Understanding Burnout, Anxiety & Mental Health in Healthcare

Posted on Sep 9, 2024 in Psychology and Sociology

Psychology: Burnout

Definition

Burnout is a feeling of fatigue and wear observed in professionals working in stressful activities in the service of people. It has been observed more frequently in health professionals, particularly doctors.

Dimensions of Burnout (Professor Maslach)

  1. Emotional exhaustion
  2. Depersonalization
  3. Reduced personal accomplishment

Symptomatic Heart of Burnout

Each person expresses burnout in a unique way, but there is a recurring symptomatic heart:

  1. Loss of attachment to work: The workplace becomes unpleasant and does not meet personal needs.
  2. Emotional changes: Feelings of excitement, safety, and enjoyment give way to anxiety, distress, and insecurity experienced in chronic form.
  3. Low performance at work: People experiencing burnout see a dramatic decrease in job performance. These symptoms change the working lives of people in a phased manner due to an imbalance between the needs of individuals and labor demands.

Fundamental Features of Burnout

  1. Emotional exhaustion: Feeling emotionally exhausted or saturated by the job.
  2. Depersonalization: Responding coldly, distantly, and impersonally to patients.
  3. Decreased personal accomplishment: Feelings of competence in carrying out the work and the ability to achieve personal goals are diminished.

Variables in the Maslach Burnout Inventory

  1. Workload
  2. Loss of control
  3. Insufficient reward
  4. Types of relationships developed in the work community
  5. Absence of justice
  6. Conflict of values

Major Factors of Conflict

After an investigation, the following variables were determined to be major factors of conflict within the Maslach Burnout Inventory:

  1. Mental aspects: Absenteeism, lack of initiative, lack of empathy with the patient.
  2. Physical symptoms: Fatigue, depression, anxiety, boredom, and sleep disturbances.
  3. Emotional: Feelings of worthlessness, intolerance, feelings of helplessness, frustration, lack of support and containment.
  4. Cognitive area: Little recognition by superiors, lack of commitment (a highly significant variable).
  5. Institutional: Lack of inputs, equipment and building infrastructure, personal insecurity, cronyism and favoritism, low income, lack of communication.
  6. Healthcare system aspect: Inadequate distribution of materials and equipment within the hospital.

Burnout vs. Stress

It is important to differentiate burnout from stress. Stress emerges in two types of situations:

  1. Major events: Unpredictable, catastrophic, uncontrollable events with no possibility of being anticipated.
  2. Minor stimuli: Everyday occurrences in a context where death and pain are constant.

Unlike stress, which is characterized by a temporary state where situational awareness and adaptability are present, burnout is a chronic condition where there is no situational awareness, adaptability, or reaction margin.

Fundamental Characteristics of Workers Who Suffer Burnout

Neomanagement is undoubtedly the primary risk factor for workers developing burnout syndrome.

  1. Workload
  2. Lack of control over one’s work
  3. Lack of professional recognition
  4. Breakdown of the sense of community
  5. Lack of integrity and honesty in the organization
  6. Conflict with personal values

Anxiety

A person experiencing anxiety may strongly question procedures performed on them and take excessive precautions. They may be restless, worried, and irritable. Anxiety is not harmful in itself, as long as it does not exceed a certain threshold. It can be a positive development as it acts as an alarm signal and allows us to prepare for a future danger. Anxious behavior can manifest in three areas: mind (anxiety), body (anguish), or the external world (fear). A person with anxiety may experience fear when the object of their anxiety is not present, and this fear decreases as the individual is able to react to the object.

Anguish

Anguish can manifest as tachycardia, hyper or hypotension, excessive sweating, and loss of appetite.

Fear

A patient may be afraid of injections or surgery, among other things.

Structure of Paranoid Behavior

In paranoid behavior, the person accuses or identifies an object of persecution or danger in the external world. They feel threatened by dangers from the outside. While these dangers may be real, they are often amplified by projections of the subject’s own experiences. Paranoid behavior is experienced as a dangerous external object onto which the projection has been deposited.

Structure of Avoidance Behavior

Avoidance behavior is characterized by avoiding the dangerous object. For example, when faced with a difficult study, the figure of an attendant assumes a protective role and is able to cope with the object.

Structure of Confusional Behavior

In confusional behavior, the ego of the subject has been disrupted or destroyed. This may be the result of coping with unknown situations. For example, after a robbery, the subject may be in a state of shock and need someone to restrain them.

Structure of Hypochondriacal Behavior

Hypochondriacal behavior is characterized by a dominant relationship with the body and complaints about it. The subject needs contact and connection and shows little ability to process emotions through words.

