Burnout syndrome in students of helping professions: connection with the concept of "sense of coherence" and self-esteem

Burnout syndrome is characterized by long-term feelings of mental and emotional exhaustion and feelings of depersonalization. Also, the competence to manage the demands of work and everyday life is significantly reduced. Emotional fatigue is considered a key component of burnout syndrome, which is characterized by experiencing a lack of sources of positive feelings and encouragement, which leads to a loss of energy and feelings of long-term fatigue. which does not disappear even after adequate rest. Depersonalization is associated with a loss of idealism, a negative attitude towards clients and cynicism (1). A higher risk of developing burnout syndrome was consistently recorded among workers in helping professions (medical and teaching staff), showing its negative impact not only on the work area (2), but also on the overall quality of their life, especially on their health status. V in a systematic review of research studies dealing with the relationship between burnout syndrome and the risk of somatic health problems (3), a lot of evidence was identified testifying to the impact of burnout syndrome on the increased risk of hypertension and ischemic heart disease, metabolic syndrome, regulation disorders on the hypothalamo-pituitary-adrenal axis, sleep disorders, inflammatory processes, immune disorders, coagulation blood and risk behavior in terms of health. The concept of "vital exhaustion" is particularly important, the characteristics of which are largely consistent with the classic concept of burnout syndrome, and which is considered an important etiological risk factor for ischemic heart disease and myocardial infarction, as well as a factor worsening the prognosis of the disease (4, 5).

Although it is possible to identify personality (neuroticism) and socio-demographic predictors (age, education) of the burnout syndrome, work characteristics are mentioned as important factors influencing its occurrence. These include excessively high job demands (overload) combined with low levels of control and insufficient remuneration, low levels of social support, perceived unfairness in the decision-making process at work, and a conflict between the individual's values ​​and the organization's values ​​(6). On the contrary, well-managed coping strategies are considered protective factors in relation to burnout syndrome: emotionally oriented stress management strategies were associated with a higher incidence, on the contrary, problem-oriented cognitive strategies were predictors of a lower level of the syndrome (7). Also, positive self-evaluation - higher self-esteem, higher level of self-efficacy (8) and sense of meaning (9) are shown to be factors positively affecting the ability to resist the symptoms of burnout.

Educational programs aimed at developing communication competences and improving coping strategies are generally considered to be an effective tool for the prevention of burnout syndrome, yet there are relatively few studies focusing on research confirmation of this relationship. A positive effect of social-psychological interventions on the individual components of burnout syndrome among healthcare workers in psychiatric wards has been recorded (10,11).

Recently, several studies have focused on the occurrence of burnout syndrome in students as well - although preparing for studies is not work in the classical sense of the word, it includes regular participation in structured activities and the need to perform. It can therefore be assumed that the strategies for managing the study load will also be related to the strategies for later managing the work load, and that activities aimed at developing stress management competencies will also be useful in preventing the later development of burnout syndrome already during the practice of the profession. Personality characteristics such as self-evaluation and "sense of coherence" (sense of integrity) may be important factors influencing individual abilities to cope with burnout. This study focuses on investigating the relationships between the mentioned personality factors and burnout syndrome in students of helping professions.

Methods

75 full-time bachelor's degree students of the 1st and 2nd year took part in the research (women: 81.1%; age average 20.7±2.8, range 19 - 37). Of the participating students, there were 48 students of psychology (average age 21.1±3.3; 29% men) and 27 students of health fields - nursing and public health (19.8±1.7; 100% women). The return rate of the questionnaires was 88.3%, the data collection took place between February and April 2010 at the Jesseni Faculty of Medicine of the Charles University in Martin (nursing and public health departments) and at the Faculty of Arts of the Catholic University in Ružomberok (psychology department). The School Burnout Scale (SBI, the maximum score of the questionnaire is 54, a higher score means a higher level of burnout) was used to measure the level of burnout. Furthermore, Antonovsky's sense of integrity scale (SOC, 13-item version, maximum score is 91, a higher score means a higher level of sense of integrity) and Rosenberg's self-esteem scale (RSS, maximum score of 30 with the coding of items 0-1-2-3, a higher score means higher self-esteem) were used. Descriptive statistical procedures, Student's t-test, correlation analysis and linear regression were used for statistical data processing. The linear regression model included age and gender as possible intervening variables, level of self-esteem (RSS) and sense of integrity as possible predictors, and level of burnout syndrome (SBI) as a dependent variable.

Results

The average values of individual psychological variables are shown in Table 1. Psychology students and health students differed in the average values of burnout syndrome (p≤ 0.05, Student's t-test).

The values ​​of the SBI - burnout syndrome questionnaire were significantly negatively related to the level of self-esteem (r = -0.29), and the negative correlation between burnout syndrome and sense of integrity (r = -0.41) was also statistically significant. The correlation of the variable self-esteem and sense of coherence was also statistically significant. The values of Pears' correlation coefficient are shown in Table 2

The level of burnout syndrome was significantly predicted only by the level of the sense of integrity - sense of coherence ((β= -0.35; 95% CI: -0.45, -0.32). Self-esteem was not a significant predictor of the level of burnout syndrome among students of helping professions (β= -0.05; 95% CI: -0.65,0.46).

Discussion

It can be assumed that burnout syndrome, in addition to the characteristics of the working (or in this case study) environment itself, is also significantly influenced by personality characteristics, especially those that are closely related to self-concept (self-esteem) and resources for managing stress, coping strategies. The results of the presented research indicate that the sense of integrity (sense of coherence), which is characterized by understanding the world as logically comprehensible, "making sense", consistent and relatively predictable and safe, can be particularly significant in this context. It is also characterized by a high ability to engage, to invest energy in solving life problems, which are understood as manageable challenges rather than insurmountable obstacles (12). It is obvious that such a personality setting for the perception of the surrounding world is advantageous for handling stressful situations and also from the point of view of a lower risk of burnout.

The interrelationships between burnout syndrome and personality characteristics are complex, and in the future it will be appropriate to confirm their results in a larger and more consistent group of participants, as some results may have been influenced by methodological limitations (size and composition of the research group). Also, in the next phase of the research project, verification of the impact of social-psychological training on individual psychological variables relevant to burnout syndrome is planned.

Conclusion

Research results show that burnout is significantly related to a low level of sense of integrity. It is likely that the coping strategies used in the fulfillment of study obligations will be significantly related to the strategies used later at work, and it can also be assumed that improving skills for managing stress and developing characteristics that have a positive effect against burnout syndrome is already appropriate for students - from the point of view of preventing the later occurrence of burnout syndrome during the performance of the profession.

Authors: Z. Škodová, Ľ. Banovčinová, M. Bubeníková, J. Holdoš Literature:

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The paper was presented at the 5th annual conference entitled ,,Psychology of health 2010", which took place on May 19, 2010 in Bratislava. The conference was organized by the health psychology section of the SPS at SAV in cooperation with the health section of the Ministry of Health of the Slovak Republic. The following participated in the preparation of the event: National Institute of Heart and Vascular Diseases in Bratislava, VŠZaSP St. Elizabeth in Bratislava, WHO Office in Slovakia, KISH Košice, Department of Psychology FF KU in Ružomberok and Department of Psychology FF TU in Trnava.

Proceedings from the 5th conference of health psychology, Bratislava, 2010 was published only in electronic form Availability: http://www.prohuman.sk/psychologia/zbornik-prispevkov-z-konferencie-psychologia-zdravia-2010