BioMed Central
Page 1 of 9
(page number not for citation purposes)
BMC Health Services Research
Open AccessResearch article
Prevalence and associated factors in burnout and psychological
morbidity among substance misuse professionals
Adenekan Oyefeso*1, Carmel Clancy2 and Roger Farmer3
Address: 1Division of Mental Health, Medical School, St George's, University of London, London SW17 0RE, UK, 2School of Health and Social
Sciences, Middlesex University, F Block, Holborn Union Building, Archway Campus, Highgate Hill, London N19 3UA, UK and 3South West
London and St George's Mental Health NHS Trust, Richmond Royal Hospital, Kew Foot Road, Surrey TW9 2TE, UK
Email: Adenekan Oyefeso* - [email protected]; Carmel Clancy - [email protected]; Roger Farmer - [email protected]
* Corresponding author
Abstract
Background: Studies of psychological stress among substance misuse professionals rarely
describe the nature of burnout and psychological morbidity. The main aim of this study was to
determine the extent, pattern and predictors of psychological morbidity and burnout among
substance misuse professionals.
Methods: This study was a cross-sectional mail survey of 194 clinical staff of substance misuse
services in the former South Thames region of England, using the General Health Questionnaire
(GHQ-12) the Maslach Burnout Inventory (MBI) as measures of psychological morbidity and
burnout, respectively.
Results: Rates of psychological morbidity (82%: 95% CI = 76–87) and burnout (high emotional
exhaustion – 33% [27–40]; high depersonalisation – 17% [12–23]; and diminished personal
accomplishment – 36% [29–43]) were relatively high in the study sample. High levels of alienation
and tension (job stressors) predicted emotional exhaustion and depersonalisation (burnout) but
not psychological morbidity. Diminished personal accomplishment was associated with higher
levels of psychological morbidity
Conclusion: In the sample of substance misuse professionals studied, rates of psychological
morbidity and burnout were high, suggesting a higher level of vulnerability than in other health
professionals. Furthermore, pathways to psychological morbidity and burnout are partially related.
Therefore, targeted response is required to manage stress, burnout and psychological morbidity
among substance misuse professionals. Such a response should be integral to workforce
development.
Background
Since the introduction of the United Kingdom Govern-
ment's Drug Strategy in 1998, substance misuse services
have expanded with increases in funding available from
central government as part of implementation of the drug
strategy [1]. The targets set in the strategy may have put
extra demands on substance misuse services with a likely
increase in job-related stress, burnout and associated psy-
chological morbidity.
Studies of stress and burnout in various occupational
groups and settings have been widely reported [2-4].
Published: 8 February 2008
BMC Health Servic ...
(Student name Jason Mendez) The need for and the propriet.docxgertrudebellgrove
(Student name: Jason Mendez)
The need for and the propriety of employment drug testing
The need and convenience of drug tests in employment, are several measures or tests used by
employers to assess the ability and behavior of their employees or future candidates to whom
they
will use, normally these tests are performed before hiring and normally They are analyzed
through In the urine of people, small samples are taken that will undergo immediate tests that
will give
the diagnosis. These types of tests measure the drug and alcohol in the blood; However, other
tests, such as blood tests, measure the truthfulness and amount of substance in the body. Of the
person, these tests are performed to measure the ability of people, since the use of drugs or
alcohol can decrease a person's work performance.
Some of the tests used are: random lie detection tests, amphetamines, genetic tests to detect
diseases in high-risk employees, but these tests are used as well for competitions as they measure
athletes and their skills in such a way that play well and don't make mistakes or win a race
without justification or effort
References
UPCOUNSE, PRE-EMPLOYMENT DRUG TESTING RECOVERED FROM
https://www.upcounsel.com/pre-employment-drug-testi
https://www.upcounsel.com/pre-employment-drug-testing
(Student name: Yelena Contreras)
Many employers require their employees to submit to drug testing before and after being hired.
Most of the time after being hired an employer requires reasonable suspicion before having an
employee take a drug test. Even with the recent legalization of marijuana in some states,
employees in those states can still be punished for testing positive. The punishments for a failed
drug test can include rehabilitation, termination, and losing unemployment benefits.
Drug testing is becoming more critical for the hiring process year after year. It is important for
employers to conduct drug test for background screening and re-screening because workplace
drug use and abuse can come with serious consequences for business owners.
Many federal employees, such as those who handle classified information, those who work in
national security, law enforcement officers, employees with duties to protect property, life,
health and safety, and even the President are subject to drug testing . The Supreme Court has
ruled that while drug testing does infringe on an employee's privacy, it may be necessary in order
to protect the health and safety of others . Most state laws are similar to federal laws and
generally maintain the legality of drug testing for state employees.
Employees that abuse drugs in the workplace cause major disruptions due to their lack of
productivity, poor performance, potential for work place injuries and their negative impact on
other employees. In developing and enforcing an effective drug testing policy, compliance with
applicable federal and ...
Effect of an E-mental Health Approach to Workers’Health SurvEvonCanales257
Effect of an E-mental Health Approach to Workers’
Health Surveillance versus Control Group on Work
Functioning of Hospital Employees: A Cluster-RCT
Sarah M. Ketelaar1*, Karen Nieuwenhuijsen1, Fania R. Gärtner1, Linda Bolier2, Odile Smeets2,
Judith K. Sluiter1
1 Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands, 2 Innovation Center of Mental Health and
Technology (I.COM), Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
Abstract
Objective: To evaluate an e-mental health (EMH) approach to workers’ health surveillance (WHS) targeting work functioning
(WF) and mental health (MH) of healthcare professionals in a randomised controlled trial.
Methods: Nurses and allied health professionals (N = 1140) were cluster-randomised at ward level to the intervention (IG) or
control group (CG). The intervention consisted of two parts: (a) online screening and personalised feedback on impaired WF
and MH, followed by (b) a tailored offer of self-help EMH interventions. CG received none of these parts. Primary outcome
was impaired WF (Nurses Work Functioning Questionnaire), assessed at baseline and after three and six months. Analyses
were performed in the positively screened subgroup (i) and in all participants (ii).
Results: Participation rate at baseline was 32% (NIG = 178; NCG = 188). Eighty-two percent screened positive for at least mild
impairments in WF and/or MH (NIG = 139; NCG = 161). All IG-participants (N = 178) received part (a) of the intervention, nine
participants (all positively screened, 6%) followed an EMH intervention to at least some extent. Regarding the subgroup of
positively screened participants (i), both IG and CG improved over time regarding WF (non-significant between-group
difference). After six months, 36% of positively screened IG-participants (18/50) had a relevant WF improvement compared
to baseline, versus 28% (32/115) of positively screened CG-participants (non-significant difference). In the complete sample
(ii), IG and CG improved over time but IG further improved between three and six months while CG did not (significant
interaction effect).
Conclusions: In our study with a full compliance rate of 6% and substantial drop-out leading to a small and underpowered
sample, we could not demonstrate that an EMH-approach to WHS is more effective to improve WF and MH than a control
group. The effect found in the complete sample of participants is not easily interpreted. Reported results may be useful for
future meta-analytic work.
Trial Registration: Dutch Trial Register NTR2786 http://www.trialregister.nl
Citation: Ketelaar SM, Nieuwenhuijsen K, Gärtner FR, Bolier L, Smeets O, et al. (2013) Effect of an E-mental Health Approach to Workers’ Health Surveillance versus
Control Group on Work Functioning of Hospital Employees: A Cluster-RCT. PLoS ONE 8(9): e72546. doi:10.1371/journal.pone.0072546
Editor: Jim v ...
Int. J. Environ. Res. Public Health 2013, 10, 2214-2240; doi1TatianaMajor22
Int. J. Environ. Res. Public Health 2013, 10, 2214-2240; doi:10.3390/ijerph10062214
International Journal of
Environmental Research and
Public Health
ISSN 1660-4601
www.mdpi.com/journal/ijerph
Review
Burnout in Relation to Specific Contributing Factors and Health
Outcomes among Nurses: A Systematic Review
Natasha Khamisa
1,2,
*, Karl Peltzer
3,4,5
and Brian Oldenburg
2,6
1
School of Health Sciences, Department of Public Health, Monash South Africa, 144 Peter Road,
Roodepoort, Johannesburg 1725, South Africa
2
Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Melbourne 3800,
Australia; E-Mail: [email protected]
3
Human Science Research Council, 134 Pretorius Street, Pretoria 0002, South Africa;
E-Mail: [email protected]
4
University of Limpopo, University Street, Turfloop, Sovenga, Polokwane 0727, South Africa
5
ASEAN Institute for Health Development, Mahidol University, Salaya 73170, Thailand
6
Monash Alfred Hospital Campus, Level 3 Burnet Tower, 89 Commercial Road, Melbourne 3004,
Australia
* Author to whom correspondence should be addressed; E-Mail: [email protected];
Tel.: +27-11-950-4450.
Received: 1 March 2013; in revised form: 16 May 2013 / Accepted: 24 May 2013 /
Published: 31 May 2013
Abstract: Nurses have been found to experience higher levels of stress-related burnout
compared to other health care professionals. Despite studies showing that both job
satisfaction and burnout are effects of exposure to stressful working environments, leading
to poor health among nurses, little is known about the causal nature and direction of these
relationships. The aim of this systematic review is to identify published research that has
formally investigated relationships between these variables. Six databases (including
CINAHL, COCHRANE, EMBASE, MEDLINE, PROQUEST and PsyINFO) were
searched for combinations of keywords, a manual search was conducted and an
independent reviewer was asked to cross validate all the electronically identified articles.
Of the eighty five articles that were identified from these databases, twenty one articles
were excluded based on exclusion criteria; hence, a total of seventy articles were included
in the study sample. The majority of identified studies exploring two and three way
relationships (n = 63) were conducted in developed countries. Existing research includes
OPEN ACCESS
Int. J. Environ. Res. Public Health 2013, 10 2215
predominantly cross-sectional studies (n = 68) with only a few longitudinal studies (n = 2);
hence, the evidence base for causality is still very limited. Despite minimal availability of
research concerning the small number of studies to investigate the relationships between
work-related stress, burnout, job satisfaction and the general health of nurses, this review
has identified some contradictory evidence for the role of job satisfaction. This emphasizes
the nee ...
Trends shaping corporate health in the workplaceApollo Hospitals
The paradigm for corporate health is morphing from traditional curative services to health protection and promotion. An epidemic of “lifestyle diseases” has developed in the India which warrants an organized integration of company's health, safety and environment policy through a directed wellness program. The current study explored the burden and determinants of lifestyle diseases among an organization.
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Revista Científica da Ordem dos Médicos www.actamedicaportuguesa.com 31
RESUMO
Introdução: A violência no local de trabalho é um dos principais fatores de risco no mundo do trabalho. Os trabalhadores da saúde
apresentam um risco superior. O nosso estudo teve como objetivo caracterizar a violência física e verbal num hospital público e definir
estratégias de prevenção e vigilância em saúde ocupacional.
Material e Métodos: Estudo observacional transversal monocêntrico, conduzido num hospital público em Lisboa com trabalhadores
da saúde. Foi realizado um inquérito qualitativo com entrevistas em profundidade a seis trabalhadores e um inquérito quantitativo
com questionários a 32 trabalhadores. Aceitou-se um nível de significância de 5% na avaliação das diferenças estatísticas. O teste de
Mann-Whitney e o teste exato de Fisher foram usados para calcular os valores de p.
Resultados: Os principais resultados são: (1) 41 episódios reportados na fase quantitativa; (2) 5/21 [23,81%] vítimas notificaram o in-
cidente; (3) 18/21 [85.71%] vítimas reportaram estados de hipervigilância permanente; (4) 22/28 [78,57%] participantes não conheciam
ou conheciam mal os procedimentos de notificação; (5) 24/28 [85,71%] consideravam possível minimizar o problema.
Discussão: A violência é favorecida pelo acesso livre às zonas de trabalho, ausência de agentes de segurança e polícia ou falta da
respetiva intervenção. A baixa notificação contribui para a ausência de medidas organizacionais. O estado de hipervigilância relatado
reflete o efeito prejudicial da exposição a fontes de stress e ameaça.
Conclusão: A violência no local de trabalho é um fator de risco relevante, com impacto negativo na saúde dos trabalhadores e merece
uma abordagem individualizada no âmbito da saúde ocupacional, cujas áreas e estratégias prioritárias foram definidas neste estudo.
Palavras-chave: Fatores de Risco Profissionais; Prevenção; Saúde Ocupacional; Trabalhadores da Saúde; Violência no Local de
Trabalho
Workplace Violence in Healthcare: A Single-Center Study
on Causes, Consequences and Prevention Strategies
A Violência no Local de Trabalho em Instituições
de Saúde: Um Estudo Monocêntrico sobre Causas,
Consequências e Estratégias de Prevenção
1. Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisboa. Portugal.
2. Emergency Department. Hospital Professor Doutor Fernando da Fonseca. Amadora. Portugal.
3. CISP - Centro de Investigação em Saúde Pública. CHRC - Comprehensive Health Research Center. Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisboa.
Portugal.
4. Occupational Health Department. Centro Hospitalar Universitário de Lisboa Central. Lisboa. Portugal.
Autor correspondente: Helena Sofia Antão. [email protected]
Recebido: 22 de outubro de 2018 - Aceite: 10 de julho de 2019 | Cop.
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Revista Científica da Ordem dos Médicos www.actamedicaportuguesa.com 31
RESUMO
Introdução: A violência no local de trabalho é um dos principais fatores de risco no mundo do trabalho. Os trabalhadores da saúde
apresentam um risco superior. O nosso estudo teve como objetivo caracterizar a violência física e verbal num hospital público e definir
estratégias de prevenção e vigilância em saúde ocupacional.
Material e Métodos: Estudo observacional transversal monocêntrico, conduzido num hospital público em Lisboa com trabalhadores
da saúde. Foi realizado um inquérito qualitativo com entrevistas em profundidade a seis trabalhadores e um inquérito quantitativo
com questionários a 32 trabalhadores. Aceitou-se um nível de significância de 5% na avaliação das diferenças estatísticas. O teste de
Mann-Whitney e o teste exato de Fisher foram usados para calcular os valores de p.
Resultados: Os principais resultados são: (1) 41 episódios reportados na fase quantitativa; (2) 5/21 [23,81%] vítimas notificaram o in-
cidente; (3) 18/21 [85.71%] vítimas reportaram estados de hipervigilância permanente; (4) 22/28 [78,57%] participantes não conheciam
ou conheciam mal os procedimentos de notificação; (5) 24/28 [85,71%] consideravam possível minimizar o problema.
Discussão: A violência é favorecida pelo acesso livre às zonas de trabalho, ausência de agentes de segurança e polícia ou falta da
respetiva intervenção. A baixa notificação contribui para a ausência de medidas organizacionais. O estado de hipervigilância relatado
reflete o efeito prejudicial da exposição a fontes de stress e ameaça.
Conclusão: A violência no local de trabalho é um fator de risco relevante, com impacto negativo na saúde dos trabalhadores e merece
uma abordagem individualizada no âmbito da saúde ocupacional, cujas áreas e estratégias prioritárias foram definidas neste estudo.
Palavras-chave: Fatores de Risco Profissionais; Prevenção; Saúde Ocupacional; Trabalhadores da Saúde; Violência no Local de
Trabalho
Workplace Violence in Healthcare: A Single-Center Study
on Causes, Consequences and Prevention Strategies
A Violência no Local de Trabalho em Instituições
de Saúde: Um Estudo Monocêntrico sobre Causas,
Consequências e Estratégias de Prevenção
1. Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisboa. Portugal.
2. Emergency Department. Hospital Professor Doutor Fernando da Fonseca. Amadora. Portugal.
3. CISP - Centro de Investigação em Saúde Pública. CHRC - Comprehensive Health Research Center. Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisboa.
Portugal.
4. Occupational Health Department. Centro Hospitalar Universitário de Lisboa Central. Lisboa. Portugal.
Autor correspondente: Helena Sofia Antão. [email protected]
Recebido: 22 de outubro de 2018 - Aceite: 10 de julho de 2019 | Cop ...
Student ProfileThe student profile will serve as an introduction.docxorlandov3
Student Profile
The student profile will serve as an introduction of the student to the Professor.
In a double spaced, one page essay, please tell me about your academic background, major, career goals, favorite subjects, learning style (visual/audio learner), etc. Add anything else that you think would be pertinent for a new professor to know about you before taking this class.
_____________________________________________________________________________
Essay Writing Rules:
When writing these essays, please refer to the fatal writing flaws included below. Late papers will never be accepted. You have plenty of warning on when the papers are due, so take into the account the possibility of an emergency and get it done early. For example, your internet being down at the time it is due is NOT a valid excuse. Each essay carries 15 points and only 3 best will be counted into your final grade. Fatal Writing Flaws
In grading writing submissions, when the “fifth” of any combination of the “flaws” listed below is reached, your paper will be returned with a failing grade. You are strongly encouraged to use the ReWrite Connection on campus to help prevent committing these writing mistakes.
1. Subject/Verb Agreement
2. Rambling/Run-On Sentences
3. Grammatical Errors
4. Poor Sentence Structure
5. Pervasive Spelling Errors (more than a couple typos)
6. Informal or Inappropriate Language
7. No Conclusion
July/August 2015 Corrections Today — 41
Kerry Kuehl, M.D., Dr.P.H., was the lead investigator
in the NIOSH-funded “Safety and Health Improve-
ment: Enhancing Law Enforcement Departments”
study,7 which established an evidence-based safety
and health program for municipal and county law
enforcement officers. It was natural to extend that
work to COs. An initial step compared survey find-
ings from COs at prisons of different security levels
in an effort to characterize staff and use that informa-
tion to match facilities in a prospective trial of a pro-
gram to improve COs’ TWH. Despite similar years on
the job across sites, stress levels, body weight, alco-
hol intake and sick days all increased as the security
level intensified. However, even at the minimum-
security sites, COs had higher body weights and
more cardiovascular risk factors than the average
police officer. Findings pointed to a gradient of
increasing stress relating to greater health problems.
Tim Morse, Ph.D., and colleagues from the Cen-
ter for Promoting Health in the New England Work-
place (CPH-NEW) used surveys, focus groups and
physical assessments to understand the health of
COs from two prisons.8 Morse and his colleagues
found COs had more obesity than the U.S. aver-
age. Only 15 percent of COs were in the normal
weight range, about half what is found in the gen-
eral adult population. The COs’ interview data was
remarkable for findings of stress relating to poor
dietary habits and barriers to regular exercise.
Kuehl’s subsequent study among .
(Student name Jason Mendez) The need for and the propriet.docxgertrudebellgrove
(Student name: Jason Mendez)
The need for and the propriety of employment drug testing
The need and convenience of drug tests in employment, are several measures or tests used by
employers to assess the ability and behavior of their employees or future candidates to whom
they
will use, normally these tests are performed before hiring and normally They are analyzed
through In the urine of people, small samples are taken that will undergo immediate tests that
will give
the diagnosis. These types of tests measure the drug and alcohol in the blood; However, other
tests, such as blood tests, measure the truthfulness and amount of substance in the body. Of the
person, these tests are performed to measure the ability of people, since the use of drugs or
alcohol can decrease a person's work performance.
Some of the tests used are: random lie detection tests, amphetamines, genetic tests to detect
diseases in high-risk employees, but these tests are used as well for competitions as they measure
athletes and their skills in such a way that play well and don't make mistakes or win a race
without justification or effort
References
UPCOUNSE, PRE-EMPLOYMENT DRUG TESTING RECOVERED FROM
https://www.upcounsel.com/pre-employment-drug-testi
https://www.upcounsel.com/pre-employment-drug-testing
(Student name: Yelena Contreras)
Many employers require their employees to submit to drug testing before and after being hired.
Most of the time after being hired an employer requires reasonable suspicion before having an
employee take a drug test. Even with the recent legalization of marijuana in some states,
employees in those states can still be punished for testing positive. The punishments for a failed
drug test can include rehabilitation, termination, and losing unemployment benefits.
Drug testing is becoming more critical for the hiring process year after year. It is important for
employers to conduct drug test for background screening and re-screening because workplace
drug use and abuse can come with serious consequences for business owners.
Many federal employees, such as those who handle classified information, those who work in
national security, law enforcement officers, employees with duties to protect property, life,
health and safety, and even the President are subject to drug testing . The Supreme Court has
ruled that while drug testing does infringe on an employee's privacy, it may be necessary in order
to protect the health and safety of others . Most state laws are similar to federal laws and
generally maintain the legality of drug testing for state employees.
Employees that abuse drugs in the workplace cause major disruptions due to their lack of
productivity, poor performance, potential for work place injuries and their negative impact on
other employees. In developing and enforcing an effective drug testing policy, compliance with
applicable federal and ...
Effect of an E-mental Health Approach to Workers’Health SurvEvonCanales257
Effect of an E-mental Health Approach to Workers’
Health Surveillance versus Control Group on Work
Functioning of Hospital Employees: A Cluster-RCT
Sarah M. Ketelaar1*, Karen Nieuwenhuijsen1, Fania R. Gärtner1, Linda Bolier2, Odile Smeets2,
Judith K. Sluiter1
1 Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands, 2 Innovation Center of Mental Health and
Technology (I.COM), Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
Abstract
Objective: To evaluate an e-mental health (EMH) approach to workers’ health surveillance (WHS) targeting work functioning
(WF) and mental health (MH) of healthcare professionals in a randomised controlled trial.
Methods: Nurses and allied health professionals (N = 1140) were cluster-randomised at ward level to the intervention (IG) or
control group (CG). The intervention consisted of two parts: (a) online screening and personalised feedback on impaired WF
and MH, followed by (b) a tailored offer of self-help EMH interventions. CG received none of these parts. Primary outcome
was impaired WF (Nurses Work Functioning Questionnaire), assessed at baseline and after three and six months. Analyses
were performed in the positively screened subgroup (i) and in all participants (ii).
Results: Participation rate at baseline was 32% (NIG = 178; NCG = 188). Eighty-two percent screened positive for at least mild
impairments in WF and/or MH (NIG = 139; NCG = 161). All IG-participants (N = 178) received part (a) of the intervention, nine
participants (all positively screened, 6%) followed an EMH intervention to at least some extent. Regarding the subgroup of
positively screened participants (i), both IG and CG improved over time regarding WF (non-significant between-group
difference). After six months, 36% of positively screened IG-participants (18/50) had a relevant WF improvement compared
to baseline, versus 28% (32/115) of positively screened CG-participants (non-significant difference). In the complete sample
(ii), IG and CG improved over time but IG further improved between three and six months while CG did not (significant
interaction effect).
Conclusions: In our study with a full compliance rate of 6% and substantial drop-out leading to a small and underpowered
sample, we could not demonstrate that an EMH-approach to WHS is more effective to improve WF and MH than a control
group. The effect found in the complete sample of participants is not easily interpreted. Reported results may be useful for
future meta-analytic work.
Trial Registration: Dutch Trial Register NTR2786 http://www.trialregister.nl
Citation: Ketelaar SM, Nieuwenhuijsen K, Gärtner FR, Bolier L, Smeets O, et al. (2013) Effect of an E-mental Health Approach to Workers’ Health Surveillance versus
Control Group on Work Functioning of Hospital Employees: A Cluster-RCT. PLoS ONE 8(9): e72546. doi:10.1371/journal.pone.0072546
Editor: Jim v ...
