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Burnout Syndrome in the Helping Professions

Article in Psychological Reports · March 2002

DOI: 10.2466/PR0.90.1.309-314 · Source: PubMed

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 Psychological Reporfr,2002,90,309-314. O Psychological Reports 2002

BURNOUT SYNDROME IN THE HELPING PROFESSIONS '

PIER CIORGIO GABASSl SARA CERV A1 PATRIZIA ROZBOWShT

Departmetzt of Prycbology Departmen! of Political Scietzces Deparfmenl of Hurnatz Sciences

U t ~ i v e r sof
i ~ Trierte

ARIANNA SEiMERARO DAN0 GREGORI

I/alTbr SpA, Biomedical and Scientt$c Departtnent of Ecotzomics and Sfati.ifics
Technologies University of Trieste

Summary.-Burnout can be d e f i e d as a long-term reaction to occupational stress

which involves, particularly, the helping professions. The main aim of this study was
the assessment of burnout in a sample of professional and voluntary health care work-
ers and comparison of the two samples on scores from the Maslach Burnout Invenco-
ry. Analysis suggests a significant ddference in mean scores for Emotional Exhaustion
of volunteers vs professional workers. Some evidence has supported the hypothesis of
a fourth dimension, called Behavioral Exhaustion, in the burnout syndrome.

Burnout can be considered a reaction to occupational stress. Initially

Freudenberger (1974) defined burnout as a state of emotional exhaustion
based on interactions with other people. The syndrome is most common
among people whose work involves intensive interactions (Jackson, Schwab,
& Schuler, 1986). Maslach and Jackson (1981) identified three dimensions, a
part~cularaspect of emotional exhaustion, depersonalization, and reduced
personal accomplishment.
They devised a measure of 22 items, the Maslach Burnout Lnventory.
The testee rates each item on a 7-point scale for the frequency with which
feehgs are experienced. Anchors are 0 for no experience of the f e e h g
described, and 6 indicates frequent experience. The inventory assesses stress
in the work setting (Belcastro, Gold, & Hays, 1983). The items are distrib-
uted across the three dimensions with 9 on Emotional Exhaustion or the
fatigue related to excess work, 5 items on Depersonalization describe hostil-
ity toward service users, and 8 items on Reduced Personal Accomplishment
concern competence and success in the profession. Originally, external v&-
dation of the Maslach Burnout Inventory was reflected in the correlation of
inventory scores with independent external judgment. Discriminant vahdity
was estimated by other measures such as depression, unhappiness, etc. The
internal consistency of each subscale was estimated with the Cronbach coef-
ficient alpha (Maslach &Jackson, 1981).

Address enquiries to Prof. Pier Giorgio Gabassi, Dipartimento di Psicologia, Universitl de 11

itudi di Trieste, Via S. Anas~asio12, 34131 Trieste, Italy or e-mail (gabassi@pug.uniu.trieste.itf.
 P. G: GABASSI, ET X.

Researchers (Maslach & Pines, 1977; Jackson & Maslach, 1982) have
conducted studies considering different aspects of the work situation (work
load, work state, time spent near people, problems' difficulties, work con-
flicts, etc.). Another job characteristic which could be relevant to burnout is
job motivation. One may infer that highly motivated subjeccs or those who
hke their work are more advantaged than people who work every day in a
place in which they do not feel gratified. A job situation that fulfills ambi-
tions may help workers face their problems at work. The present intent was
to verify whether burnout varies for voluntary and professional workers. If
volunteers have different job motivations than professionals, say, in perceiv-
ing their work as a "vocation," whereas the professional group considers
their work mainly as a source of earning, a different state of mind may char-
acterize the two groups' interactions with service users.

Sample
The sample included 50 health care workers, 25 of whom were volun-
teers, and 25 professionals. The latter belonged to the Association "La Nos-
tra Farniglia," a private religious association which provides professional as-
sistance to physically and mentally dl children 5 to 18 years of age. The sam-
ple ranged in age from 22 to 44 years, and their work experience, measured
by the time belonging to the Association, was from 24 to 240 months (cf.
Table 1).
The volunteers belonged to the Association "La Ginestra," a voluntary
association which organizes several activities (excursions, walks, etc.) for per-
sons with less serious disabhties. Ages in this group ranged from 18 to 68
years and work experience from 3 to 96 months; cf. Table 1.
TABLE 1
MEANA N D RANGEO F AGEAND WORKEXPERIENCE (11s=25)
IN T w o GROUPS

Measure Volunteers Professionals

1M Lower Upper M Lower Upper
QuarriIe Quarule Quarule Quart~le
Age, y r. 30 27 33 30 23 47
Work Experience, rno. 18 18 24 120 72 120

