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  1. 1. Burnout, WorkBurnout, Work Engagement andEngagement and PerformancePerformance Evangelia Demerouti, PhDEvangelia Demerouti, PhD Athens, May 2004Athens, May 2004
  2. 2. OutlineOutline • Burnout: backgroundBurnout: background • Measurement of BurnoutMeasurement of Burnout • Research FindingsResearch Findings • EngagementEngagement • Burnout InterventionsBurnout Interventions
  3. 3. Burnout: ‘discovery’Burnout: ‘discovery’ • Since 1974 (Freudenberger)Since 1974 (Freudenberger) • Definition: Syndrome of emotionalDefinition: Syndrome of emotional exhaustion, depersonalisation, andexhaustion, depersonalisation, and reduced personal accomplishment thatreduced personal accomplishment that can occur among people who docan occur among people who do “people work” of some kind“people work” of some kind (Maslach,(Maslach, 1982)1982) • Main cause: Emotional demands posedMain cause: Emotional demands posed by clientsby clients
  4. 4. Burnout: reasons for interestBurnout: reasons for interest • Negative consequences for employeesNegative consequences for employees (lack of interest in work – existential(lack of interest in work – existential doubts)doubts) • Consequences for clients (low quality ofConsequences for clients (low quality of service)service) • High costs for organizationsHigh costs for organizations • Its excessive spread (around 20% ofIts excessive spread (around 20% of the employees)the employees) • Important social problem but stillImportant social problem but still unclear conceptunclear concept
  5. 5. Causes of burnoutCauses of burnout • Work pressureWork pressure • Emotional demandsEmotional demands • Role problemsRole problems • Work-family conflictWork-family conflict • Social supportSocial support • FeedbackFeedback • Participation in decision makingParticipation in decision making
  6. 6. Consequences of burnoutConsequences of burnout Individual levelIndividual level • DepressionDepression • Psychosomatic complaintsPsychosomatic complaints • InfectionsInfections Work-related attitudesWork-related attitudes • Job satisfactionJob satisfaction • Organizational commitmentOrganizational commitment • Turnover intentionTurnover intention Organizational levelOrganizational level • AbsenteeismAbsenteeism • TurnoverTurnover
  7. 7. Burnout and PersonalityBurnout and Personality • NeuroticismNeuroticism • Low extraversionLow extraversion • Low hardinessLow hardiness • External locus of controlExternal locus of control • Low self-esteemLow self-esteem • Type A personalityType A personality • Passive coping stylePassive coping style
  8. 8. Depression vs. BurnoutDepression vs. Burnout (clinical)(clinical) DepressionDepression • Depressive moodDepressive mood • Unhappiness,Unhappiness, displeasuredispleasure • Weight lossWeight loss • FearfulnessFearfulness • Sleeping problemsSleeping problems (wake up early)(wake up early) • Guilt feelingsGuilt feelings • Suicide thoughtsSuicide thoughts • IndecisivenessIndecisiveness • Attribution of theAttribution of the problem: sicknessproblem: sickness • GeneralGeneral • Low vitalityLow vitality BurnoutBurnout • Anger, aggressionAnger, aggression • Low pleasureLow pleasure • No weight symptomsNo weight symptoms • No fearfulnessNo fearfulness • Sleeping problemsSleeping problems (difficulty to fall asleep)(difficulty to fall asleep) • Guilt feelingsGuilt feelings • No suicide thoughtsNo suicide thoughts • IndecisivenessIndecisiveness (complaint)(complaint) • Attribution of theAttribution of the problem: workproblem: work • Work-relatedWork-related • Moderate vitalityModerate vitality
  9. 9. Occupation-independentOccupation-independent conceptualisation of burnoutconceptualisation of burnout • Related to traditional work stressorsRelated to traditional work stressors • Work stressors better predictors thanWork stressors better predictors than ‘working with people’‘working with people’ (Schaufeli & Enzmann,(Schaufeli & Enzmann, 1998)1998) • Burnout symptoms parallel toBurnout symptoms parallel to phenomena in non-service occupationsphenomena in non-service occupations (e.g., fatigue, alienation, withdrawal, efficacy)(e.g., fatigue, alienation, withdrawal, efficacy) • Artefact of the utilized researchArtefact of the utilized research designs: alternative hypothesesdesigns: alternative hypotheses untesteduntested
