1. bookVolume 10 (2020): Issue 1 (October 2020)
Journal Details
License
Format
Journal
eISSN
2248-0854
First Published
15 Dec 2017
Publication timeframe
1 time per year
Languages
English
access type Open Access

Burnout and Depression in Medical Assistants in State-Owned Healthcare Institutions in Romania

Published Online: 29 Oct 2020
Volume & Issue: Volume 10 (2020) - Issue 1 (October 2020)
Page range: 115 - 138
Journal Details
License
Format
Journal
eISSN
2248-0854
First Published
15 Dec 2017
Publication timeframe
1 time per year
Languages
English
Abstract

Similarly to other countries in the Eastern European Region, the situation of medical assistants in Romania is fairly difficult. Due to the lack of personnel, health professionals are typically overwhelmed with work. The Quality of Life Research Centre at Sapientia Hungarian University of Transylvania conducted a non-representative survey among medical assistants in Romanian state-owned healthcare institutions. The sample size is 312 Romanian and Hungarian speaking nurses from six counties. The present study problematizes the mental health of medical assistants, more precisely burnout and depression, along demographic, social, and labour market features. The determinants of burnout and depression are being searched for among these structural and situational variables, and their controlled impact is being assessed with linear regression. Results indicate an excessive risk of burnout and depression for nurses with lower-qualification working in outpatient care. Differences in the mental health of medical assistants echo to a large extent social inequalities, so that controlled for covariates, household income has a significant impact upon burnout and depression. From demographic agents, the protective effect of partnership is outstanding, and the number of supportive relationships is a protective factor of its own right against both burnout and depression. Female assistants are more at risk for depression but not for burnout, whereas workload increases the risk of burnout but not of depression. The analysis takes sides of the distinctness of burnout and depression. Although both syndromes are largely influenced by social features, burnout seems to be more situationally influenced whereas depression more structurally affected.

Keywords

Ádám, Szilvia, Nistor, Anikó, Nistor, Katalin, Cserháti, Zoltán, Mészáros, Veronika. 2015. A kiégés és a depresszió diagnosztizálásának elősegítése demográfiai és munkahelyi védő és kockázati tényezőinek feltárásával egészségügyi szakdolgozók körében. Orvosi Hetilap 156(32): 1294–1303.10.1556/650.2015.30220Search in Google Scholar

Ahola, Kirsi, Hakanen, Jari, Perhoniemi, Riku, Mutanen, Pertti. 2014. Relationship between Burnout and Depressive Symptoms: A Study Using the Person-Centred Approach. Burnout Research 1: 29–37.10.1016/j.burn.2014.03.003Search in Google Scholar

Alarcon, Gene M. 2011. A Meta-Analysis of Burnout with Job Demands, Resources, and Attitudes. Journal of Vocational Behavior 79: 549–562.10.1016/j.jvb.2011.03.007Search in Google Scholar

Bakker, Arnold B., Schaufeli, Wilmar B., Demerouti, Evangelia, Janssen, Peter P. M., Van Der Hulst, Renée, Brouwer, Janneke. 2000. Using Equity Theory to Examine the Difference between Burnout and Depression. Anxiety Stress Coping 13: 247–268.10.1080/10615800008549265Search in Google Scholar

Bakusic, Jelena, Schaufeli, Wilmar B., Claes, Stephan J., Godderis, Lode. 2017. Stress, Burnout and Depression: A Systematic Review on DNA Methylation Mechanisms. Journal of Psychosomatic Research 92: 34–44.Search in Google Scholar

Bianchi, Renzo, Boffy, Claire, Hingray, Coreline, Truchot, Didier, Laurent, Eric. 2013. Comparative Symptomatology of Burnout and Depression. Journal of Health Psychology 18: 782–787.10.1177/1359105313481079Search in Google Scholar

Bianchi, Renzo, Schonfeld, Irvin Sam, Laurent, Eric. 2015. Burnout–Depression Overlap: A Review. Clinical Psychology Review 36: 28–41.10.1016/j.cpr.2015.01.004Search in Google Scholar

Borritz, Marianna, Villadsen, Ebbe, Christensen, Karl B. 2005. The Copenhagen Burnout Inventory: A New Tool for the Assessment of Burnout. Work and Stress 19(3): 192–207.10.1080/02678370500297720Search in Google Scholar

