Burnout, Employee Engagement,
and Coping in High-Risk Occupations
L
Jennifer Falkoski, PsyD
This study assessed whether there were any significant relationships among burnout,
type of coping, and employee engagement in a population of employees actively working
in the medical and mental health fields. It also evaluated preferred workplace motivators
across two overarching job categories: medical and mental health caregivers and admin
istrative and supporting roles. The results showed that as employee burnout increased,
so did the use of more harmful coping mechanisms. The study also found an inverse
relationship between emotional exhaustion and employee engagement. Additionally,
employee engagement and personal accomplishment were positively related. Employee
preferred workplace motivators across two job-overarching job categories were also
assessed. The highest-ranking employee-preferred workplace motivators identified in the
participant sample were nature of the work itself, responsibility, salary, relationship with
peers, and professional growth.
Burnout
Burnout is a phenomenon that has been
studied in organizations for more than 20
years. The applied research on burnout was
initially examined within industries that
had a high rate of interpersonal interaction
(Maslach & Leiter, 1997, 2008). More spe
cifically, these industries included human
services, health care, and education. Over
the last two decades, research in this area
has expanded to all industries, including
international companies.
One downside to the extensive research
in this area is that the term "burnout" has
lost its meaning in the workplace (Maslach
& Leiter, 1997). People have become inured
to this term and expect burnout with
any type of job. Burnout's perception
as an inevitable state has made it increa
singly more difficult to manage in the
workplace.
It is imperative that organizations con
tinuously find ways to enhance protective
factors against burnout in the workforce,
especially because most companies are
dynamic in nature. Maslach and Leiter
(1997) cite several contemporary factors
that affect burnout in the workplace. These
factors include less intrinsic work, global
economics, increase in the use of technol
ogy to run business operations, redistri
bution of power, and failing corporate
citizenship. Employees who are experienc
ing burnout also report feeling overloaded
at work, a lack of control over their own
work, unrewarded by their work, a lack of
community within the organization, unfair
/011mal of Psyc/10/ogical lssues in Orga11izatio11al Culture, Volume 2. Number,!, 2012 02012 Bridgepoint Education. lnc. and \VilL')' PL·rindicals, Inc
Pub!ishl'd onlinl' in \VilL')' Onlinl' Library (wikyunlindibr.iry.com), DOI: 10.1002/jpuc.20085 49
treatment, and conflicting personal values with
company values (Maslach & Leiter, 1997).
Burnout is a powerful .
Burnout, Employee Engagement, and Coping in High-Risk Occupa.docx
1. Burnout, Employee Engagement,
and Coping in High-Risk Occupations
L
Jennifer Falkoski, PsyD
This study assessed whether there were any significant
relationships among burnout,
type of coping, and employee engagement in a population of
employees actively working
in the medical and mental health fields. It also evaluated
preferred workplace motivators
across two overarching job categories: medical and mental
health caregivers and admin-
istrative and supporting roles. The results showed that as
employee burnout increased,
so did the use of more harmful coping mechanisms. The study
also found an inverse
relationship between emotional exhaustion and employee
engagement. Additionally,
employee engagement and personal accomplishment were
positively related. Employee-
preferred workplace motivators across two job-overarching job
2. categories were also
assessed. The highest-ranking employee-preferred workplace
motivators identified in the
participant sample were nature of the work itself, responsibility,
salary, relationship with
peers, and professional growth.
Burnout
Burnout is a phenomenon that has been
studied in organizations for more than 20
years. The applied research on burnout was
initially examined within industries that
had a high rate of interpersonal interaction
(Maslach & Leiter, 1997, 2008). More spe-
cifically, these industries included human
services, health care, and education. Over
the last two decades, research in this area
has expanded to all industries, including
international companies.
One downside to the extensive research
3. in this area is that the term "burnout" has
lost its meaning in the workplace (Maslach
& Leiter, 1997). People have become inured
to this term and expect burnout with
any type of job. Burnout's perception
as an inevitable state has made it increa-
singly more difficult to manage in the
workplace.
