RESEARCH ON WORKLOAD, JOB SATISFACTION AND BURNOUT STATUS AMONG HEALTH CARE STAFF

Öz

Since the beginning of COVID-19 pandemic, the workload of hospitals and their staff has increased. This research is a study in which the workload, job satisfaction and burnout status of health employees and the relationship among them are examined together. For this purpose, a survey has been applied to 202 health care staff working in public hospitals. According to the findings, there is a moderately same direction between workload and burnout; and a moderately opposite relationship between workload and job satisfaction, and a moderately opposite relationship between burnout and job satisfaction. On the other hand, full mediation was found in the effect of job satisfaction on the feeling of decreasing in personal achievement, which is the sub-dimension of burnout; and it was found that it played a partial mediating role in the effect of emotional exhaustion and depersonalization. Besides, the findings indicate that employees working in COVID-19 related departments have higher levels of workload, burnout, emotional exhaustion and depersonalization and also shows that job satisfaction and internal satisfaction levels are lower. The results depicts that the job satisfaction of health workers decreased due to the naturally increased workload because of the pandemic, which causes increased burnout.

Anahtar Kelimeler

• Workload
• Burnout
• Job Satisfaction
• Mediation Effect
• Regression
• Difference Tests
• Health Care Staff
• COVID-19

SAĞLIK SEKTÖRÜ ÇALIŞANLARINDA İŞ YÜKÜ, İŞ TATMİNİ VE TÜKENMİŞLİK DURUMUNUN İNCELENMESİ

Öz

COVID-19 salgınının başından itibaren hastanelerin ve çalışanlarının yoğunluğu artmıştır. Bu araştırma sağlık çalışanlarının iş yükü, iş tatmini ve tükenmişlik durumlarının ve aralarındaki ilişkilerin birlikte incelendiği bir çalışmadır. Bu amaçla kamu hastanelerindeki 202 sağlık çalışanına yönelik anket uygulanmıştır. Elde edilen bulgulara göre, iş yükü ile tükenmişlik arasında orta düzeyde aynı yönde; iş yükü ile iş tatmini arasında ortaya yakın düzeyde zıt yönde, tükenmişlik ile iş tatmini arasında ise orta düzeyde zıt yönde anlamlı ilişki bulunmaktadır. Öte yandan iş tatmininin, iş yükünün tükenmişliğin alt boyutu olan kişisel başarıda düşme hissine olan etkisinde tam aracılık; duygusal tükenmeye ve duyarsızlaşmaya olan etkisinde ise kısmi aracılık rolü üstlendiği bulunmuştur. Ayrıca bulgular, COVID-19 ile ilgili bölümlerde görev yapan çalışanlarda iş yükü, tükenmişlik, duygusal tükenme ve duyarsızlaşma düzeylerinin daha yüksek; iş tatmini ve içsel tatmin düzeylerinin ise daha düşük olduğunu göstermektedir. Sonuçlar, sağlık çalışanlarının salgın nedeniyle doğal olarak artan iş yükünün etkisiyle işte tatmin durumlarının azaldığını, bunun da artan tükenmişliğe neden olduğunu ortaya koymaktadır.

Anahtar Kelimeler

• İş Yükü
• Tükenmişlik
• İş Tatmini
• Aracılık Etkisi
• Regresyon
• Fark Testleri
• Sağlık Çalışanları
• COVID-19

Kaynakça

1. Acea-López, L., Pastor-Bravo, M. del M., Rubinat-Arnaldo, E., Bellon, F., Blanco-Blanco, J., Gea-Sanchez, M., & Briones-Vozmediano, E. (2021). Burnout and job satisfaction among nurses in three Spanish regions. Journal of Nursing Management, 29(7). https://doi.org/10.1111/jonm.13376
2. Akman, O., Ozturk, C., Bektas, M., Ayar, D., & Armstrong, M. A. (2016). Job satisfaction and burnout among paediatric nurses. Journal of Nursing Management, 24(7). https://doi.org/10.1111/jonm.12399
3. Alrawashdeh, H. M., Al-Tammemi, A. B., Alzawahreh, M. K., Al-Tamimi, A., Elkholy, M., Al Sarireh, F., … Ghoul, I. (2021). Occupational burnout and job satisfaction among physicians in times of COVID-19 crisis: a convergent parallel mixed-method study. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-10897-4
4. Altaf, A., & Awan, M. A. (2011). Moderating Affect of Workplace Spirituality on the Relationship of Job Overload and Job Satisfaction. Journal of Business Ethics, 104(1). https://doi.org/10.1007/s10551-011-0891-0
5. Baron, R. M., & Kenny, D. A. (1986). The Moderator-Mediator Variable Distinction in Social Psychological Research: Conceptual, Strategic, and Statistical Considerations. Journal of Personality and Social Psychology, 51(6), 1173-1182.
6. Baycan, F. A. (1985). Analiysis of Several Aspects of Job Satisfaction Between Different Occupational Groups. Yüksek Lisans Tezi. İstanbul: Boğaziçi Üniversitesi Sosyal Bilimler Enstitüsü.
7. Bennett, J. A. (2000). Mediator and Moderator Variables in Nursing Research: Conceptual and Statistical Differences. Research in Nursing & Health(23), 415-420.
8. Bilgiç, R. (1998). he Relationship Between Job Satisfaction and Personal Characteristics of Turkish Workers. The Journal of Psychology, 132(5), 549-557. doi:10.1080/00223989809599287