  10. 10. Measurement ofMeasurement of BurnoutBurnout
  11. 11. Two ways of diagnosisTwo ways of diagnosis • (Company) doctors using diagnostic(Company) doctors using diagnostic session - decision treesession - decision tree • Questionnaire (self-reports)Questionnaire (self-reports)
  12. 12. MBIMBI OLBIOLBI • Emotional ExhaustionEmotional Exhaustion (9): feelings of being(9): feelings of being emotionallyemotionally overextended andoverextended and drained by othersdrained by others • DepersonalizationDepersonalization (5): feelings of callous,(5): feelings of callous, cynical and detachedcynical and detached responses towardresponses toward clientsclients • Reduced Personal Ac-Reduced Personal Ac- complishmentcomplishment (8):(8): decline in one’s feelingsdecline in one’s feelings of competence andof competence and successful achievementsuccessful achievement in work with peoplein work with people • ExhaustionExhaustion (7):(7): feelings of emotionalfeelings of emotional emptiness, overtaxingemptiness, overtaxing from work, strong needfrom work, strong need for rest and a state offor rest and a state of physical exhaustionphysical exhaustion • Distancing from workDistancing from work (8): distancing oneself(8): distancing oneself from one’s work,from one’s work, negative attitudes andnegative attitudes and behaviours toward workbehaviours toward work in general, workin general, work contents and objectcontents and object
  13. 13. Oldenburg Burnout InventoryOldenburg Burnout Inventory • Positive and negative worded itemsPositive and negative worded items • Only the core dimensions of burnoutOnly the core dimensions of burnout • Not context-specificNot context-specific • Based on theory and not on empiricalBased on theory and not on empirical findingsfindings • Cut-off scores: - clinical burnoutCut-off scores: - clinical burnout - above the 75- above the 75 percentile on bothpercentile on both dimensionsdimensions Demerouti, 1999
  14. 14. Example items OLBI & MBI-GSExample items OLBI & MBI-GS • Exhaustion (OLBI)Exhaustion (OLBI) • ““After my work, I usually feel worn out and weary”After my work, I usually feel worn out and weary” • ““After my work, I usually feel totally fit for my leisureAfter my work, I usually feel totally fit for my leisure activities” (R).activities” (R). • Distancing from work (OLBI)Distancing from work (OLBI) • ““I usually talk about my work in a derogatory way”I usually talk about my work in a derogatory way” • ““I get more and more engaged in my work” (R)I get more and more engaged in my work” (R) • (1 = totally disagree, 4 = totally agree)(1 = totally disagree, 4 = totally agree) • Exhaustion (MBI-GS)Exhaustion (MBI-GS) • ““I feel burned out from my work”, “I feel tired when I get up inI feel burned out from my work”, “I feel tired when I get up in the morning and have to face another day on the job”.the morning and have to face another day on the job”. • Cynicism (MBI-GS)Cynicism (MBI-GS) • ““I have become less enthusiastic about my work”, “I haveI have become less enthusiastic about my work”, “I have become more cynical about whether my work contributesbecome more cynical about whether my work contributes anything”.anything”. • Professional efficacy (MBI-GS)Professional efficacy (MBI-GS) • ““I feel I am making an effective contribution to what thisI feel I am making an effective contribution to what this organization does”, “In my opinion, I am good at my job”.organization does”, “In my opinion, I am good at my job”. • (0 = never, 6 = every day)(0 = never, 6 = every day)
  15. 15. TheoreticalTheoretical explanationsexplanations
  16. 16. Demand-Control ModelDemand-Control Model Job DemandsJob Demands AutonomyAutonomy Karasek, 1979Karasek, 1979
  17. 17. Effort-Reward Imbalance ModelEffort-Reward Imbalance Model InternalInternal DemandsDemands SalarySalary Siegrist, 1996Siegrist, 1996 ExternalExternal DemandsDemands Status, Self-Status, Self- esteemesteem DevelopmentDevelopment