It is imperative that organizations con-
tinuously find ways to enhance protective
factors against burnout in the workforce,
especially because most companies are
dynamic in nature. Maslach and Leiter
(1997) cite several contemporary factors
that affect burnout in the workplace. These
factors include less intrinsic work, global
economics, increase in the use of technol-
ogy to run business operations, redistri-
4. bution of power, and failing corporate
citizenship. Employees who are experienc-
ing burnout also report feeling overloaded
at work, a lack of control over their own
work, unrewarded by their work, a lack of
community within the organization, unfair
/011mal of Psyc/10/ogical lssues in Orga11izatio11al Culture,
Volume 2. Number,!, 2012 02012 Bridgepoint Education. lnc.
and VilL')' PL·rindicals, Inc
Pub!ishl'd onlinl' in VilL')' Onlinl' Library
(wikyunlindibr.iry.com), DOI: 10.1002/jpuc.20085 49
treatment, and conflicting personal values with
company values (Maslach & Leiter, 1997).
Burnout is a powerful demotivator in the
workplace. People experiencing burnout due to
chronic stress often experience and display nega-
tive feelings and attitudes toward their specific
job role and coworkers (Jenaro, Flores, & Arias,
2007). Employees experiencing burnout can also
5. feel physically and emotionally exhausted.
Coping
Coping strategies are methods of navigating various
environmental and intrapersonal stressors (Jenaro
et al., 2007). These strategies can be either adaptive
or maladaptive. These resources are crucial to the
prevention and management of burnout.
In an occupational setting, resources include
physical, psychological, social, or organizational
aspects of any given job within an organization
(Jenaro et al., 2007). In particular, these resources
help employees achieve work goals, foster per-
sonal development, and decrease overall job
demands. Adaptive coping skills have been shown
to reduce vulnerability to burnout and increase
occupational resiliency. Resiliency is a term used
to describe psychological endurance or hardiness
that aids individuals in dealing effectively with
6. negative life stressors through adaptive coping
skills (Jenaro et al., 2007).
Employee Engagement
Employee engagement is a term used to describe
the degree to which an employee works with
passion and feels a profound connection to the
company (Crabtree, 2004). He or she seeks new
ways to be innovative and helps propel the
company forward. Factors that contribute to
employee engagement include positive relation-
ship with supervisor, workplace friendships, an
50 Journal of Psychologicnl lssues in Orga11izatio11al Culture.
Volume 2, Number 4, DOI: 10.1002/jpoc
element of selflessness in interpersonal relation-
ships at work, development of goals, and a clear
understanding of the requirements of the job.
Statement of Purpose
Most research in this area has focused on the neg-
7. ative effects of burnout in high-risk occupations,
but little research has focused on the resiliency.
The ideology of how resiliency is developed in
individuals and what workplace factors hinder or
foster this adaptive disposition is not well defined.
This study provides the field of organizational psy-
chology with insight into the relationships between
burnout, coping, and employee engagement, as
well as how these factors combined with employee-
preferred workplace characteristics can be aligned
to foster resiliency in employees.
Research Questions
Primarily this study aimed to investigate if there
were any relationships between burnout, employee
engagement, and type of coping mechanism for
people employed in the medical and mental health
fields. Additionally, years of active employment
and its relationship to burnout was assessed.
8. Finally, common themes regarding employee pre-
ferred workplace characteristics were assessed
with regard to job category.
Method
Sample
Data were collected from 268 participants who
completed four assessments online through
Surveymonkey.com. Of the 268 responses, eight
responses were completely eliminated for missing
data (N = 260). I recruited participants from among
employees working in outpatient treatment units
of public health care facilities, including both
medical and behavioral health. Treatment units
I
I
I
I
9. level of employee engagement. This survey mea-
sures employee and workplace performance using
13 questions on a Likert scale. The Gallup Orga-
nization is the foremost institution studying
employee engagement, thus making this survey
an appropriate choice to examine employee
engagement.