Psychosis

Psychosis is a form of mental illness that is very intense and incapacitating. The personality is disorganized, and the individual is unable to function socially as normal.

Features of Psychosis

  1. Marked loss of voluntary control of thoughts, emotions, and impulses.
  2. Impaired ability to differentiate between reality and subjective experience.
  3. The patient may not understand that there is something wrong with them and may not accept their condition.
  4. Marked disorganization of the personality.

Neurosis

Neurosis are mental disorders arising from anxiety symptoms that interfere with normal activity but do not completely block it. They do not require hospitalization.

Causes of Neurosis

  1. An internal conflict between the impulses of the id and the fears of the superego.
  2. The presence of sexual impulses.
  3. The inability of the ego, through rational and logical influence, to help the person overcome the conflict.
  4. Powerful drives within the mind that seek expression through neurotic anxiety.

Presbyopia

Presbyopia is a type of farsightedness that includes difficulty reading or focusing on nearby objects. It occurs in adulthood, typically after the age of 40. It is the condition in which near objects, such as reading material, appear blurry, while distance vision remains clear. It can be corrected with lenses for near vision, but these lenses will blur distance vision.

Myopia

Myopia, or nearsightedness, is a refractive error that is most often seen in children. It means that one can see clearly up close but has difficulty seeing far away. It is usually not a congenital condition but develops as the child grows. It is often seen in children aged 9 or 10 and can be noticed when the child cannot read the blackboard from the back of the room but can read and write without problems. Other signs and symptoms may include headaches, nausea after reading, holding books close to the face, or writing with the head close to the table.

Hyperopia

Hyperopia is a refractive error in which the child cannot see things that are very close but has no trouble seeing far away. It is possible that those who suffer from hyperopia may experience strabismus, eye strain, loss of interest in studying, and difficulty reading. However, the development of this disorder is rare in children.

Astigmatism

Astigmatism is a vision disorder in which an abnormal curvature of the cornea leads to a decline in vision. It may start in childhood or adulthood. If it causes problems, it can be easily corrected with lenses. Some signs and symptoms may include headache, eye strain, and difficulty reading. The use of lenses depends on the severity of the disorder.

Verbal Communication

Verbal communication consists of transmitting information through language. It is what is said and involves specific content transmitted through speech.

Nonverbal Communication

Nonverbal communication is a form of meta-communication that is very diverse and varied. It is done through voice tone, gestures, and body postures. Its messages are relational and need to be interpreted by the receiver.

Communication in Nursing Care

The nursing process is both educational and therapeutic. Nurse and patient must get to know and respect each other as equals, involved in solving problems. This relationship must be based on positive, effective, and empathetic communication that allows the person to feel free to voice their doubts and fears. When communication is faulty, the following can happen:

  1. Nurses may isolate themselves and become less communicative.
  2. Professionals may rely more on intuition than knowledge and become insecure.
  3. Fear and anxiety increase, making it difficult for the patient to improve.
  4. Patients may not follow the prescribed treatment.

Factors Involved in Successful Communication

Perceptions of ourselves and others, as well as the context in which communication takes place, are factors that decisively influence the establishment of interpersonal relationships.

Verbal Communication in Nursing

Verbal communication is the means through which nurses and patients connect. Patients seek to satisfy their needs and find support from nursing professionals through words. They use words to describe their clinical situation, which will be translated into technical language by the professional.

Purposes of Communication for Nurses

  1. Establish a relationship with the patient.
  2. Obtain information about the patient’s condition and progress.
  3. Provide information to colleagues.
  4. Guide and instruct the patient and their family.

Factors for Effective Communication

The success of effective communication depends on the following factors:

  • The manner in which the material is presented.
  • The language used.
  • Clarity of voice and organization of sentences.
  • The attitude of the speaker.
  • The tone and volume of the voice.
  • The degree of authority of the speaker.
  • The ability to understand what is being heard.

Nonverbal Communication in Nursing

The nurse should be attentive not only to verbal communication but also to nonverbal cues transmitted by both the patient and themselves. Nonverbal communication can confirm or contradict verbal messages. Attitudes and feelings are expressed through this type of communication. The nurse must express, through their own nonverbal communication, an attitude of understanding and interest towards the patient. This will make the patient feel that the nurse’s desire to help is sincere.

Forms of Nonverbal Communication

There are two forms of nonverbal communication: mime and pantomime (or meta-communication). Mime can be considered an exaggerated form of meta-communication that supplements, but does not replace, verbal communication. It may be used with patients who have limited intellectual ability. Pantomime is always used during the interaction of two people. This type of communication is expressed through facial expressions, tone and volume of voice, and posture. It should be used consciously in many situations.