Brewer, Ernest W., Shapard, Leslie. 2004. Employee Burnout: A Meta-Analysis of the Relationship between Age or Years of Experience. Human Resource Development Review 3(2):102–123.10.1177/1534484304263335Search in Google Scholar

Bria, Mara, Spânu, Florina, Băban, Adriana, Dumitraşcu, Dan L. 2013. Burnout among Romanian Healthcare Professionals: The Role of Work-Home Interference. Sociologie Românească 9(3): 85–98. 2014. Maslach Burnout Inventory – General Survey: Factorial Validity and Invariance among Romanian Healthcare Professionals. Burnout Research 1: 103–111.10.1016/j.burn.2014.09.001Search in Google Scholar

Bridgeman, Patrick J., Bridgeman, Mary Barna, Barone, Joseph. 2018. Burnout Syndrome among Healthcare Professionals. American Journal of Health-System Pharmacy 75: 147–152.10.2146/ajhp170460Search in Google Scholar

Chang, Tak Wing, Goldthorpe, John H. 2004. Is There a Status Order in Contemporary British Society? Evidence from the Occupational Structure of Friendship. European Sociological Review 20 (5): 383–401.10.1093/esr/jch033Search in Google Scholar

Delaney, Liam, Doyle, Orla, McKenzie, Kenneth, Wall, Patrick G. 2007. The Distribution of Wellbeing in Ireland. Dublin: UCD Geary Institute.Search in Google Scholar

Demerouti, Evangelia, Bakker, Arnold B., Nachreiner, Friedhelm, Schaufeli, Wilmar B. 2001. The Job Demands-Resources Model of Burnout. Journal of Applied Psychology 86: 499–512.10.1037/0021-9010.86.3.499Search in Google Scholar

Deutsch, Szilvia, Fejes, Enikő, Kun, Ágota, Medves, Dóra. 2015. A jóllétet meghatározó tényezők vizsgálata egészségügyi dolgozók körében. Alkalmazott Pszichológia 15(2): 49–71.Search in Google Scholar

Freeney, Yseult, Fellenz, Martin. 2013. Work Engagement as a Key Driver of Quality of Care: A Study of with Midwives. Journal of Health Organization and Management 27(3): 330–349.10.1108/JHOM-10-2012-0192Search in Google Scholar

Freudenberger, Herbert J., Richelson, Geraldine. 1980. Burn-Out: The High Cost of High Achievement. Garden City, NY: Anchor Press.Search in Google Scholar

Gal, Melinda, Timofe, Mara Paula, Rus, Diana, Zavtochi, E. S., Boeriu, Cristian, Chereches, Răzvan M., Peek-Asa, Corinne. 2013. Emergency Health Care Violence: Who Is at Risk? Evidence from a Large Emergency Department in Mureş County, Romania. European Journal of Public Health 23, Supplement 1: 164.Search in Google Scholar

Gascón, Santiago, Martínez-Jarreta, Begoña, González-Andrade, J. Fabrizio, Santed, M. Angél, Casalod, Yolanda, Rueda, M. Ángeles. 2009. Aggression towards Health Care Workers in Spain. International Journal of Occupational and Environmental Health 15(1): 32–33.10.1179/oeh.2009.15.1.29Search in Google Scholar

Glise, Kristina, Hadzibajramovic, Emina, Jonsdottir, Ingibjörg H., Ahlborg, Gunnar Jr. 2010. Self-Reported Exhaustion: A Possible Indicator of Reduced Work Ability and Increased Risk of Sickness Absence among Human Service Workers. International Archives of Occupational and Environmental Health 83(5): 511–520.10.1007/s00420-009-0490-xSearch in Google Scholar

Gonçalves, Alice, Fontes, Liliana, Simães, Clara, Gomes, Rui. 2019. Stress and Burnout in Health Professionals. In: Arezes, P. et al. (eds.), Occupational and Environmental Safety and Health. Springer. 563–571.10.1007/978-3-030-14730-3_60Search in Google Scholar