Coping
To identify coping strategies that influence resil-
iency, the Brief COPE Dispositional Inventory
(Brief COPE) was used. This abbreviated, multidi-
mensional inventory assesses the various ways
that people respond to stress (Carver, Scheier, &
Weintraub, 1989). In this assessment, respondents
report the extent to which they perform the activi-
ties listed in the questionnaire items when they are
stressed out (Carver, 2007). This assessment is
available for fair use in an academic setting and
10. does not require the permission of the author
to use.
The Brief COPE has 14 subscales, with 28
items total. "The scales are: self-distraction, active
coping, denial, substance use, use of emotional
support, use of instrumental support, behavioral
disengagement, venting, positive reframing, plan-
ning, humor, acceptance, religion, and self-blame"
(Carver, 2007, p. 96).
The subscales in the Brief COPE were adjusted
from the original version. The Restraint Coping
and Suppression of Competing Activities were
omitted due to a lack of value in previous research,
as well as displaying redundancy to the Active
Coping subscale (Carver, 1997). In the abbreviated
version, the Positive Reinterpretation and Growth
subscale was renamed Positive Reframing. Fur-
thermore, the Focus on and Venting of Emotions
11. subscale was renamed Venting. The Mental
Disengagement subscale was renamed Self-
Distraction in the abbreviated version. Carver
52 Jourunl of Psychological Issues in Orga11izatioun/ Culture.
Vulunll' 2. Number•I , DOI: 10.1002/jpoc
(1997) created a Self-Blame subscale because it
was found that self-blame is a predictor of poor
adjustment under stress.
In the complete version, although not strongly
intercorrelated, the scales do correlate in concep-
tual meaningful ways (Carver et al., 1989). For
example, one group reflected adaptive strategies.
More specifically, Active Coping and Planning
were linked with Positive Reinterpretation and
Growth (Positive Reframing) and Instrumental
and Emotional Social Support. Positive Reinter-
pretation and Growth (Positive Reframing) is cor-
related with acceptance as are other adaptive
strategies, but not as strongly (Carver et al., 1989).
12. A second group comprises scales with an
emphasis on maladaptive strategies (Carver et al.,
1989). In particular, these scales include Denial,
Behavioral Disengagement, Venting, and Sub-
stance Use and are all moderately correlated.
These scales tend to be inversely related to the
adaptive strategies. For example, Active Coping
and Planning are negatively correlated with Denial
and Behavioral Disengagement.
Workplace Motivators
Workplace motivators were assessed through an
inquiry on the demographic survey. "Workplace
motivators included for analysis in this study are
achievement, recognition and reward, nature
of the work itself, responsibility, advancement,
growth, company policy and administration, rela-
tionship with supervisor, salary, relationship(s)
with peers, relationship(s) with subordinates,
13. status, and security/safety" (Herzberg, 2003, p. 90).
This inquiry asked participants to identify
their top six preferred workplace motivators and
then rank in order of preference (1 = Most impor-
tant, 6 = Least important) their preferred type of
workplace motivators. These data were analyzed
using a job category and workplace motivator
I
I
I
filter in Surveymonkey.com and tabulated into an
overall frequency diagram by job category.
Procedures
After obtaining institutional review board (IRB)
approval, the demographic survey, Maslach
Burnout Inventory-Health Services Survey, Ql2,
and Brief COPE Dispositional Inventory were
loaded onto Surveymonkey.com. These were
14. online surveys; no paper forms of the surveys were
distributed. The online interface allowed complete
anonymity of the participants as no personal iden-
tifying information was collected. Informed
consent took place electronically as well. After the
completion of this project, all raw data gathered
directly from the participants were destroyed.
Data Analysis
A canonical correlation was conducted to assess
whether there were any relationships between
burnout, employee engagement, and type of
coping. Canonical analysis determines the rela-
tionship between a set of predictor variables and
a set of criterion variables; because two of the
three assessments used had multiple subscales,
this type of analysis was the most appropriate.
