Department of Psychology and Social Work, Mid Sweden University, 831 25 Östersund, Sweden.
Int J Environ Res Public Health. 2021 Mar 26;18(7):3446. doi: 10.3390/ijerph18073446.
Burnout is common in many countries and is associated with several other problems such as depression, anxiety, insomnia, and memory deficits, and prospectively it predicts long-term sick-leave, cardiovascular disease, and death. Clinical burnout or its residual symptoms often last several years and a common assumption is that recovery takes a long time by nature, despite full time sick-leave and the absence of work stress. The literature suggests models that hypothetically explain the development, but not maintenance, of the syndrome. Based on cognitive and behavioral principles, stress research, and stress theories, this paper describes a theoretical model explaining how clinical burnout can develop and be maintained. While the development of clinical burnout is mainly explained by prolonged stress reactions and disturbed recovery processes due to work related stressors, maintenance of the syndrome is particularly explained by prolonged stress reactions and disturbed recovery processes due to the new context of experiencing burnout and being on sick-leave. Worry about acquired memory deficits, passivity and excessive sleep, shame, fear of stress reactions, and the perception of not being safe are examples of responses that can contribute to the maintenance. The model has important implications for research and how to intervene in clinical burnout. For example, it can offer support to professional care providers and patients in terms of focusing on, identifying, and changing current contextual factors and behaviors that maintain the individual's clinical burnout symptoms and by that facilitate burnout recovery. Regarding research, the model provides a highly important reason for researchers to study contextual factors and behaviors that contribute to the maintenance of clinical burnout, which has been neglected in research.
burnout 在许多国家都很常见，与其他一些问题有关，如抑郁、焦虑、失眠和记忆缺陷，前瞻性地预测长期病假、心血管疾病和死亡。临床倦怠或其残留症状通常持续数年，人们普遍认为，尽管请了全时病假且没有工作压力，但恢复自然需要很长时间。文献提出了一些模型，假设性地解释了该综合征的发展，但不能解释其维持。基于认知和行为原则、压力研究和压力理论，本文描述了一个理论模型，解释了临床倦怠如何发展和维持。虽然临床倦怠的发展主要归因于工作相关压力源引起的长期应激反应和恢复过程紊乱，但该综合征的维持主要归因于倦怠和病假这一新环境下的长期应激反应和恢复过程紊乱。对获得性记忆缺陷、被动和过度睡眠、羞耻感、对应激反应的恐惧以及对不安全的感知的担忧，都是可能导致维持的反应的例子。该模型对研究和如何干预临床倦怠具有重要意义。例如，它可以为专业护理人员和患者提供支持，帮助他们关注、识别和改变当前维持个体临床倦怠症状的情境因素和行为，从而促进倦怠恢复。就研究而言，该模型为研究有助于维持临床倦怠的情境因素和行为提供了一个非常重要的理由，这在研究中被忽视了。