Green, Dianna E., Walkey, Frank H., Taylor, Antony J. W. 1991. The Three-Factor Structure of the Maslach Burnout Inventory: A Multicultural, Multinational Confirmatory Study. Journal of Social Behavior and Personality 6: 453–472.Search in Google Scholar

Gupta, Manish, Shaheen, Musarrat S. 2018. Does Work Engagement Enhance General Well-Being and Control at Work? Mediating Role of Psychological Capital. Evidence-Based HRM: A Global Forum for Empirical Scholarship. https://doi.org/10.1108/EBHRM-05-2017-0027.10.1108/EBHRM-05-2017-0027Search in Google Scholar

Hailemichael, Yohannes, Hanlon, Charlotte, Tirfessa, Kebede, Docrat, Sumaiyah, Alem, Atalay, Medhin, Girmay, Fekadu, Abebaw, Lund, Crick, Chisholm, Dan, Hailemariam, Damen. 2019. Mental Health Problems and Socioeconomic Disadvantage: A controlled Household Study in Rural Ethiopia. International Journal for Equity in Health 18: 121.10.1186/s12939-019-1020-4Search in Google Scholar

Hall, Louise H, Johnson, Judith, Watt, Ian, Tsipa, Anastasia, O’Connor, Daryl B. 2016. Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review. PLoS ONE 11(7): e0159015.Search in Google Scholar

Hamdan, Motasem, Hamra, Asma’a Abu. 2017. Burnout among Workers in Emergency Departments in Palestinian Hospitals: Prevalence and Associated Factors. BMC Health Services Research 17: 407.10.1186/s12913-017-2356-3Search in Google Scholar

Harmat, György, Czárán, Erzsébet. 2008. Erőszak az egészségügyben. Egészségügyi Gazdasági Szemle 5: 34–35.Search in Google Scholar

Häusler, Nadine, Bopp, Matthias, Hämming, Oliver. 2018. Effort–Reward Imbalance, Work–Privacy Conflict, and Burnout among Hospital Employees. Journal of Occupational and Environmental Medicine 60(4): e183–e187.Search in Google Scholar

Hobfoll, Stevan E. 1989. Conservation of Resources. A New Attempt at Conceptualizing Stress. American Psychologist 44(3): 513–524.10.1037/0003-066X.44.3.513Search in Google Scholar

Hobfoll, Stevan E., Shirom, Arie. 1993. Stress and Burnout in the Workplace: Conservation of Resources. In: Golembiewski, R. T. (ed.), Handbook of Organizational Behaviour. New York: M. Dekker. 41–60.Search in Google Scholar

Hudson, Christopher G. 2005. Socioeconomic Status and Mental Illness: Tests of the Social Causation and Selection Hypotheses. American Journal of Orthopsychiatry 75(1): 3–18.10.1037/0002-9432.75.1.3Search in Google Scholar

Irinyi, Tamás, Németh, Anikó. 2017. Az egészségügyi szakdolgozókat ért agresszív cselekmények kapcsolata szociodemográfiai és munkahelyi tényezőkkel. Orvosi Hetilap 158(6): 229–237.10.1556/650.2017.30658Search in Google Scholar

Johari, Farah Shazlin, Omar, Rosmini. 2019. Exploring Factors Impacting on Psychological Well-Being of Health Care Workers. International Journal of Academic Research in Business and Social Sciences 9(2): 5672–5684.10.6007/IJARBSS/v9-i2/5711Search in Google Scholar

Kalliath, Thomas J., O’ Driscoll, Michael P., Gillespie, David F., Bluedorn, Allen C. 2000. A Test of the Maslach Burnout Inventory in Three Samples of Healthcare Professionals. Work and Stress 14: 35–50.10.1080/026783700417212Search in Google Scholar

Kawachi, Ichiro, Berkman Lisa F. 2001. Social Ties and Mental health. Journal of Urban Health 78(3): 458–467.10.1093/jurban/78.3.458Search in Google Scholar

Kleinbaum, David G., Kupper, Lawrence L., Nizam, Azhar, Rosenberg, Eli S. 2014. Applied Regression Analysis and Other Multivariable Methods (5th ed.). Boston: Cengage Learning.Search in Google Scholar

Koeske, Gary F., Koeske, Randi Daimon. 1989. Construct Validity of the Maslach Burnout Inventory: A Critical Review and Reconceptualization. The Journal of Applied Behavioral Science 25(2): 131–144.10.1177/0021886389252004Search in Google Scholar