Figure 1
Participant Range of Burnout by Level
15. This is in contrast to using a standard regression
analysis that measures the relationship between a
single predictor and criterion variable. Workplace
motivators were assessed through frequency dia-
grams for each job category.
Hypothesis 1 (H1): There is a significant
relationship between level of burnout
and level of employee engagement.
The data analysis showed that there was a
significant relationship between these two vari-
ables (Wilks's lambda= .73, p < .001). The value of
multiple R, also referred to as the magnitude of the
canonical correlation, is .52 and the value of R2 is
.27. A significant, positive relationship was found
between employee engagement and the Personal
Accomplishment subscale (canonical coefficient=
.48). Additionally, a significant, negative relation-
ship was found between employee engagement
16. and the Emotional Exhaustion subscale of the
MBI-HSS (canonical correlation = .70; Figures 1
and 2).
Hypothesis 2 (Hi}: There are significant
relationship(s) between level of burnout
and type of coping skills.
Assessment of Burnout
Range of Experienced Burnout
Joumal of Psyclwlogica/ Issues i11 Orgm1izntio11a/ Culture.
Volume 2, Numbl'r4, DOI: 10.1002/jpoc 53
Figure 2
Mean Scores on Employee Engagement
al Mean Values of Employee Engagement
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� 0 50 100 150 200 250 300
Number of Participants
The data analysis showed that there were sig-
nificant relationships between these two variables
(Cluster 1: Wilks's lambda = .50, p < .001; Cluster
2: Wilks's lambda= .81, p < .003). The magnitude
of the Cluster 1 canonical correlation is .62 and
the squared value is .38. The magnitude of the
Cluster 2 canonical correlation is .38 and the
squared value is .14.
Regarding Cluster 1, significant, positive rela-
tionships were found between the Emotional
Exhaustion subscale of the MBI-HSS (canonical
coefficient = -.67) and the following subscales of
the Brief COPE: Self-Distraction (canonical coef-
ficient= -46), Denial ( canonical coefficient= -.40),
Behavioral Disengagement (canonical coefficient
18. = -.57), Venting (canonical coefficient= -.46), and
Self-Blame (canonical coefficient = -.53). In other
words, the canonical statistical analysis computed
which, if any, of the three MBI-HSS subscales were
related to which, if any, of the 14 subscales of the
Brief COPE. The analysis showed that Emotional
Exhaustion is positively related to Self-Distraction,
Denial, Behavioral Disengagement, Venting, and
Self-Blame.
Regarding Cluster 2, significant, positive rela-
tionships were found between the Personal
Accomplishment subscale of the MBI-HSS and
the following subscales of the Brief COPE: Denial
54 foumal of Psyc/10/ogical Issues i11 Orgnniwtiona{ Culture,
Volume 2. Number4, DOI: 10.Jt)02fjpoc
(canonical coefficient = .66), Substance Use
(canonical coefficient = .53), Use of Emotional
Support (canonical coefficient = .47), Planning
19. (canonical coefficient = .65), and Humor (canoni-
cal coefficient= .52). In other words, the canonical
statistical analysis computed which, if any, of the
three MBI-HSS subscales were related to which, if
any, of the 14 subscales of the Brief COPE. The
analysis showed that personal accomplishment is
positively related to Denial, Substance Use, Use of
Emotional Support, Planning, and Humor.
Furthermore, significant, negative relation-
ships were found between the Personal Accom-
plishment subscale of the MBI-HSS and the
following subscales of the Brief COPE: Use of
Instrumental Support (canonical coefficient =
-.60) and Behavioral Disengagement (canonical
coefficient = -.92). In other words, the canonical
statistical analysis computed which, if any, of the
three MBI-HSS subscales were related to which, if
any, of the 14 subscales of the Brief COPE. The
20. analysis also showed that Personal Accomplish-
ment is negatively related to Instrumental Support
and Behavioral Disengagement.