Statistical Methods
Burnout was assessed on the validated Italian version of the Maslach
Burnout Inventory (Sirigatti, Stefanile, & Menoni, 1988). The scoring meth-
od was partially modified: the subjects answered on the original 0 to 6 scale,
but the scores were reweighted using -3 (which corresponds to 0) to + 3
(which corresponds to 6). The median value and the quartiles of the re-
 DIMENSIONS OF BURNOUT AT WORK 3 11

sponses of the two groups were calculated for each item. Lntercorrelations of
responses on the frequency scale were submitted to principal components
factor analysis with varimax rotation. According to the Kaiser criterion, the
first four factors of 22 were selected as significant. Then, interpretation of
the components was based on rotated factor loadings. Reliabdity on Maslach
original scales and new subscales was computed as well as the Cronbach al-
pha.
To examine the ddferences in scores on subscales for the volunteer and
professional groups we estimated a h e a r regression model separately for
each dimension (the Anderson-Rubin rotation, used to derive latent vari-
ables, produces nearly uncorrelated covariates), which has the form:
Ci = Poi + P l j S + 3 Age + ti Work

where C represents the expected value of the dimension j ( i = 1, . . . , 4), S is

a dummy variable with the value of O for the professional group and of 1 for
the volunteer group. Significance was set at an alpha level of 05. Age and
work are two continuous variables indicating, respectively, age m years and
work experience in months. The hypothesis tested was based on PI = 0, as a
test for the equahty of the mean scores on each dmension. The model was
adjusted by age and work experience (y, Age and ti Work), treating both as
potential confounding factors.
RESULTS
Four factors were selected as significant, with a cumulative variance of
.57 captured by the model, cf. Table 2 . To choose the right interpretation of

TABLE 2
E X P ~ N EAND
D CUMULAT~VE
VARIANCE
IN FACTORIAL
MODEL
Component Factor
I I1 111 Iv
Standard Deviation 2.49 1.61 1.39 1.34
Variance Proportion .28 .I1 08 .08
Cumulative Variance .28 .40 -I8 .57

the four components the rotated factor loadings of each item (Table 3) were
analyzed. The first component was called Emotional Exhaustion and coin-
cides with Maslach's first dimension. The second component was called Per-
sonal Accomplishment and coincides with Maslach's second dimension. The
third and the fourth dimensions can be considered parts of the last dimen-
sion of Maslach's subscale of Depersonalization and were defined Behavioral
Exhaustion and Depersonalization.
Tables 4 and 5 summarize the results of the estimated model. For the
three Maslach dimensions, the higher PI value in the first dimension (-6.73;
3 12 P. G. GABASSI, ET AL.

TABLE 3
ROTATEDFACTORLOADINGS

Item Factor
1 I1 I11 IV

p = .0004) seems to indicate that volunteers present a mean score on emo-

tional exhaustion lower than that of professionals. On the other Maslach di-
mensions, scores show that mean ratings of Personal Accomplishment and
Depersonalization are similar and not s~gn~ficantlydifferent (1.90 and -.5).

TABLE 4
L SCALESAND CRONBACH
MODELSFOR O N C I N A MASLACH ALPHA

Dimension a Estimate SE t P
Emotional Exhausdon .90 Po - 5.46 4.39 -1.24 ns
p, - 6.73 1.77 -3.81 ,0004
Y - .09 .12 .74 ns
5 - .06 .03 -1.85 ns
Personal Accomplishment .59 Po 10.76 2.90 3.71 ,0006
PI 1.90 1.17 -1.63 ns
Y - .08 .08 .98 ns
- .04 .02 1.93 ns
Depersonalization .61 Po -12.57 1.95 -6.44 .OOOO
PI -.52 .79 - .66 ns
Y .01 .05 .09 ns
5 .01 .01 33 ns
 DIMENSIONS OF BURNOUT AT WORK 3 13

Considering the four current dimensions, the only significant differ-

ences are evident for the first and the fourth dimensions i ~ m i t i o n a Exhaus-
l
tion and Depersonalization) which present values of PI of -1.58 and -38
with p = .0004 and p = .03. This suggests that, also on these mean ratings, the
volunteers scored lower than professionals.

TABLE 5
MODELS
FORFOURDIMENSIONS
DERIVED
I N PWENTANALYSIS
AND CRONBACH
ALPHA

Dimension Q Estimate SE t P
Emotional Exhauscjon .89 Po 1.24 1.10 1.12 ns

Personal Accomplishment .68 Po

PI
Y
5
Behavioral Exhaustion .48 Po
PI
Y
5
Depersonalization .44 Po
PI
Y
E

Drscuss~o~
The initial hypothesis seems to be confirmed since the comparison of
the mean scores for the two groups shows them to be M e r e n t for the volun-
teers and professionals. Moreover, the estimated model confirms this find-
ing, as the-following analysis of the parameters shows.
The only . significant
- difference between median scores of volunteers and
professionals was on the first Maslach dimension on which volunteers had
lower median ratings of exhaustion than professionals. For the second di-
mension, Personal Accomplishment, the volunteers scored lower; profes-
sionals had higher ratings on Reduced Personal Accomplishment. The struc-
ture of the Maslach Burnout Lnventory, based on our samples' responses,
supports other studies which have suggested the presence of two subscales
(Garden, 1987). The third Maslach dimension was split into two subscales
of Behavioral Exhaustion and Depersonahzation. In other words, responses
from this sample suggest two subscales, not subdimensions of Depersonal-
ization and Behavioral Exhaustion, because the former presents those items
for Depersonalization in the original Maslach factor structure.
Analyzing PI values of the third and the fourth dimensions of Behav-
 3 14 P. G. GABASSI, ET AL.

ioral Exhaustion and Depersonahzation, volunteers seemed less emotionally

exhausted than the professionals; they were less cynical and established bet-
ter relationships with service users.
In the present study the small sample and the small number of covari-
ates, which may potentially influence people's ability to interact, limit gener-
alization. There are some indications consistent with literature that Maslach
burnout may not apply to people with nonstandard motivation, such as the
volunteers in our research. The new subscale may permit more sensitive and
precise rnodehg as research continues with larger and more varied samples.
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Accepled December 26, 2001

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