ABSTRACT
BACKGROUND AND AIMS: Research dealing with occupational strain and burnout in geriatric care is generally focused on the behavioral problems of the patient and/or the psychological traits or attitudes of the carers rather than on organizational functionality. This paper describes data from a survey of all geriatric professions, using the Stressful Events Questionnaire (SEQ), a tool that takes into account multiple dimensions that can affect the genesis of burnout, including the patient, the geriatric health care professional, and the health care organization. The aim of this study is to compare patterns of answers among different roles in geriatric care. METHOD: PATTERNS OF SEQ ANSWERS ARE DESCRIBED FOR THE ENTIRE SAMPLE AS WELL AS FOR WORKERS EXPERIENCING BURNOUT AND FOR EACH CARING PROFESSION INVESTIGATED: certified nursing assistants (CNAs), registered nurses and physicians/psychologists. RESULTS;: In general, carers refer more often as stressful the facility-related events; the only exception is that CNAs working in general hospital geriatric wards refer most often as stressful the patient-related events. The self-related events area seems to have a great importance for all professions. DISCUSSION: The specificity of gerontological burnout has to be discussed, to better define the role played by caring problems, including psychological attitudes of carers versus the role played by the institution and by the social situation of each worker. For CNAs, the interaction between educational background and the length of time spent as a CNA seems to be a critical topic.
ABSTRACT
OBJECTIVE: To compare levels of stress and burnout among staff caregivers in nursing homes and acute geriatric wards of general hospitals. METHODS: A cross-sectional survey was conducted in three nursing homes (total of 522 beds, 270 caregivers) and nine geriatric sections of general hospitals (total of 371 beds, 280 caregivers). Staff caregivers were asked to answer a four-part questionnaire made up of socio-demographic data, the General Health Questionnaire (GHQ-12), the Maslach Burnout Inventory (MBI) and the Stressful Events Questionnaire (SEQ). RESULTS: 355 carers (172 from nursing homes, 183 from acute geriatric wards) answered the questionnaire (response rate 66%). Bivariate analysis reveals that general hospital carers show higher GHQ scores, higher MBI-Depersonalisation (DP) and Emotional Exhaustion (EE) sub-scores and lower MBI-Personal Accomplishment sub-scores. Stressful Events (as revealed by the SEQ) are more frequently reported by general hospital carers, particularly events related to patients' behavioural disorders. Multivariate analysis shows that general hospital work-setting, professional role, female gender and patient/carer ratio are significant explanatory variables of a high MBI-EE sub-score, while general work setting and disability are the best explanatory variables of a high MBI-DP sub-score. Professional role and general hospital work-setting are independent factors in a low MBI-Personal Accomplishment (PA) sub-score. CONCLUSION: These results appear to show that levels of stress and burnout among staff caregivers are moderate in acute geriatric wards, but significantly higher than in nursing homes. This suggests that increasing the rate of trained staff and improving staff support-for instance by the implementation of Consultation-Liaison (C-L) Psychiatry and/or continuing education programmes-could be needed mostly in acute geriatric wards.