Also with regard to Cluster 2, significant, pos-
itive relationships were found between the Deper-
sonalization subscale of the MBI-HSS and the
following subscales of the Brief COPE: Denial
(canonical coefficient = .66), Substance Use
(canonical coefficient = .53), Use of Emotional
Support (canonical coefficient = .47), Planning
(canonical coefficient= .65), and Humor (canoni-
cal coefficient= .52). In other words, the canonical
statistical analysis computed which, if any, of the
three MBI-HSS subscales were related to which, if
any, of the 14 subscales of the Brief COPE. The
results showed that the MBI-HSS subscale of Dep-
ersonalization is positively related to Denial, Sub-
stance Use, Use of Emotional Support, Planning,
21. and Humor.
In addition, significant, negative relationships
were found between the Depersonalization sub-
scale of the MBI-HSS and the following subscales
on the Brief COPE: Use of Instrumental Support
(canonical coefficient= -.60) and Behavioral Dis-
engagement (canonical coefficient =-.92). In other
words, the canonical statistical analysis computed
which, if any, of the three MBI-HSS subscales were
related to which, if any, of the 14 subscales of
the Brief COPE. The results showed that Deper-
sonalization is negatively related to Use of Instru-
mental Support and Behavioral Disengagement
(Figures 3-13).
Figure 3
Participant Range of Burnout by Level
Hypothesis 3 (H3): There are significant
22. relationships between type of coping skills
and level of employee engagement.
The data analysis showed that there was a
significant relationship between these two vari-
ables (Wilks's lambda = .75, p < .001). The value
of multiple R, also referred to as the magnitude of
the canonical correlation, is .50 and the value of
R2 is .25. A significant, positive relationship was
found between Employee Engagement and the
Behavioral Disengagement subscale of the Brief
COPE (canonical coefficient= .43). Additionally, a
Assessment of Burnout
2
Range of Experienced Burnout
Figure 4
Participant Responses on Self-Distraction Subscale
Coping: Self-Distraction (SD)
9-,-----....,...------------�---,
8
7
33. ....................................... _ ... ·-· . • -- -
•----�----i
0 50 100 150 200 250 300
Number of Participants
I
I
I
significant, negative relationship was found
between Employee Engagement and the Use of
Emotional Support subscale of the Brief COPE
(canonical correlation= .70; Figures 14-16).
Hypothesis 4 (H4): There is a significant
relationship between years of active
employment in critical care areas in the
medical or mental health field and level
of burnout.
Figure 14
Mean Scores for Employee Engagement
34. Mean Values of Employee Engagement
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- •
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:
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• 4) ' .. • 4>. t.
:a; a. 0 5
� o:o 1----�-----�--�---�--�
0 50 100 150 200 250 300
Number of Participants
Figure 15
Participant Responses on Emotional Support Subscale
Coping: Use of Emotional Support (ES)
36. 300
0 4 -·- • _____. ....... _._ . . . ... ··· ··-
(.) 3 ... ....... _. .... ...... .... _....,. ..... -·
(/) 2 ..... -,, ....... . ...... . .................... _....
1 -- _ ____._ -+- -----+ - ---
0 ---+-+--+
0 50 100 150 200 250 300
Number of Participants
The data analysis showed that there is a sig-
nificant, negative relationship between the total
number of years in active employment and the
Depersonalization subscale of the MBI-HSS
(Pearson correlation = -.20, p < .01; Figures 17
and 18).
To address this hypothesis, a two-tailed
Pearson correlation analysis was used to deter-
mine whether there was a relationship between
any of the subscales of the MBI-HSS and the
demographic variable years of active employment
in the field.
37. Hypothesis 5 (H5): There are different work-
place motivators that are more effective in
motivating employees depending on their
job category within an organization.
Figure 17
Participant Scores of Number of Years of Active Work
Years of Active Work in …
