Burnout of Long-term Care Facility Employees: Relationship with Employees' Expressed Emotion Toward Patients

Tanaka, Koji; Iso, Nozomi; Sagari, Akira; Tokunaga, Akiko; Iwanaga, Ryoichiro; Honda, Sumihisa; Nakane, Hideyuki; Ohta, Yasuyuki; Tanaka, Goro

doi:10.1016/j.ijge.2015.04.001

Cited by 18 publications

(16 citation statements)

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“…In LTC settings, the high prevalence of burnout among nurses [ 3 , 17 , 45 , 46 ] and its repercussions on care quality [ 46 , 47 ] have been documented. For instance, higher burnout was associated with lower residential satisfaction [ 15 ], lower perceived quality-of-life [ 15 ], more depressive symptoms among residents [ 15 ], expressed emotions of criticism and hostility toward patients [ 48 ], and inadequate provision of comfort and support care [ 49 ]. Previous research also documented significant associations between hospital nurses’ burnout and negative patient outcomes, such as falls [ 20 , 21 ] and nosocomial infection [ 19 – 21 ].…”

Section: Discussionmentioning

confidence: 99%

The association between nurses’ burnout and objective care quality indicators: a cross-sectional survey in long-term care wards

et al. 2021

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Background Worldwide, rather few studies have examined the association between burnout and care quality using objectively measured quality indicators, with most of the studies have relied on perceived quality outcomes. This study aimed to examine the association between staff nurses’ burnout and selected objective quality metrics in long-term care wards in Japan. Methods This is a secondary analysis of a cross-sectional survey. Nurse managers and staff nurses working at randomly selected hospitals with long-term care wards—the equivalent of skilled nursing homes in Western countries— completed self-administered, anonymous questionnaires. The questionnaires collected data regarding care quality indicators, staff nurses’ burnout, and other confounders (e.g., ward size, participants’ years of experience, and patients’ conditions). All statistical analyses were conducted at the ward level. A multivariate regression analysis was used to examine associations between burnout and outcome indicators. Results Data from 196 wards in 196 hospitals (196 nurse managers and 2473 staff nurses) across Japan were analyzed. Multivariate regression analysis showed that higher emotional exhaustion was associated with higher rates of pneumonia and pressure ulcers (p-value = .036 and .032, respectively), and that reduced personal accomplishment was associated with higher rates of tube feeding (p-value = .018). A larger ward size was also associated with low rates of pneumonia (regression coefficient = −.001, p-value = .019). Conclusions Staff nurses’ burnout is a significant determinant of care quality in long-term care wards, implying that organizations that implement burnout reducing strategies may see greater benefits in patient outcomes. A large ward size was significantly associated with better care outcomes—specifically, low rates of pneumonia. Future research needs to determine feasible quality improvement measures in small-scale long-term care facilities, and to provide more comprehensive insights on ward-level variables that influence care quality in long-term care settings.

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Section: Discussionmentioning

confidence: 99%

The association between nurses’ burnout and objective care quality indicators: a cross-sectional survey in long-term care wards

et al. 2021

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“…We only examined burnout and stress in long-term care settings and it would be unsurprising if this varied between settings. For example, two studies in Japan in intermediate care and psychiatric hospitals reported high levels of burnout and stress in care staff (Tanaka et al 2015,Yada et al 2014). This may be because of higher care needs and more challenging behavioural symptoms of patients which are associated with burnout level of staff (Agoub, Elyazaji et al 2000).…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta-analysis of the prevalence and associations of stress and burnout among staff in long-term care facilities for people with dementia

Costello

Walsh

Cooper

et al. 2018

Int. Psychogeriatr.

108

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Background:Care home staff stress and burnout may be related to high turnover and associated with poorer quality care. We systematically reviewed and meta-analyzed studies reporting stress and burnout and associated factors in staff for people living with dementia in long-term care.Methods:We searched MEDLINE, PsycINFO, Web of Science databases, and CINAHL database from January 2009 to August 2017. Two raters independently rated study validity using standardized criteria. We meta-analyzed burnout scores across comparable studies using a random effects model.Results:17/2854 identified studies met inclusion criteria. Eight of the nine studies reporting mean Maslach Burnout Inventory (MBI) scores found low or moderate burnout levels. Meta-analysis of four studies using the 22-item MBI (n = 598) found moderate emotional exhaustion levels (mean 18.34, 95% Confidence Intervals 14.59–22.10), low depersonalization (6.29, 2.39–10.19), and moderate personal accomplishment (33.29, 20.13–46.46). All three studies examining mental health-related quality of life reported lower levels in carer age and sex matched populations. Staff factors associated with higher burnout and stress included: lower job satisfaction, lower perceived adequacy of staffing levels, poor care home environment, feeling unsupported, rating home leadership as poor and caring for residents exhibiting agitated behavior. There was preliminary evidence that speaking English as a first language and working shifts were associated with lower burnout levels.Conclusions:Most care staff for long-term care residents with dementia experience low or moderate burnout levels. Prospective studies of care staff burnout and stress are required to clarify its relationship to staff turnover and potentially modifiable risk factors.

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“…A systematic review by Cooper et al [10] showed that individual demographic factors such as being married, older, more educated, and having a sense of optimism had a buffering effect on burnout. In Japan, Tanaka et al [11] reported that burnout was related to feelings of criticism and hostility towards residents among long-term care facility employees. To the best of our knowledge, however, relationships between burnout, provision of end-of-life care and religion in long-term care facilities have not been discussed.…”

Section: Introductionmentioning

confidence: 99%

A positive attitude towards provision of end-of-life care may protect against burnout: Burnout and religion in a super-aging society

et al. 2018

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AimThe aim of our study was to investigate factors associated with burnout of nurses and care workers in nursing homes and geriatric hospitals in Japan. The use of Buddhist priests, the major religion in Japan, was also explored.MethodsQuestionnaires for nurses and care workers were sent to 10 care facilities. The survey questions included basic demographic information, the Japanese Burnout Index and the Japanese version of the Frommelt Attitude Toward Care Of Dying Scale Form B. They also asked questions about use of Buddhist priests for tasks such as helping to manage the anxiety or distress of patients, families, and staff, or providing sutra chanting.ResultsIn total, 323 questionnaires were returned, of which 260 were used for analysis. Only 18 (6.9%) answered that they had any religious beliefs, which was relatively low compared to 27% from governmental survey data. In total, however, 71% expressed a need for Buddhist priests to help with anxiety or distress among patients. A positive attitude towards providing end-of-life care was a protective factor against depersonalization. It was, however, also related to lower feelings of personal accomplishment.ConclusionCare homes and geriatric hospitals may want to consider calling more on religious resources as a support for staff and patients.

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Burnout of Long-term Care Facility Employees: Relationship with Employees' Expressed Emotion Toward Patients

Cited by 18 publications

References 20 publications

The association between nurses’ burnout and objective care quality indicators: a cross-sectional survey in long-term care wards

The association between nurses’ burnout and objective care quality indicators: a cross-sectional survey in long-term care wards

A systematic review and meta-analysis of the prevalence and associations of stress and burnout among staff in long-term care facilities for people with dementia

A positive attitude towards provision of end-of-life care may protect against burnout: Burnout and religion in a super-aging society

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