  18. 18. Inequity ModelInequity Model InvestmentsInvestments OutcomesOutcomes SSchaufeli et al.chaufeli et al. 19961996
  19. 19. Job DemandsJob Demands WorkWork PressurePressure EmotiEmotionalonal DemandsDemands Work timesWork times Work-HomeWork-Home Role conflictRole conflict
  20. 20. Job ResourcesJob Resources AutonomyAutonomy SocialSocial SupportSupport SupervisorySupervisory CoachingCoaching PossibilitiesPossibilities Self-growthSelf-growth Skill VarietySkill Variety
  21. 21. BalanceBalance WorkWork pressurepressure EmotiEmotionalonal DemandsDemands Work timesWork times Work-HomeWork-Home Role conflictRole conflict AutonomyAutonomy SocialSocial SupportSupport CoachingCoaching PossibilitiesPossibilities Self-growthSelf-growth Skill VarietySkill Variety
  22. 22. Job Demands-Resources ModelJob Demands-Resources Model Job Resources Support Autonomy - Feedback Etc. Job Demands Mental Emotional Physical Etc. Organizational Outcomes Demerouti et al., 2001 (Impaired) Health Motivation + + - +
  23. 23. AssumptionsAssumptions • Unique Working Environment for everyUnique Working Environment for every occupational groupoccupational group • 2 categories: Job Demands and Job2 categories: Job Demands and Job ResourcesResources • 2 Processes2 Processes • Health Impairment processHealth Impairment process • Motivational processMotivational process • Job Resources can be Buffer against JobJob Resources can be Buffer against Job DemandsDemands • Job Demands may undermine theJob Demands may undermine the Motivational Impact of Job ResourcesMotivational Impact of Job Resources
  24. 24. Research findingsResearch findings
  25. 25. Human services, production, ATC, N = 374Human services, production, ATC, N = 374 Self-reports, observers ratings (italics)Self-reports, observers ratings (italics) Demerouti et al., 2001Demerouti et al., 2001
  26. 26. Slide 26 Demerouti et al., 2000Demerouti et al., 2000
  27. 27. Food Processing Industry, N=214Food Processing Industry, N=214 Job Resources Autonomy -.68 Participation Job Demands WP Reorgan Bakker, Demerouti, De Boer & Schaufeli, 2003 Burnout Commitment T2 LT Absence T2 ST Absence .63 .58 .62 .67 .96 .92 .21 -.20
  28. 28. Human Services, N=146Human Services, N=146 Emotional Demands Job Demands Workload Possibilities Development Autonomy Job Resources OLBI – Exhaustion OLBI – Disengagement Exhaustion Disengagement In-Role Performance Extra-Role Performance Self-rating Work-Home Conflict Social Support Other-rating e1 e2 e3 e4 e5 e6 e8 e7 e11 e12 Self-rating Other-rating e8 e8 e9 e10 e9 e10 .66 .51 .68 .55 .88 .37 .86 .89 .67 -.90 -.42 -.45 .25 .90 .52 .99 .53 .68 .80-.45.26 Bakker, Demerouti & Verbeke, 2004
  29. 29. (Im) Balance(Im) Balance Impaired health Low motivation Impaired health Motivation Health Low motivation Health Motivation L H L H JOB RESOURCES JOBDEMANDS
  30. 30. Study among salespersonsStudy among salespersons (N=(N= 650)650) • burned-outburned-out salespeople: lowest in-role & extra-rolesalespeople: lowest in-role & extra-role performanceperformance • non burned-outnon burned-out salespeople: highest in-role &salespeople: highest in-role & extra-role performanceextra-role performance • customer-exhaustedcustomer-exhausted: among the highest: among the highest performers (in-role & extra-role performance)performers (in-role & extra-role performance)  compensation strategycompensation strategy • customer-depersonalizedcustomer-depersonalized: in-role performance: in-role performance uninfluenced, extra-role performance diminisheduninfluenced, extra-role performance diminished  loss-based selection, in a proactive mannerloss-based selection, in a proactive manner • ineffectiveineffective:: highest similarity with the burned-outhighest similarity with the burned-out group (low in- & extra-role performance)group (low in- & extra-role performance)  feelingsfeelings of in-efficiency & poor professional self-esteemof in-efficiency & poor professional self-esteem !!! The relationship between burnout –!!! The relationship between burnout – performance is not clear cut!performance is not clear cut!
