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Reducing the risk of burnout in end-of-life care settings: The role of daily spiritual experiences and training

  • JASON M. HOLLAND (a1) and ROBERT A. NEIMEYER (a1)

Abstract

Objective: Individuals in the helping professions are subject to unique stressors that may lead to burnout, and research has shown that those who work with dying or bereaved individuals might be particularly at-risk. This study explores how factors such as spirituality and level of training might buffer the stress of working with terminally ill clients and their families.

Method: A total of 80 medical and mental health practitioners attending palliative care seminars were surveyed, with each completing validated measures of daily spiritual experiences and caregiver burnout, as well as assessments of demographic factors, their general education and training experiences specific to working in end-of-life care and bereavement settings.

Results: Findings indicate that daily spiritual experiences might mitigate physical, cognitive, and emotional forms of burnout in the workplace. In addition, a negative correlation was found between the amount of end-of-life training received and burnout in the physical and cognitive domains. However, training was not related to professionals' level of emotional exhaustion.

Significance of the research: Results reinforce a growing literature on the salutary effects of spirituality, and underscore its relevance as one possible form of constructive coping for professionals attending to the needs of the dying and bereaved. The study carries further implications for how the stresses of such work might be ameliorated by enhanced training efforts, as well as creative facilitation of diverse spiritual expressions (e.g., inclusive forms of ritual recognition of loss) in the workplace.

Copyright

Corresponding author

Corresponding author: Robert A. Neimeyer, Department of Psychology, University of Memphis, Memphis, TN 38152, USA. E-mail: neimeyer@memphis.edu