Int. J. Environ. Res. Public Health 2013, 10, 2214-2240; doi1TatianaMajor22
Int. J. Environ. Res. Public Health 2013, 10, 2214-2240; doi:10.3390/ijerph10062214
International Journal of
Environmental Research and
Public Health
ISSN 1660-4601
www.mdpi.com/journal/ijerph
Review
Burnout in Relation to Specific Contributing Factors and Health
Outcomes among Nurses: A Systematic Review
Natasha Khamisa
1,2,
*, Karl Peltzer
3,4,5
and Brian Oldenburg
2,6
1
School of Health Sciences, Department of Public Health, Monash South Africa, 144 Peter Road,
Roodepoort, Johannesburg 1725, South Africa
2
Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Melbourne 3800,
Australia; E-Mail: [email protected]
3
Human Science Research Council, 134 Pretorius Street, Pretoria 0002, South Africa;
E-Mail: [email protected]
4
University of Limpopo, University Street, Turfloop, Sovenga, Polokwane 0727, South Africa
5
ASEAN Institute for Health Development, Mahidol University, Salaya 73170, Thailand
6
Monash Alfred Hospital Campus, Level 3 Burnet Tower, 89 Commercial Road, Melbourne 3004,
Australia
* Author to whom correspondence should be addressed; E-Mail: [email protected];
Tel.: +27-11-950-4450.
Received: 1 March 2013; in revised form: 16 May 2013 / Accepted: 24 May 2013 /
Published: 31 May 2013
Abstract: Nurses have been found to experience higher levels of stress-related burnout
compared to other health care professionals. Despite studies showing that both job
satisfaction and burnout are effects of exposure to stressful working environments, leading
to poor health among nurses, little is known about the causal nature and direction of these
relationships. The aim of this systematic review is to identify published research that has
formally investigated relationships between these variables. Six databases (including
CINAHL, COCHRANE, EMBASE, MEDLINE, PROQUEST and PsyINFO) were
searched for combinations of keywords, a manual search was conducted and an
independent reviewer was asked to cross validate all the electronically identified articles.
Of the eighty five articles that were identified from these databases, twenty one articles
were excluded based on exclusion criteria; hence, a total of seventy articles were included
in the study sample. The majority of identified studies exploring two and three way
relationships (n = 63) were conducted in developed countries. Existing research includes
OPEN ACCESS
Int. J. Environ. Res. Public Health 2013, 10 2215
predominantly cross-sectional studies (n = 68) with only a few longitudinal studies (n = 2);
hence, the evidence base for causality is still very limited. Despite minimal availability of
research concerning the small number of studies to investigate the relationships between
work-related stress, burnout, job satisfaction and the general health of nurses, this review
has identified some contradictory evidence for the role of job satisfaction. This emphasizes
the nee ...
Trends shaping corporate health in the workplaceApollo Hospitals
The paradigm for corporate health is morphing from traditional curative services to health protection and promotion. An epidemic of “lifestyle diseases” has developed in the India which warrants an organized integration of company's health, safety and environment policy through a directed wellness program. The current study explored the burden and determinants of lifestyle diseases among an organization.
A
R
TI
G
O
O
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IN
A
L
Revista Científica da Ordem dos Médicos www.actamedicaportuguesa.com 31
RESUMO
Introdução: A violência no local de trabalho é um dos principais fatores de risco no mundo do trabalho. Os trabalhadores da saúde
apresentam um risco superior. O nosso estudo teve como objetivo caracterizar a violência física e verbal num hospital público e definir
estratégias de prevenção e vigilância em saúde ocupacional.
Material e Métodos: Estudo observacional transversal monocêntrico, conduzido num hospital público em Lisboa com trabalhadores
da saúde. Foi realizado um inquérito qualitativo com entrevistas em profundidade a seis trabalhadores e um inquérito quantitativo
com questionários a 32 trabalhadores. Aceitou-se um nível de significância de 5% na avaliação das diferenças estatísticas. O teste de
Mann-Whitney e o teste exato de Fisher foram usados para calcular os valores de p.
Resultados: Os principais resultados são: (1) 41 episódios reportados na fase quantitativa; (2) 5/21 [23,81%] vítimas notificaram o in-
cidente; (3) 18/21 [85.71%] vítimas reportaram estados de hipervigilância permanente; (4) 22/28 [78,57%] participantes não conheciam
ou conheciam mal os procedimentos de notificação; (5) 24/28 [85,71%] consideravam possível minimizar o problema.
Discussão: A violência é favorecida pelo acesso livre às zonas de trabalho, ausência de agentes de segurança e polícia ou falta da
respetiva intervenção. A baixa notificação contribui para a ausência de medidas organizacionais. O estado de hipervigilância relatado
reflete o efeito prejudicial da exposição a fontes de stress e ameaça.
Conclusão: A violência no local de trabalho é um fator de risco relevante, com impacto negativo na saúde dos trabalhadores e merece
uma abordagem individualizada no âmbito da saúde ocupacional, cujas áreas e estratégias prioritárias foram definidas neste estudo.
Palavras-chave: Fatores de Risco Profissionais; Prevenção; Saúde Ocupacional; Trabalhadores da Saúde; Violência no Local de
Trabalho
Workplace Violence in Healthcare: A Single-Center Study
on Causes, Consequences and Prevention Strategies
A Violência no Local de Trabalho em Instituições
de Saúde: Um Estudo Monocêntrico sobre Causas,
Consequências e Estratégias de Prevenção
1. Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisboa. Portugal.
2. Emergency Department. Hospital Professor Doutor Fernando da Fonseca. Amadora. Portugal.
3. CISP - Centro de Investigação em Saúde Pública. CHRC - Comprehensive Health Research Center. Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisboa.
Portugal.
4. Occupational Health Department. Centro Hospitalar Universitário de Lisboa Central. Lisboa. Portugal.
Autor correspondente: Helena Sofia Antão. [email protected]
Recebido: 22 de outubro de 2018 - Aceite: 10 de julho de 2019 | Cop.
A
R
TI
G
O
O
R
IG
IN
A
L
Revista Científica da Ordem dos Médicos www.actamedicaportuguesa.com 31
RESUMO
Introdução: A violência no local de trabalho é um dos principais fatores de risco no mundo do trabalho. Os trabalhadores da saúde
apresentam um risco superior. O nosso estudo teve como objetivo caracterizar a violência física e verbal num hospital público e definir
estratégias de prevenção e vigilância em saúde ocupacional.
Material e Métodos: Estudo observacional transversal monocêntrico, conduzido num hospital público em Lisboa com trabalhadores
da saúde. Foi realizado um inquérito qualitativo com entrevistas em profundidade a seis trabalhadores e um inquérito quantitativo
com questionários a 32 trabalhadores. Aceitou-se um nível de significância de 5% na avaliação das diferenças estatísticas. O teste de
Mann-Whitney e o teste exato de Fisher foram usados para calcular os valores de p.
Resultados: Os principais resultados são: (1) 41 episódios reportados na fase quantitativa; (2) 5/21 [23,81%] vítimas notificaram o in-
cidente; (3) 18/21 [85.71%] vítimas reportaram estados de hipervigilância permanente; (4) 22/28 [78,57%] participantes não conheciam
ou conheciam mal os procedimentos de notificação; (5) 24/28 [85,71%] consideravam possível minimizar o problema.
Discussão: A violência é favorecida pelo acesso livre às zonas de trabalho, ausência de agentes de segurança e polícia ou falta da
respetiva intervenção. A baixa notificação contribui para a ausência de medidas organizacionais. O estado de hipervigilância relatado
reflete o efeito prejudicial da exposição a fontes de stress e ameaça.
Conclusão: A violência no local de trabalho é um fator de risco relevante, com impacto negativo na saúde dos trabalhadores e merece
uma abordagem individualizada no âmbito da saúde ocupacional, cujas áreas e estratégias prioritárias foram definidas neste estudo.
Palavras-chave: Fatores de Risco Profissionais; Prevenção; Saúde Ocupacional; Trabalhadores da Saúde; Violência no Local de
Trabalho
Workplace Violence in Healthcare: A Single-Center Study
on Causes, Consequences and Prevention Strategies
A Violência no Local de Trabalho em Instituições
de Saúde: Um Estudo Monocêntrico sobre Causas,
Consequências e Estratégias de Prevenção
1. Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisboa. Portugal.
2. Emergency Department. Hospital Professor Doutor Fernando da Fonseca. Amadora. Portugal.
3. CISP - Centro de Investigação em Saúde Pública. CHRC - Comprehensive Health Research Center. Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisboa.
Portugal.
4. Occupational Health Department. Centro Hospitalar Universitário de Lisboa Central. Lisboa. Portugal.
Autor correspondente: Helena Sofia Antão. [email protected]
Recebido: 22 de outubro de 2018 - Aceite: 10 de julho de 2019 | Cop ...
Student ProfileThe student profile will serve as an introduction.docxorlandov3
Student Profile
The student profile will serve as an introduction of the student to the Professor.
In a double spaced, one page essay, please tell me about your academic background, major, career goals, favorite subjects, learning style (visual/audio learner), etc. Add anything else that you think would be pertinent for a new professor to know about you before taking this class.
_____________________________________________________________________________
Essay Writing Rules:
When writing these essays, please refer to the fatal writing flaws included below. Late papers will never be accepted. You have plenty of warning on when the papers are due, so take into the account the possibility of an emergency and get it done early. For example, your internet being down at the time it is due is NOT a valid excuse. Each essay carries 15 points and only 3 best will be counted into your final grade. Fatal Writing Flaws
In grading writing submissions, when the “fifth” of any combination of the “flaws” listed below is reached, your paper will be returned with a failing grade. You are strongly encouraged to use the ReWrite Connection on campus to help prevent committing these writing mistakes.
1. Subject/Verb Agreement
2. Rambling/Run-On Sentences
3. Grammatical Errors
4. Poor Sentence Structure
5. Pervasive Spelling Errors (more than a couple typos)
6. Informal or Inappropriate Language
7. No Conclusion
July/August 2015 Corrections Today — 41
Kerry Kuehl, M.D., Dr.P.H., was the lead investigator
in the NIOSH-funded “Safety and Health Improve-
ment: Enhancing Law Enforcement Departments”
study,7 which established an evidence-based safety
and health program for municipal and county law
enforcement officers. It was natural to extend that
work to COs. An initial step compared survey find-
ings from COs at prisons of different security levels
in an effort to characterize staff and use that informa-
tion to match facilities in a prospective trial of a pro-
gram to improve COs’ TWH. Despite similar years on
the job across sites, stress levels, body weight, alco-
hol intake and sick days all increased as the security
level intensified. However, even at the minimum-
security sites, COs had higher body weights and
more cardiovascular risk factors than the average
police officer. Findings pointed to a gradient of
increasing stress relating to greater health problems.
Tim Morse, Ph.D., and colleagues from the Cen-
ter for Promoting Health in the New England Work-
place (CPH-NEW) used surveys, focus groups and
physical assessments to understand the health of
COs from two prisons.8 Morse and his colleagues
found COs had more obesity than the U.S. aver-
age. Only 15 percent of COs were in the normal
weight range, about half what is found in the gen-
eral adult population. The COs’ interview data was
remarkable for findings of stress relating to poor
dietary habits and barriers to regular exercise.
Kuehl’s subsequent study among .
Freudenberger and subsequently developed by Maslach and colleagues, chronic stress associated with emotionally intense work demands for which resources are inadequate can result in burnout. Burnout is a work-related syndrome involving emotional exhaustion, depersonalization and a sense of reduced personal accomplishment.
This report was produced by Peter Butterworth, Liana S. Leach and Kim M. Kiely of the Centre for Research on Ageing, Health and Wellbeing, The Australian National University under commission from Safe Work Australia.
Abstract— If job satisfaction is there in employees, work done by these employees is usually of better quality in comparison where the employees are not satisfied with their jobe. So this study to assess job satisfaction and influence of demographic variables on job satisfaction, this study was carried out on 105 doctors of teaching hospitals. Questionnaire method of data collection was adopted. Job satisfaction was measured by six domains: Organizational functioning, Interpersonal relationship, Financial incentives, Non-financial incentives, Physical facilities and Working conditions. Study observed that over all, doctors were moderately satisfied with their job. Domains such as Interpersonal relationship and Working conditions, doctors were highly satisfied, whereas rest of the domains: Organizational functioning, Financial incentives, Non-financial incentives, and Physical facilities doctors were moderately satisfied. It is important to note that even though overall satisfaction is moderate, there were few components, where doctors were highly satisfied were - Communication system between patients and doctors, Involvement in decision making in the department, Rules and regulations of the institution, relationship between the department colleagues and other department colleagues, Provision for leave encashment, reward given for research work, workload of clinical aspect and workload of teaching aspect. Age and sex both shown significant association on level of satisfaction where as experience, designation and marital status of the doctors have not shown significant association.
Background: Behavioral health conditions are prevalent among patients in inpatient medical settings and when not adequately treated contribute to diminished treatment outcomes and quality of life. Substantial evidence has demonstrated the effectiveness of psychological interventions in addressing behavioral health conditions in a range of settings but, to a lesser extent with psychologically-based interventions delivered in inpatient medical settings. Purpose: The purpose of this paper is to increase attention on psychological interventions being delivered to patients across a broad spectrum of medical specialties in inpatient medical settings to support the implementation of interventions to address increasing patient needs. Methods: This selected, brief review of the literature sought to describe published psychologically-based interventions delivered in inpatient medical settings. A search for studies catalogued on PubMed from 2007 to 2016 was examined and studies were included in the review if they were delivered within inpatient medical settings. Two reviewers independently assessed relevant studies for criteria. Results: A total of ten articles met the inclusion criteria with interventions targeting outcomes across four primary domains: 1) pain and fatigue; 2) cognition; 3) affective/emotional and; 4) self-harm. Several articles support interventions grounded in Cognitive-Behavioral Therapy and brief psychological interventions. Most studies reported favorable outcomes for the interventions relative to controls. Conclusions: Psychologically-based interventions, especially those that integrate components of cognitive-behavioral therapy and a multidisciplinary approach, can be implemented in inpatient medical settings and may promote improved patient outcomes. However, the quality of this evidence requires formal assessment, requiring more comprehensive reviews are needed to replicate findings and clarify effectiveness of interventions.
BUSI 230Project 1 InstructionsBased on Larson & Farber sectio.docxRAHUL126667
BUSI 230
Project 1 Instructions
Based on Larson & Farber: section 2.1
Use the Project 1 Data Set to create the graphs and tables in Questions 1–4 and to answer both parts of Question 5. If you cannot figure out how to make the graphs and tables in Excel, you are welcome to draw them by hand and then submit them as a scanned document or photo.
1. Open a blank Excel file and create a grouped frequency distribution of the maximum daily temperatures for the 50 states for a 30 day period. Use 8 classes. (8 points)
2. Add midpoint, relative frequency, and cumulative frequency columns to your frequency distribution. (8 points)
3. Create a frequency histogram using Excel. You will probably need to load the Data Analysis add-in within Excel. If you do not know how to create a histogram in Excel, view the video located at: http://www.youtube.com/watch?v=_gQUcRwDiik. A simple bar graph will also work.
If you cannot get the histogram or bar graph features to work, you may draw a histogram by hand and then scan or take a photo (your phone can probably do this) of your drawing and email it to your instructor. (8 points)
4. Create a frequency polygon in Excel (or by hand). For help, view http://www.youtube.com/watch?v=7Q-KdmDJirg(8 points)
5. A. Do any of the temperatures appear to be unrealistic or in error? If yes, which ones and why? (4 points)
B. Explain how this affects your confidence in the validity of this data set. (4 points)
Project 1 is due by 11:59 p.m. (ET) on Monday of Module/Week 1.
International Journal o f Clinical and Health Psychology (2014) 14, 216-220
International Journal
of Clinical and Health Psychology
w w w .elsevier.es/ijchp
THEORETICAL ARTICLE
The end of mental illness thinking?
Richard Pemberton3 *, Tony Wainwrightb
<DCrossMark
ELSEVIER
DOYMA
a University o f Brighton, United Kingdom
b University o f Exeter, United Kingdom
Received 26 May 2014; accepted 15 June 2014
A vailable on lin e 9 July 2014
KEYWORDS A b s tra c t M ental he alth th e o ry and p ra ctice are in a s ta te o f sig nifica nt flu x . This th e o re t-
Diagnosis; ic a l a rtic le places th e position taken by th e British Psychological Society Division o f C linical
F o rm u la tio n ; Psychology (DCP) in th e c o n te x t o f c u rre n t p ra ctice and seeks to c ritic a lly exam ine some o f
DSM-5; th e key fa cto rs th a t are d rivin g these transfo rm a tion s. The im petus fo r a co m p le te overhaul
W e llb e in g ; o f existing th in k in g comes fro m th e m a n ife stly poor perform ance o f m e n ta l health services in
T h e o re tic a l s tu d y w hich those w ith serious m e n ta l health problem s have reduced life expectancy. It advocates
using th e advances in our understanding o f th e psychological, social and physical mechanisms
th a t underpin psychological w e llb e in g and m e n ta l distress, and re je c tin g th e disease m odel o f
m e n ta l distress as p a rt o f an ou td a te d paradi ...
Recovery from Addictions in Healthcare workers - by Ann Sparks (research synt...Ann Hinnen Sparks
Research Proposal of Experiential responses for various levels of health care workers who are in active recovery from addictions to mood altering substances.
· 3.3 Writing AssignmentComplete all of the following.docxodiliagilby
· 3.3 Writing Assignment
Complete all of the following:
1. Dynamics Lab - examine accelerometers and explore how linear forces are captured and depicted. Examine available literature to research and discuss how accelerometers are currently used in UAS designs; provide examples of three specific COTS accelerometers, available on the market today (standalone, single axis, multi-axes, or integrated into an inertial measurement unit [IMU])
2. Power Plant - examine two commonly used propulsion options (internal combustion and electrical motors). Examine available literature to research and discuss why a specific propulsion type would be chosen, over others (you may also compare to turbines); provide examples of three specific COTS engines/motors, available on the market today (brushed, brushless, two-stroke, four-stroke, turbine, etc.)
Seung Hee Choi, PhD, RN
Roxane R. Chan, PhD, RN
Rebecca H. Lehto, PhD, RN
Relationships Between Smoking Status
and Psychological Distress, Optimism, and
Health Environment Perceptions at Time
of Diagnosis of Actual or Suspected
Lung Cancer
K E Y W O R D S
Anxiety
Lung neoplasms
Optimism
Perception
Smoking
Background: While much research and practice resources have addressed
smoking cessation among cancer patients, less emphasis has been placed on
personal psychological and environment factors associated with smoking at the time
of diagnosis. Objective: The aim of this study was to examine differences in
psychological distress, optimism, and perceptions of the health environment/illness
experience based on smoking status in patients with current, former, and no smoking
history with newly diagnosed suspected or actual lung cancer. Methods: Data
were derived from a descriptive study of 52 patients (34 men and 18 women
aged 37-83 years) undergoing diagnostic evaluation for actual or suspected lung
cancer. Descriptive statistics were used to characterize data. Analysis of variance,
#2, and Spearman correlation tests were used to determine relationships among
main study variables (smoking status, anxiety, worry, perceived cognitive
functioning, optimistic outlook, health environment/illness experience perceptions).
Results: Current smoking status was associated with higher psychological distress
(anxiety and worry) among patients facing a new suspected or actual cancer
diagnosis. Conclusions: The study was able to provide important information
relative to smoking status and psychological distress at the time of diagnosis of
suspected or actual lung cancer. Findings demonstrate needs for assessment and
156 n Cancer NursingA, Vol. 42, No. 2, 2019 Choi et al
Copyright B 2018 Wolters Kluwer Health, Inc. All rights reserved.
Author Affiliations: College of Nursing, Michigan State University, East Lansing.
This study was funded by a National Institute of Nursing Research grant
(1 F31 NR07695-01A1).
The authors have no conflicts of interest to disclose.
Correspondence: Seung Hee Choi, PhD ...
Drug abuse has now become a major public health problem in Nigeria requiring urgent attention. Although drug abuse cut across all age groups, the youths are however the most affected. This study aimed at assessing Community Pharmacists involvement in the rehabilitation of drug abuse victims. The study was carried out in Abuja Municipal Area Council, questionnaires were administered to Community Pharmacists practicing within the Area Council. A total of 176 Community Pharmacists participated in the study, and slightly above a quarter (27.43%) of them had post-graduate degrees. More than three-quarters (79.5%) of the study participants had received training on drug abuse. A total of 89.2% of the study participants had come across persons suspected to be abusing prescription medicines. Almost all (96.6%) of the study participants indicated that they are willing to advise persons suspected to be abusing drugs on the dangers of drug abuse, and 88.1% of the study participants had spoken to clients concerning abuse of prescription medicines. Also, more than three-quarters (80.1%) of the study participants indicated that pharmacists’ role in the prevention of drug abuse is very important. The study has revealed that Community Pharmacists can play an invaluable role in the rehabilitation of drug abuse victims in Nigeria.
Burnout among Health Workers: Case of the Military Hospital of Ouakam, Senegalinventionjournals
Background: Mental Health is responsible for 13% of global morbidity, and is a priority according to World Health Organization which predicts a duplication of this frequency by 2020. The cult of performance and the quest for maximum profit have led to the emergence of new types of diseases in societies such as professional exhaustion or burnout. The analysis of factors promoting burnout showed that this syndrome is primarily related to chronic stress. Studies in several countries, mostly Western, have showed its importance. This study has aimed to assess burnout in the military hospitalof Ouakam. Method: It was a qualitative study conducted among Ouakam Military Hospital workers in 2012. The sampling was complete and the target was made by all hospital workers: technical, administrative and support staff. Participation was free and voluntary. The collection tool consisted of Maslach Burnout Inventory (MBI) on socio-demographic characteristics and criteria of emotional exhaustion, depersonalization and personal achievement. As suggested by Maslach, burnout was first determined for each criterion; then their combination enabled to determine the overall burnout. Results: A total of 66 individuals participated in the study. The average age was 34.5 years, sex ratio1.64; Married 57.6% and singles 42.4%. About 94% had a level of education equal to or higher than secondary school. Paramedics were 78.8%, support staff 13.6%. Emotional exhaustion was observed in 30.3% of participants, depersonalization of the relationship in 21.2% and disorders of personal accomplishment at 36.3%. The combination of these three parameters has enabled to determine the overall burnout that was 68.2%, the mild form was 46.9% and the moderate form 21.2%; no severe form was observed. Burnout was more common among elderly and paramedics. These results are similar to those observed in other countries that have shown high prevalence of burnout among health workers. Conclusion: Burnout is a reality and, in long-term, can negatively impact health system’s performance.
Problem 1
Problem 2 (two screen shots)
Problem 3 (two screen shots)
Problem 4 (three screen shots)
Problem 5 (one screen shot)
Problem 6 (six screenshots plus a data table)
.
Problem 20-1A Production cost flow and measurement; journal entrie.docxChantellPantoja184
Problem 20-1A Production cost flow and measurement; journal entries L.O. P1, P2, P3, P4
[The following information applies to the questions displayed below.]
Edison Company manufactures wool blankets and accounts for product costs using process costing. The following information is available regarding its May inventories.