Koutsimani, Panagiota, Montgomery, Anthony, Georganta, Katerina. 2019. The Relationship between Burnout, Depression, and Anxiety: A Systematic Review and Meta-Analysis. Frontiers in Psychology 10: 284.Search in Google Scholar

Kumar, Amit, Bhat, Pookala Shivaram, Ryali, Sumalatha. 2018. Study of Quality of Life among Health Workers and Psychosocial Factors Influencing It. Industrial Psychiatry Journal 27(1): 97–102.Search in Google Scholar

Loera, Barbara, Converso, Daniela, Viotti, Sara. 2014. Evaluating the Psychometric Properties of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) among Italian Nurses: How Many Factors Must a Researcher Consider? PLoS One 9(12): e114787.10.1371/journal.pone.0114987Search in Google Scholar

Luciani, Michaela, Spedale, Valentina, Romanenghi, Monica, Villa, Candida Ester, Ausili, D., Di Mauro, Stefania. 2016. Atti di violenza verso gli infermieri e fattori associati alla violenza nel contesto ospedaliero: uno studio trasversale. Medicina del Lavoro 107(3): 191–204.Search in Google Scholar

Makkai, Kinga. 2018. Evaluating the Level of Burnout among Healthcare Professionals. Acta Universitatis Sapientiae, Social Analysis 8: 23–39.Search in Google Scholar

Malach-Pines, Ayala. 2000. Nurses’ Burnout: An Existential Psychodynamic Perspective. Journal of Psychosocial Nursing and Mental Health Services 38(2): 23–31.10.3928/0279-3695-20000201-06Search in Google Scholar

Maslach, Christina, Jackson, Susan E. 1986. Maslach Burnout Inventory Manual (2nd ed.). Palo Alto, CA: Consulting Psychologists Press.Search in Google Scholar

Maslach, Christina, Schaufeli, Wilmar B., Leiter, Michael P. 2001. Job Burnout. Annual Review of Psychology 52: 397–422.10.1146/annurev.psych.52.1.397Search in Google Scholar

Mészáros, Veronika, Ádám, Szilvia, Szabó, M, Szigeti, Réka, Urbán, Róbert. 2013. The Bifactor Model of the Maslach Burnout Inventory–Human Services Survey (MBI-HSS): An Alternative Measurement Model of Burnout. Stress and Health 30: 82–88.10.1002/smi.2481Search in Google Scholar

Molarius, Anu, Berglund, Kenneth, Eriksson, Charli, Eriksson, Hans G., Lindén-Boström, Margareta, Nordström, Eva, Persson, Carina, Sahlqvist, Lotta, Starrin, Bengt, Ydreborg, Berit. 2009. Mental Health Symptoms in Relation to Socio-Economic Conditions and Lifestyle Factors – A Population-Based Study in Sweden. BMC Public Health 9(302): 1–9.10.1186/1471-2458-9-302Search in Google Scholar

Molina-Praena, Jesús, Ramirez-Baena, Lucia, Gómez-Urquiza, José L., Cañadas, Gustavo R., De la Fuente, Emilia, Cañadas-De la Fuente, Guillermo A. 2018. Levels of Burnout and Risk Factors in Medical Area Nurses: A Meta-Analytic Study. International Journal of Environmental Research and Public Health 15: 2800.10.3390/ijerph15122800Search in Google Scholar

Palenzuela, Patricia, Delgado, Naira, Rodriguez, José A. 2019. Exploring the Relationship between Contextual Performance and Burnout in Healthcare Professionals. Journal of Work and Organizational Psychology 35: 115–121.10.5093/jwop2019a13Search in Google Scholar

Pálfi, Ilona, Németh, Katalin Anna, Kerekes, Zsuzsanna, Kállai, János, Betlehem, József. 2008. The Role of Burnout among Hungarian Nurses. International Journal of Nursing Practice 14: 19–25.10.1111/j.1440-172X.2007.00662.xSearch in Google Scholar

Rahimnia, Fariborz, Sharifirad, Mohammad S. 2015. Authentic Leadership and Employee Well-Being: The Mediating Role of Attachment Insecurity. Journal of Business Ethics 132(2): 365–377.10.1007/s10551-014-2318-1Search in Google Scholar

