The Relationship Between Workload and Burnout Among Nurses

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The professional activity of nurses is connected with significant workload and stress, which negatively influences their physiological and psychological health. Among the widespread problems is burnout syndrome which comes on average several years earlier for nurses than for the staff of other professions. This work aims to determine the conditions contributing to burnout and how to overcome it based on four qualitative and quantitative studies.

PICOT: In nurses with higher workloads, how do psychological interventions to cope with stress versus communication skills development affect the severity of professional burnout syndrome for a year?

Research Background

This paper will focus on research that determines the conditions of emotional burnout syndrome severity. The purpose of the Diehl et al. (2021) study is to assess nurses’ professional performance and potential association with poor health. The article identifies how the problem of burnout affects nurses whose main activity is palliative care. It establishes whether workload affects emotional well-being; a quantitative online survey is used to address the question. The work is relevant to nursing because it establishes a relationship between a nurse’s most important ability, empathy, and hospital workload. The Zare et al. (2021) study was conducted to evaluate nurses who encountered Covid-19 and had burnout syndrome consequences. It establishes the connection between the problem of burnout and the influence of Covid-19 due to social and emotional distancing. The research question was to determine the main factor provoking the development of burnout; for the answer, there was a task in the form of a quantitative measurement of burnout level. The significance of nursing consists in the necessity to establish the long-term consequences of the pandemic.

For the study, articles were also devoted to determining ways to overcome burnout. A study by Mudallal et al. (2017) was conducted to determine ways to reduce burnout in nurses. The article makes the connection between the leadership behavior of executives and the prevalence of burnout. The research question was how this could be accomplished; the goal was to determine the influencing factors on stress levels qualitatively. The work is relevant to nursing practice because it points to the value of competent leadership and its role in reducing stress. A study by Wang et al. (2021) examines how online interventions reduce burnout in medical staff. The paper discusses how the burnout problem is overcome by online counseling. The research questions included establishing depression, anxiety, and stress levels following psychological interventions. Research objectives included determining symptoms’ prevalence and severity based on employee characteristics. Significance to nursing practice consisted of determining the value of psychological interventions.

Supporting the Selected Problem

Diehl et al. (2021) article will be used to answer what psychological conditions create work stress. The interventions in this paper were not discussed, and comparison groups included nurses with and without a palliative care orientation – correlating which interventions would be effective for specific clinic departments. The work of Zare et al. (2021) will answer the PICOT question about what influences increased workload and stress levels. The study’s interventions involve an offline survey that will establish stress levels before and after conducting their interventions; the study groups will include individuals before and after psychological interventions that were not included in the Zare et al. (2021) study. Consequently, these works will help determine the actual presence of the problem and potential recommendations, but not in solving it.

The Mudallal et al. (2017) paper will answer the question of whether communication by leaders will overcome burnout. Interventions correlate with the implementation of leadership in nursing practice, and comparison groups are associated with weak and powerful workplace business culture. The Wang et al. (2021) study will examine how psychological interventions affect stress levels. They are fully aligned with the goals of the PICOT-based study and include comparison groups across clinic departments. Consequently, these papers will help determine the actual impact of interventions on burnout levels.

Research Method

The studies used qualitative methods (interviews) and quantitative methods (measurement of burnout). Diehl et al.’s (2021) study consisted of a quantitative workload measurement, differing from the others in having a stratified sample. The method has the advantage of online access, but random sampling may not account for all experimental conditions. Zare et al. (2021) used a quantitative method to measure burnout, which differs from the others by having a predominant dependency factor, Covid-19. The method’s advantage is the breadth of the sample, but there is a lack of qualitative study of the results. Mudallal et al. (2017) included an interview-based assessment, which has the advantage of a face-to-face interview but is less effective for objective data. Unlike other methods, it is a more fuzzy method with no specific boundaries. Wang et al. (2021) also used a qualitative method to assess symptom severity in other medical staff, which differs from other methods because it gives an objective assessment based on psychological tests. The method’s advantage is its versatility, but the difficulty interpreting the results is its disadvantage.

Research Results

Diehl et al. (2021) found that palliative care in nursing practice is a significant predictor of burnout. Implications for nursing practice in the need for transformation of the nursing work environment. The changes will raise the value of nurses’ work and create a better environment for them. Zare et al. (2021) found that Covid-19 and social distancing are among the major factors currently leading to high-stress levels. Implications for nursing practice in the potential to manage the long-term effects of coronavirus. Long-term effects are likely to be monitored and addressed by preventive measures.

Mudallal et al. (2017) determined that leadership and communication within the organization can reduce burnout among nurses. Implications for nursing practice in transitioning to solid business culture and developed social communication channels. This could lead to more competent management of employees and their distribution in the workplace. Wang et al. (2021) determined that psychological interventions positively affect anxiety and depression levels while maintaining stress levels. Implications for nursing practice include increased online psychological testing and assistance for nurses in the face of professional stress. As a result, psychological comfort will be a primary goal for union organizations and the clinics themselves.

Ethical Considerations

Ethical standards cover protecting the rights and safety of subjects, which must be applied in any study. One crucial ethical aspect is obtaining informed consent from the patient – participants must know all relevant information and provide informed and voluntary consent to participate based on it. Another aspect is the prior assessment of risks and their minimization to obtain the expected benefits. Biomedical research should be as safe as possible and appropriate to the risk-benefit ratio of the intervention. All the articles used for the study took into account obtaining informed, voluntary consent for the treatment: it was done using online forms or by written consent. The studies were approved by ethics committees, which mean that the research was either conducted with minimal risks or was safe for the participants. In addition, participants’ anonymity and data confidentiality were ensured.