Beginning
Inventory
Ending
Inventory
Raw materials inventory
$
60,000
$
41,000
Goods in process inventory
449,000
521,500
Finished goods inventory
610,000
342,001
The following additional information describes the company's production activities for May.
Raw materials purchases (on credit)
$
250,000
Factory payroll cost (paid in cash)
1,850,300
Other overhead cost (Other Accounts credited)
82,000
Materials used
Direct
$
200,500
Indirect
50,000
Labor used
Direct
$
1,060,300
Indirect
790,000
Overhead rate as a percent of direct labor
115
%
Sales (on credit)
$
3,000,000
The predetermined overhead rate was computed at the beginning of the year as 115% of direct labor cost.
\\\\\
rev: 11_02_2011
references
1.
value:
2.00 points
Problem 20-1A Part 1
Required:
1(a)
Compute the cost of products transferred from production to finished goods. (Omit the "$" sign in your response.)
Cost of products transferred
$
1(b)
Compute the cost of goods sold. (Omit the "$" sign in your response.)
Cost of goods sold
$
rev: 10_31_2011
check my workeBook Links (4)references
2.
value:
5.00 points
Problem 20-1A Part 2
2(a)
Prepare journal entry dated May 31 to record the raw materials purchases. (Omit the "$" sign in your response.)
Date
General Journal
Debit
Credit
May 31
2(b)
Prepare journal entry dated May 31 to record the direct materials usage. (Omit the "$" sign in your response.)
Date
General Journal
Debit
Credit
May 31
2(c)
Prepare journal entry dated May 31 to record the indirect materials usage. (Omit the "$" sign in your response.)
Date
General Journal
Debit
Credit
May 31
2(d)
Prepare journal entry dated May 31 to record the payroll costs. (Omit the "$" sign in your response.)
Date
General Journal
Debit
Credit
May 31
2(e)
Prepare journal entry dated May 31 to record the direct labor costs. (Omit the "$" sign in your response.)
Date
General Journal
Debit
Credit
May 31
2(f)
Prepare journal entry dated May 31 to record the indirect labor costs. (Omit the "$" sign in your response.)
Date
General Journal
Debit
Credit
May 31
2(g)
Prepare journal entry dated May 31 to record the other overhead costs. (Omit the "$" sign in your response.)
Date
General Journal
Debit
Credit
May 31
2(h)
Prepare journal entry dated May 31 to record the overhead applied. (Omit the "$" sign in your response.)
Date
General Journal
Debit
Credit
May 31
2(i)
Prepare journal entry dated May 31 to record the goods transferred from production to finished goods.(Omit the "$" sign in yo.
More Related Content
Similar to BioMed CentralPage 1 of 9(page number not for citation p
Freudenberger and subsequently developed by Maslach and colleagues, chronic stress associated with emotionally intense work demands for which resources are inadequate can result in burnout. Burnout is a work-related syndrome involving emotional exhaustion, depersonalization and a sense of reduced personal accomplishment.
This report was produced by Peter Butterworth, Liana S. Leach and Kim M. Kiely of the Centre for Research on Ageing, Health and Wellbeing, The Australian National University under commission from Safe Work Australia.
Abstract— If job satisfaction is there in employees, work done by these employees is usually of better quality in comparison where the employees are not satisfied with their jobe. So this study to assess job satisfaction and influence of demographic variables on job satisfaction, this study was carried out on 105 doctors of teaching hospitals. Questionnaire method of data collection was adopted. Job satisfaction was measured by six domains: Organizational functioning, Interpersonal relationship, Financial incentives, Non-financial incentives, Physical facilities and Working conditions. Study observed that over all, doctors were moderately satisfied with their job. Domains such as Interpersonal relationship and Working conditions, doctors were highly satisfied, whereas rest of the domains: Organizational functioning, Financial incentives, Non-financial incentives, and Physical facilities doctors were moderately satisfied. It is important to note that even though overall satisfaction is moderate, there were few components, where doctors were highly satisfied were - Communication system between patients and doctors, Involvement in decision making in the department, Rules and regulations of the institution, relationship between the department colleagues and other department colleagues, Provision for leave encashment, reward given for research work, workload of clinical aspect and workload of teaching aspect. Age and sex both shown significant association on level of satisfaction where as experience, designation and marital status of the doctors have not shown significant association.
Background: Behavioral health conditions are prevalent among patients in inpatient medical settings and when not adequately treated contribute to diminished treatment outcomes and quality of life. Substantial evidence has demonstrated the effectiveness of psychological interventions in addressing behavioral health conditions in a range of settings but, to a lesser extent with psychologically-based interventions delivered in inpatient medical settings. Purpose: The purpose of this paper is to increase attention on psychological interventions being delivered to patients across a broad spectrum of medical specialties in inpatient medical settings to support the implementation of interventions to address increasing patient needs. Methods: This selected, brief review of the literature sought to describe published psychologically-based interventions delivered in inpatient medical settings. A search for studies catalogued on PubMed from 2007 to 2016 was examined and studies were included in the review if they were delivered within inpatient medical settings. Two reviewers independently assessed relevant studies for criteria. Results: A total of ten articles met the inclusion criteria with interventions targeting outcomes across four primary domains: 1) pain and fatigue; 2) cognition; 3) affective/emotional and; 4) self-harm. Several articles support interventions grounded in Cognitive-Behavioral Therapy and brief psychological interventions. Most studies reported favorable outcomes for the interventions relative to controls. Conclusions: Psychologically-based interventions, especially those that integrate components of cognitive-behavioral therapy and a multidisciplinary approach, can be implemented in inpatient medical settings and may promote improved patient outcomes. However, the quality of this evidence requires formal assessment, requiring more comprehensive reviews are needed to replicate findings and clarify effectiveness of interventions.
BUSI 230Project 1 InstructionsBased on Larson & Farber sectio.docxRAHUL126667
BUSI 230
Project 1 Instructions
Based on Larson & Farber: section 2.1
Use the Project 1 Data Set to create the graphs and tables in Questions 1–4 and to answer both parts of Question 5. If you cannot figure out how to make the graphs and tables in Excel, you are welcome to draw them by hand and then submit them as a scanned document or photo.
1. Open a blank Excel file and create a grouped frequency distribution of the maximum daily temperatures for the 50 states for a 30 day period. Use 8 classes. (8 points)
2. Add midpoint, relative frequency, and cumulative frequency columns to your frequency distribution. (8 points)
3. Create a frequency histogram using Excel. You will probably need to load the Data Analysis add-in within Excel. If you do not know how to create a histogram in Excel, view the video located at: http://www.youtube.com/watch?v=_gQUcRwDiik. A simple bar graph will also work.
If you cannot get the histogram or bar graph features to work, you may draw a histogram by hand and then scan or take a photo (your phone can probably do this) of your drawing and email it to your instructor. (8 points)
4. Create a frequency polygon in Excel (or by hand). For help, view http://www.youtube.com/watch?v=7Q-KdmDJirg(8 points)
5. A. Do any of the temperatures appear to be unrealistic or in error? If yes, which ones and why? (4 points)
B. Explain how this affects your confidence in the validity of this data set. (4 points)
Project 1 is due by 11:59 p.m. (ET) on Monday of Module/Week 1.
International Journal o f Clinical and Health Psychology (2014) 14, 216-220
International Journal
of Clinical and Health Psychology
w w w .elsevier.es/ijchp
THEORETICAL ARTICLE
The end of mental illness thinking?
Richard Pemberton3 *, Tony Wainwrightb
<DCrossMark
ELSEVIER
DOYMA
a University o f Brighton, United Kingdom
b University o f Exeter, United Kingdom
Received 26 May 2014; accepted 15 June 2014
A vailable on lin e 9 July 2014
KEYWORDS A b s tra c t M ental he alth th e o ry and p ra ctice are in a s ta te o f sig nifica nt flu x . This th e o re t-
Diagnosis; ic a l a rtic le places th e position taken by th e British Psychological Society Division o f C linical
F o rm u la tio n ; Psychology (DCP) in th e c o n te x t o f c u rre n t p ra ctice and seeks to c ritic a lly exam ine some o f
DSM-5; th e key fa cto rs th a t are d rivin g these transfo rm a tion s. The im petus fo r a co m p le te overhaul
W e llb e in g ; o f existing th in k in g comes fro m th e m a n ife stly poor perform ance o f m e n ta l health services in
T h e o re tic a l s tu d y w hich those w ith serious m e n ta l health problem s have reduced life expectancy. It advocates
using th e advances in our understanding o f th e psychological, social and physical mechanisms
th a t underpin psychological w e llb e in g and m e n ta l distress, and re je c tin g th e disease m odel o f
m e n ta l distress as p a rt o f an ou td a te d paradi ...
Recovery from Addictions in Healthcare workers - by Ann Sparks (research synt...Ann Hinnen Sparks
Research Proposal of Experiential responses for various levels of health care workers who are in active recovery from addictions to mood altering substances.
· 3.3 Writing AssignmentComplete all of the following.docxodiliagilby
· 3.3 Writing Assignment
Complete all of the following:
1. Dynamics Lab - examine accelerometers and explore how linear forces are captured and depicted. Examine available literature to research and discuss how accelerometers are currently used in UAS designs; provide examples of three specific COTS accelerometers, available on the market today (standalone, single axis, multi-axes, or integrated into an inertial measurement unit [IMU])
2. Power Plant - examine two commonly used propulsion options (internal combustion and electrical motors). Examine available literature to research and discuss why a specific propulsion type would be chosen, over others (you may also compare to turbines); provide examples of three specific COTS engines/motors, available on the market today (brushed, brushless, two-stroke, four-stroke, turbine, etc.)
Seung Hee Choi, PhD, RN
Roxane R. Chan, PhD, RN
Rebecca H. Lehto, PhD, RN
Relationships Between Smoking Status
and Psychological Distress, Optimism, and
Health Environment Perceptions at Time
of Diagnosis of Actual or Suspected
Lung Cancer
K E Y W O R D S
Anxiety
Lung neoplasms
Optimism
Perception
Smoking
Background: While much research and practice resources have addressed
smoking cessation among cancer patients, less emphasis has been placed on
personal psychological and environment factors associated with smoking at the time
of diagnosis. Objective: The aim of this study was to examine differences in
psychological distress, optimism, and perceptions of the health environment/illness
experience based on smoking status in patients with current, former, and no smoking
history with newly diagnosed suspected or actual lung cancer. Methods: Data
were derived from a descriptive study of 52 patients (34 men and 18 women
aged 37-83 years) undergoing diagnostic evaluation for actual or suspected lung
cancer. Descriptive statistics were used to characterize data. Analysis of variance,
#2, and Spearman correlation tests were used to determine relationships among
main study variables (smoking status, anxiety, worry, perceived cognitive
functioning, optimistic outlook, health environment/illness experience perceptions).
Results: Current smoking status was associated with higher psychological distress
(anxiety and worry) among patients facing a new suspected or actual cancer
diagnosis. Conclusions: The study was able to provide important information
relative to smoking status and psychological distress at the time of diagnosis of
suspected or actual lung cancer. Findings demonstrate needs for assessment and
156 n Cancer NursingA, Vol. 42, No. 2, 2019 Choi et al
Copyright B 2018 Wolters Kluwer Health, Inc. All rights reserved.
Author Affiliations: College of Nursing, Michigan State University, East Lansing.
This study was funded by a National Institute of Nursing Research grant
(1 F31 NR07695-01A1).
The authors have no conflicts of interest to disclose.
Correspondence: Seung Hee Choi, PhD ...
Drug abuse has now become a major public health problem in Nigeria requiring urgent attention. Although drug abuse cut across all age groups, the youths are however the most affected. This study aimed at assessing Community Pharmacists involvement in the rehabilitation of drug abuse victims. The study was carried out in Abuja Municipal Area Council, questionnaires were administered to Community Pharmacists practicing within the Area Council. A total of 176 Community Pharmacists participated in the study, and slightly above a quarter (27.43%) of them had post-graduate degrees. More than three-quarters (79.5%) of the study participants had received training on drug abuse. A total of 89.2% of the study participants had come across persons suspected to be abusing prescription medicines. Almost all (96.6%) of the study participants indicated that they are willing to advise persons suspected to be abusing drugs on the dangers of drug abuse, and 88.1% of the study participants had spoken to clients concerning abuse of prescription medicines. Also, more than three-quarters (80.1%) of the study participants indicated that pharmacists’ role in the prevention of drug abuse is very important. The study has revealed that Community Pharmacists can play an invaluable role in the rehabilitation of drug abuse victims in Nigeria.
Burnout among Health Workers: Case of the Military Hospital of Ouakam, Senegalinventionjournals
Background: Mental Health is responsible for 13% of global morbidity, and is a priority according to World Health Organization which predicts a duplication of this frequency by 2020. The cult of performance and the quest for maximum profit have led to the emergence of new types of diseases in societies such as professional exhaustion or burnout. The analysis of factors promoting burnout showed that this syndrome is primarily related to chronic stress. Studies in several countries, mostly Western, have showed its importance. This study has aimed to assess burnout in the military hospitalof Ouakam. Method: It was a qualitative study conducted among Ouakam Military Hospital workers in 2012. The sampling was complete and the target was made by all hospital workers: technical, administrative and support staff. Participation was free and voluntary. The collection tool consisted of Maslach Burnout Inventory (MBI) on socio-demographic characteristics and criteria of emotional exhaustion, depersonalization and personal achievement. As suggested by Maslach, burnout was first determined for each criterion; then their combination enabled to determine the overall burnout. Results: A total of 66 individuals participated in the study. The average age was 34.5 years, sex ratio1.64; Married 57.6% and singles 42.4%. About 94% had a level of education equal to or higher than secondary school. Paramedics were 78.8%, support staff 13.6%. Emotional exhaustion was observed in 30.3% of participants, depersonalization of the relationship in 21.2% and disorders of personal accomplishment at 36.3%. The combination of these three parameters has enabled to determine the overall burnout that was 68.2%, the mild form was 46.9% and the moderate form 21.2%; no severe form was observed. Burnout was more common among elderly and paramedics. These results are similar to those observed in other countries that have shown high prevalence of burnout among health workers. Conclusion: Burnout is a reality and, in long-term, can negatively impact health system’s performance.
Similar to BioMed CentralPage 1 of 9(page number not for citation p (20)
Problem 1
Problem 2 (two screen shots)
Problem 3 (two screen shots)
Problem 4 (three screen shots)
Problem 5 (one screen shot)
Problem 6 (six screenshots plus a data table)
.
Problem 20-1A Production cost flow and measurement; journal entrie.docxChantellPantoja184
Problem 20-1A Production cost flow and measurement; journal entries L.O. P1, P2, P3, P4
[The following information applies to the questions displayed below.]
Edison Company manufactures wool blankets and accounts for product costs using process costing. The following information is available regarding its May inventories.
Beginning
Inventory
Ending
Inventory
Raw materials inventory
$
60,000
$
41,000
Goods in process inventory
449,000
521,500
Finished goods inventory
610,000
342,001
The following additional information describes the company's production activities for May.
Raw materials purchases (on credit)
$
250,000
Factory payroll cost (paid in cash)
1,850,300
Other overhead cost (Other Accounts credited)
82,000
Materials used
Direct
$
200,500
Indirect
50,000
Labor used
Direct
$
1,060,300
Indirect
790,000
Overhead rate as a percent of direct labor
115
%
Sales (on credit)
$
3,000,000
The predetermined overhead rate was computed at the beginning of the year as 115% of direct labor cost.
\\\\\
rev: 11_02_2011
references
1.
value:
2.00 points
Problem 20-1A Part 1
Required:
1(a)
Compute the cost of products transferred from production to finished goods. (Omit the "$" sign in your response.)
Cost of products transferred
$
1(b)
Compute the cost of goods sold. (Omit the "$" sign in your response.)
Cost of goods sold
$
rev: 10_31_2011
check my workeBook Links (4)references
2.
value:
5.00 points
Problem 20-1A Part 2
2(a)
Prepare journal entry dated May 31 to record the raw materials purchases. (Omit the "$" sign in your response.)
Date
General Journal
Debit
Credit
May 31
2(b)
Prepare journal entry dated May 31 to record the direct materials usage. (Omit the "$" sign in your response.)
Date
General Journal
Debit
Credit
May 31
2(c)
Prepare journal entry dated May 31 to record the indirect materials usage. (Omit the "$" sign in your response.)
Date
General Journal
Debit
Credit
May 31
2(d)
Prepare journal entry dated May 31 to record the payroll costs. (Omit the "$" sign in your response.)
Date
General Journal
Debit
Credit
May 31
2(e)
Prepare journal entry dated May 31 to record the direct labor costs. (Omit the "$" sign in your response.)
Date
General Journal
Debit
Credit
May 31
2(f)
Prepare journal entry dated May 31 to record the indirect labor costs. (Omit the "$" sign in your response.)
Date
General Journal
Debit
Credit
May 31
2(g)
Prepare journal entry dated May 31 to record the other overhead costs. (Omit the "$" sign in your response.)
Date
General Journal
Debit
Credit
May 31
2(h)
Prepare journal entry dated May 31 to record the overhead applied. (Omit the "$" sign in your response.)
Date
General Journal
Debit
Credit
May 31
2(i)
Prepare journal entry dated May 31 to record the goods transferred from production to finished goods.(Omit the "$" sign in yo.
Problem 2 Obtain Io.Let x be the current through j2, ..docxChantellPantoja184
Problem 2: Obtain Io.
Let x be the current through j2, .
Let .
.
.
.
………..1.
…………2.
.
.
…………3.
……………….4.
Solving these 4 equations we can get .
.
Problem 1:Find currents I1, I2, and I3
Problem 2: Obtain Io
Problem 3:Obtain io
.
Problem 1On April 1, 20X4, Rojas purchased land by giving $100,000.docxChantellPantoja184
Problem 1On April 1, 20X4, Rojas purchased land by giving $100,000 in cash and executing a $400,000 note payable to the former owner. The note bears interest at 10% per annum, with interest being payable annually on March 31 of each year. Rojas is also required to make a $100,000 payment toward the note's principal on every March 31.(a)Prepare the appropriate journal entry to record the land purchase on April 1, 20X4.(b)Prepare the appropriate journal entry to record the year-end interest accrual on December 31, 20X4.(c)Prepare the appropriate journal entry to record the payment of interest and principal on March 31, 20X5.(d)Prepare the appropriate journal entry to record the year-end interest accrual on December 31, 20X5.(e)Prepare the appropriate journal entry to record the payment of interest and principal on March 31, 20X6.
&R&"Myriad Web Pro,Bold"&20B-13.01
B-13.01
Worksheet 1(a), (b), (c), (d), (e)GENERAL JOURNALDateAccountsDebitCredit04-01-X412-31-X403-31-X512-31-X503-31-X6
&L&"Myriad Web Pro,Bold"&12Name:
Date: Section: &R&"Myriad Web Pro,Bold"&20B-13.01
B-13.01
Problem 2Ace Brick company issued $100,000 of 5-year bonds. The bonds were issued at par on January 1, 20X1, and bear interest at a rate of 8% per annum, payable semiannually.(a)Prepare the journal entry to record the bond issue on January, 20X1.(b)Prepare the journal entry that Ace would record on each interest date.(c)Prepare the journal entry that Ace would record at maturity of the bonds.
&R&"Myriad Web Pro,Bold"&20B-13.06
B-13.06
Worksheet 2(a)(b)(c)GENERAL JOURNAL DateAccountsDebitCreditIssueInterestMaturity
&L&"Myriad Web Pro,Bold"&12Name:
Date: Section: &R&"Myriad Web Pro,Bold"&20B-13.06
B-13.06
Problem 3Erik Food Supply Company issued $100,000 of face amount of 4-year bonds on January 1, 20X1. The bonds were issued at 98, and bear interest at a stated rate of 8% per annum, payable semiannually. The discount is amortized by the straight-line method.(a)Prepare the journal entry to record the initial issuance on January, 20X1.(b)Prepare the journal entry that Erik would record on each interest date.(c)Prepare the journal entry that Erik would record at maturity of the bonds.
&R&"Myriad Web Pro,Bold"&20B-13.08
B-13.08
Worksheet 3(a)(b)(c)GENERAL JOURNAL DateAccountsDebitCreditIssueInterestMaturity
&L&"Myriad Web Pro,Bold"&12Name:
Date: Section: &R&"Myriad Web Pro,Bold"&20B-13.08
B-13.08
Problem 4Horton Micro Chip Company issued $100,000 of face amount of 6-year bonds on January 1, 20X1. The bonds were issed at 103, and bear interest at a stated rate of 8% per annum, payable semiannually. The premium is amortized by the straight-line method.(a)Prepare the journal entry to record the initial issue on January, 20X1.(b)Prepare the journal entry that Horton would record on each interest date.(c)Prepare the journal entry that Horton would record at maturity of the bonds.
&R&"Myriad We.
Problem 17-1 Dividends and Taxes [LO2]Dark Day, Inc., has declar.docxChantellPantoja184
Problem 17-1 Dividends and Taxes [LO2]
Dark Day, Inc., has declared a $5.60 per share dividend. Suppose capital gains are not taxed, but dividends are taxed at 15 percent. New IRS regulations require that taxes be withheld at the time the dividend is paid. Dark Day sells for $94.10 per share, and the stock is about to go ex-dividend.
What do you think the ex-dividend price will be? (Round your answer to 2 decimal places. (e.g., 32.16))
Ex-dividend price
$
Problem 17-2 Stock Dividends [LO3]
The owners’ equity accounts for Alexander International are shown here:
Common stock ($0.60 par value)
$
45,000
Capital surplus
340,000
Retained earnings
748,120
Total owners’ equity
$
1,133,120
a-1
If Alexander stock currently sells for $30 per share and a 10 percent stock dividend is declared, how many new shares will be distributed?
New shares issued
a-2
Show how the equity accounts would change.
Common stock
$
Capital surplus
Retained earnings
Total owners’ equity
$
b-1
If instead Alexander declared a 20 percent stock dividend, how many new shares will be distributed?
New shares issued
b-2
Show how the equity accounts would change. (Negative amount should be indicated by a minus sign.)
Common stock
$
Capital surplus
Retained earnings
Total owners’ equity
$
Problem 17-3 Stock Splits [LO3]
The owners' equity accounts for Alexander International are shown here.
Common stock ($0.50 par value)
$
35,000
Capital surplus
320,000
Retained earnings
708,120
Total owners’ equity
$
1,063,120
a-1
If Alexander declares a five-for-one stock split, how many shares are outstanding now?
New shares outstanding
a-2
What is the new par value per share? (Round your answer to 3 decimal places. (e.g., 32.161))
New par value
$ per share
b-1
If Alexander declares a one-for-seven reverse stock split, how many shares are outstanding now?
New shares outstanding
b-2
What is the new par value per share? (Round your answer to 2 decimal places. (e.g., 32.16))
New par value
$ per share
Problem 17-4 Stock Splits and Stock Dividends [LO3]
Red Rocks Corporation (RRC) currently has 485,000 shares of stock outstanding that sell for $40 per share. Assuming no market imperfections or tax effects exist, what will the share price be after:
a.
RRC has a four-for-three stock split? (Round your answer to 2 decimal places. (e.g., 32.16))
New share price
$
b.
RRC has a 15 percent stock dividend? (Round your answer to 2 decimal places. (e.g., 32.16))
New share price
$
c.
