Occupational burnout is prevalent and problematic in healthcare. Burnout is a psychological syndrome encompassing emotional exhaustion, depersonalisation, and diminished sense of personal accomplishment due to prolonged exposure to occupational stressors (Maslach, 1982). For individuals, burnout has psychological, psychosomatic, physiological, and relational consequences. Burnout has economic implications for healthcare organisations due to staff absenteeism and turnover. Importantly, burnout has serious repercussions in terms of patient care, safety and satisfaction.
Low job satisfaction is associated with burnout amongst healthcare professionals. Job satisfaction is considered a pleasurable and positive state of affect resulting from the appraisals of work experiences (Lock, 1967). As with burnout, low job satisfaction has ramifications for the quality of care received by patients, patient satisfaction and staff turnover.
The relationship between job satisfaction and burnout has been studied in specific populations of healthcare professionals. In light of the limitations of previous reviews, the association between burnout and job satisfaction in healthcare professionals more generally was explored in this systematic review and meta-analysis.
Fifty-eight studies were eligible for inclusion in the review. Fifty-four studies were included in the meta-analysis whilst four met the inclusion criteria for the narrative synthesis only. The results of the meta-analysis revealed a small-to-medium negative association between burnout and job satisfaction. The unique associations between job satisfaction and emotional exhaustion, depersonalisation, and personal accomplishment were also reported. Further analysis demonstrated that methodological differences accounted for differences in the data. Studies included in the narrative synthesis corroborated the findings of the meta-analysis.
The thesis research was a secondary analysis of data from a randomised control trial called the UpLift Trial. The research aimed to investigate whether healthcare professionals could be accurately prescribed (or “matched”) to either a Cognitive Behaviour Therapy (CBT) intervention for burnout or a novel Job Crafting (JC) intervention for burnout risk factors, based on their individual pre-intervention characteristics and their response to intervention. The pre-intervention characteristics included demographic data (such as age, gender, ethnicity and occupation), burnout profiles, and the results of questionnaires relating to job satisfaction, stress and mental wellbeing, turnover intentions, job autonomy, self-efficacy, work-family conflict, overcommitment, social support and personality. Two models were developed for each intervention. These models demonstrated which pre-intervention characteristics predicted an individual’s response to intervention (i.e., their post-intervention burnout scores) for each respective intervention. A sophisticated algorithm was developed and evaluated in terms of its clinical utility in matching healthcare professionals to interventions for burnout.
Both models included disengagement and exhaustion subdomains of burnout, stress, satisfaction with the work and satisfaction with the job role as predictors of intervention response. The JC intervention included the addition of pre-intervention turnover interventions, whilst the CBT intervention included the addition of pre-intervention mental wellbeing and stress. Through evaluating the utility of these models, CBT was predicted to be the most beneficial intervention for burnout for all participating healthcare professionals. These results are discussed, particularly in relation to this research demonstrating little evidence for the developing ways of prescribing interventions for burnout to healthcare professionals in a personalised way.