Randall, Kelvin J. 2007. Examining the Relationship between Burnout and Age among Anglican Clergy in England and Wales. Mental Health, Religion and Culture 10(1): 39–46.10.1080/13674670601012303Search in Google Scholar

Rehm, Jürgen, Shield, Kevin D. 2019. Global Burden of Disease and the Impact of Mental and Addictive Disorders. Current Psychiatry Reports 21(2):10.10.1007/s11920-019-0997-0Search in Google Scholar

Rodwell, John, Munro, Louise E. 2013. Well-Being, Satisfaction and Commitment: The Substitutable Nature of Resources for Maternity Hospital Nurses. Journal of Advanced Nursing 69(10): 2145–2372.10.1111/jan.12096Search in Google Scholar

Rotilă, Viorel, Celmare, Lidia, Ciobanu, Georgiana, Palade, Traian. Lungu, Laurenţiu. 2014. Cariere în sănătate: Oportunităţi şi piedici. Studiu privind nevoile specifice de consiliere şi orientare profesională ale salariaţilor din sănătate. Analiză de caz: Regiunea Bucureşti – Ilfov. Galaţi: Sodalitas.Search in Google Scholar

Rotilă, Viorel, Ciobanu, Georgiana, Celmare, Lidia, Palade, Traian, Tetiva, Elena, Andoniu, Loredana. 2016. Calitatea vieţii profesionale a salariaţilor din sănătate. Studii, analize şi demersuri privind unii dintre indicatori. Galaţi: Sodalitas.Search in Google Scholar

Roy-Byrne Peter R., Joesch, Jutta M., Wang Philip S, Kessler Ronald C. 2009. Low Socioeconomic Status and Mental Health Care Use among Respondents with Anxiety and Depression in the NCS-R. Psychiatric Services 60(9): 1190–1197.10.1176/ps.2009.60.9.1190Search in Google Scholar

Sántha, Ágnes Rózsa. 2016. Social, Demographic and Labour Market Related Determinants of Health in the Adult European Population. Finnish Yearbook of Population Research 51: 77–88.Search in Google Scholar

Shanafelt, Tait D., Boone, Sonja, Tan, Litjen, Dyrbye, Lotte N., Sotile, W., Satele, Daniel, West, Colin P., Sloan, Jeff, Oreskovich, Michael R. 2012. Burnout and Satisfaction with Work-Life Balance Among US Physicians Relative to the General US Population. Archives of Internal Medicine 172(18): 1377–1385.10.1001/archinternmed.2012.3199Search in Google Scholar

Schaufeli, Wilmar B., Enzmann, Dirk. 1998. The Burnout Companion to Study and Practice: A Critical Analysis. Philadelphia: Taylor & Francis.Search in Google Scholar

Schaufeli, Wilmar B., Greenglass, Esther R. 2001. Introduction to Special Issue on Burnout and Health. Psychology and Health 16: 501–510.10.1080/08870440108405523Search in Google Scholar

Spânu, Florina, Băban, Adriana, Bria, Mara, Lucăcel, Raluca, Dumitras, Dan L. 2013. A Study of Health Professionals’ Burnout and Quality of Care in Romania. Procedia – Social and Behavioral Sciences 84: 1149–1153.10.1016/j.sbspro.2013.06.717Search in Google Scholar

Suñer-Soler, Rosa, Grau-Martín, Armand, Font-Mayolas, Silvia, Gras, M. Eugenia, Bertran, C. Sullman, Mark J. M. 2013. Burnout and Quality of Life among Spanish Healthcare Personnel. Journal of Psychiatric and Mental Health Nursing 20: 305–313.10.1111/j.1365-2850.2012.01897.xSearch in Google Scholar

Tachtsoglou, Kiriaki, Lera, Maurizio, Iliadis, Christos, Frantzana, Aikaterini, Kourkouta, Lambrini. 2018. Occupational Burnout of Health Care Professionals in Hospitals. Journal of Healthcare Communications 3(3):38.Search in Google Scholar