RRC has a 54.5 percent stock dividend? (Round your answer to 2 decimal places. (e.g., 32.16))
New share price
$
d.
RRC has a two-for-seven reverse stock split? (Round your answer to 2 decimal places. (e.g., 32.16))
New share price
$
Determine the new number of shares outstanding in parts (a) through (d).
a.
New shares outstanding
b.
New shares o.
Problem 1Problem 1 - Constant-Growth Common StockWhat is the value.docxChantellPantoja184
Problem 1Problem 1 - Constant-Growth Common StockWhat is the value of a common stock if the firm's earnings and dividends are growing annually at 10%, the current dividend is $1.32,and investors require a 15% return on investment?What is the stock's rate of return if the market price of the stock is $35?
Problem 2Problem 2 - Preferred Stock Price and ReturnA firm has preferred stock outstanding with a $1,000 par value and a $40 annual dividend with no maturity. If the required rate of return is 9%, what is the price of the preferred stock?The market price of a firm's preferred stock is $24 and pays an annual dividend of $2.50. If the stock's par value is $1,000 and it has no maturity, what is the return on the preferred stock?
Problem 3Problem 3 - Bond Valuation and YieldA bond has a par value of $1,000, pays $50 semiannually and has a maturity of 10 years.If the bond earns 12% per year, what is the price of the bond?RateNperPMTFVTypePVWhat is the yield to maturity for the bond?NperPMTPVFVTypeRateWhat would be the bond's price if the rate earned declined to 8% per year?RateNperPMTFVTypePVIf the maturity period is reduced to 5 years and the required rate of return is 8%, what would be the price of the bond?RateNperPMTFVTypePVWhat is the yield to maturity for the bond when the maturity is 5 years and the required rate of return is 8%?NperPMTPVFVTypeRateWhat generalizations about bond prices, interest rates and maturity periods can be made based on the calculations made above?
Problem 4Problem 4 - Callable BondsThe following bonds have a par value of $1,000 and the required rate of return is 10%.Bond XY: 5¼ percent coupon, with interest paid annually for 20 yearsBond AB: 14 percent coupon, with interest paid annually for 20 yearsWhat is each bond's current market price?Bond XYBond ABRateNperPMTFVTypePVIf current interest rates are 9%, which bond would you expect to be called? Explain.
Exercise 10-5
During the month of March, Olinger Company’s employees earned wages of $69,500. Withholdings related to these wages were $5,317 for Social Security (FICA), $8,145 for federal income tax, $3,366 for state income tax, and $434 for union dues. The company incurred no cost related to these earnings for federal unemployment tax but incurred $760 for state unemployment tax.
Prepare the necessary March 31 journal entry to record salaries and wages expense and salaries and wages payable. Assume that wages earned during March will be paid during April. (Credit account titles are automatically indented when amount is entered. Do not indent manually.)
Date
Account Titles and Explanation
Debit
Credit
Mar. 31
SHOW LIST OF ACCOUNTS
LINK TO TEXT
Prepare the entry to record the company’s payroll tax expense. (Credit account titles are automatically indented when amount is entered. Do not indent manually.)
Date
Account Titles and Explanation
Debit
Credit
Mar. 31
===========================================
E.
Problem 1Prescott, Inc., manufactures bookcases and uses an activi.docxChantellPantoja184
Problem 1Prescott, Inc., manufactures bookcases and uses an activity-based costing system. Prescott's activity areas and related data follows:ActivityBudgeted Cost
of ActivityAllocation BaseCost Allocation
RateMaterials handling$230,000Number of parts$0.50Assembly3,200,000Direct labor hours16.00Finishing180,000Number of finished
units4.50Prescott produced two styles of bookcases in October: the standard bookcase and an unfinished bookcase, which has fewer parts and requires no finishing. The totals for quantities, direct
materials costs, and other data follow:ProductTotal Units
ProducedTotal Direct
Materials CostsTotal Direct
Labor CostsTotal Number
of PartsTotal Assembling
Direct Labor HoursStandard bookcase3,000$36,000$45,0009,0004,500Unfinished bookcase3,50035,00035,0007,0003,500Requirements:1. Compute the manufacturing product cost per unit of each type of bookcase.2. Suppose that pre-manufacturing activities, such as product design, were assigned to the standard bookcases at $7 each, and to the unfinished bookcases at $2 each. Similar analyses
were conducted of post-manufacturing activities such as distribution, marketing, and customer service. The post-manufacturing costs were $22 per standard bookcase and $14 per
unfinished bookcase. Compute the full product costs per unit.3. Which product costs are reported in the external financial statements? Which costs are used for management decision making? Explain the difference.4. What price should Prescott's managers set for unfinished bookcases to earn $15 per bookcase?
Problem 2Corbertt Pharmaceuticals manufactures an over-the-counter allergy medication. The company sells both large commercial containers of 1,000 capsules to health-care facilities
and travel packs of 20 capsules to shops in airports, train stations, and hotels. The following information has been developed to determine if an activity-based costing system
would be beneficial:ActivityEstimated Indirect Activity
CostsAllocation BaseEstimated Quantity of
Allocation BaseMaterials handling$95,000Kilos19,000 kilosPackaging219,000Machine hours5,475 hoursQuality assurance124,500Samples2,075 samplesTotal indirect costs$438,500Other production information includes the following:Commercial ContainersTravel PacksUnits produced3,500 containers57,000 packsWeight in kilos14,0005,700Machine hours2,625570Number of samples700855Requirements:1. Compute the cost allocation rate for each activity.2. Use the activity-based cost allocation rates to compute the activity costs per unit of the commercial containers and the travel packs. (Hint: First compute the total activity
cost allocated to each product line, and then compute the cost per unit.)3. Corbertt's original single-allocation-base costing system allocated indirect costs to produce at $157 per machine hour. Compute the total indirect costs allocated to the
commercial containers and to the travel packs under the original system. Then compute the indirect cost per unit for ea.
Problem 1Preston Recliners manufactures leather recliners and uses.docxChantellPantoja184
Problem 1Preston Recliners manufactures leather recliners and uses flexible budgeting and a standard cost system. Preston allocates overhead based on yards of direct materials. The company's performance report includes the following selected data:Static Budget
(1,000 recliners)Actual Results
(980 recliners)Sales (1,000 recliners X $495)$495,000 (980 recliners X $475)$465,500Variable manufacturing costs: Direct materials (6,000 yds @ $8.80/yard)52,800 (6,150 yds @ $8.60/yard)52,890 Direct labor (10,000 hrs @ $9.20/hour)92,000 (9,600 hrs @ $9.30/hour)89,280Variable overhead (6,000 yds @ $5.00/yard)30,000 (6,510 yds @ $6.40/yard)39,360Fixed manufacturing costs: Fixed overhead60,00062,000Total cost of goods sold$234,800$243,530Gross profit$260,200$221,970Requirements:1. Prepare a flexible budget based on the actual number of recliners sold.2. Compute the price variance and the efficiency variance for direct materials and for direct labor. For manufacturing overhead, compute the variable overhead spending, variable overhead efficiency, fixed overhead spending, and fixed overhead volume variances.3. Have Preston's managers done a good job or a poor job controlling materials, labor, and overhead costs? Why?4. Describe how Preston's managers can benefit from the standard costing system.
Problem 2AllTalk Technologies manufactures capacitors for cellular base stations and other communications applications. The company's January 2012 flexible budget income statement shows output levels of 6,500, 8,000, and 10,000 units. The static budget was based on expected sales of 8,000 units.ALLTALK TECHNOLOGIES
Flexible Budget Income Statement
Month Ended January 31, 2012Per UnitBy Units (Capacitors)6,5008,00010,000Sales revenue$24$156,000$192,000$240,000Variable expenses$1065,00080,000100,000Contribution margin$91,000$112,000$140,000Fixed expenses53,00053,00053,000Operating income$38,000$59,000$87,000The company sold 10,000 units during January, and its actual operating income was as follows:ALLTALK TECHNOLOGIES
Income Statement
Month Ended January 31, 2012Sales revenue$246,000Variable expenses104,500Contribution margin$141,500Fixed expenses54,000Operating income$87,500Requirements:1. Prepare an income statement performance report for January.2. What was the effect on AllTalk's operating income of selling 2,000 units more than the static budget level of sales?3. What is AllTalk's static budget variance? Explain why the income statement performance report provides more useful information to AllTalk's managers than the simple static budget variance. What insights can AllTalk's managers draw from this performance report?
Problem 3Java manufacturers coffee mugs that it sells to other companies for customizing with their own logos. Java prepares flexible budgets and uses a standard cost system to control manufacturing costs. The standard unit.
Problem 1Pro Forma Income Statement and Balance SheetBelow is the .docxChantellPantoja184
Problem 1Pro Forma Income Statement and Balance SheetBelow is the income statement and balance sheet for Blue Bill Corporation for 2013. Based on the historical statements and theadditional information provided, construct the firm's pro forma income statement and balance sheet for 2014.Blue Bill CorporationIncome StatementFor the year ended 2013Projected201220132014Revenue$60,000$63,000Cost of goods sold42,00044,100Gross margin18,00018,900SG&A expense6,0006,300Depreciation expense1,8002,000Earnings Before Interest and Taxes (EBIT)10,20010,600Interest expense1,5001,800Taxable income8,7008,800Income Tax Expense3,0453,080Net income5,6555,720Dividends750800To retained earnings$4,905$4,920Additional income statement information:Sales will increase by 5% in 2014 from 2013 levels.COGS and SG&A will be the average percent of sales for the last 2 years.Depreciation expense will increase to $2,200.Interest expense will be $1,900.The tax rate is 35%.Dividend payout will increase to $850.Blue Bill CorporationBalance SheetDecember 31, 2013Projected20132014Current assetsCash$8,000Accounts receivable3,150Inventory9,450Total current assets20,600Property, plant, and equipment (PP&E)28,500Accumulated depreciation16,400Net PP&E12,100Total assets$32,700Current liabilitesAccounts payable$3,780Bank loan (10%)3,200Other current liabilities1,250Total current liabilities8,230Long-term debt (12%)4,800Common stock1,250Retained earnings18,420Total liabilities and equity$32,700Additional balance sheet information:The minimum cash balance is 12% of sales.Working capital accounts (accounts receivable, accounts payable, and inventory) will be the same percent of sales in 2014 as they were in 2013.$8,350 of new PP&E will be purchased in 2014.Other current liabilities will be 3% of sales in 2014.There will be no changes in the common stock or long-term debt accounts.The plug figure (the last number entered that makes the balance sheet balance) is bank loan.
1
Rough Draft
Rough Draft
Rasmussen College
Metro Dental Care is a dental office that provides affordable, convenient, and high quality of care to patients. As a patient at Metro, I personally believe that Metro Dental Care is one of the best dental clinics around, and that’s why I have chosen this company. Metro Dental Care measures their results by recording patient satisfaction.
Managing financial reports, and the quality of service they provide to their customers. Furthermore, the dentists and staff at Metro Dental Care know how important your smile is. Their mission statement states “We pride ourselves in making your smile look great so you not only look good, but feel confident with your smile.”
Metro Dental Care offers convenience for their patients with more than 40 offices throughout the Minneapolis and St. Paul metro area offering flexible hours including early morning, evening and Saturday appointments. Whether you work or live Metro Dental Care has a location near you. Metro Dental .
PROBLEM 14-6AProblem 14-6A Norwoods Borrowings1. Total amount of .docxChantellPantoja184
PROBLEM 14-6AProblem 14-6A: Norwoods Borrowings1. Total amount of each installment payment.Present value of an ordinary annuity$200,000Interest per period(i)0.08Number of periods(n)5Total amount of each installment payment($50,091.29)Therefore the total amount of each installment payment is $ 50,091.292.Norwoods Amortization TablePeriod Ending DateBeginning balance Interest expenseNotes PayableCash paymentEnding Balance10/31/15$200,000.00$16,000.00$34,091.29$50,091.29$165,908.7110/31/16$165,909.00$13,272.72$36,818.57$50,091.29$129,090.4310/31/17$129,090.43$10,327.23$39,764.06$50,091.29$89,326.3710/31/18$89,326.37$7,146.11$42,945.18$50,091.29$46,381.1910/31/19$46,381.19$3,710.50$46,380.79$50,091.29$0.403.a) Accrued interest as December 31st 2015Accrued interest expense = $200,000*8%*2/12= $2,666.67. Thus the journal entry is as shown below:DescriptionDr($)Cr($)interest expense $2,666.67 Interest payable $2,666.67b) The first annual payment on the note.Ten more months of interest has accrued $200,000*8%*10/12 =$13,333.33 accrued interest .Therefore the journal entry is as shown below:DescriptionDr($)Cr($)Notes payable$34,091.29interest expense$13,333.33interest payable$2,666.67 Cash$50,091.29
PROBLEM 14-7AProblem 14-7AQuestion 1a) Debt to equity ratiosPulaski CompanyScott Company Total liabilities$360,000.00$240,000.00Total Equity$500,000.00$200,000.00Debt-Equity Ratio0.721.2Question 2The debt to equity ratio measures the amount of debt a company uses has to finance its business for every dollar of equity it has. A higher debt to equity ratio implies that a company uses more debt than equity for financing. In this case, the debt to equity ratio for Pulaski Company is 0.72 which is less than 1 implying that the stockholder's equity exceeds the amount of debt borrowed. Thus Pulaski Company may not likely suffer from risks brought about by huge amount of debts in the capital structure. On the other hand, the debt to equity ratio of Scott Company is 1.2 which is greater than 1 implying that the debt exceeds the totalamount stockholders equity. Huge debts is associated with a lot of risks. First, there is the risk of defaulting whereby the company may be unable to repay its debt and therefore leading to bankruptcy. Second, a company may find it difficult to obtain additional funding from creditors.This is because the creditors prefer companies with low debt to equity ratio. Finally, there is the risks of violating the debt covenants. A covenant is an agreement that requires a company to maintain adequate financial ratio levels. Too much borrowings may violate this covenant. Since ScottCompany has a higher debt to equity ratio, it may experience these risks which may eventually lead to the company being declared bankrupt .
PROBLEM 14-6BProblem 14-6B: Gordon Enterprises Borrowings1. Total amount of each installment payment.Present value of an ordi.
Problem 13-3AThe stockholders’ equity accounts of Ashley Corpo.docxChantellPantoja184
Problem 13-3A
The stockholders’ equity accounts of Ashley Corporation on January 1, 2012, were as follows.
Preferred Stock (8%, $49 par, cumulative, 10,200 shares authorized)
$ 387,100
Common Stock ($1 stated value, 1,937,100 shares authorized)
1,408,700
Paid-in Capital in Excess of Par—Preferred Stock
123,200
Paid-in Capital in Excess of Stated Value—Common Stock
1,496,800
Retained Earnings
1,814,400
Treasury Stock (10,300 common shares)
51,500
During 2012, the corporation had the following transactions and events pertaining to its stockholders’ equity.
Feb. 1
Issued 24,100 shares of common stock for $123,900.
Apr. 14
Sold 6,000 shares of treasury stock—common for $33,800.
Sept. 3
Issued 5,100 shares of common stock for a patent valued at $35,700.
Nov. 10
Purchased 1,100 shares of common stock for the treasury at a cost of $5,700.
Dec. 31
Determined that net income for the year was $456,600.
No dividends were declared during the year.
(a)
Journalize the transactions and the closing entry for net income. (Credit account titles are automatically indented when amount is entered. Do not indent manually.)
Date
Account Titles and Explanation
Debit
Credit
Feb. 1
Apr. 14
Sept. 3
Nov. 10
Dec. 31
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Problem 12-9AYour answer is partially correct. Try again..docxChantellPantoja184
Problem 12-9A
Your answer is partially correct. Try again.
Condensed financial data of Odgers Inc. follow.
ODGERS INC.Comparative Balance Sheets
December 31
Assets
2014
2013
Cash
$ 131,704
$ 78,892
Accounts receivable
143,114
61,940
Inventory
183,375
167,646
Prepaid expenses
46,292
42,380
Long-term investments
224,940
177,670
Plant assets
464,550
395,275
Accumulated depreciation
(81,500
)
(84,760
)
Total
$1,112,475
$839,043
Liabilities and Stockholders’ Equity
Accounts payable
$ 166,260
$ 109,699
Accrued expenses payable
26,895
34,230
Bonds payable
179,300
237,980
Common stock
358,600
285,250
Retained earnings
381,420
171,884
Total
$1,112,475
$839,043
ODGERS INC.Income Statement Data
For the Year Ended December 31, 2014
Sales revenue
$633,190
Less:
Cost of goods sold
$220,800
Operating expenses, excluding depreciation
20,228
Depreciation expense
75,795
Income tax expense
44,466
Interest expense
7,710
Loss on disposal of plant assets
12,225
381,224
Net income
$ 251,966
Additional information:
1.
New plant assets costing $163,000 were purchased for cash during the year.
2.
Old plant assets having an original cost of $93,725 and accumulated depreciation of $79,055 were sold for $2,445 cash.
3.
Bonds payable matured and were paid off at face value for cash.
4.
A cash dividend of $42,430 was declared and paid during the year.
Prepare a statement of cash flows using the indirect method. (Show amounts that decrease cash flow with either a - sign e.g. -15,000 or in parenthesis e.g. (15,000).)
ODGERS INC.Statement of Cash Flows
For the Year Ended December 31, 2014
$
Adjustments to reconcile net income to
$
$
Problem 12-10A
Condensed financial data of Odgers Inc. follow.
ODGERS INC.Comparative Balance Sheets
December 31
Assets
2014
2013
Cash
$ 151,904
$ 90,992
Accounts receivable
165,064
71,440
Inventory
211,500
193,358
Prepaid expenses
53,392
48,880
Long-term investments
259,440
204,920
Plant assets
535,800
455,900
Accumulated depreciation
(94,000
)
(97,760
)
Total
$1,283,100
$967,730
Liabilities and Stockholders’ Equity
Accounts payable
$ 191,760
$ 126,524
Accrued expenses payable
31,020
39,480
Bonds payable
206,800
274,480
Common stock
413,600
329,000
Retained earnings
439,920
198,246
Total
$1,283,100
$967,730
ODGERS INC.Income Statement Data
For the Year Ended December 31, 2014
Sales revenue
$730,305
Less:
Cost of goods sold
$254,665
Operating expenses, excluding depreciation
23,331
Depreciation expense
87,420
Income taxes
51,286
Interest expense
8,892
Loss on disposal of plant assets
14,100
439,694
Net income
$ 290,611
Additional information:
1.
New plant assets costing $188,000 were purchased for c.
Problem 1123456Xf122437455763715813910106Name DateTopic.docxChantellPantoja184
Problem 1123456Xf122437455763715813910106
Name: Date:
Topic One: Mean, Variance, and Standard Deviation
Please type your answer in the cell beside the question.
5. The following is the heart rate for 10 randomly selected patients on the unit. Find the mean, variance, and standard deviation of the data using the descriptive statistics option in the data analysis toolpak.
75, 80, 62, 97, 107, 59, 76, 83, 84, 69
6. The following is a frequency distribution fo the number of times patience use the call light in a days time. X is the number of times the call light is used and f is the frequency (meaning the number of patients). Create a histogram of the data.
Sheet2
Sheet3
EXERCISE 11 USING STATISTICS TO DESCRIBE A STUDY SAMPLE
STATISTICAL TECHNIQUE IN REVIEW
Most studies describe the subjects that comprise the study sample. This description of the sample is called the sample characteristics which may be presented in a table or the narrative of the article. The sample characteristics are often presented for each of the groups in a study (i.e. experimental and control groups). Descriptive statistics are used to generate sample characteristics, and the type of statistic used depends on the level of measurement of the demographic variables included in a study (Burns & Grove, 2007). For example, measuring gender produces nominal level data that can be described using frequencies, percentages, and mode. Measuring educational level usually produces ordinal data that can be described using frequencies, percentages, mode, median, and range. Obtaining each subject's specific age is an example of ratio data that can be described using mean, range, and standard deviation. Interval and ratio data are analyzed with the same type of statistics and are usually referred to as interval/ratio level data in this text.
RESEARCH ARTICLE
Source: Troy, N. W., & Dalgas-Pelish, P. (2003). The effectiveness of a self-care intervention for the management of postpartum fatigue. Applied Nursing Research, 16 (1), 38–45.
Introduction
Troy and Dalgas-Pelish (2003) conducted a quasi-experimental study to determine the effectiveness of a self-care intervention (Tiredness Management Guide [TMG]) on postpartum fatigue. The study subjects included 68 primiparous mothers, who were randomly assigned to either the experimental group (32 subjects) or the control group (36 subjects) using a computer program. The results of the study indicated that the TMG was effective in reducing levels of morning postpartum fatigue from the 2nd to 4th weeks postpartum. These researchers recommend that “mothers need to be informed that they will probably experience postpartum fatigue and be taught to assess and manage this phenomenon” (Troy & Dalgas-Pelish, 2003, pp. 44-5).
Relevant Study Results
“A total of 80 women were initially enrolled [in the study] … twelve of these women dropped out of the study resulting in a final sample of 68.” (Troy & Dalgas-Pelish, 2003, p. 39). The researchers presen.
Problem 1. For the truss and loading shown below, calculate th.docxChantellPantoja184
Problem 1. For the truss and loading shown below, calculate the horizontal
displacement of point "D" using the method of virtual work. Show ALL your work!
HW No. 8 - Part 1
Solution
HW FA15 2 Page 1
Problem 1 Continued
Member L (in.) N (lb) N (in) NnL
HW No. 8 - Part 1
.
Problem 1 (30 marks)Review enough information about .docxChantellPantoja184
Problem 1 (30 marks)
Review enough information about Trinidad Drilling Ltd. to propose a vision and strategic objectives for the company. Develop a balanced scorecard that will help the company achieve this vision and monitor how well it is accomplishing its strategic objectives. Include a strategy map in table format that shows objectives and performance measures, with arrows illustrating hypothesized cause-and -effect relationships. Provide rationale for your strategy map. The body of your report should not exceed 1,000 words. Cite material you used to prepare the response and provide references in an appendix.
Problem 2 (20 marks)
Ajax Auto Upholstery Ltd. manufactures upholstered products for automobiles, vans, and trucks. Among the various Ajax plants around Canada is the Owlseye plant located in rural Alberta.
The chief financial officer has just received a report indicating that Ajax could purchase the entire annual output of the Owlseye plant from a foreign supplier for $37 million per year.
The budgeted operating costs (in thousands) for the Owlseye plant’s for the coming year is as follows:
Materials $15,000
Labor
Direct $12,000
Supervision 4,000
Indirect plant 5,000 19,000
Overhead
Depreciation – plant 6,000
Utilities, property tax, maintenance 2,000
Pension expense 4,500
Plant manager and staff 2,500
Corporate headquarters overhead allocation 3,000 18,000
Total budgeted costs $52,000
If material purchase orders are cancelled as a consequence of the plant closing, termination charges would amount to 10 percent of the annual cost of direct materials in the first year (zero thereafter).
A clause in the Ajax union contract requires the company to provide employment assistance to its former employees for 12 months after a plant closes. The estimated cost to administer this service if the Owlseye plant closes would be $2 million. $3.6 million of next year’s pension expense would continue indefinitely whether or not the plant remains open. About $900,000 of labour would still be required in the first year after closure to decommission the plant. After that, the plant would be sold for an estimated $1 million. Utilities, property taxes, and maintenance costs would remain unchanged in the first year after closure, but disappear when the plant is sold.
