Department of Psychiatry, University of Zaragoza, Zaragoza, Spain.
BMC Public Health. 2013 Dec 30;13:1240. doi: 10.1186/1471-2458-13-1240.
Burnout is the result of prolonged workplace exposure to chronic stress factors and may present itself in one of the following subtypes: "frenetic", "under-challenged" and "worn-out". The aims of the present study were to identify the causes of workplace discomfort that affect employees in large organizations and to determine the predictive power of these causes with regard to the burnout subtypes.
We employed a qualitative and quantitative analysis (QQA), using a cross-sectional design with an online survey administered to a randomly selected sample of University workers (n = 409). To determine the causes of discomfort, we raised the following open question: "What aspects of your work generate discomfort for you?". The responses were subjected to content analysis and categorized by three independent referees. The concordance between the responses was estimated with the kappa coefficient (k). Subtype classification was assessed according to the "Burnout Clinical Subtype Questionnaire" (BCSQ-36). The degree of association between the motives for the complaint and the burnout profiles was evaluated using adjusted odds ratio (OR), which was based on multivariate logistic regression models.
The causes of discomfort included: physical environment (setting aspects, material conditions, journey/access), organization (schedules, structure, functions, interpersonal relations) and individual conditions (workload, powerlessness, rewards, negligence). The concordance index between the referees was k = 0.80. Employees who were upset with the hierarchical structure were more likely to be classified as frenetic (OR = 4.32; 95% CI = 1.43-13.06; p = 0.010); those who complained of routine duties were more likely to be classified as under-challenged (OR = 5.33; 95% CI = 1.84-15.40; p = 0.002); those whose discomfort was caused by structure control systems were more likely to be classified as worn-out (OR = 6.13; 95% CI = 1.57-23.91; p = 0.009).
The causes of discomfort among the different burnout subtypes are primarily attributable to the organization itself, in response to the structure and functions. The associations observed between the different subtypes and motives for complaint are consistent with the clinical profile-based syndrome definition, which suggests that interventions should be case-specific.
burnout 是由于长期暴露在工作场所的慢性压力因素下而导致的，可能表现为以下三种亚型之一：“狂热型”、“挑战性不足型”和“疲惫型”。本研究的目的是确定影响大型组织员工工作不适的原因，并确定这些原因对 burnout 亚型的预测能力。
我们采用了定性和定量分析（QQA）方法，采用横断面设计，对随机抽取的大学工作人员（n=409）进行在线调查。为了确定不适的原因，我们提出了以下开放式问题：“你的工作中哪些方面让你感到不适？”。对回答内容进行了分析，并由三位独立评审员进行了分类。通过 kappa 系数（k）来估计回答的一致性。根据“倦怠临床亚型问卷”（BCSQ-36）对亚型进行分类。使用调整后的比值比（OR）评估投诉动机与倦怠特征之间的关联程度，该 OR 基于多变量逻辑回归模型。
不适的原因包括：物理环境（环境方面、物质条件、行程/通道）、组织（时间表、结构、功能、人际关系）和个人条件（工作量、无力感、奖励、忽视）。评审员之间的一致性指数为 k=0.80。对等级结构感到不满的员工更有可能被归类为狂热型（OR=4.32；95%CI=1.43-13.06；p=0.010）；抱怨日常工作的员工更有可能被归类为挑战性不足型（OR=5.33；95%CI=1.84-15.40；p=0.002）；因结构控制系统引起不适的员工更有可能被归类为疲惫型（OR=6.13；95%CI=1.57-23.91；p=0.009）。
不同 burnout 亚型的不适原因主要归因于组织本身，与结构和功能有关。观察到的不同亚型与投诉动机之间的关联与基于临床特征的综合征定义一致，这表明干预措施应该是具体情况具体分析的。