Comparison of Outcomes

Psychological interventions are expected to reduce stress levels compared to developing communication skills. Skills are also needed to develop leadership and culture, but they will only indirectly act on the magnitude of emotional exhaustion. On the other hand, psychological interventions will specifically act on nurses because tests will establish the actual causes of the prevalence of burnout syndrome. These interventions are expected to reduce susceptibility to stress by at least 30% within a year.

The results are likely similar to Wang et al.’s (2021) findings of reduced overall stress and improved all other interactions. In addition, according to Mudallal et al. (2017), there may be progress in internal leadership, but its magnitude cannot be precisely determined. According to Diehl et al. (2021) and Zare et al. (2021), recommendations for organizations on overcoming stress and ways to eliminate stressful conditions contributing to professional burnout will be established. At the same time, the stress level determined in the study may differ significantly from the data of Wang et al. (2021) because only nurses, not residents, will take part in the experiment. Likely, the palliative care data in Diehl et al. (2021) may also not support the findings. Consequently, selected studies will be needed to discuss their findings and make the connection between the data and the literature.

Proposed Changes in Evidence-Based Practice

The PICOT question refers to an evidence-based intervention in nursing practice to address professional burnout syndrome. The answer will establish the nature of the interaction between the effective practices used to manage stress and their actual impact. The results will establish whether the emphasis on psychological comfort among nurses is correct and effective or if it has no valid effect. The research articles simultaneously answer how burnout syndrome occurs and why it is so prevalent; from this, assumptions about how to deal with it effectively correlate with the PICOT goals.

Potential changes in evidence-based practice could be leadership strategies for improving the professional environment, where psychological support tools would already exist. A review by Melnyk et al. (2020) found that evidence-based practice, which includes cognitive behavioral interventions and mindfulness practices, positively affects stress and anxiety among nurses. Dincer and Inangil (2021) argue that psychological interventions are central to evidence-based practice because they have proven effective in reducing stress levels. The same conclusion is reached by Fiol-DeRoque et al. (2021), who found that connecting mobile psychological care reduces stress by nearly 2-fold and significantly improves nursing. Consequently, the introduction of psychological strategies is the most critical proven tool for overcoming professional burnout syndrome in evidence-based practice.

Conclusion

The problem of professional burnout syndrome is widespread in nursing because of high psychological and physical stress. High levels of stress, the presence of anxiety and depression symptoms, and emotional exhaustion force organizations to search for ways to fight it. Studies by Diehl et al. (2021) and Zare et al. (2021) indicate that changing the work environment and reducing trigger factors are recommended to overcome. Clinical studies by Wang et al. (2021) and Mudallal et al. (2017) confirm the positive effects of psychological interventions and the implementation of leadership and communication. As part of the PICOT question under investigation, the methods in the selected studies will synthesize a procedure that will meet ethical standards. PICOT research is expected to establish that psychological interventions are more effective than communication skills development. This is likely to be the beginning of a change in preventive strategies in evidence-based practice, which will focus on the psychological comfort of employees.

References

Diehl, E., Rieger, S., Letzel, S., Schablon, A., Nienhaus, A., Escobar Pinzon, L. C., & Dietz, P. (2021). The relationship between workload and burnout among nurses: The buffering role of personal, social and organisational resources.PloS One, 16(1), 1-17.

Dincer, B., & Inangil, D. (2021). The effect of Emotional Freedom Techniques on nurses’ stress, anxiety, and burnout levels during the COVID-19 pandemic: A randomized controlled trial.Explore (New York, N.Y.), 17(2), 109–114.

Fiol-DeRoque, M. A., Serrano-Ripoll, M. J., Jiménez, R., Zamanillo-Campos, R., Yáñez-Juan, A. M., Bennasar-Veny, M., Leiva, A., Gervilla, E., García-Buades, M. E., García-Toro, M., Alonso-Coello, P., Pastor-Moreno, G., Ruiz-Pérez, I., Sitges, C., García-Campayo, J., Llobera-Cánaves, J., & Ricci-Cabello, I. (2021). A Mobile phone-based intervention to reduce mental health problems in health care workers during the COVID-19 Pandemic (PsyCovidApp): Randomized controlled trial. JMIR mHealth and uHealth, 9(5).

Melnyk, B. M., Kelly, S. A., Stephens, J., Dhakal, K., McGovern, C., Tucker, S., Hoying, J., McRae, K., Ault, S., Spurlock, E., & Bird, S. B. (2020). Interventions to improve mental health, well-being, physical health, and lifestyle behaviors in physicians and nurses: A systematic review.American Journal of Health Promotion: AJHP, 34(8), 929–941.

Mudallal, R. H., Othman, W. A. M., & Al Hassan, N. F. (2017). Nurses’ burnout: the influence of leader empowering behaviors, work conditions, and demographic traits.The Journal of Health Care Organization, Provision, and Financing, 54, 1-10.

Wang, J., Song, B., Shao, Y., & Zhu, J. (2021). Effect of online psychological intervention on burnout in medical residents from different majors: An exploratory study. Frontiers in psychology, 12.

Zare, S., Kazemi, R., Izadi, A., & Smith, A. (2021). Beyond the outbreak of Covid-19: Factors affecting burnout in nurses in Iran.Annals of Global Health, 87(1), 1-8.

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The Relationship Between Workload and Burnout Among Nurses

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