The plant manager and her staff would be somewhat affected by the closing of the Owlseye plant. Some managers would still be responsible for managing three other plants. As a result, total management salaries would be about 50% of the current level, starting at closure and remaining into the future.
Required:
Assume you are the company’s chief financial officer. Perform a five-year financial analysis and make a recommendation whether to close the Owlseye plant on this basis. Provide support for and cautions about your recommendation with organized, clearly-labeled data. Use bullet points where appropriate.
Problem 3 (16 marks)
Br.
Problem 1 (10 points) Note that an eigenvector cannot be zero.docxChantellPantoja184
Problem 1 (10 points): Note that an eigenvector cannot be zero, but an eigenvalue can
be 0. Suppose that 0 is an eigenvalue of A. What does it say about A? (Hint: One of the
most important properties of a matrix is whether or not it is invertible. Think about the
Invertible Matrix Theorem and all the ‘good things’ of dealing with invertible matrices)
Problem 5: (20 points): The figure below shows a network of one-way streets with
traffic flowing in the directions indicated. The flow rate along the streets are measured
as the average number of vehicles per hour.
a) Set up a mathematical model whose solution provides the unknown flow rates
b) Solve the model for the unknown flow rates
c) If the flow rates along the road A to B must be reduced for construction, what is
the minimum flow that is required to keep traffic flowing on all roads?
Problem 6 (20 points): Problem 7 (9 points): Prove that if A and B are matrices of the same
size, then tr(A+B)=tr(A)+tr(B)
Given:
Goal:
Proof:
Problem 7 (20 points)*: In the 1990, the northern spotted owl became the center of a
nationwide controversy over the use and misuse of the majestic forests in the Pacific
Northwest. Environmentalists convinced the federal government that the owl was
threatened with extinction if logging continued in the old-growth forests (with trees over
200 years old), where the owls prefer to live. The timber industry, anticipating the loss of
30,000 to 100,000 jobs as a result of new government restrictions on logging, argued that
the owl should not be classified as a “threatened species” and cited a number of published
scientific reports to support its case.
Caught in the crossfire of the two lobbying groups, mathematical ecologists
intensified their drive to understand the population dynamics of the spotted owl. The life
cycle of a spotted owl divides naturally into three stages: juvenile (up to 1 year old),
subadult (1 to 2 years), and adult (over 2 years). The owls mate for life during the subadult
and adult stages, begin to breed as adults, and live for up to 20 years. Each owl pair
requires about 1,000 hectares (4 square miles) for its own home territory. A critical time in
the life cycle is when the juveniles leave the nest. To survive and become a subadult, a
juvenile must successfully find a new home range (and usually a mate).
A first step in studying the population dynamics is to model the population at yearly
intervals, at times denoted by 𝑘𝑘 = 0,1,2, …. Usually, one assumes that there is a 1:1 ratio of
males to females in each life stage and counts only the females. The population at year 𝑘𝑘
can be described by a vector 𝒙𝒙𝒌𝒌 = (𝑗𝑗𝑘𝑘 , 𝑠𝑠𝑘𝑘 , 𝑎𝑎𝑘𝑘 ), where 𝑗𝑗𝑘𝑘 , 𝑠𝑠𝑘𝑘 , and 𝑎𝑎𝑘𝑘 are the numbers of
females in the juvenile, subadult, and adult stages, respectively. Using actual field data from
demographic studies, a rese
Probation and Parole 3Running head Probation and Parole.docxChantellPantoja184
Probation and Parole 3
Running head: Probation and Parole
Probation and Parole
Student Name
Allied American University
Author Note
This paper was prepared for Probation and Parole, Module 8 Check Your Understanding taught by [INSERT INSTRUCTOR’S NAME].
Directions: Respond to the following questions using complete sentences. Your answer should be at least 1 paragraph in length, which must be composed of three to five sentences.
1. What is meant by intermediate punishments and what programs are included in this category?
2. How do intermediate punishments serve to keep down prison populations?
3. Why has electronic monitoring proven so popular?
4. What is meant by shock probation/parole?
5. What are the essential features of the boot camp program?
6. Why has intensive supervision been a public relations success?
7. What are the criticisms of boot camp programs?
8. What has research revealed with respect to intensive supervision?
9. What are the criticisms of electronic monitoring in probation and parole?
10. What are the criticisms leveled at intensive supervision?
11. What are the purposes of and services offered by a day reporting center?
12. Why would heroin addicts who have no intention of giving up drug use voluntarily enter a drug treatment program? What are the advantages of using methadone to treat heroin addicts?
13. Why is behavior modification difficult to use in treating drug abusers?
14. What are the characteristics of chemical dependency (CD) programs?
15. What are the primary characteristics of the therapeutic community (TC) approach for treating drug abusers?
16. What are criticisms of the Alcoholics Anonymous approach?
17. What are the problems inherent in drug testing?
18. What are the typical characteristics of sex offenders? How have sex offender laws affected P/P supervision?
19. What are the pros and cons of restitution and charging offenders fees in probation or parole?
20. What are the problems encountered in using the interstate compact?
.
Problem 1(a) Complete the following ANOVA table based on 20 obs.docxChantellPantoja184
Problem 1:
(a) Complete the following ANOVA table based on 20 observations for the regression equation
(a) Is the overall regression significant? Fill in the missing values in the table.
Source DF SS MS F
Regression ___ 350 ____ ____
Error ___ _____
Total 500
(b) Suppose that you have computed the following sequential sums of squares due to regression:
Regressor Variables in Model SS Regression
………………………………………. 300
……………………………………… 250
…………………………………….. 340
……………………………………. 325
Fill in the missing values in the following “computer output”:
Source DF Partial SS F-value Pr>F
……………………………………………………………………………………….. 0.1245
………………………………………………………………………………………. 0.3841
………………………………………………………………………………………. 0.0042
………………………………………………………………………………………. 0.0401
Problem 2:
The time required for a merchandise to stock a grocery store shelf with a soft drink product as well as the number of cases of product stocked are given below. Consider a linear regression of delivery time against number of cases.
X=number of cases
Y=delivery time
Delivery time number of cases Hat diagonals
1.41 4 0.5077
2.96 6 0.3907
6.04 14 0.2013
7.57 19 0.3092
9.38 24 0.5912
Observations used L.S. Model
4,6,14,19,24
6,14,19,24
4,14,19,24
4,14,19,24
4,6,14,24
4,6,14,19
(a)
Calculate the PRESS statistic for the model .
(b) Calculate the regular residual for the model above. Then, compare these residuals with the PRESS residuals for this model.
Exercises from the Text
Use SAS whenever possible to do these exercises:
# 3.4 on p 122
# 3.5
# 3.8
# 3.15
# 3.21
# 3.27
# 3.28
# 3.31
# 3.38
# 3.39
Example with SAS on Sequential and Partial Sum of Squares
Data Weather;
Title 'Lows and Highs from N&O Jan 28,29,30 1992';
Title2 'using actual numbers (yesterday values)';
input city $ hi2 lo2 yhi ylo thi tlo;
* Mon Tues Wed ;
cards;
seattle 51 44 52 44 59 47
.
.
.
;
proc reg; model thi = yhi hi2 tlo ylo lo2/ss1 ss2;
test tlo=0, ylo=0, lo2=0;
/*-----------------------------------------------
| Showing sequential and partial sums of squares|
| Note t**2 = F relationship for partial F. By |
| hand, construct F to leave out .
Probe 140 SPrecipitation in inchesTemperature in F.docxChantellPantoja184
Probe 1
40 S
Precipitation in inches
Temperature in F
J F M A M J J A S O N D
2
4
6
8
10
12
0
10
20
30
40
50
60
70
80
90
POTET 26.8
Precip 27.1
MAT(F) 59.8
Probe 2
6 S
Precipitation in inches
Temperature in F
J F M A M J J A S O N D
2
4
6
8
10
12
0
10
20
30
40
50
60
70
80
90
POTET 69.2
Precip 124.6
MAT(F) 77.9
Probe 3
57 S
Precipitation in inches
Temperature in F
J F M A M J J A S O N D
2
4
6
8
10
12
0
10
20
30
40
50
60
70
80
90
POTET 21.5
Precip 38.7
MAT(F) 43.5
Probe 4
38 N
Precipitation in inches
Temperature in F
J F M A M J J A S O N D
2
4
6
8
10
12
0
10
20
30
40
50
60
70
80
90
POTET 30.3
Precip 16.5
MAT(F) 53.6
Probe 5
55 N
Precipitation in inches
Temperature in F
J F M A M J J A S O N D
2
4
6
8
10
12
0
10
20
30
40
50
60
70
80
90
POTET 21.3
Precip 28.1
MAT(F) 40.6
Probe 6
43 N
Precipitation in inches
Temperature in F
J F M A M J J A S O N D
2
4
6
8
10
12
0
10
20
30
40
50
60
70
80
90
POTET 25.4
Precip 14.4
MAT(F) 47.2
Probe 7
42 N
Precipitation in inches
Temperature in F
J F M A M J J A S O N D
2
4
6
8
10
12
0
10
20
30
40
50
60
70
80
90
POTET 17.3
Precip 31.2
MAT(F) 26.0
Probe 8
42 N
Precipitation in inches
Temperature in F
J F M A M J J A S O N D
2
4
6
8
10
12
0
10
20
30
40
50
60
70
80
90
POTET 29.6
Precip 38.8
MAT(F) 51.6
Probe 9
18 S
Precipitation in inches
Temperature in F
J F M A M J J A S O N D
2
4
6
8
10
12
0
10
20
30
40
50
60
70
80
90
POTET 66.1
Precip 74.8
MAT(F) 77.7
Probe 10
58 N
Precipitation in inches
Temperature in F
J F M A M J J A S O N D
2
4
6
8
10
12
0
10
20
30
40
50
60
70
80
90
POTET 16.5
Precip 24.8
MAT(F) 36.9
Probe 11
26 N
Precipitation in inches
Temperature in F
J F M A M J J A S O N D
2
4
6
8
10
12
0
10
20
30
40
50
60
70
80
90
POTET 47.6
Precip 3.8
MAT(F) 70.1
Probe 12
29 N
Precipitation in inches
Temperature in F
J F M A M J J A S O N D
2
4
6
8
10
12
0
10
20
30
40
50
60
70
80
90
POTET 44.0
Precip 47.3
MAT(F) 63.2
Probe 4
Probe 2
Probe 10
Probe 5
Probe 6
Probe 7
Probe 11
Probe 12
Probe 8
Probe 9
Probe 3
Probe 1
Map 1
20 N
40 N
60 N
80 N
0
20 S
40 S
60 S
0
1000
miles
Geography 204
Koppen Climate Classification Guidelines
If POTET exceeds Precip then B
BW = POTET more than 2x Precip
(desert)
h = mean annual temp > 18 C (64.4 F)
k = mean annual temp < 18 C (64.4 F)
BS = POTET less than 2x Precip
(steppe)
h = mean annual t.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
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Unit 8 - Information and Communication Technology (Paper I).pdf
BioMed CentralPage 1 of 9(page number not for citation p
1. BioMed Central
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BMC Health Services Research
Open AccessResearch article
Prevalence and associated factors in burnout and psychological
morbidity among substance misuse professionals
Adenekan Oyefeso*1, Carmel Clancy2 and Roger Farmer3
Address: 1Division of Mental Health, Medical School, St
George's, University of London, London SW17 0RE, UK,
2School of Health and Social
Sciences, Middlesex University, F Block, Holborn Union
Building, Archway Campus, Highgate Hill, London N19 3UA,
UK and 3South West
London and St George's Mental Health NHS Trust, Richmond
Royal Hospital, Kew Foot Road, Surrey TW9 2TE, UK
Email: Adenekan Oyefeso* - [email protected]; Carmel Clancy -
[email protected]; Roger Farmer - [email protected]
* Corresponding author
Abstract
Background: Studies of psychological stress among substance
misuse professionals rarely
describe the nature of burnout and psychological morbidity. The
main aim of this study was to
determine the extent, pattern and predictors of psychological
morbidity and burnout among
2. substance misuse professionals.
Methods: This study was a cross-sectional mail survey of 194
clinical staff of substance misuse
services in the former South Thames region of England, using
the General Health Questionnaire
(GHQ-12) the Maslach Burnout Inventory (MBI) as measures of
psychological morbidity and
burnout, respectively.
Results: Rates of psychological morbidity (82%: 95% CI = 76–
87) and burnout (high emotional
exhaustion – 33% [27–40]; high depersonalisation – 17% [12–
23]; and diminished personal
accomplishment – 36% [29–43]) were relatively high in the
study sample. High levels of alienation
and tension (job stressors) predicted emotional exhaustion and
depersonalisation (burnout) but
not psychological morbidity. Diminished personal
accomplishment was associated with higher
levels of psychological morbidity
Conclusion: In the sample of substance misuse professionals
studied, rates of psychological
morbidity and burnout were high, suggesting a higher level of
vulnerability than in other health
professionals. Furthermore, pathways to psychological
morbidity and burnout are partially related.
Therefore, targeted response is required to manage stress,
burnout and psychological morbidity
among substance misuse professionals. Such a response should
be integral to workforce
development.
Background
Since the introduction of the United Kingdom Govern-
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However, few studies have examined burnout in sub-
stance misuse workers. An earlier study of burnout among
substance misuse workers in the UK [5] revealed high
emotional exhaustion and high depersonalisation in this
population. In addition, very few studies have examined
work-related predictors of burnout in substance misuse
workers, and these have been limited to the addiction
workforce in the United States [6,7]. Similarly, many stud-
ies have been conducted on the prevalence and pattern of
psychological morbidity in different occupational groups
and settings [8-10]. Yet, very few have focused on psycho-
logical morbidity and its predictors in substance misuse
professionals.
There are pointers in the literature to the presence of high
occupational stress burnout and high psychological mor-
bidity among substance misuse professionals. Human
services, such as substance misuse practice, that entail rel -
atively low practitioner autonomy tend to be strongly
associated with high psychological morbidity [11]). Sec-
ondly, substance misuse practice has been associated with
high demands and low control over caseload and tasks
[5]. These circumstances are similar to the concept of job
strain that has been articulated by Karasek et al [12]. Fur -
thermore, Calnan et al [13] have demonstrated a strong
relationship between job strain and psychological mor-
bidity.
5. Determining the extent, pattern and predictors of burnout
and psychological morbidity among substance misuse
professionals can lead to major benefits such as:
• Improving job satisfaction and retention in the work-
force, given the significant negative relationship between
stress and job satisfaction
• Providing information that should assist employee sup-
port and the development of programmes to promote
employee well-being
• Helping employers address employee mental health
needs with a view to improving overall psychological
health and job performance.
The aim of this study was to determine the prevalence,
pattern and predictors of burnout and psychological mor-
bidity using data collected during the earlier stages of
implementation of the Government's ten-year drug strat-
egy.
The study objectives were to determine the prevalence of
burnout and psychological morbidity among substance
misuse service workers; the influence of demographic var-
iables, job characteristics and job stressors on burnout
and psychological morbidity; and examine the relation-
ship between burnout and psychological morbidity.
Methods
This study was designed to test the following hypotheses:
1. Age and gender would predict burnout and psycholog-
ical morbidity.
6. 2. Job characteristics would predict burnout and psycho-
logical morbidity.
3. Job stressors would predict burnout and psychological
morbidity.
4. There would be a significant positive relationship
between burnout and psychological morbidity.
Maslach and Jackson's [14] definition of burnout was
adopted in this study. However, the three dimensions of
burnout, emotional exhaustion, depersonalisation and
diminished were examined separately. Psychological mor-
bidity was defined as scores on the General Health Ques-
tionnaire – 12 (GHQ-12) [15].
The data reported in this article were collected as part of a
cross-sectional postal survey of clinical staff of substance
misuse services in the former South Thames region of Eng-
land in 2000. Staff from private clinics were excluded
from this analysis. The survey questionnaire covered
many areas including demographic details, job character-
istics, measures of burnout, job stressors, visual analogue
scales of job stress and job satisfaction and psychological
morbidity. The relationships between job stress, burnout
and job satisfaction have been reported previously in the
development and validation of an occupational stress
scale among substance misuse professionals [16].
Subjects
The sample consisted of clinical staff working in substance
misuse services (statutory and non-statutory) in the
former South Thames (West) region of England. The sam-
pling frame was based on the number of services listed in
the directory of substance misuse services published by
health authorities. Secondly, the manager of each service
7. was requested to provide the number of current staff with
existing caseload. This mapping exercise yielded 280 staff
that were surveyed from 46 services. Staff from these serv-
ices provided a sample size of 194, yielding a response
rate of 69% (the number of respondents returning a ques-
tionnaire as a percentage of all identified clinical staff in
participating agencies), after a second wave that involved
a telephone reminder. The first wave of the postal survey
yielded a response rate of 52% after one month. We were
unable to determine the nature and magnitude of non-
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response bias because at the time of the study, there was
no information on the characteristics of substance misuse
clinical staff in the region.
The mean age of respondents was 38 years (SD = 9.9). Par -
ticipants were 57% female and the following occupa-
tional groups were represented: Nurses (36%, n = 70);
drug/alcohol counsellors (29%, n = 56); social workers
(8%, n = 15); doctors (6%, n = 12); clinical psychologists
(3%, n = 6); and others (e.g., occupational therapist, pro-
bation officers, outreach workers, drug support workers,
etc: 18%, n = 35).
Dependent variables
The four dependent variables were emotional exhaustion
(EE); depersonalisation (DP) and diminished personal
accomplishment (PA) and psychological morbidity (PM).
8. The three dimensions of burnout were measured with the
Maslach Burnout Inventory (MBI) [17]. Using the norm
reported in the manual [17], respondents with the follow-
ing scores were classified as 'high' scorers and, therefore
fulfilled the criteria for burnout: EE ≥ 27; DP ≥ 13; and PA
≤ 31. Psychological morbidity was measured with the gen-
eral health questionnaire-12 (GHQ-12), scored using the
0-0-1-1 scoring format with scores ranging from 0–12.
Caseness for psychological morbidity was determined
using a cut-off of 4 [18]. Both measures are widely used
instrument for measuring burnout and psychological
morbidity, respectively.
Independent variables
The independent variables were demographic characteris-
tics; job characteristics and job stressors. The demographic
variables included in the analysis were age and gender.
Job characteristics were intensity of client contact (ICC:
number of hours of weekly contact) and tenure (number
of years of experience in substance misuse). Participants
were asked to indicate the extent to which a list of 112 job
stressors, obtained from the literature and from discus-
sions with a sample of clinical staff, gave them pressure
using a Likert-type scale (no pressure, slight pressure;
moderate pressure, considerable pressure, extreme pres-
sure).
Job stressors
Participants' response to the questions on job stressors
was subjected to internal consistent analysis (Cronbach
α). Items that resulted in a decrease in α were excluded
from further analysis. This procedure yielded 68 internally
consistent items.
Principal component analysis, with varimax rotation, was
used to reduce the number of internally consistent job
9. stressors experienced by respondents to manageable types
or factors. The Scree test was used to determine the
number of factors (or types). A stressor belonged to a fac-
tor if it returned a factor loading ≥ 0.40. Furthermore, a
job stressor was excluded from the rotated factors if it had
a factor loading ≥ 0.40 loaded on two or more factors [19].
The principal component analysis yielded three orthogo-
nal factors. Factor 1 termed 'Alienation' consisted of 15
stressors. Examples of stressors in this factor were "Lack of
support from senior staff"; "Feelings of isolation"; and
"Role ambiguity." Factor 2, termed 'Case complexity',
consisted of 13 stressors with the following examples:
"Manipulative clients"; "Demanding clients"; and "Deal-
ing with clients with overdose." Factor 3, termed 'Ten-
sion" consisted of 15 stressors such as "Conflicting
demands of my time at work by others"; Having too little
time to do what is expected of me"; and "Work overload"
(Additional file 1).
The three job stressor variables were categorised into two
levels. Participants whose scores were greater than or
equal to the mean on each factor were classified as experi -
encing high levels of Alienation, Case complexity and
Tension, respectively. Participants that score below the
mean were classified as experiencing low levels of each
category of job stressor.
Statistical analysis
Cronbach's α was used to assess internal consistency of
validated measures – MBI and GHQ-12 (Likert-type
scale).
Prior to logistic regression analysis, univariate odds ratio
was used to determine the relationship between categori-
10. cal independent and dependent variables. The relation-
ship between interval independent variables (ICC and
tenure) and categorical dependent variables was deter-
mined using point-biserial correlation. Logistic regression
analysis was used to examine the association between
independent and the dependent variables. Using the Hos-
mer and Lemeshow [20] criterion, an independent varia-
ble was included in the logistic regression model if the
univariate odds ratio or point-biserial correlation had a p
value of 0.1 or less.
Dummy variables of occupational groups, with nurses as
the referent variable, were developed and introduced into
logistic regression as control variables. A p-value of < 0.05
was considered to indicate statistical significance. SPSS
version 15 was used for all statistical analyses.
Ethics approval
The Wandsworth Local Research Ethics Committee
approved this study.
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Results
Internal consistency of measures
The four dependent measures in the study had acceptable
internal consistency in the study sample: GHQ-12, Cron-
bach's α = 0.75; MBI EE subscale, α = 0.90; DP subscale, α
= 0.76; and PA subscale, α = 0.75.
11. Prevalence of psychological morbidity
The prevalence rate of psychological morbidity in the
sample was 82.3% (95% CI = 76.1–87.4). Male and
female prevalence rates were 82.4% (95% CI = 72.6–89.8)
and 82.2% (73.7–89.0), respectively.
Prevalence of burnout
The rate of burnout was as follows: high emotional
exhaustion (EE), 33.2% (95% CI = 26.5–40.4); high
depersonalisation (DP), 17.0% (95% CI = 11.9–23.2);
and diminished personal accomplishment (PA), 35.8%
(95% CI = 29.0–43.2). Male and female burnout rates
were as follows: Male high EE rate, 31.7% (95% CI =
21.9–42.9); female high EE rate 34.3% (95% CI = 25.3–
44.2); male high DP rate, 20.7% (95% CI = 12.6–31.1);
female high DP rate, 14.2% (95% CI = 8.1–22.3); male
low PA rate, 29.3% (95% CI = 19.7–40.4); and female low
PA rate, 41.0% (95% CI = 31.5–51.0).
Summary of dependent measures
There was no significant difference between occupational
groups on all dependent measures (Table 1).