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REFERENCES

Bandura, A. (1997). Self-efficacy: The exercise of control. New York: W.H. Freeman.
Barnard, D. (1995). The promise of intimacy and fear of our own undoing. Journal of Palliative Care, 11, 2226.
Bivens, A.J., Neimeyer, R.A., Kirchberg, T.M., et al. (1995). Death concern and religious beliefs among gays and bisexuals of variable proximity to AIDS. Omega, 30, 105120.
Carr, M. & Merriman, M.P. (1995–96). Comparison of death attitudes among hospice workers and health care professionals in other settings. Omega, 32, 287301.
Carson, J. & Fagin, L. (1996). Editorial: Stress in mental health professionals: A cause for concern or an inevitable part of the job? International Journal of Social Psychiatry, 42, 7981.
Center for the Advancement of Health. (2004). Report on bereavement and grief research. Death Studies, 28, 6.
Collins, S. & Long, A. (2003). Too tired to care? The psychological effects of working with trauma. Journal of Psychiatric and Mental Health Nursing, 10, 1727.
Csiernik, R. & Adams, D.W. (2002). Spirituality, stress and work. Employee Assistance Quarterly, 18, 2937.
Davies, F.W. & Yates, B.T. (1982). Self-efficacy expectancies versus outcome expectancies as determinants of performance deficits and depressive affect. Cognitive Therapy and Research, 6, 2335.
Dickinson, G.E. & Field, D. (2002). Teaching end-of-life issues: Current status in United Kingdom and United States medical schools. American Journal of Hospice & Palliative Care, 19, 181186.
Durlak, J.A. & Riesenberg, L.A. (1991). The impact of death education. Death Studies, 15, 3958.
Edwards, D., Burnard, P., Coyle, D., et al. (2000). Stress and burnout in community mental health nursing: A review of the literature. Journal of Psychiatric and Mental Health Nursing, 7, 714.
Field, D. & Howells, K. (1985). Medical students' self-reported worries about aspects of death and dying. Death Studies, 10, 147154.
Fiori, K., Hays, J., & Meador, K.G. (2004). Spiritual turning points and perceived control over the life course. International Journal of Aging and Human Development, 59, 391420.
Figley, C.R. (1995). Compassion fatigue: Toward a new understanding of the costs of caring. In Secondary Traumatic Stress: Self-care Issues for Clinicians, Researchers and Educators, Stamm, B.H. (ed.), pp. 328. Lutherville, MD: Sidran Press.
Firth-Cozens, J. & Morrison, L. (1989). Sources of stress and ways of coping in junior house-officers. Stress Medicine, 5, 121126.
Golden, J., Piedmont, R.L., Ciarrocchi, J.W., et al. (2004). Spirituality and burnout: An incremental validity study. Journal of Psychology and Theology, 32, 115125.
Guy, J.D., Poelstra, P.L., & Stark, M.J. (1989). Personal distress and therapeutic effectiveness: National survey of psychologists practicing psychotherapy. Professional Psychology: Research and Practice, 20, 4850.
Haley, W.E., Larson, D.G., Kasl-Godley, J.K., et al. (2003). Roles for psychologists in end-of-life care: Emerging models of practice. Professional Psychology: Research and Practice, 34, 626633.
Harper, H. & Minghella, E. (1997). Pressures and rewards of working in community mental health teams. Mental Health Care, 1, 1821.
Hill, P.C. & Butter, E.M. (1995). The role of religion in promoting physical health. Journal of Psychology and Christianity, 14, 141155.
Hungelmann, J., Kenkel-Rossi, E., Klassen, L., et al. (1996). JAREL spiritual well-being scale. In Handbook of Community and Home Health Nursing: Tools for Assessment Intervention and Education, 3rd ed., Stanhope, M. & Knollmueller, R.N. (eds.), pp. 166168. St. Louis: Mosby.
Jackson, S.E., Schwab, R.L., & Schuler, R.S. (1986). Toward an understanding of the burnout phenomenon. Journal of Applied Psychology, 71, 630640.
Kaplan, L.J. (2000). Toward a model of caregiver grief: Nurses' experiences of treating dying children. Omega, 41, 187206.
Kirchberg, T.M. & Neimeyer, R.A. (1991). Reactions of beginning counselors to situations involving death and dying. Death Studies, 15, 603610.
Kirchberg, T.M., Neimeyer, R.A., & James, R.K. (1998). Beginning counselors' death concerns and empathic responses to client situations involving death and grief. Death Studies, 22, 99120.
Kushnir, T. & Melamed, S. (1992). The Gulf War and burnout. Psychological Medicine, 22, 987995.
Leiter, M.P. (1992). Burn-out as a crisis in self-efficacy: Conceptual and practical implications. Work and Stress, 6, 107115.
McCammon, S.L., Durham, T.W., Allison, E.J., et al. (1988). Emergency workers' cognitive appraisal and coping with traumatic events. Journal of Traumatic Stress, 1, 353372.
McCann, L. & Pearlman, L.A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3, 131149.
Melamed, S., Kushnir, T., & Shirom, A. (1992). Burnout and risk factors for cardiovascular disease. Behavioral Medicine, 18, 5361.
Melamed, S., Ugarten, U., Shirom, A., et al. (1999). Chronic burnout, somatic arousal and elevated cortisol levels. Journal of Psychosomatic Research, 46, 591598.
