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

Published online by Cambridge University Press:  03 March 2006

JASON M. HOLLAND  and
ROBERT A. NEIMEYER
JASON M. HOLLAND
Affiliation:
Department of Psychology, University of Memphis, Memphis, Tennessee, USA
ROBERT A. NEIMEYER
Affiliation:
Department of Psychology, University of Memphis, Memphis, Tennessee, USA
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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.

Keywords

BurnoutSpiritualityPersonnel trainingDeath and dyingGrief
Type
Research Article
Information
Palliative & Supportive Care , Volume 3 , Issue 3 , September 2005 , pp. 173 - 181
Copyright
© 2005 Cambridge University Press

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References

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, 22–26.Google Scholar
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, 105–120.Google Scholar
Carr, M. & Merriman, M.P. (1995–96). Comparison of death attitudes among hospice workers and health care professionals in other settings. Omega, 32, 287–301.Google Scholar
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, 79–81.Google Scholar
Center for the Advancement of Health. (2004). Report on bereavement and grief research. Death Studies, 28, 6.Google Scholar
Collins, S. & Long, A. (2003). Too tired to care? The psychological effects of working with trauma. Journal of Psychiatric and Mental Health Nursing, 10, 17–27.Google Scholar
Csiernik, R. & Adams, D.W. (2002). Spirituality, stress and work. Employee Assistance Quarterly, 18, 29–37.Google Scholar
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, 23–35.Google Scholar
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, 181–186.Google Scholar
Durlak, J.A. & Riesenberg, L.A. (1991). The impact of death education. Death Studies, 15, 39–58.Google Scholar
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, 7–14.Google Scholar
Field, D. & Howells, K. (1985). Medical students' self-reported worries about aspects of death and dying. Death Studies, 10, 147–154.Google Scholar
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, 391–420.Google Scholar
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. 3–28. Lutherville, MD: Sidran Press.
Firth-Cozens, J. & Morrison, L. (1989). Sources of stress and ways of coping in junior house-officers. Stress Medicine, 5, 121–126.Google Scholar
Golden, J., Piedmont, R.L., Ciarrocchi, J.W., et al. (2004). Spirituality and burnout: An incremental validity study. Journal of Psychology and Theology, 32, 115–125.Google Scholar
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, 48–50.Google Scholar
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, 626–633.Google Scholar
Harper, H. & Minghella, E. (1997). Pressures and rewards of working in community mental health teams. Mental Health Care, 1, 18–21.Google Scholar
Hill, P.C. & Butter, E.M. (1995). The role of religion in promoting physical health. Journal of Psychology and Christianity, 14, 141–155.Google Scholar
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. 166–168. 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, 630–640.Google Scholar
Kaplan, L.J. (2000). Toward a model of caregiver grief: Nurses' experiences of treating dying children. Omega, 41, 187–206.Google Scholar
Kirchberg, T.M. & Neimeyer, R.A. (1991). Reactions of beginning counselors to situations involving death and dying. Death Studies, 15, 603–610.Google Scholar
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, 99–120.Google Scholar
Kushnir, T. & Melamed, S. (1992). The Gulf War and burnout. Psychological Medicine, 22, 987–995.Google Scholar
Leiter, M.P. (1992). Burn-out as a crisis in self-efficacy: Conceptual and practical implications. Work and Stress, 6, 107–115.Google Scholar
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, 353–372.Google Scholar
McCann, L. & Pearlman, L.A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3, 131–149.Google Scholar
Melamed, S., Kushnir, T., & Shirom, A. (1992). Burnout and risk factors for cardiovascular disease. Behavioral Medicine, 18, 53–61.Google Scholar
Melamed, S., Ugarten, U., Shirom, A., et al. (1999). Chronic burnout, somatic arousal and elevated cortisol levels. Journal of Psychosomatic Research, 46, 591–598.Google Scholar
Moore, J.E. (2000). Why is this happening? A causal attribution approach to work exhaustion consequences. Academy of Management Review, 25, 335–349.Google Scholar
Moss, M.S., Braunschweig, H., & Rubinstein, R.L. (2002). Terminal care for nursing home residents with dementia. Alzheimer's Care Quarterly, 3, 233–246.Google Scholar
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. 197–216. 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, 551–560.Google Scholar
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. 89–118. 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, 309–340.Google Scholar
Oliver, D. (1989). Training in and knowledge of terminal care in medical students and junior doctors. Palliative Medicine, 3, 293–297.Google Scholar
Papadatou, D. (2000). A proposed model of health professionals' grieving process. Omega, 41, 59–77.Google Scholar
Pines, A. & Maslach, C. (1978). Characteristic of staff burnout in mental health setting. Hospital and Community Psychiatry, 29, 233–237.Google Scholar
Powell, L.H., Shahabi, L., & Thoresen, C.E. (2003). Religion and spirituality: Linkages to physical health. American Psychologist, 58, 36–52.Google Scholar
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, 1–6.Google Scholar
Riordan, R.J. & Saltzer, S.K. (1992). Burnout prevention among health care providers working with the terminally ill: A literature review. Omega, 25, 17–24.Google Scholar
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, 517–527.Google Scholar
Seeman, T.E., Dubin, L., & Seeman, M. (2003). Religiosity/spirituality and health: A critical review of the evidence for biological pathways. American Psychologist, 58, 53–63.Google Scholar
Shirom, A. (1989). Burnout in work organizations. In International Review of Industrial and Organizational Psychology, Cooper, C.L. & Robertson, I. (eds.), pp. 26–48. 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. 245–264. 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, 275–288.Google Scholar
Smith, A. & Harkness, J. (2002). Spirituality and meaning: A qualitative inquiry with caregivers of Alzheimer's disease. Journal of Family Psychotherapy, 13, 87–108.Google Scholar
Stamm, B.H. (1997). Work-related secondary traumatic stress. PTSD Research Quarterly, 8, 25–34.Google Scholar
Strang, S. & Strang, P. (2001). Spiritual thoughts, coping, and “sense of coherence” in brain tumor patients and their spouses. Palliative Medicine, 15, 127–134.Google Scholar
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.Google Scholar
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, 269–285.Google Scholar
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, 124–126.Google Scholar
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, 22–34.Google Scholar
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, 51–70.Google Scholar
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, 1916–1920.Google Scholar
Yancik, R. (1984). Coping with hospice work stress. Journal of Psychosocial Oncology, 2, 19–35.Google Scholar