Selection of potential predictors of psychological
morbidity
Univariate odds ratio, using the Hosmer & Lemeshow cri-
terion (p < = 0.1) revealed acceptable correlation coeffi -
cients between psychological morbidity (PM) and
Alienation (p = 0.07); Tension (p = 0.07); EE (0.02); DP
(0.1); and PA (0.009. Point-biserial correlation analysis
revealed significant positive relationship between PM and
age (p = 0.1); intensity of client contact (ICC: p = 0.07);
Table 1: Summary statistics of dependent measures by
occupational group
12. Occupation GHQ-12* EE DP PA
Nurses
Mean 5.6 21.9 8.2 33.0
SD 2.6 9.8 5.9 7.7
N 68 68 69 69
Social workers
Mean 71 26.1 9.2 33.7
SD 2.5 13.5 5.8 5.1
N 15 15 15 15
Doctors
Mean 6.4 19.3 6.6 30.7
SD 2.2 8.8 4.8 9.2
N 11 11 10 10
Clinical psychologists
Mean 5.7 29.4 6.2 35.8
SD 3.1 8.6 7.5 9.0
N 6 5 5 6
Drug and alcohol counsellors
Mean 5.7 21.4 6.1 35.4
SD 2.8 10.6 5.4 6.3
N 54 54 54 53
Other
Mean 6.1 21.7 7.7 33.1
SD 2.9 11.9 5.8 7.2
N 33 34 34 34
F statistic 0.9 (p = 0.48) 1.1 (p = 0.37) 1.2 (p = 0.31) 1.2 (p =
0.30)
13. * Scoring: 0-0-1-1
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and tenure (0.05). These variables were included in the
logistic regression model.
Selection of potential predictors of EE, DP and PA
Correlation between EE and the following variables met
the criterion for selection: Tension (p = 0.0001); Aliena-
tion (p = 0.0001); Case complexity (p = 0.04); and age (p
= 0.01). Correlation between DP and Tension (p =
0.0001); Alienation (p = 0.004); Case complexity (p =
0.001); age (p = 0.02); and tenure (p = 0.1) met the crite-
rion for selection. Finally, correlation between PA, age (p
= 0.1); and gender (p = 0.07) met the criterion for selec-
tion.
Five logistic regression models emerged from the findings
of the univariate analysis. These models were adjusted for
occupational groups and used to test the study hypothe-
ses:
1. Log [P(PM = 1)/P(PM = 0)] = b0+ b1Tension + b2Age +
b3ICC + b4Tenure.
2. Log [P(PM = 1)/P(PM = 0)] = b0 + b1EE + b2DP +b3PA.
3. Log [P(EE = 1)/P(EE = 0)] = b0+ b1Tension + b2Alienation
+ b3Case complexity +b4Age + b5Tenure.
14. 4. Log [P(DP = 1)/P(DP = 0)] = b0+ b1Tension + b2Alienation
+ b3Case complexity + b4Age + b5Tenure.
5. Log [P(PA = 1)/P(PA = 0)] = b0+ b1Age + b2Gender.
The variables were coded as follows: Gender (0 = Male, 1
= Female); age (dummy variables were developed for
under-25s; 25–34; 35–44; referent = 45 and over); ICC
(categorised as low – below the mean = 0; and high –
mean and above = 1); Tenure (categorised as short –
below the mean = 0; and long – mean and above = 1);
Alienation (0 = low, 1 = high); Case Complexity (0, low,
1 = high); Tension (0 = low, 1 = high); PM (0 = low, 1 =
high); EE (0 = low, 1 = high); DP (0 = low, 1 = high);and
PA (0 = high, 1 = low).
Predictors of psychological morbidity and burnout
The first hypothesis, which predicted that age and gender
would predict psychological morbidity and burnout, was
partially confirmed. Gender did not predict psychological
morbidity and the three dimensions of burnout. How-
ever, age was a significant predictor of emotional exhaus-
tion. Compared to those aged 45 years and over,
participants aged below 25 years were seven times as likely
to experience high emotional exhaustion. However, there
was no association between age and psychological mor-
bidity and other dimensions of burnout (DP and PA)
(Table 2).
As stated in the second hypothesis, there was no evidence
that job characteristics (tenure and ICC) predicted psy-
chological morbidity and burnout. However, the third
hypothesis, which stated that job stressors would predict
psychological morbidity and burnout, was partially sup-
ported. High scorers on alienation and tension were thrice
15. as likely to experience emotional exhaustion as low scor -
ers on both independent variables. Furthermore, high
scorers on alienation were five times as likely to experi -
ence depersonalisation as low scorers (Table 2)
The fourth hypothesis that predicted a significant positive
relationship between burnout and psychological morbid-
ity was partially confirmed. Diminished personal accom-
plishment was the only burnout dimension that
significantly predicted psychological morbidity. Respond-
ents with diminished personal accomplishment were
about four times as likely to experience psychological
morbidity (Table 2)
Discussion
The findings of this study reveal that the prevalence of psy-
chological morbidity among substance misuse workers is
high (82%). The prevalence of burnout was not as pro-
nounced, with 33% of participants reporting high EE;
17% reporting high DP; and 36% reporting diminished
PA. The average EE, DP and PA scores in the study sample
were 22.1, 7.4 and 33.7, respectively. The EE score in our
sample was higher than that in most human services occu-
pational groups, e.g., teaching, 21.3; postsecondary edu-
cation, 18.6; social services, 21.4; and mental health, 16.9;
but similar to that in medicine, 22.2 [17]. Our findings,
therefore, strongly indicate that substance misuse profes-
sionals are more vulnerable to burnout than most human
services professionals. Furthermore, compared to nurses,
social workers were at higher risk of emotional exhaus-
tion. This is an observation that has not been previously
reported among substance misuse professionals.
One of the novel findings in this study is the identification
of three types of stressors among substance misuse profes-
sionals – Alienation, Tension and Case Complexity. The
16. constructs of alienation and tension are consistent with
the Job Demand-Control (JDC) model developed by Kar-
asek [21], while Case Complexity encompasses the Client
Demand subscale of the Addiction Employee Stress Scale
[16].
Identification of these three categories of stressors is use-
ful for two reasons. It helps to organise the wide range of
job stressors linked to substance misuse practice into
manageable segments. Secondly, it facilitates better
understanding of the link between job stressors and burn-
out by revealing the types of job stressors that are directly
associated with burnout. From this study, alienation and
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Table 2: Logistic regression models for psychological morbidity
and burnout
Dependent variable Multivariate predictors Wald χ2 P value
Adjusted OR 95% CI
Model 1
Psychological morbidity (GHQ-12) High level of Alienation
1.50 0.22 2.00 0.66–6.11
High level of Tension 0.13 0.72 1.19 0.47–6.11
Age: Under 25s 0.51 0.48 2.32 0.23–23.23-
Age: 25–34 years 1.40 0.24 0.53 0.18–1.52
Age: 35–44 years 0.04 0.85 0.90 0.30–2.69
17. Age: 45 year and over - - 1.00 -
Long tenure 0.56 0.46 1.39 0.59–3.30
High ICC 0.38 0.54 1.30 0.57–2.95
Social worker 2.04 0.15 4.95 0.55–44.28
Doctor 0.60 0.44 2.40 0.26–21.96
Clinical psychologist 0.02 0.89 1.19 0.11–12.64
Drug and alcohol counsellor 0.14 0.71 1.22 0.44–3.35
Other 0.44 0.51 0.70 0.24–2.03
Nurse - - 1.00 -
Model 2
Psychological morbidity (GHQ-12) High emotional exhaustion
3.47 0.06 2.83 0.95–8.43
High depersonalisation 0.11 0.74 1.28 0.31–5.35
Diminished personal accomplishment 6.61 0.01 3.65 1.36–9.79
Social worker 1.11 0.29 3.22 0.37–28.19
Doctor 0.66 0.42 2.50 0.28–22.72
Clinical psychologist 0.004 0.95 0.93 0.09–10.19
Drug and alcohol counsellor 0.48 0.49 1.41 0.53–3.76
Other 1.15 0.28 0.57 0.20–1.59
Nurse - - 1.00 -
Model 3
Burnout: Emotional exhaustion High levels of Alienation 7.54
0.006 3.49 1.43–8.51
High levels of Tension 4.46 0.04 2.65 1.10–6.52
High levels of Case complexity 0.04 0.85 1.10 0.41–2.94
Long tenure 0.002 0.96 1.02 0.43–2.40
Age: Under 25s 4.43 0.04 7.15 1.15–44.65
Age: 25–34 years 1.55 0.21 2.02 0.67–6.11
Age: 35–44 years 0.62 0.43 1.54 0.53–4.45
Age: 45 & over - - 1.00 -
Social worker 5.53 0.02 4.82 1.30–17.87
Doctor 0.03 0.87 0.86 0.14–5.46
18. Clinical psychologist 0.20 0.67 1.58 0.21–11.68
Drug and alcohol counsellor 0.07 0.79 1.15 0.42–3.10
Other 2.07 0.15 2.18 0.75–6.312
Nurse 1.00
Model 4
Burnout: Depersonalisation High levels of Alienation 1.30 0.25
1.87 0.64–5.48
High levels of Tension 5.68 0.02 4.57 1.31–15.91
High levels of Case complexity 1.85 0.17 2.07 0.73–5.86
Long tenure 2.31 0.13 0.43 0.15–1.27
Age: Under 25s 2.25 0.13 5.45 0.60–48.90
Age: 25–34 years 0.92 0.34 2.14 0.45–10.14
Age: 35–44 years 1.78 0.18 2.78 0.62–12.45
Social worker 0.05 0.83 1.22 0.20–7.34
Doctor 0.56 0.45 0.38 0.03–4.73
Clinical psychologist 0.72 0.40 0.33 .003–4.25
Drug and alcohol counsellor 2.11 0.15 0.32 0.07–1.49
Other 0.03 0.86 1.12 0.33–3.84
Nurse - - 1.00 -
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tension emerged as strong predictors of emotional
exhaustion and
depersonalisation.
Although job stressors (alienation and tension) predicted
19. two dimensions of burnout, none of these factors was
directly linked to psychological morbidity. This finding
contrasts with that of Calnan et al [9] where high demand,
low control and low support – concepts similar to aliena-
tion and tension in our study – predicted higher GHQ
scores. Rather diminished personal accomplishment,
which was independent of job stressors, predicted psycho-
logical morbidity. This finding suggests that individual
differences – personality, motivation, attitudes, need for
achievement, mental health history- rather than job-
related variables alone are more likely to predict psycho-
logical morbidity. Furthermore, there is an indication that
substance misuse practice involves psychological
demands that are different from workload, dealing with
complex patients, etc. These demands may include the
practitioner's feeling of self-worth, role adequacy and per-
sonal achievement, which are often associated with
opportunities to develop new skills and the use of a vari -
ety of skills [22,23].
Limitations
There are limitations of this study that are mainly linked
to the study design and sample. Firstly, the study adopted
a cross-sectional design, which prevented conclusion
regarding causality. A longitudinal design is better able to
determine the causal relationship between job-related fac-
tors, burnout and psychological morbidity. McManus et al
[10] have demonstrated the usefulness of longitudinal
designs in burnout studies. Secondly, it was difficult to
exclude the influence of social desirability that is often
associated with self-administered questionnaire surveys.
However, this is a limitation shared with many other stud-
ies of burnout and psychological morbidity. Thirdly, the
reasons for non-response and the influence of age, gender
and professional group on response rate were not exam-
20. ined. Consequently, it is plausible that the effect of non-
response bias could have affected the results as non-
responders may have differed in their experience of job
stress, psychological morbidity and burnout. Another lim-
itation is the age of the data, which may not reflect current
patterns of psychological morbidity and burnout in the
group studied.
Study implications
Despite these limitations, the findings have provided use-
ful information on job-related risks of burnout and psy-
chological morbidity that can assist in the development of
employee well-being programmes, and eventually
enhance performance among substance misuse profes-
sionals. Furthermore, the findings can serve as a baseline
for monitoring changes over time in the prevalence and
pattern of burnout and psychological morbidity in the tar-
get group, by conducting repeated cross-sectional surveys
in similar cohorts.
In terms of substance misuse practice, the findings should
assist relevant policy makers in maintaining a healthy
workforce. Firstly, there is evidence in this study that sub-
stance misuse professionals aged 25 years and below are
at risk of emotional exhaustion. Therefore, there is a need
for managers to provide adequate support for young prac-
titioners who are likely to be new to the demands and
challenges of substance misuse practice. Secondly, the
strong association between personal accomplishment and
psychological morbidity proves the need for employers to
enhance staff competencies through professional devel -
opment; this inevitably leads to improved self-esteem.
Finally, the significant association between alienation,
tension and the two burnout dimensions (EE and DP)
suggests the need for employers to develop a work-based
stress reduction programme that can assist substance mis-
21. use professionals in developing personal stress coping
strategies.
Model 5
Burnout: Diminished Personal
accomplishment
Gender 2.42 0.12 1.67 0.88–3.18
Age: Under 25s 0.70 0.40 1.86 0.43–7.94
Age: 25–34 years 0.01 0.93 1.04 0.47–2.27
Age: 35–44 years 0.12 0.73 0.86 0.37–2.02
Age: 45 and over - - 1.00 -
Social worker 2.43 0.12 0.34 0.09–1.32
Doctor 0.002 0.97 1.03 0.26–4.09
Clinical psychologist 0.18 0.67 0.68 0.11–4.05
Drug and alcohol counsellor 3.00 0.08 0.49 0.22–1.10
Other 0.02 0.90 0.95 0.40–2.22
Nurse - - 1.00 -
Table 2: Logistic regression models for psychological morbidity
and burnout (Continued)
BMC Health Services Research 2008, 8:39
http://www.biomedcentral.com/1472-6963/8/39
Page 8 of 9
(page number not for citation purposes)
Still, there are many unresolved questions about the rela-
tionship between demographic characteristics, job charac-
teristics, job stressors and psychological morbidity. These
include finding out the role of potential moderating vari -
ables such as personality, motivation, job attitudes, and
22. mental health history. It is also possible that these varia-
bles are associated with burnout. These and other ques-
tions should be explored in future research on job stress
among substance misuse professionals.
Conclusion
In the sample of substance misuse professionals studied,
rates of psychological morbidity and burnout were high,
suggesting a higher level of vulnerability than in other
health professionals. Furthermore, pathways to psycho-
logical morbidity and burnout are partially related. There-
fore, targeted response is required to manage stress,
burnout and psychological morbidity among substance
misuse professionals. Such a response should be integral
to workforce development.
Competing interests
The author(s) declare that they have no competing inter-
ests.
Authors' contributions
AO wrote the manuscript, analysed the data, interpreted
the results and co-ordinated the study.
CC collected data, interpreted the results and revised the
article for intellectual content.
RF was involved in study design, data interpretation and
revising the article for intellectual content.
AO is the study guarantor.
This article is a product of the "Professionals Help Your -
self" (PHY) programme being developed at St George's,
University of London
23. Additional material
Acknowledgements
We are grateful to the substance misuse professionals that
participated in
this study and to the peer reviewers for their constructive
comments. The
comments of the statistical reviewer were particularly useful
and for these
we are grateful.
References
1. National Treatment Agency for substance Misuse: Models of
care for
treatment of adult drug misusers: Update 2006. London 2006.
2. Elit L, Trim K, Mand-Bains IH, Sussman J, Grunfeld E: Job
satisfac-
tion, stress and burnout among Canadian gynaecologic
oncologists. Gynecologic Oncology 2004, 94:134-139.
3. Vanagas G, Bihari-Axelson S: The factors associated to
psycho-
social stress among general practitioners in Lithuania.
Cross-sectional study. BMC Health Services Research 2005,
5:45.
4. Cunrandi CB, Greiner BA, Ragland DR, Fisher JM: Burnout
and
alcohol problems among urban transit operators in San
Francisco. Addictive Behaviors 2003, 28:91-109.
5. Farmer R: Stress and working with drug misusers. Addiction
Research 1995, 3:113-122.
24. 6. Knudsen HK, Ducharme LJ, Roman PM: Counselor emotional
exhaustion and turnover intention in therapeutic communi-
ties. Journal of Substance Abuse Treatment 2006, 31:173-180.
7. Lacoursiere RB: "Burnout" and substance user treatment: The
phenomenon and the administrator-clinician's experience.
Substance Use & Misuse 2001, 36:1839-1874.
8. Avery AJ, Betts DS, Whittington A, Heron TB, Wilson SH,
Reeves JP:
The mental and physical health of miners following the 1992
national pit closure programme. A cross-sectional survey
using General Health Questionnaire GHQ-12 and Short
Form SF-36. Public Health 1998, 112:169-173.
9. Calnan M, Wainwright D, Forsythe M, Wall B, Almond S:
Mental
health and stress in the workplace: the case of general prac-
tice in the UK. Social Science and Medicine 2001, 52:499-507.
10. McManus IC, Winder BC, Gordon D: The causal links
between
stress and burnout in a longitudinal study of UK doctors. Lan-
cet 2002, 359:2089-2090.
11. SÖderfeldt M, SÖderfeldt B, Ohlson C-G, Thoerell T, Jones
I: The
impact of sense of coherence and high-demand/low-control
job environment on self-reported health, burnout and psy-
chophysiological stress indicators. Work & Stress 2000, 14:1-
15.
12. Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P,
Amick B:
The Job Content Questionnaire (JCQ). An instrument for
25. internationally comparative assessments of psychosocial job
characteristics. Journal of Occupational Health Psychology
1998,
3:322-355.
13. Calnan M, Wainwright D, Almond S: Job strain, effort-
reward
imbalance and mental distress: a study of occupations in gen-
eral medical practice. Work & Stress 2000, 14:297-311.
14. Maslach C, Jackson SE: Maslach Burnout Inventory Manual
2nd edition.
Palo Alto, CA: Consulting Psychologists Press; 1986.
15. Goldberg DP, Hillier VF: A scaled version of the General
Health
Questionnaire. Psychological Medicine 1979, 9:139-145.
16. Farmer R, Clancy C, Oyefeso A, Rassool GH: Stress and
work with
substance misusers: The development and cross-validation
of a new instrument to measure staff stress. Drugs: education,
prevention and policy 2002, 9:377-388.
17. Maslach C, Jackson SE, Leiter MP: Maslach Burnout
Inventory Manual
3rd edition. Palo Alto, California, Consulting Psychologists
Press;
1996.
18. Erens B, Primatesta P: Health Survey for England London:
The Station-
ery Office; 1998.
19. De Vaus DA: Surveys in social research London: Routledge;
2002.
26. 20. Hosmer DW, Lemeshow S: Applied logistic regression 2nd
edition. New
York: John Wiley; 2000.
21. Karasek R: Job demands, job decision latitude, and mental
strain: Implications for job redesign. Administrative Science
Quar-
terly 1979, 24:285-311.
22. Rafferty Y, Friend R, Landsbergis PA: The association
between job
skill discretion, decision authority and burnout. Work & Stress
2001, 15:73-85.
23. Janssen PM, Schaufeli WB, Houkes J: Work-related and
individual
determinants of the three burnout dimensions. Work & Stress
1999, 13:74-86.
Additional file 1
Principal component analysis of job stressors with varimax
rotation. The
table describe three categories of job stressors – alienation, case
complexity
and tension.
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6963-8-39-S1.doc]
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6963-8-39-S1.doc
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b=PubMed&dopt=Abstract&list_uids=15262131
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stress, coping strategies, and
burnout among abuse-specific
counselors
Sam Loc Wallace
Jayoung Lee
Sang Min Lee
The purpose of this study is to investigate whether effective
coping strategies play an
important role to reduce burnout levels among sexual or
substance abuse counselors.
The authors examined whether coping strategies mediated or
moderated relations
between job stress and burnout in a sample of 232 abuse-
specific counselors. Results
indicated that self-distraction and behavior disengagement
30. coping strategies medi-
ated the relationships between 3 job stress variables (workload,
role conflict, and
job ambiguity) and burnout. Although venting and humor
coping strategies positively
moderated the relationship between role ambiguity and burnout,
active coping strate-
gies negatively moderated the relationship between workload
and burnout.
Although the counseling profession can have many rewards,
burnout can be a potential
outcome of providing counseling and psychotherapy. Burnout is
conceptualized as a
psychological syndrome in response to chronic emotional and
interpersonal stress
on the job and is most widely defined by the dimensions of
exhaustion, deperson-
alization, and inefficacy (Maslach, Schaufeli, & Leiter, 2001).
Much of the focus of
burnout research has been with individuals who work in the
human services field
(Vredenburgh, Carlozzi, & Stein, 1999). There has been
increasing recognition and
study of this problem in the counselors who are working with
sexual offenders and
substance abuse clients. It is believed that burnout is a potential
response to the
emotional stress of working with others who are troubled
(Everall & Paulson, 2004).
Several studies (Pearlman, 1996; Pearlman & Saakvitne, 1995;
Rich, 1997) reported
that abuse-specific counselors working with sexual offenders
and substance abuse
clients would exhibit evidence of cognitive disruptions at levels
higher than those of
32. behavior to develop awareness of burnout (American
Counseling Association, 2005;
Everall & Paulson, 2004).
The relationships between people and work have been
recognized as a catalyst for
potential problems (Maslach et al., 2001). Adverse emotional
and behavioral sequelae
of job satisfaction and burnout for helping professionals have
been identified in several
studies (Bingham, Valenstein, Blow, & Alexander, 2002; Kirk-
Brown & Wallace, 2004;
Malach-Pines & Yafe-Yanai, 2001). The importance of studying
burnout within an
organizational context has been suggested by several
researchers (Emerson & Markos,
1996; T D. Evans & Villavisanis, 1997; Malach-Pines & Yafe-
Yanai, 2001; McCarthy
& Frieze, 1999). Job-related factors have been demonstrated to
affect counselors' levels
of burnout, with counselors in institutional settings being more
vulnerable to burnout
(Färber, 1990; Rosenberg & Pace, 2006; Trudeau, Russell, de la
Mora, & Schmitz,
2001; Yu, Lee, & Lee, 2007). Higher rates of emotional
exhaustion and depersonali-
zation were found in counselors working in community agency
settings versus those
in private practice, where it is believed that counselors are able
to regulate their job-
related stress easier because of working outside of a
bureaucratic hierarchical system
(Rosenberg & Pace, 2006). These findings are consistent with
the Job Demand-Control
(JD-C) model (Karasek, 1979) that suggests that job control
protects the individual
33. from problematic and damaging work environments. Models of
job environment and
the subsequent work-life have been proposed to play a central
role in the process of
burnout (Maslach et al., 2001). The interaction of these factors
and personal charac-
teristics contribute to a rich matrix of considerations for
developing burnout. Within
the expanded conceptualization of burnout, the work—life and
job stress framework
can augment the understanding of burnout.
Coping strategies are the ways in which individuals choose to
respond to stressful
situations (Welbourne, Eggerth, Hartley, Andrew, & Sanchez,
2007). Parkes (1994)
suggested that personal characteristics such as coping strategies
can mediate or
moderate relations between job demands (stressors) and job
strains (burnout symp-
toms). Individual differences in coping strategies have been
theorized to derive
from traditional personality dimensions and have been
supported in several studies
(Armstrong-Strassen, 2004; Carver, Scheier, & Weintraub,
1989; McCormick, Dowd,
Quirk, & Zegarra, 1998). Effective coping strategies may play
an important role in
reducing stress levels and increasing job satisfaction.
Welbourne et al. (2007) reported
that using nonavoidant coping strategies was associated with
higher job satisfaction
rates. Avoidant coping strategies have also been shown to be
related to increased
emotional exhaustion and decreased personal accomplishment
(G. D. Evans, Bry-
34. ant, Owens, & Koukos, 2004). Increasing the understanding of
the role of various
coping strategies on the relations between job stress and
burnout can help identify
effective coping skills to reduce exhaustion and
depersonalization and increase a
sense of personal competence and efficacy (G. D. Evans et al.,
2004).
The purpose of this study is to examine the relationships among
organizational job
stress, coping strategies, and burnout. We examined whether the
function of coping
strategies mediated or moderated relations between job stress
and counselor burnout.