Tizón, Jorge L. 2004. Burn-Out Professionals, Disillusioned Professionals or Professionals with Psycho-Pathological Disorders? Atención Primaria 33: 326–330.Search in Google Scholar

Toker, Sharon, Biron, Michal. 2012. Job Burnout and Depression: Unraveling Their Temporal Relationship and Considering the Role of Physical Activity. Journal of Applied Psychology 97: 699.10.1037/a0026914Search in Google Scholar

Topp, Christian Winter, Østergaard, Søren Dinesen, Søndergaard, Susan, Bech, Per. 2015. The WHO-5 Well-Being Index: A Systematic Review of the Literature. Psychotherapy and Psychosomatics 84: 167–176.10.1159/000376585Search in Google Scholar

Van de Velde, Sarah, Bracke, Piet, Levecque, Katia, Meuleman, Bart. 2010a. Gender Differences in Depression in 25 European Countries after Eliminating Measurement Bias in the CES-D 8. Social Science Research 39(3): 396–404.10.1016/j.ssresearch.2010.01.002Search in Google Scholar

Van de Velde, Sarah, Bracke, Piet, Levecque, Katia. 2010b. Gender Differences in Depression in 23 European Countries. Cross-National Variation in the Gender Gap in Depression. Social Science & Medicine 71: 305–313.10.1016/j.socscimed.2010.03.035Search in Google Scholar

Vingender, István, Szalóczy, Nóra, Pálvölgyi, Miklós. 2018. The Structural Components of the Situation of Nurses in Hungary. Developments in Health Sciences 1(2): 49–55.10.1556/2066.2.2018.15Search in Google Scholar

Visser, Mechteld R. M., Smets, Ellen M. A., Oort, Frans J., De Haes, Hanneke C. J. M. 2003. Stress, Satisfaction and Burnout among Dutch Medical Specialists. CMAJ: Canadian Medical Association Journal 168: 271–275.Search in Google Scholar

Waqas, Ahmed, Ahmad, Waqas, Haddad, Mark, Taggart, Frances M., Muhammad, Zerwah, Bukhari, Muhammad Hamza, Sami, Shahzad Ahmed, Batool, Sayyeda Mehak, Najeeb, Fiza, Hanif, Ayesha, Rizvi, Zehra Ali, Ejaz, Sumbul. 2015. Measuring the Well-Being of Health Care Professionals in the Punjab: A Psychometric Evaluation of the Warwick–Edinburgh Mental Well-Being Scale in a Pakistani Population. PeerJ 3: e126410.7717/peerj.1264Search in Google Scholar

Wheeler, Denna L., Vassar, Matt, Worley, Jody A., Barnes, Laura L. B. 2011. A Reliability Generalization Meta-Analysis of Coefficient Alpha for the Maslach Burnout Inventory. Educational and Psychological Measurement 71: 231–244.10.1177/0013164410391579Search in Google Scholar

WHO. 1998. Wellbeing Measures in Primary Health Care/The DepCare Project. Copenhagen: WHO Regional Office for Europe.Search in Google Scholar

Zander, Britta, Aiken, Linda H., Busse, Reinhard, Rafferty, Anne Marie, Sermeus, Walter, Bruyneel, Luk. 2016. The State of Nursing in the European Union. Eurohealth 22(1): 3–6.Search in Google Scholar

Zarei, Ehsan, Ahmadi, Fariba, Sial, Muhammad Safdar, Hwang, Jinsoo, Thu, Phung Anh, Usman, Sardar Muhammad. 2019. Prevalence of Burnout among Primary Health Care Staff and Its Predictors: A Study in Iran. International Journal of Environmental Research and Public Health 16: 2249.10.3390/ijerph16122249Search in Google Scholar

Ziegler, Matthias, Bensch, Doreen. 2013. Lost in Translation: Thoughts regarding the Translation of Existing Psychological Measures into Other Languages. European Journal of Psychological Assessment 29: 81–83.10.1027/1015-5759/a000167Search in Google Scholar

Zubairi, Akbar Jaleel, Noordin, Shahryar. 2016. Factors Associated with Burnout among Residents in a Developing Country. Annals of Medicine and Surgery 6: 60–63.10.1016/j.amsu.2016.01.090Search in Google Scholar

Recommended articles from Trend MD

Plan your remote conference with Sciendo