9. Briggs, S., & Cheek, J. (1986). The role of factor analysis in the development and evaluation of personality scales. Journal of Personality(54), 106-148.
10. Cambridge Dictionary. (2021). dictionary.cambridge. https://dictionary.cambridge.org/dictionary/english/workload.
11. Carvalho, D. P. de, Rocha, L. P., Pinho, E. C. de, Tomaschewski-Barlem, J. G., Barlem, E. L. D., & Goulart, L. S. (2019). Workloads and burnout of nursing workers. Revista Brasileira de Enfermagem, 72(6). https://doi.org/10.1590/0034-7167-2017-0659
12. Chiang, H. Y., Hsiao, Y. C., & Lee, H. F. (2017). Predictors of Hospital Nurses’ Safety Practices: Work Environment, Workload, Job Satisfaction, and Error Reporting. Journal of Nursing Care Quality, 32(4). https://doi.org/10.1097/NCQ.0000000000000240
13. Cullen, J. C., Silverstein, B. A., & Foley, M. P. (2008). Linking biomechanical workload and organizational practices to burnout and satisfaction. Journal of Business and Psychology, 23(1–2). https://doi.org/10.1007/s10869-008-9079-8
14. Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020). Burnout in nursing: A theoretical review. Human Resources for Health, Vol. 18. https://doi.org/10.1186/s12960-020-00469-9
15. Derya, S. (2008, Nisan). Crossover of Work-Family Conflict: Antecedent and Consequences of Crossover Process in Dual-Earner Couples. Doktora Tezi. İstanbul: Koç Üniversitesi Sosyal Bilimler Enstitüsü.
16. DiStefano, C., & Morgan, G. B. (2014). A Comparison of Diagonal Weighted Least Squares Robust Estimation Techniques for Ordinal Data. Structural Equation Modeling: A Multidisciplinary Journal, 21(3), 425-438.
17. Dwinijanti, L., Adhikara, M. F. A., & Kusumapradja, R. (2020). Job satisfaction and turnover intention among public sector nurses: Is workload and burnout the issue? JEMA: Jurnal Ilmiah Bidang Akuntansi Dan Manajemen, 17(1). https://doi.org/10.31106/jema.v17i1.4951
18. Ergin, C. (1992). Doktor ve Hemşirelerde Tükenmişlik ve Maslach Tükenmişlik Ölçeği’nin Uyarlanması. R. Bayraktar, & İ. Dağ içinde, 7. Ulusal Psikoloji Kongresi Bilimsel Çalışmaları (s. 143-154). Ankara: Hacettepe Üniversitesi.
19. Fairchild, A. J., & MacKinnon, D. P. (2009). A General Model for Testing Mediation and Moderation Effects. Prevention Science(10), 87-99. doi:10.1007/s11121-008-0109-6
20. Faragher, E. B., Cass, M., & Cooper, C. L. (2005). The relationship between job satisfaction and health: A meta-analysis. Occupational and Environmental Medicine, 62(2). https://doi.org/10.1136/oem.2002.006734
21. Filzmoser, P., & Gschwandtner, M. (2021). mvoutlier: Multivariate Outlier Detection Based on Robust Methods. R package version 2.1.1. https://CRAN.R-project.org/package=mvoutlier adresinden alındı
22. George, D., & Mallery, P. (2016). IBM SPSS Statistics 23 Step by Step: A Simple Guide and Reference (14 b.). New York: Routledge.
23. Goetz, K., Musselmann, B., Szecsenyi, J., & Joos, S. (2013). The influence of workload and health behavior on job satisfaction of general practitioners. Family Medicine, 45(2).
24. Greenglass, E. R., Burke, R. J., & Fiksenbaum, L. (2001). Workload and burnout in nurses. Journal of Community and Applied Social Psychology, 11(3), 211–215. https://doi.org/10.1002/casp.614
25. Gross, J., & Ligges, U. (2015). nortest: Tests for Normality. R package version 1.0-4. https://CRAN.R-project.org/package=nortest adresinden alındı
26. Gürsakal, S. (2019). Sosyal Bilimlerde SPSS Uygulamalı Çok Değişkenli İstatistiksel Analiz Teknikleri. Bursa: Dora Yayıncılık.
27. IBM Corp. (2016). IBM SPSS Statistics for Windows, Version 24.0. Armonk, New York.
28. Inegbedion, H., Inegbedion, E., Peter, A., & Harry, L. (2020). Perception of workload balance and employee job satisfaction in work organisations. Heliyon, 6(1). https://doi.org/10.1016/j.heliyon.2020.e03160