112 journal of employment counseling • September 2010 •
Volume 47
Specifically, using the Baron and Kenny's (1986) mediation and
moderation model,
we analyzed for identifying mediating and moderating
relationships between coping
strategies and counselor burnout as they relate to types and
severity of job stress as
perceived by abuse-specific counselors. This study is innovative
in that it identifies
the role and function of coping strategies as mediating and
moderating factors in
relation to job stress and counselor burnout.
METHOD
Participants
35. The participants were 232 abuse-specific counselors (i.e., either
sexual abuse
counselors or substance abuse counselors). Participants in the
study were col-
lected through a web-based survey or by mail. An e-mail
containing a link to the
survey and measures was sent to two electronic mailing lists;
one with a focus on
sex offender treatment and research (Association for the
Treatment of Sexual Abus-
ers electronic mailing list and one with a focus on maltreatment
and victim issues
[Prevent—Connect]). Additionally, e-mails were sent to
substance abuse treatment
facilities located on the Substance Abuse and Mental Health
Services Administration
facility locator webpage. Of the hard copy surveys, 120 were
mailed to treatment
facilities or individual practitioners that were identified to work
in one of the three
areas of treatment specialty. Facilities and practitioners were
identified through a
web search of programs and practitioners who were identified as
having a treat-
ment focus in one or more of the respective categories (e.g.,
certified sex offender
treatment providers in Texas, rape crisis centers, substance
abuse programs). Of
the aforementioned surveys, 44 were returned for review
making the response rate
36.67%. Included in the sample were participants from 35 states
as well as seven
other countries (Japan, France, India, Israel, Canada, Australia,
and the United
Kingdom; n - 21). The mean age of the sample was 42.96 years
36. (SD = 11.94, range
= 23—76 years). Of the 232 participants included in the study,
71.4% were women
and 28.4% were men. The racial/ethnic composition of the
participants was 93.5%
European American, 3.9% Asian American, 1.3% African
American, 0.9% Indian
American, and 0.4% Hispanic American. These individuals had
been working in their
respective counseling organizations for an average of 10.71
years {SD — 7.51). Their
main discipline fields were social work (32.1%), mental health
(17.7%), counselor
education (5.6%), rehabilitation counseling (1.9%), and others
(42.1%). Also, this
sample is composed of master-level counselors (63.6%),
doctoral-level counselors
(21.8%), graduate counselors (11.1%; i.e., nonlicensed
counselors with a bachelor's
degree), and specialist counselors (3.1%; i.e., counselors with
an educational specialist's
degree such as Ed.S.). (Percentages may not total 100% because
of rounding.)
Instruments
Job Stress Scale (JSS; Caplan, Cobb, French, Van Harrison, &
Pinneau, 1975). The
JSS is a 13-item self-report questionnaire that measures the
frequency with which
journal of employment counseling • September 2010 • Volume
47 113
37. an individual experiences four dimensions of job stress: (a)
Workload, which measures
the quantitative aspect of work overload resulting from time
pressures (e.g., "How often
does your job leave you with little or no time to get things
done?"); (b) Role Conflict,
which is a state in which rationally incompatible demands are
made upon the individual
by two or more persons whose jobs are functionally
codependent with the individual's
job (e.g., "How often do persons equal in rank and authority
over you ask you to do
things which conflict?"); (c) Role Ambiguity, which is a state in
which a person has
inadequate information to perform their role in an organization
(e.g., "How often are
you clear on what your job responsibilities are?"); and (d) Lack
of Utilization, which is
a stress factor related to underutilization of previously acquired
skills in carrying out
tasks required on the job (e.g., "How often can use the skills
from previous training?").
Individuals respond to items using a 7-point Likert-type scale
ranging from 1 {never)
to 7 {always). The four-factor structure was confirmed in a
study conducted by Hamel
and Bracken (1986) and was additional support for the
contention that job stress is a
multidimensional phenomenon. In this study, Cronbach's alphas
of .90, .81, .69, and
.83 were obtained, respectively, for the Workload, Role
Conflict, Role Ambiguity, and
Lack of Utilization JSS subscales.
Brief COPE (Coping Orientations to Problems Experienced)
Inventory (Carver,
38. 1997). The Brief COPE Inventory is a 28-item self-report
questionnaire that assesses
an individual's cognitive and behavior coping strategies. It is an
abbreviated ver-
sion of the COPE Inventory (Carver et al., 1989), which has
problems regarding the
length and redundancy of the full instrume nt as well as the
overall time burden of
the assessment protocol. The Brief COPE Inventory produces
distinct scores for each
of the 14 coping strategies: (a) active coping, (b) planning, (c)
use of instrumental
support, (d) religion, (e) venting, (f) positive reframing, (g)
humor, (h) acceptance,
(i) use of emotional support, (j) self-distraction, (k) denial, (1)
behavioral disengage-
ment, (m) self-blame, and (n) substance use. Individuals
respond to iems using a
4-point Likert-type scale ranging from 0 (/ haven't been doing
this at all) to 3 {I've
been doing this alot) to express the frequency of use for each of
the coping behaviors.
In this study, the Cronbach's alpha achieved for all items of the
inventory was .78.
Counselor Burnout Inventory (CBI; Lee et al., 2007). The CBI
is a 20-item self-
report questionnaire that measures various levels of burnout.
The CBI provides
norm-referenced measures of a counselor's burnout syndrome on
five factorially
derived burnout dimensions: Exhaustion, Incompetence,
Negative Work Environment,
Devaluing Client, and Deterioration in Personal Life. Its focus
on the counselor's
work environment is unique to this inventory. This unique
39. component corresponds
with recent counseling burnout literature that accentuates the
role one's workplace
environment plays in promoting burnout (Azar, 2000; Maslach,
2005; Osborn, 2004;
Savicki & Cooley, 1981; Thompson, 1999). In this study, the
CBI total score was
used to assess the overall level of a counselor's burnout.
Individuals respond to items
using a 5-point Likert-type scale (1 = never true; 5 = always
true). The CBI contains
items reflecting characteristics of feelings and behaviors that
indicate various levels
of burnout. Lee et al. (2007) reported alpha coefficient total
scores of .88. Support
for construct validity was obtained through exploratory factor
analysis that identified
a five-factor solution and a confirmatory factor analysis with all
goodness-of-fit in-
114 journal of employment counseling • September 2010 •
Volume 47
dexes also indicating an adequate fit to the data (Lee et al.,
2007; Yu, Lee, & Nesbit,
2008). In this study, the Cronbach's alpha achieved for all items
of the CBI was .88.
Data Analyses
In this study, 19 variables were investigated: four variables
rating perceived severity of
job stress, 14 variables rating coping strategies, and one
variable rating level of counselor
40. burnout. We analyzed the relationships among these variables
by using multiple regression/
correlation analyses by the Baron and Kenny (1986) model (i.e.,
mediation and moderation
analyses). Specifically, we examined whether the function of
coping strategies mediated
between job stress and counselor burnout. The test for
mediation in this study involved
evaluating if the influence of job stress on counselor burnout
manifests itself through the
types and severity of the counselor's coping strategies; also, we
analyzed whether coping
strategies moderated the relationship between job stress and
burnout. The test for modera-
tion in this study involved evaluating the 56 interactions
between four subscales of the JSS
(predictors) and 14 types of coping strategies (moderators) on
counselor burnout (criterion
variable). Namely, in our analysis, we identified mediating and
moderating relationships
between coping strategies and counselor burnout, as they relate
to types, and severity of
job stress, as perceived by abuse-specific counselors. All data
were analyzed using SPSS
(Version 15.0), and all significance values shown were based on
two-tailed tests.
RESULTS
To test the hypothesis that 14 types of coping strategies would
mediate the relationship
between four types of job stress and counselor burnout, the
three-step tests of media-
tion suggested by Baron and Kenny (1986) were used. In this
study, the three-step
test for mediation involved (a) regressing the criterion variable
41. (counselor burnout) on
the predictor variables (subscales of the JSS), (b) regressing the
mediators (scales of
the Brief COPE Inventory) on the predictor variables (subscale s
of the JSS), and (c)
regressing the criterion variable (counselor burnout) on both the
predictors (subscales
of the JSS) and mediators (scales of the Brief COPE Inventory).
First, the relationships between subscales of the JSS (predictor
variables) and counselor
burnout (criterion variable) were significant, F(4, 203) -
29.50,/> < .01. Significant main
effects were shown for Workload (ß = .40,p < .01), Role
Conflict (ß - .77, p < .01), Role
Ambiguity (ß = .53, p < .05), and Lack of Utilization (ß = .60, p
< .01) on counselor bum-
out. These results fulfilled the mediation criteria in the first
step of Baron and Kenny's
(1986) model. Second, a correlation analysis was used to
measure the relationship be-
tween perceived severity of four types of job stress and 14 types
of coping strategies. Nine
mediators (i.e., self-distraction, active coping, denial, substance
use, use of instrumental
support, behavioral disengagement, planning, humor, and self-
blame) were statistically
significantly correlated with at least one of the predictor
variables. However, five media-
tors (i.e., use of emotional suppjort, venting, positive reframing,
acceptance, and religion)
were not statistically significantly correlated with any predictor
variables. Additionally, a
multiple regression analysis was used to test the relationship
between significant variables
in the second step (seK-distraction, active coping, denial,
42. substance use, use of instrumen-
journal of employment counseling • September 2010 • Volume
47 115
tal support, behavioral disengagement, planning, humor, and
seK-blame variables) and
counselor burnout (the criterion variable). Among nine
mediators, only seven mediators,
self-distraction (ß = .16, p < .05), denial (ß = .12, p < .05),
substance use (ß = .15, p <
.05), behavioral disengagement (ß = .33, p < .01), planning (ß =
.33, p < .01), humor (ß
= .14,p < .05), and self-blame (ß = .13, p < .05), were
statistically significant. Therefore,
when considering these results, active coping and use of
instrumental support of coping
strategies were not considered for further analysis in the third
step.
In the third step, a test of the additional variance explained by
the mediators (seven •
coping strategies: self-distraction, denial, substance use,
behavioral disengagement,
planning, humor, and self-blame variables) in addition to four
job stress variables were
significant, F(9,190) = 13.65, p < .01, AR^ = .16. As shown in
Table 1, the follow-up
tests indicated that greater workload, role conflict, and role
ambiguity and greater
self-distraction and behavioral disengagement uniquely
predicted more counselor
burnout, i(197) = 2.62,p < .05 and i(197) = 3.74,p < .01,
respectively. More important,
43. complete mediation was observed because the predictor variable
(job ambiguity) was
not significantly related to the criterion variable (counselor
burnout) in the presence
of the mediators (seK-distraction and behavioral
disengagement). In addition, the re-
lationship between two predictor variables (workload and role
conflict) and criterion
variable (counselor burnout) were partially mediated by two
mediator variables (self-
distraction and behavior disengagement) because the effect on
counselor burnout of
two job stress variables (workload and role conflict) was
substantially decreased (see
Table 1). When applying Sobel's (1982) mediation test to
determine if the amount of
mediation was significant, the self-distraction variable partially
mediated the rela-
TABLE 1
Multiple Regression Anaiysis of Counselor Burnout (Criterion
Variable)
Predicted by Coping Strategies (Mediator Variables) and
Job Stress (Predictor Variables)
Variable
Step 1
Workload^
Role Conflict"
Role Ambiguity"
Lack of Utilization"
Step 2
44. Workload"
Role Conflict"
Role Ambiguity"
Lack of Utilization"
Self-Distraction'=
Denial
Substance Use"
Behavioral Disengagement"
Planning"
Humor*
Self-Blame"
B
0.42
0.78
0.64
0.42
0.32
0.71
0.36
0.34
0.98
0.85
0.79
2.08
0.52
0.23
0.46
SE
.11
.27
47. 3.74**
1.65
0.83
1.22
AFP
.39
.16
fP
.39
.55
AF
30.86
13.65
^Job Stress Scale subscale. "Brief COPE (Coping Orientations
to Problems Experienced)
Inventory scale.
* p < . 0 5 . * * p < . 0 1 .
116 journal of employment counseling • September 2010 •
Volume 47
tionship between workload and counselor burnout (Z = 2.25, p <
.05). In addition,
behavior disengagement partially mediated the relationship
between workload and
counselor burnout [Z = 3.49, p < .01) as well as the relationship
between role conflict
48. and counselor burnout {Z = 3.53, p < .01).
Next, we tested the altemative hypothesis that coping strategies
moderated the relation-
ship between job stress and counselor bumout. A moderator is a
variable that changes the
relationship between a predictor variable and a criterion
variable (Frazier, Tix, & Barron,
2004). The main purpose for identifying and constructing
moderators is to increase pre-
dictive effectiveness (Abrahams & Alf, 1972). The moderator
model tested the effects of
four types of job stress (predictors) and the 14 types of coping
strategies (moderators) as
well as their interactions (e.g.. Workload X Active Coping) on
counselor bumout (criterion
variable). For these tests, both the amount of variance (/? :̂
effect size) accounted for by
job stress and coping strategies and their interactions and the
statistical significance of the
change in F produced by entering the job stress and coping
strategies and their interac-
tions were considered. When the interaction increased the R^ by
a statistically significcmt
amount, the two variables were moderating each other's
relationship with bumout. Table 2
summarizes only the significant moderating effects of coping
strategies on the relationship
between job stress (predictors) and counselor bumout (criterion
variable). Specifically, ac-
tive coping strategies moderated the relationship between
workload and counselor bumout
and increased the explained variance by a statistically
significant amount (ß = - . 1 7 , F =
16.59, AR^ = .03,p < .01). In addition, venting coping strategies
moderated the relationship
49. between role ambiguity and counselor bumout and increased the
explained variance by a
statistically significant amount (ß - .14, AF = 25.00, AR^ = .02,
p < .05). Humor coping
strategies also moderated the relationship between role
ambiguity and counselor bumout
and increased the explained variance by a statistically
significant amount (ß = .13, AF =
DISCUSSION
The findings of the current research contribute to an increased
understanding of the
relationship between coping strategies and counselor burnout as
these processes relate
to specific types of job stress among abuse-specific counselors.
There are several
TABLE 2
Moderating Effects of Coping Strategies on Job Stress
and Counselor Burnout
Variable
Workload" x Active Coping"
Role Ambiguity" x Venting"
Role Ambiguity" x Humor*
IE I ß
-.17*
.19**
.03*
50. I E 2 ß
.13*
.27**
.02*
I E 3 ß
.13*
.23**
.02*
Note. IE = interaction effect.
"Job Sress Scale subscale. "Brief COPE (Coping Orientations to
Problems Experienced)
Inventory scale.
*p< .05. **p< .01.
journal of employment counseling • September 2010 • Volume
47 117
significant implications for theory, training, and practice for the
profession of abuse-
specific counseling. In support of the Job Demand—Resource
(JD-R) or JD-C models
that were the widely known theories used to explain the worker
burnout process
(Demerouti, Bakker, Nachreiner, & Schaufeli, 2001; Schaufeli
& Bakker, 2004), the
51. noteworthy outcome of the present research is that the job
demand variables (e.g.,
JSS subscales) increased counselor burnout while the resource
or control variables
(e.g., active coping strategies) helped reduce job demand
variables, thereby helping
to decrease the feeling of burnout among abuse-specific
counselors.
The JD-R or JD-C models conceptualize burnout not only as the
result of a period
of expending too much effort at work while having too little
recovery (Osborn, 2004)
but also as an erosion of engagement with the job (Schaufeli,
Salanova, Gonzales-
Roma, & Bakker, 2002). Results of the present study also
indicated that avoidant
emotional coping strategies, specifically self-distraction and
behavior disengagement,
mediated the relationship between three JSS subscales (Work
Load, Role Conflict, and
Job Ambiguity) and counselor burnout. In particular, the
complete mediation effect
was observed between job ambiguity and counselor burnout.
That is, the job stress
variables were positively related to greater levels of self-
distraction and behavior
disengagement coping strategies, and, in turn, greater self-
distraction and behavior
disengagement coping strategies were positively related to
greater burnout among
abuse-specific counselors. The interpretation of these findings
suggests that the re-
lationship between job stress and burnout is accounted for, in
part, by the function
of how negatively counselors cope with the stressful situation
52. (i.e., avoidant coping
strategies and erosion of engagement with the job).
In addition, the findings of the present study show some
moderation effects.
Emotional coping strategies, such as venting and humor,
positively moderate the
relationship between role ambiguity job stress and counselor
burnout. Significant
findings reflect that when abuse-specific counselors use venting
and humor coping
strategies and report higher role ambiguity, they have higher
levels of burnout.
Conversely, active coping strategies negatively moderate the
relationship between
work load stress and counselor burnout. Unlike emotional
coping strategies, even
when abuse-specific counselors reported higher work load in
their jobs, if they used
an active coping strategy, they reported lower levels of burnout.
These findings sug-
gested that investigating and discussing counselors' current
coping strategies toward
job stress may lead to preventing or alleviating their burnout
symptoms.
The present study supports the importance of understanding
coping strategies
that may alleviate abuse-specific counselors' burnout when they
are faced with the
stressful demands of their particular field of work. The findings
can be discussed
within a supervisory relationship in which the counselor can be
monitored and nur-
tured. Supervision can guide abuse-specific counselors to
understand their internal
53. mechanisms by helping them identify their current coping
strategies and by exploring
alternative effective coping strategies, especially for novice
abuse-specific counselors.
Yu et al. (2008) also stressed that supervision contributes
significantly in preventing
and alleviating counselors' burnout. Thus, ongoing supervision
is essential for both
those who are just entering the counseling profession and for
those who are more
experienced counselors. Clinical supervision helps novice
counselors to shape ap-
118 journal of employment counseling • September 2010 •
Volume 47
propriate coping strategies (i.e., active coping strategies based
on the results of the
present study) and also helps experienced counselors reduce the
existing ineffec-
tive coping strategies (i.e., self-distraction, behavior
disengagement, venting, and
humor based on the results of the present study) in situations
that are stressful in
their jobs. In other words, supervisors could discuss the
appropriate coping styles
to help address unsettled role conflict and ambiguity in the
work environment that
could potentially result in professional impairment. Thus,
identifying individual
counselors' dysfunctional and functional coping strategies could
be a valuable
supplemental supervisory tool that could lead to productive
discourse within the
54. supervisory relationship.
The findings of this study lend support to the expanded
conceptualization of
burnout that includes organizational sources. The findings also
increase explanatory
research on conceptual development of job stress models. The
social environment
and functioning of the workplace play an important role in how
people interact with
one another and, ultimately, how they perform their jobs
(Maslach, 2005). Organi-
zational development strategies may be of interest when
considering the role of the
organization on job stress and burnout. Diagnostic models
indicate that job design,
or the value of the work, should be supported by job inputs, or
organizational work
environment and culture, in order to produce the most effective
job outputs, or
products and results (Cummings & Worley, 2005). The most
salient organizational
variable contributing to burnout in this study was job
ambiguity. When abuse-specific
counselors are not clear on what their job responsibilities are,
what others in the
workplace expect of them, or how to define their standard of
performance, occupa-
tional stress will likely occur. It is important for supervisors
and administrators to
understand that clarity in the role of the abuse-specific
counselor is a key factor to
consider in job design and role assignment. Special attention
should be paid to the
roles of abuse-specific counselors in some settings, such as
residential treatment,
55. where conflict may arise when interacting with other
professionals who have different
job functions (e.g., nurses, physicians, teachers, and direct care
staff). These other
professional staff members may place demands on the counselor
that are contrary
to counselors' training, thereby increasing role ambiguity and
the likelihood for
burnout. Additionally, counselors who work with sex offenders
often have outside
stakeholders such as probation officers and officers of the
courts who may view the
counselor as an extension of law enforcement, thereby
potentially creating additional
expectations and job ambiguity. Attention to these types of
potential Stressors and
organizational pitfalls as well as how counselors cope with
these Stressors are im-
portant considerations for those in supervisory roles. Clarifying
the abuse-specific
counselor's role and performance of duties should be a routine
part of counselor job
orientation and ongoing training.
It is important to note that statistical mediation and moderation
were examined
in this study, and, as such, no causal inferences may be drawn
from this study
(Skowron, Wester, & Azen, 2004). In addition, all measures
were obtained by
self-report questionnaires, and participants were anonymous and
self-selected.
Thus, abuse-specific counselors may have responded in ways
that did not reflect
their actual attitudes and beliefs for various personal reasons.
Also, some abuse-
56. journal of employment counseling • September 2010 • Volume
47 119
specific counselors who did not identify any job stress within
their work environment may
have judged their participation in this study to have litue impact
on them and chose not
to participate. Thus, future research could use multiple
measures (e.g., observation) to
assess the variables, thereby giving a clearer picture of the
long-term effects of job stress
and coping strategies on burnout. Considering the sample of the
current study, it is also
important to know the limitations of the generalizability of the
results. For example, the
skewed distribution of sex and race (European American,
female counselors) might have
an effect on the variability of the results. Finally, further
limitations of the study relate
to cultural implications of construct definition and our sample
selection. Healthy coping
strategies are contextually and socially defined and may vary
from culture to culture (Sue
& Sue, 2003). Ultimately, coping strategies cannot be viewed
apart from the influences of
race, ethnicity, and culture. For example, in some cultures (e.g.,
African American and
Hispanic), spiritual or religious coping may be strongly
emphasized, whereas in others
(e.g., European American), intrinsic sources of support (e.g.,
self-reliance) are highly
valued. Also, although some cultures encourage open disclosure
and expression of emo-
57. tion (e.g., Hispanic), others discourage such displays (e.g..
Native American; Sue & Sue,
2003). Further research with more diverse counselors (in terms
of sex and race) would
allow counseling researchers to determine if significant
similarities or differences exist
in job stress, coping strategies, and burnout levels between male
and female counselors
and between European American counselors and minority
counselors.
REFERENCES
Abrahams, N. M., & Alf, E., Jr. (1972). Pratfalls in moderator
research. Journal of Applied Psychology,
56, 245-251.
American Counseling Association. (2005). ACA code of ethics.
Alexandria, VA: Author.
Armstrong-Strassen, M. (2004). The influence of prior
commitment on the reactions of layoff survivors to
organizational downsizing. Journal of Oeeupational Health
Psychology, 9, 46—60.
Azar, S. T. (2000). Preventing burnout in professionals and
paraprofessionals who work with child abuse
and neglect cases: A cognitive behavioral approach to
supervision. Psychotherapy in Practice, 56,
643-66.3.
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator
variable distinction in social psychological
research. Journal of Personality and Social Psychology, 51,
1173-1183.
58. Bingham, C. R., Valenstein, M., Blow, F. C , & Alexander, J. A.
(2002). The mental healthcare context
and patient characteristics: Implications for provider job
satisfaction. Journal of Behavioral Health
Services & Research, 29, 335-344.
Caplan, R., Cobb, S., French, J., Van Harrison, R., & Pinneau,
S. (1975). Demands and worker health:
Main effects and organizational differences. Washington, DC:
Government Printing Office.
Carver, C. S. (1997). You want to measure coping but your
protocol's too long: Consider the Brief COPE.
International Journal of Behavioral Medicine, 4, 92-100.
Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989).
Assessing coping strategies: A theoretically
based approach. Journal of Personality and Social Psychology,
56, 267-283.