  31. 31. Reciprocal effectsReciprocal effects • ExhaustionExhaustion  ErrorsErrors  more JDmore JD  moremore ExhaustionExhaustion • DepersonalisationDepersonalisation  negative behaviournegative behaviour  less JRless JR  more Depersonalisationmore Depersonalisation • CompetenceCompetence  good performancegood performance  more JRmore JR  more Competencemore Competence • NegativeNegative oror PositivePositive Spiral...Spiral...
  32. 32. Exhaustion I Job Demands I Exhaustion II Job Demands II Exhaustion III Job Demands III Personal Accomplishment I Personal Accomplishment II Depersonalization I Job Resources I Depersonalization II Job Resources II Depersonalization III Job Resources III Personal Accomplishment III Bakker, Demerouti, van Dierendock & Schaufeli, submittedBakker, Demerouti, van Dierendock & Schaufeli, submitted
  33. 33. Work engagementWork engagement
  34. 34. Towards positive psychology • Most psychologists are busy with sicknesses insteadMost psychologists are busy with sicknesses instead of well-beingof well-being - Publications on negative vs. positive states are 17:1- Publications on negative vs. positive states are 17:1 (Diener et al., 1999)(Diener et al., 1999) • Causes of sicknesses are not identical with the causesCauses of sicknesses are not identical with the causes of well-beingof well-being • Absence of sickness does not automatically meanAbsence of sickness does not automatically mean presence of well-beingpresence of well-being • Different focus: instead of treatment and prevention,Different focus: instead of treatment and prevention, improvement and optimalization!improvement and optimalization!
  35. 35. Burnout vs. Engagement Exhaustion Cynicism Red. Competence Vigor Dedication Absorption
  36. 36. Work engagement: definitionWork engagement: definition • Engagement: a positive, fulfilling, work-related state of mind that is characterized by vigor, dedication, and absorption (Schaufeli et al., 2004). It refers to a persistent and pervasive affective–cognitive state that is not focused on any particular object, event, individual, or behavior. Dimensions • Vigor is characterized by high levels of energy and mental resilience while working, the willingness to invest effort in one’s work, and persistence also in the face of difficulties. • Dedication is characterized by a sense of significance, enthusiasm, inspiration, pride, and challenge. • Absorption is characterized by being fully concentrated and happily engrossed in one’s work, whereby time passes quickly and one has difficulties with detaching oneself from work.
  37. 37. Work Engagement • VigorVigor • At my work, I feel bursting with energyAt my work, I feel bursting with energy • At my job, I feel strong and vigorousAt my job, I feel strong and vigorous • DedicationDedication • To me, my job is challengingTo me, my job is challenging • I am enthusiastic about my jobI am enthusiastic about my job • AbsorptionAbsorption • When I am working, I forget everything else around meWhen I am working, I forget everything else around me • I am completely immersed in my workI am completely immersed in my work
  38. 38. Engaged Employees • Take personal initiativeTake personal initiative • Generate their own positive feedbackGenerate their own positive feedback • Are also engaged outside their workAre also engaged outside their work • Are tired in a different wayAre tired in a different way • Also want to do other things thanAlso want to do other things than workingworking
  39. 39. PrevalencePrevalence 0 4 8 12 16 20 24 28 Burnout Engagement %
  40. 40. Home Care, N=45.000Home Care, N=45.000 Job Resources Support Autonomy + Feedback Coaching Job Demands Workload Emotions Intimity Work-Home Burnout Engagement - + Client Satisfaction Efficiency + - Source: Taris, Bakker et al. (in prep.)
