALTH AND WELLNESS 1/2014

Wellness and team

64

9. Płotka A., Pitek A., Makara-Studzińska M. Stres a zespół wypalenia zawodowe-

go. Pielęgniarstwo, nr 5 (40), 26-30, 2000.

10. Terelak J. Psychologia stresu, Oficyna Wydawnicza Branta, Bydgoszcz 2001.

11. Uszyński M. Stres i antystres - patomechanizm i skutki zdrowotne, Wydawnic-

two MedPharm Polska, Wrocław 2009.

ABSTRACT

Nurses working in psychiatric wards constitute “a bridge between the world of

the patient's psychotic experiences and the outside world”. Therefore society often

perceives them through the prism of the patient. This perception is a stress factor,

though it is not the only essential component of nurses’ work. Among other factors

are: significant workload, excessive requirements, improper communication, inter-

personal conflicts, lack of opportunities for personal development. There are, how-

ever, also the factors that relate to situations occurring outside work. Undoubtedly,

these include living conditions, level of education, place of residence, family situa-

tion, financial situation. They also can also form stressful situations, which conse-

quently may be an indirect cause of burnout syndrome. The present study analyzed

the socio-demographic situation of the respondents and factors from individual

scales of professional burnout. Basing on the results, an attempt has been made to

single out the threatening factors and alternatives have been presented.

STRESZCZENIE

Pielęgniarki zatrudnione w oddziałach psychiatrycznych stanowią ,,pomost łą-

czący świat przeżyć psychotycznych pacjenta ze światem zewnętrznym” stąd częste

postrzeganie ich przez społeczeństwo poprzez pryzmat pacjenta. Takie postrzeganie

stanowi czynnik stresujący, chociaż - nie tylko on jest w pracy pielęgniarek istotny.

Wśród innych wymienić należy: obciążenie obowiązkami, nadmierne wymagania,

niewłaściwą komunikację, konflikty interpersonalne, brak możliwości osobistego

rozwoju. Istnieją jednak i takie czynniki, które dotyczą sytuacji występujących poza

pracą. Niewątpliwie należą do nich: warunki materialne, poziom wykształcenia,

miejsce zamieszkania, sytuacja rodzinna, sytuacja finansowa. One również mogą

stanowić sytuacje stresujące, które w konsekwencji mogą być pośrednią przyczyną

rozwoju zespołu wypalenia. W prezentowanej pracy analizie poddano sytuację so-

cjodemograficzną badanych oraz czynniki z poszczególnych skal wypalenia zawo-

dowego. Na podstawie uzyskanych wyników dokonano próby wyodrębnienia czyn-

ników zagrażających oraz zaprezentowano alternatywne rozwiązania.

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