The prevalence of burnout among therapy staff employed in life health care rehabilitation units

Du Plessis, Theresa (2012-03)

Thesis (MPhil)--Stellenbosch University, 2012.

Thesis

ENGLISH ABSTRACT: Rehabilitation therapists are at risk for burnout as a result of their emotionally challenging and stressful jobs. No South African studies could be found that focus on burnout in therapists who work in the field of rehabilitation. This study attempted to determine the prevalence of burnout amongst a select group of therapists in South Africa i.e. therapy staff employed by Life Rehabilitation. In addition, contributing factors to burnout in this environment, current management of the problem and suggestions for future management were explored. A descriptive design which used both quantitative and qualitative methods was utilised. Forty-nine therapists and seven managers participated in the study. No sampling was done. Quantitative data was collected through a demographic coding sheet and the Maslach Burnout Inventory (MBI). Data were statistically analysed and a p value of < 0.05 was deemed statistically significant. Interview schedules were used to guide the qualitative interviews on participants’ understanding of burnout, contributing factors, its impact on the therapists and company as well as management strategies. Qualitative data was analysed according to the inductive method. Regarding burnout prevalence in each of the subsections of the MBI, 57.14% of the therapy staff had high levels of Emotional Exhaustion (EE), 20.4% reported depersonalisation (DP) and 38.77% had low levels of Personal Accomplishment (PA). The variables associated with high burnout scores were: male gender (p=0.0238) (PA), absence of children (P=0.02994) (EE), (p=0.03895) (PA), ≤ four years tertiary education (p=0.03640) (PA), ≤ R15 000 income (p=0.02262) (PA), not working weekends (p=0.02882) (DP), none or poor coping skills (p=0.03180) (EE), high overwhelming work load (p=0.03972) (EE), (p=0.01227) (DP), overwhelming/too small patient load (p=0.02365) (EE), high administration load (p=0.00302) (PA), seldom achievable deadlines (p=0.03693) (DP), postponed contact with patients (p=0.02023) (DP), (p=0.01164) (PA) and a poor work environment (p=0.02162) (EE), (p=0.04034) (DP). The qualitative data identified the following factors as causes of burnout: relationship challenges, lack of planning and coping skills, personality type, disempowerment, the nature of rehabilitation work, private health care environment, ethical dilemmas, time pressures, lack of rewards, lack of space and resources, uncertainty/change, lack of support from management and high workload. The following burnout management strategies emerged from the qualitative data: psycho-social intervention, team building, decrease in workload/increase in staff, adjustment of administrative workload, acknowledgement of staff through salaries and other rewards, adjustment to leave package, improved orientation and induction of staff, “time-out” opportunities, development of staff and managers, improved treatment facilities, feedback from discharged patients as well as implementation of burnout monitoring systems and development of a burnout policy and burnout management system. Recommendations to Life Rehabilitation focus on practical strategies regarding the detection, prevention and management of burnout in therapists. The groundwork has been done through this research. Successful strategic implementation will depend on the leadership of the organisation and without these key players and all the other role players involved, commitment in terms of time, money and allocation of resources it will remain an academic exercise.

AFRIKAANSE OPSOMMING: Die gevaar bestaan dat gesondheidswerkers hulle kan “uitbrand” as gevolg van die emosioneel uitmergelende aspekte van hul werk en die kroniese inspanning waaraan hulle blootgestel word. Geen Suid-Afrikaanse studies kon gevind word wat op uitbranding van die terapeut of die terapeut-assistent in die rehabilitasieveld fokus nie. Hierdie studie het die oogmerk om die prevalensie van uitbranding onder ’n selektiewe groep terapeute, die terapeute in diens van Life Rehabilitasie in Suid Afrika, te bepaal. Ter aanvulling van die prevalensie van uitbranding, is die bydraende faktore van uitbranding in hierdie omgewing, die huidige bestuur van die probleem en voorstelle vir toekomstige bestuur ondersoek. ’n Beskrywende studie-ontwerp, wat sowel kwantitatiewe as kwalitatiewe metodes insluit, is vir data-insameling en -ontleding gebruik. ’n Steekproef is nie gebruik nie. Nege-en-veertig terapeute en sewe bestuurders het aan die studie deelgeneem. Die demografiese inligting is met behulp van ’n demografiese kodeblad ingesamel en maak deel uit van die kwantitatiewe data. ’n P waarde van < 0,05 is as statisties beduidend beskou. Daar is van die Maslach Uitbranding-Inventaris (Maslach Burnout Inventory) gebruik gemaak om die prevalensie van uitbranding te bepaal. Onderhoudskedules is gebruik tydens die kwalitatiewe onderhoude waartydens deelnemers se begrip van uitbranding, die bydraende faktore en die impak op die terapeute en maatskappy, asook die bestuurstrategieë te bepaal. Die kwalitatiewe data is volgens die induktiewe metode ontleed. Aangaande die dimensies van uitbranding, het die studie bevind dat 57,14% van die terapeute hoog getoets het vir emosionele uitputting (EU), 20.4% het in die hoë kategorie vir depersonalisasie (DP) geval en 38,77% het lae vlakke van persoonlike vervulling (PV) gehad. Die veranderlikes wat met hoë uitbranding-tellings verband gehou het, was manlike geslag (p=0.0238) (PV), gebrek aan kinders (p=0.02994) (EU), (p=0.03895) (PV), ≤ vier jaar tersiêre opleiding (p=0.03640) (PV), ≤ R15 000 inkomste (p=0.02262) (PV), geen werk oor naweke (p=0.02882) (DP), geen of min bybly-vermoëns (p=0.03180) (EU), hoë, oorweldigende werklas (p=0.03972) (EU), (p=0.01227) (DP), oorweldigende of ontoereikende pasiënt-belading (p=0.02365) (EU), hoë administratiewe werklas (p=0.00302) (PA), selde bereikbare spertye (p=0.03693) (DP), uitgestelde kontak met pasiënte (p=0.02023) (DP), (p=0.01164) (PV), ’n swak werksomgewing (p=0.02162) (EU), (p=0.04034) (DP). Die hoof-oorsake van uitbranding is faktore wat met individue, pasiënt/werk, bestuur en administrasie verband hou. Strategieë is geïdentifiseer wat gebruik kan word om uitbranding konstruktief in hierdie omgewing te bestuur en sluit psigiese-sosiale behandeling, spanverbeteringe, werk/pasiënt aanpassings, erkenning van personeel, verlofaanpassings, vakansietyd-geleenthede, personeelontwikkeling en bestuursverbetering, asook die implementering van moniteringsisteme en beleidsontwikkeling in. Aanbevelings vir Life Rehabilitation is onder meer praktiese strategieë vir die opsporing, voorkoming en bestuur van uitbranding onder terapeute. Die aanvoorwerk is deur hierdie navorsing gedoen. Suksesvolle implementering van die strategieë sal van die leierskap in die organisasie afhang. Sonder hierdie en ander sleutelfigure, hul toegewydheid ten opsigte van tyd, geld en toewysing van middele sal dit slage akademise waarde hê.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/20415
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