Moore, J.E. (2000). Why is this happening? A causal attribution approach to work exhaustion consequences. Academy of Management Review, 25, 335349.
Moss, M.S., Braunschweig, H., & Rubinstein, R.L. (2002). Terminal care for nursing home residents with dementia. Alzheimer's Care Quarterly, 3, 233246.
Moss, S.Z. & Moss, M.S. (2002). Nursing home staff reactions to resident deaths. In Disenfranchised Grief: New Directions, Challenges, and Strategies for Practice, Doka, K.J. (ed.), pp. 197216. Champaign, IL: Research Press.
Neimeyer, R.A. (1994). Death Anxiety Handbook: Research, Instrumentation, and Application. New York: Taylor & Francis.
Neimeyer, R.A. (2000). Suicide and hastened death: Toward a training agenda for counseling psychology. The Counseling Psychologist, 28, 551560.
Neimeyer, R.A. (ed.). (2001). Meaning Reconstruction and the Experience of Loss. Washington DC: American Psychological Association.
Neimeyer, R.A. & Hogan, N. (2001). Quantitative or qualitative? Measurement issues in the study of grief. In Handbook of Bereavement Research, Stoebe, M., Hansson, R., Stroebe, W. & Schut, H. (eds.), pp. 89118. Washington, DC: American Psychological Association.
Neimeyer, R.A., Wittkowski, J., & Moser, R. (2004). Psychological research on death attitudes: An overview and evaluation. Death Studies, 28, 309340.
Oliver, D. (1989). Training in and knowledge of terminal care in medical students and junior doctors. Palliative Medicine, 3, 293297.
Papadatou, D. (2000). A proposed model of health professionals' grieving process. Omega, 41, 5977.
Pines, A. & Maslach, C. (1978). Characteristic of staff burnout in mental health setting. Hospital and Community Psychiatry, 29, 233237.
Powell, L.H., Shahabi, L., & Thoresen, C.E. (2003). Religion and spirituality: Linkages to physical health. American Psychologist, 58, 3652.
Redinbaugh, E.M., Sullivan, A.M., Block, S.D., et al. (2004). Doctors' emotional reactions to recent death of a patient. British Medical Journal, 327, 16.
Riordan, R.J. & Saltzer, S.K. (1992). Burnout prevention among health care providers working with the terminally ill: A literature review. Omega, 25, 1724.
Rodgerson, T.E. & Piedmont, R.L. (1998). Assessing the incremental validity of the religious problem-solving scale in the prediction of clergy burnout. Journal for the Scientific Study of Religion, 37, 517527.
Seeman, T.E., Dubin, L., & Seeman, M. (2003). Religiosity/spirituality and health: A critical review of the evidence for biological pathways. American Psychologist, 58, 5363.
Shirom, A. (1989). Burnout in work organizations. In International Review of Industrial and Organizational Psychology, Cooper, C.L. & Robertson, I. (eds.), pp. 2648. New York: Wiley.
Shirom, A. (2002). Job-related burnout: A review. In Handbook of Occupational Health Psychology, Quick, J.C. & Tetrick, L.E. (eds.), pp. 245264. Washington DC: American Psychological Association.
Shirom, A., Westman, M., Shamai, O., et al. (1997). The effects of work overload and burnout on cholesterol and triglycerides levels: The moderating effects of emotional reactivity among male and female employees. Journal of Occupational Health Psychology, 2, 275288.
Smith, A. & Harkness, J. (2002). Spirituality and meaning: A qualitative inquiry with caregivers of Alzheimer's disease. Journal of Family Psychotherapy, 13, 87108.
Stamm, B.H. (1997). Work-related secondary traumatic stress. PTSD Research Quarterly, 8, 2534.
Strang, S. & Strang, P. (2001). Spiritual thoughts, coping, and “sense of coherence” in brain tumor patients and their spouses. Palliative Medicine, 15, 127134.
Stroebe, M.S., Hansson, R.O., Stroebe, W., et al. (eds.). (2001). Handbook of Bereavement Research: Consequences, Coping, and Care. Washington DC: American Psychological Association.
Sykes, N. (1989). Medical students’ fears about breaking bad news. Lancet, 2, 564.
Terry, M.L., Bivens, A.J., & Neimeyer, R.A. (1996). Comfort and empathy of experienced counselors in client situations involving death and loss. Omega: Journal of Death and Dying, 32, 269285.
Tiamson, M., Mcardle, R., Girolamer, T., et al. (1998). The institutional memorial service: A strategy to prevent burnout in HIV health care workers. General Hospital Psychiatry, 20, 124126.
Underwood, L.G. & Teresi, J.A. (2002). The Daily Spiritual Experience Scale: Development, theoretical description, reliability, exploratory factor analysis, and preliminary construct validity using health-related data. Annals of Behavioral Medicine, 24, 2234.
Usaf, S.O. & Kavanagh, D.J. (1990). Mechanisms of improvement in treatment for depression: Test of a self-efficacy and performance model. Journal of Cognitive Psychotherapy, 4, 5170.
Whippen, D.A. & Canellos, G.P. (1991). Burnout syndrome in the practice of oncology: Results of a random survey of 1000 oncologists. Journal of Clinical Oncology, 2, 19161920.
Yancik, R. (1984). Coping with hospice work stress. Journal of Psychosocial Oncology, 2, 1935.
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