Cummings, T. G., & Worley, C. G. (2005). Organizational
development and change (8th ed.). Mason,
OH: Southwestern.
Demerouti, E., Bakker, A. B., Nachreiner, F., & Schaufeli, W.
B. (2001). The job demands-resources
model of burnout. Journal of Applied Psychology, 86, 499-512.
Emerson, S., & Markos, P. A. (1996). Signs and symptoms of
the impaired counselor. Journal of Humanistic
Education and Development, 34, 108—117.
120 journal of employment counseling • September 2OtO •
Volume 47
59. Evans, G. D., Bryant, N. E., Owens, J. S., & Koukos, K. (2004).
Ethnie differenees in burnout, eoping,
and intervention aeceptability among ehildcare professionals.
Child and Youth Care Forum, 33,
349-371.
Evans, T. D., & Villavisanis, R. (1997). Encouragement
exchange: Avoiding therapist burnout. Family
Journal: Counseling and Therapy for Couples and Families, 5,
342-345.
Everall, R. D., & Paulson, B. L. (2004). Burnout and secondary
traumatic stress impact on ethieal be-
havior. Canadian Journal of Counselling, 38, 25—35.
Färber, B. A. (1990). Burnout in psychotherapists: Incidence,
types, and trends. Psyehotherapy in Private
Praetice, 8, 35-44.
Frazier, P. A., Tix, A. P., & Barron, K. E. (2004). Testing
moderator and mediator effects in counseling
psychology research. Journal of Counseling Psychology, 51,
115—134.
Hamel, K., & Bracken, D. (1986). Factor structure of the Job
Stress Questionnaire (JSQ) in three oc-
cupational groups. Educational and Psychological Measurement,
46, 777—786.
Karasek, R. (1979). Job demands, job decision, latitude, and
mental strain: Implications for job redesign.
Administrative Quarterly, 24, 285-308.
Kirk-Brown, A., & Wallace, D. (2004). Predicting burnout and
job satisfaction in workplace counselors:
60. The influence of role Stressors, job challenge, and
organizational knowledge. Journal of Employment
Counseling, 41, 29-37.
Lee, S. M., Baker, C. R., Cho, S. H., Heckathorn, D. E.,
Holland, M. W., Newgent, R. A., . . . Yu, K.
(2007). Development and initial psychometrics of the Counselor
Burnout Inventory. Measurement and
Evaluation in Counseling and Development, 40, 142-154.
Malach-Pines, A., & Yafe-Yanai, 0 . (2001). Unconscious
determinants of career choice and burnout:
Theoretical model and counseling strategy. Journal of
Employment Counseling, 38, 170—184.
Maslach, C. (200.5). Understanding burnout: Work and family
issues. In D. F. Halpern & S. E. Murphy
(Eds.), From work-family balance to work-family interaction:
Changing the metaphor (pp. 99—114).
Mahwah, NJ: Erlbaum.
Maslach, C , Sehaufeli, W. B., & Leiter, M. P. (2001). Job
burnout. Annual Review of Psychology, 52,
397-422.
McCarthy, W. C , & Frieze, I. R. (1999). Negative aspects of
therapy: Client perceptions of therapists'
social influenee, burnout, and quality of care. Journal of Social
Issues, 55, 33-50.
McCormick, R., Dowd, E., Quirk, S., & Zegarra, J. (1998). The
relationship of NEO-PI performance to
coping styles, patterns of use, and triggers for use among
substance abusers. Addictive Behaviors,
61. 23, 497-507.
Osborn, C. (2004). Seven salutary suggestions for counselor
stamina. Journal of Counseling & Develop-
ment, 82, 319-328.
Parkes, K. R. (1994). Personality and coping as moderators of
work stress processes: Models, methods
and measures. Work and Stress, 8, 110-129.
Pearlman, L. A. (1996). Psychometric review of TSI Belief
Scale. In B. H. Stamm (Ed.), Measurement of
stress, trauma, and adaptation (pp. 419—430). Lutherville, MD:
Sidran.
Pearlman, L. A., & Maclan, P. S. (1995). Vicarious
traumatization: An empirical study of effects of trauma
work on trauma therapists. Professional Psychology: Research
and Practice, 26, 558-565.
Pearlman, L. A., & Saakvitne, K. (1995). Trauma and the
therapist: Countertransference and viearious
traumatization in psychotherapy with incest survivors. New
York, NY: Norton.
Rich, K. D. (1997). Vicarious traumatization: A preliminary
study. In S. Bird Edmunds (Ed.), Impact:
Working with sexual abusers (pp. 75-88). Brandon, VT: Safer
Society Press.
Rosenberg, T., & Pace, M. (2006). Burnout among mental
health professionals: Special considerations
for marriage and family therapists. Journal of Marital and
Family Therapy, 32, 85-99.
Savieki, V., & Cooley, E. J. (1981). Implication of burnout
62. researeh and theory for counselor educators.
The Personnel and Guidance Journal, 60, 415-419.
Sehaufeli, W. B., & Bakker, A.B. (2004). Job demands, job
resources, and their relationship with burnout
and engagement: A multi-sample study. Journal of
Organizational Behavior, 25, 293-315.
Sehaufeli, W. B., Salanova, M., Gonzales-Roma, V., & Bakker,
A. B. (2002). The measurement of engagement
and burnout: A two sample confirmatory analytic approach.
Journal of Happiness Studies, 3, 71-92.
journal of employment counseling • September 2010 • Volume
47 121
Skorupa, J., & Agresti, A. A. (1993). Ethical beliefs about
burnout and continued professional practice.
Professional Psychology: Research and Practice, 24, 281-285.
Skowron, E. A., Wester, S. R., & Azen, R. (2004).
Differentiation of self mediates college stress and
adjustment. Journal of Counseling & Development, 82, 69-78.
Sobel, M. E. (1982). Asymptotic confidence intervals for
indirect effects in structural equation models.
In S. Leinhardt (Ed.), Sociological methodology (pp. 290-312).
Washington, DC: American Socio-
logical Association.
Sue, D. W, & Sue, D. (2003). Counseling the culturally diverse:
Theory and practice (4th ed.). New York,
NY: Wiley.
63. Thompson, T. L. (1999). Managed care: Views, practices, and
burnout of psychologists. Dissertation
Abstracts International: Section B. The Sciences and
Engineering, 60(3-B), 1318.
Trudeau, L. S., Russell, D. W, de la Mora, A., & Schmitz, M. F.
(2001). Comparisons of marriage and
family therapists, psychologists, psychiatrists, and social
workers in job-related measures and reac-
tions to managed care in Iowa. Journal of Marital and Family
Therapy, 27, 501-507.
Vredenburgh, L. D., Carlozzi, A. F., & Stein, L. B. (1999).
Burnout in counseling psychologists: Type
of practice setting and pertinent demographics. Counselling
Psychology Quarterly, 12, 293-302.
doi:10.1080/09515079908254099
Welboume, J. L., Eggerth, D., Hartley, T. A., Andrew, M. E., &
Sanchez, F. (2007). Coping strategies
in the workplace: Relationships with attributional style and job
satisfaction. Journal of Vocational
Behavior, 70, 312-325.
Yu, K. L., Lee, S. H., & Lee, S. M. (2007). Counselor's
collective self-esteem mediates job dissatisfaction
and relationship with clients. Journal of Employment
Counseling, 44, 163-172.
Yu, K. L , Lee, S. M., & Nesbit, E. A. (2008). Development of a
culturally valid Counselor Burnout
Inventory in Korean counselors. Measurement and Evaluation in
Counseling and Development, 41,
153-162.
122 journal of employment counseling • September 2010 •
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Compassion Fatigue, Compassion Satisfaction,
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COMPASSION FATIGUE, COMPASSION
66. SATISFACTION, AND BURNOUT: FACTORS
IMPACTING A PROFESSIONAL’S QUALITY OF LIFE
GINNY SPRANG and JAMES J. CLARK
College of Social Work, University of Kentucky, Lexington,
Kentucky, USA
ADRIENNE WHITT-WOOSLEY
University of Kentucky, Lexington, Kentucky, USA
This study examined the relationship between three variables,
compassion fatigue
(CF), compassion satisfaction (CS), and burnout, and provider
and setting char-
acteristics in a sample of 1,121 mental health providers in a
rural southern state.
Respondents completed the Professional Quality of Life Scale
as part of a larger
survey of provider practice patterns. Female gender was
associated with higher
levels of CF, and therapists with specialized training in trauma
work reported
higher levels of CS than nonspecialists. Provider discipline
proved to be an impor-
tant factor, with psychiatrists reporting higher levels of CF than
their non-medical
counterparts. When providers were compared using rural, urban,
and rural with
urban influence classifications, the most rural providers
reported increased levels
of burnout but could not be distinguished from their colleagues
on the CF and CS
subscales. Important practice, education, and policy
67. implications are noted for a
multidisciplinary audience.
American author James Baldwin (1963) wrote, ‘‘One can give
noth-
ing whatever without giving oneself, that is to say risking
oneself ’’
(p. 100). Risking exposure to vicarious trauma is an inherent
part
of the process when working with traumatized persons. The
empiri-
cal literature has documented mental health consequences of
professionals’ exposure to trauma patients, responses that differ
depending upon individual and contextual characteristics
specific
to the provider and the practice setting. This study explores
vari-
ables that might influence such responses to vicarious exposure
to
traumatic stress by examining compassion fatigue (CF),
compassion
Received 10 January 2007; accepted 23 January 2007.
Address correspondence to Ginny Sprang, University of
Kentucky, 3470 Blazer
Parkway, Suite 100, Lexington, KY 40509. E-mail:
[email protected]
259
Journal of Loss and Trauma, 12:259–280, 2007
Copyright # Taylor & Francis Group, LLC
ISSN: 1532-5024 print/1532-5032 online
DOI: 10.1080/15325020701238093
68. stress (CS), and burnout among mental health professionals in a
rural state. We also explore the individual, occupational, and
environmental factors that might impact the ways these
conditions
are expressed.
Literature Review
An expanding number of studies are examining the phenomena
of
CF and burnout in the helping professions. Early studies of
work-
related stresses were first conducted in business and industry,
and
subsequently in the human service professions. Maslach (1982)
defined burnout as ‘‘a syndrome of emotional exhaustion,
deperso-
nalization, and reduced personal accomplishment’’ (p. 3)
charac-
terized by cynicism, psychological distress, feelings of
dissatisfaction, impaired interpersonal functioning, emotional
numbing, and physiological problems (Fothergill, Edwards, &
Burnard, 2004). Burnout’s etiology is not significantly
associated
with worker countertransference or reactions to traumatic client
material but is associated with other workplace characteristics,
such as caseload size and institutional stress (Stamm, 1997).
McCann and Pearlman (1990a) expanded discussions of
countertransference reactions to include the term vicarious
trauma-
tization (VT), which describes the impact of repeated empathic
engagement with trauma survivors and associated cognitive,
sche-
matic, and other psychological effects. McCann and Pearlman
69. (1990b) and Pearlman and Saakvitne (1995) identified the
potential
for disruptions in therapists’ experiences of safety, trust, power,
esteem, intimacy, independence, and control. Associated symp-
tomatology includes anxiety, disconnection, avoidance of social
contact, becoming judgmental, depression, somatization, and
dis-
rupted beliefs about self and others (Cunningham, 2003;
Pearlman
& Saakvitne, 1995).
CF signifies more progressed psychological disruptions. This
term can be used interchangeably with secondary traumatic
stress
disorder (STSD) and is considered to be less stigmatizing
(Figley,
1995). The proposed continuum of responses ranges from com-
passion satisfaction to compassion stress and ends with CF
(Figley,
1995; Stamm, 2002b). Figley’s causal compassion stress and
fatigue
model (1995, 2002a, 2002b) points to the influence of nine
variables
implicated in the development of compassion fatigue, including
260 G. Sprang et al.
those related to traumatic material exposure and clinicians’
capacity for empathic engagement. He describes two positive
coping variables (sense of achievement and emotional disenga-
gement), while prolonged exposure, traumatic recollections, and
life disruption exacerbate stress reactions and may lead to the
development of compassion fatigue.
70. Literature reviews of work-related traumatic stress studies
reveal myriad terms to describe similar phenomena, leading
Stamm (1997) to opine that the controversy regarding secondary
trauma is not its existence but what it should be called. Studies
reflect commonalities and links among CF, VT, and secondary
traumatic stress (STS), so it is necessary to consider all
empirical
work regarding these concepts (Adams, Matto, & Harrington,
2001; Jenkins & Baird, 2002).
Few epidemiological studies exist regarding CF or secondary
trauma among the various groups of helping professionals routi -
nely exposed to trauma in the course of their work. Research on
STS symptomatology in child protective service (CPS) workers
suggests that this type of work carries high risk for transmission
of traumatic stress symptomatology (Dane, 2000; Pryce,
Shackelford,
& Pryce, 2007). Cornille and Meyers (1999) found 37% of study
participants exhibited clinically significant distress related to
CPS work. A study of community mental health workers found
that 17% met criteria for STSD and 18% exhibited significant
but subclinical levels of psychopathology (Meldrum, King, &
Spooner, 2002). Higher distress levels were found in studies of
dis-
aster response teams (Holtz, Salama, Cardozo, & Gotway,
2002).
Following the Oklahoma City bombing, 64.7% of trauma
workers
reported significant traumatic stress (Wee & Meyers, 2002). A
study of responders to the 9=11 attacks found 27% at extremely
high risk, 11.7% at high risk, and 15.4% at moderate risk for
developing CF (Roberts, Flannelly, Weaver, & Figley, 2003).
Empirical studies of burnout revealed it as an especially preva -
lent condition among helping professionals (Maslach & Jackson,
1984), with mental health professionals demonstrating higher
71. levels of burnout than primary health care workers (Imai,
Nakao,
Tsuchiya, Kuroda, & Katon, 2004; Korkeila et al., 2003).
Notably,
public-sector mental health providers were at higher burnout
risk
compared to their private-sector counterparts (Melamed, Szor,
&
Bernstein, 2001; Vredenburgh, Carlozzi, & Stein, 1999).
Compassion Fatigue, Compassion Satisfaction, and Burnout 261
Studies have indicated variables serving as risk or protective
factors for STS, CF, or burnout. As age increased, risk for STS,
VT, and burnout decreased (Adams et al., Harrington, 2001;
Nelson-Gardell & Harris, 2003; Vredenburgh et al., 1999), and
some
studies suggested that females were at significantly greater ris k
for
STS and VT (Brady et al., 1999; Kassam-Adams, 1999; Meyers
&
Cornille, 2002). Education mitigated burnout (Abu-Bader,
2000),
and years of professional experience were associated with a
decreased potential for VT (Cunningham, 2003; Pearlman &
MacIan, 1995). Another significant variable, personal trauma
history, was associated with increased risk for STS or VT
(Cunningham, 2003; Nelson-Gardell & Harris, 2003), though
some
studies suggest that personal coping styles and the ability to
construct
meaning in the face of stressful experiences may be truer
determi-
nants of Professionals’ emotional functioning (Follette,
72. Polusny, &
Milbeck, 1994; Ortlepp & Friedman, 2001). Researchers have
also
found that specialized training can serve a protective function
for
trauma counselors (Ortlepp & Friedman, 2002). Another study
examined the experiences of STS across mental health
disciplines
(psychologists, social workers, counselors) but did not find that
profession was a predictor of STS (Creamer & Liddle, 2005).
Exposure factors such as long work hours or length of assign-
ment and caseloads with high percentages of trauma patients
have
been associated with an increased incidence of STS and CF
(Boscarino, Figley, & Adams, 2004; Creamer & Liddle, 2005;
Meyers & Cornille, 2002). Organizational factors such as
support-
ive work environments and adequate supervision were noted to
mitigate the incidence of STS and burnout (Boscarino et al.,
2004; Korkeila et al., 2003; Ortlepp & Friedman, 2002; Webster
& Hackett, 1999). Autonomy and control seem to be mitigating
factors for burnout (Abu-Bader, 2000; Vredenburgh et al.,
1999),
while access to sufficient resources mitigated both burnout and
STS (Abu-Bader, 2000; Ortlepp & Friedman, 2001).
Workers with high caseloads of survivors of violent or human-
induced trauma (especially against children) seemed to be at
greater
risk for CF and STS (Creamer & Liddle, 2005; Cunningham,
2003). A study of mental health workers found that STS symp-
tomatology rates were higher for rural providers when compared
to their urban counterparts (Meldrum et al., 2002). Rohland
(2000) found that burnout among mental health directors did not
73. 262 G. Sprang et al.
seem to be influenced by rurality, but he studied only a small
sample of nonclinicians.
In order to address the complexity of these phenomena, our
study explores the degree to which CF, CS, and burnout vary as
a
function of provider characteristics such as age, gender,
educational
level, licensure, years of experience, setting, and whether or not
the individual has specialized trauma training. Contextual
variables
such as organizational type and setting are also considered.
Method
Sample
A total of 6,720 licensed or certified behavioral health
providers
(psychologists, psychiatrists, social workers, marriage and
family
therapists, professional counselors, and drug and alcohol
counse-
lors) currently practicing in a rural southern state were invited
to
participate in the study. Individuals who were licensed by more
than one board were counted only once, leaving a useable pool
of 5,752 potential participants.
The remaining pool of providers received a mailed survey at
their place of residence along with a self-addressed postage-
paid
74. return envelope, a coupon for free training, and an informed
con-
sent document that outlined the purpose of the study, the
potential
benefits and risks of participation, and contact information.
Return
of the survey indicated the provision of informed consent. A
total
of 1,121 completed questionnaires were returned, which consti-
tuted 19.5% of the viable candidates for inclusion. Although
response rates to mailed surveys of 10%–25% are common
(Fox, Crask, & Kim, 1988), the rate of response to this study
may have been higher if budgetary restraints had not prohibited
follow-up reminders or remailings.
Measurement
The instrument used in this study was a 102-item survey
designed
to solicit information about the providers’ practice methods,
their
use of evidenced-based practices, their knowledge of event-
specific
responses in various populations (rural, children, the elderly),
barriers to effective treatment, and levels of compassion
fatigue,
Compassion Fatigue, Compassion Satisfaction, and Burnout 263
compassion satisfaction, and burnout. This article deals with a
sub-
set of a larger study (Sprang, Craig, & Clark, 2006) and
specifically
explores the respondents’ professional quality of life and levels
75. of
compassion fatigue, compassion satisfaction, and burnout.
The Professional Quality of Life Scale (ProQOL) (Stamm,
2002b), a 30-item self-report measure, assesses risk of CF,
potential
for CS, and risk of burnout. Higher scores on the CF subscale
(10
items) indicate the respondent is at higher risk for compassion
fatigue. Higher scores on the CS subscale (10 items) indicate
the
respondent is experiencing better satisfaction with his or her
ability
to provide care (e.g., caregiving is an energy-enhancing experi-
ence, increased self-efficacy). Higher scores on the burnout
sub-
scale (10 items) indicate the individual is at risk of
experiencing
symptoms of burnout (e.g., hopelessness, helplessness). Alpha
scores range from .72 (burnout) to .80 (CF) and .87 (CS),
indicating
adequate internal consistency. The scale has good demonstrated
construct validity, and there is evidence that this version of the
measure reduced the known collinearity between compassion
fatigue and burnout (Stamm, 2005).
Providers were also asked to self-identify if they had specia-
lized training in trauma work and to specify the type of traini ng
they had received. To control for overconfidence bias, these
responses were compared with the ‘‘best-practice’’ guidelines
described previously. If the respondent identified specialized
trauma training in any of the identified empirically based
methods,
the respondent was categorized as having specialized trauma
train-
ing for the purposes of this study. Additionally, if the provider
76. reported professional experience in a trauma treatment center
(inpatient or outpatient), then the individual was character ized
as
a provider with specialized trauma training. Using this criterion,
the rate of agreement between study evaluators and respondent
self-identification was 73%. In general, respondents tended to
overidentify themselves as trauma specialists if they had
personal
histories that were positive for trauma exposure and if they had
related but non-trauma-related training experiences (i.e., ethics
training, training in the assessment and treatment of other
conditions such as depression or substance misuse).
A series of items aimed at identifying personal and professional
characteristics of each respondent were also included. These
questions solicited information about the provider’s age,
gender,
264 G. Sprang et al.
years of professional experience, discipline, highest degree
earned,
and work setting. Respondents were also asked to identify their
county
of practice so that rural and urban comparisons could be made.
Using the Beale code classification system (Butler & Beale,
1994), respondents were assigned a code of 0 to 9 that provided
a descriptor of their county of practice: metropolitan area of 1
million or more (0), fringe county of metropolitan area of 1
million
or more (1), county in metropolitan area of 250,000 to 1 million
(2),
county in metropolitan area of less than 250,000 (3), urban
77. popu-
lation of 20,000 or more adjacent to metro area (4), urban area
of 20,000 or more not adjacent to metro area (5), urban area of
2,500 to 19,999 adjacent to metro area (6), urban area of 2,500
to 19,999 not adjacent to metro area (7), completely rural area
of
less than 2,500 adjacent to metro area (8), and completely rural
areas of less that 2,500 not adjacent to metro area (9).
Results
Provider Characteristics
The average age was 45.22 years (SD ¼ 10.84), with a range
from
23 to 81 years of age. The majority of professionals (68.6%)
had
master’s degrees and, on average, the participants had 13.92
(SD ¼ 9.54) years of experience, with approximately 30% of
their
clients experiencing post-trauma distress. Over one third of the
respondents (35.8%) worked in community mental health
settings,
while 13.6% worked in other public agencies, 29.6% were in
private practice, 6.2% worked in inpatient facilities, 4.9%
worked
in private facilities, and 9.9% other worked in settings. Of the
1,121
respondents, 327 (30.4%) were male and 749 (69.6%) were
female.
This trend held true for every discipline but psychiatrists, who
were
overrepresented by males (at 52%) (v2 ¼ 8.98, df ¼ 5, p < .01).
Otherwise, there were no statistically significant differences in
age
(v2 ¼ .05, df ¼ 5, p ¼ .89), setting (v2 ¼ 1.95, df ¼ 4, p ¼
78. .178),
or caseload (v2 ¼ 3.26, df ¼ 3.62, p ¼ .09) considering
discipline.
Incidence of Compassion Fatigue, Compassion Satisfaction, and
Burnout
In general, this sample fared better on the ProQOL subscales
than
reported national norms (Stamm, 2005). The CF mean score of
Compassion Fatigue, Compassion Satisfaction, and Burnout 265
10.64 in this sample was lower than the national mean of 13,
with
13.2% of the respondent pool in our sample scoring above the
suggested cutoff (75%). On the burnout subscale, the national
mean
is reported as 23, compared to our sample mean of 19.9. Again,
just over 13% scored above the cutoff on the burnout subscale.
The potential for CS was slightly higher in our sample than
reported national norms (39.3% vs. 37%), with almost half
(48.7%) of our sample scoring above the suggested cutoff of 41.
Although these national estimates are approximates, they pro-
vided an important contextual backdrop for subsequent
analyses.
Differences by Provider Characteristics
A multivariate analysis of variance (MANOVA) was conducted
on CS, CF, and burnout by gender (male vs. female). Tests of
homogeneity of covariance matrices using Box’s M test and
homogeneity of variance assessed by Levene’s test were all
non-