  41. 41. Slide 42
  42. 42. Burnout interventionsBurnout interventions
  43. 43. Overview of the strategiesOverview of the strategies IndividualIndividualOrganizationOrganizationFocusFocus AimAim IdentificationIdentification PrimaryPrimary preventionprevention SecundarySecundary preventionprevention TreatmentTreatment
  44. 44. Organisational strategiesOrganisational strategies IdentificationIdentification PrimaryPrimary preventionprevention SecondarySecondary preventionprevention TreatmentTreatment • Risk inventarisationRisk inventarisation • ScreeningScreening • Regulation of work pressureRegulation of work pressure • Job design / task contentJob design / task content • Conflict managementConflict management • Management DevelopmentManagement Development • Contact company doctorContact company doctor • Social-medical teamSocial-medical team
  45. 45. Individual strategiesIndividual strategies IdentificationIdentification PrimaryPrimary preventionprevention SecondarySecondary preventionprevention TreatmentTreatment • Self-monitoringSelf-monitoring • Self-assessmentSelf-assessment • Didactic stress managementDidactic stress management • Work-Family balanceWork-Family balance • Time managementTime management • Relaxation trainingRelaxation training • Social medical supervisionSocial medical supervision • PsychotherapyPsychotherapy
  46. 46. Success (meta-analysis)Success (meta-analysis) Van der Klink et al. (2000)Van der Klink et al. (2000) kk 1818 1717 88 55 NN 858858 982982 470470 14631463 dd .08.08 non-sign.non-sign. .51.51 moderatemoderate .35.35 smallsmall .68.68 moderatemoderate EffectEffect Cogn. therapyCogn. therapy RelaxationRelaxation MultimodalMultimodal OrganizationOrganization
  47. 47. Critical success factorsCritical success factors • Stepwise systematic approachStepwise systematic approach • Adequate diagnosis and analysesAdequate diagnosis and analyses of the problemsof the problems • Combination of work- and person-Combination of work- and person- oriented approachesoriented approaches • Active participation of all involvingActive participation of all involving partiesparties • Commitment of the topCommitment of the top Kompier & Cooper (1999)Kompier & Cooper (1999)
  48. 48. JDR- questionnaire Project team Project Acquisition Training Consultants Data via Internet Report Interventions Follow-up JDR-ProjectJDR-Project
  49. 49. JDR- questionnaire Project team Project Acquisition Training Consultants JDR-ProjectJDR-Project Data via Internet Report Interventions Follow-up Individual Feedback
  50. 50. Feedback Well-BeingFeedback Well-Being 1 2 3 4 5 6 7 8 9 10 Exhaustion Cynicism Motivation Happiness Client Norm group Source:Source:
  51. 51. Feedback Job DemandsFeedback Job Demands 1 2 3 4 5 6 7 8 9 10 Mental Emotional Physical WHI Client Norm group Source:Source:
  52. 52. Feedback Job ResourcesFeedback Job Resources 1 2 3 4 5 6 7 8 9 10 Coaching Autonomy Support Self-growth Client Norm group Source:Source:
  53. 53. Summary and FutureSummary and Future • Burnout: Syndrome of our timesBurnout: Syndrome of our times • More clarity regarding causality & consequencesMore clarity regarding causality & consequences • Multi-dimensional approachesMulti-dimensional approaches • JDR-model: flexible and static structureJDR-model: flexible and static structure • Scientific - IntegrationScientific - Integration • Practice – Application to organizations, teams, andPractice – Application to organizations, teams, and individualsindividuals • Future ResearchFuture Research • Longitudinal, positive health indicators, reciprocalLongitudinal, positive health indicators, reciprocal relations, burnout contagion and crossover, internationalrelations, burnout contagion and crossover, international researchresearch
  54. 54. Thank you for your attention!Thank you for your attention!