29. Karacaoğlu, K., & Çetin, İ. (2015). İş yükü ve rol belirsizliğinin çalişanlarin tükenmişlik düzeyleri üzerine etkisi: AFAD örneği. Nevşehir Hacı Bektaş Veli Üniversitesi SBE Dergisi, 5(1), 46-69.
30. Kemeröz Karakaya; H. (2017). Psikiyatri kliniğinde çalışan hemşirelerde iş doyumu, tükenmişlik düzeyi ve ilişkili değişkenlerin incelenmesi. Yüksek Lisans Tezi. Okan Üniversitesi, Sağlık Bilimleri Enstitüsü, İstanbul. https://tez.yok.gov.tr/ (Tez No. 466282).
31. Khamisa, N., Oldenburg, B., Peltzer, K., & Ilic, D. (2015). Work related stress, burnout, job satisfaction and general health of nurses. International Journal of Environmental Research and Public Health, 12(1). https://doi.org/10.3390/ijerph120100652
32. Kırklareli Valiliği. (2021). İstatistikler. Ekim 10, 2021 tarihinde http://www.kirklareli.gov.tr/planlama-istatistikler adresinden alındı
33. Kline, P. (2000). Handbook of psychological testing (2. b.). New York: Routledge.
34. Kline, R. B. (2016). Principles and Practice of Structural Equation Modeling. New York: The Guilford Press.
35. Korkmaz, S., Goksuluk, D., & Zararsiz, G. (2014). MVN: An R Package for Assessing Multivariate Normality. The R Journal, 6(2), 151-162.
36. Lea, V. M., Corlett, S. A., & Rodgers, R. M. (2012). Workload and its impact on community pharmacists’ job satisfaction and stress: A review of the literature. International Journal of Pharmacy Practice, Vol. 20. https://doi.org/10.1111/j.2042-7174.2012.00192.x
37. Leskovic, L., Erjavec, K., Leskovar, R., & Vukovič, G. (2020). Burnout and job satisfaction of healthcare workers in slovenian nursing homes in rural areas during the covid-19 pandemic. Annals of Agricultural and Environmental Medicine, 27(4). https://doi.org/10.26444/aaem/128236
38. Liu, H. L., & Lo, V. hwei. (2018). An integrated model of workload, autonomy, burnout, job satisfaction, and turnover intention among Taiwanese reporters. Asian Journal of Communication, 28(2). https://doi.org/10.1080/01292986.2017.1382544
39. López-Núñez, M. I., Rubio-Valdehita, S., Diaz-Ramiro, E. M., & Aparicio-García, M. E. (2020). Psychological capital, workload, and burnout: What’s new? The impact of personal accomplishment to promote sustainableworking conditions. Sustainability (Switzerland), 12(19). https://doi.org/10.3390/su12198124
40. Lucchini, A., Iozzo, P., & Bambi, S. (2020). Nursing workload in the COVID-19 era. Intensive and Critical Care Nursing, Vol. 61. https://doi.org/10.1016/j.iccn.2020.102929
41. Lüdecke, D., Ben-Shachar, M. S., Patil, I., Waggoner, P., & Makowski, D. (2021). performance: An R Package for Assessment, Comparison and Testing of Statistical Models. Journal of Open Source Software, 6(60), 3139. doi:10.21105/joss.03139
42. Mardia, K. V. (1970). Measures of Multivariate Skewness and Kurtosis with Applications. Biometrika, 57(3), 519-530.
43. Mardia, K. V. (1974). Applications of Some Measures of Multivariate Skewness and Kurtosis in Testing Normality and Robustness Studies. Sankhyā: The Indian Journal of Statistics, Series B (1960-2002), 36(2), 115-128.
44. Maslach, C., & Jackson, S. E. (1981). The Measurement of Experienced Burnout. Journal of Occupational Behavior (2), 99-113. https://doi.org/10.1002/job.4030020205
45. Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job Burnout. Annu. Rev. Psychol., 52, 397–422.
46. Mohd Balwi, M. K., Yee, D. W., Thukiman, K., & Haziqah, A. (2021). The Relationship Between Workload and Burnout Among The Medical Staff In Hospital. Sains Humanika, 13(2–2). https://doi.org/10.11113/sh.v13n2-2.1891
47. Moloney, W., Boxall, P., Parsons, M., & Cheung, G. (2018). Factors predicting Registered Nurses’ intentions to leave their organization and profession: A job demands-resources framework. Journal of Advanced Nursing, 74(4). https://doi.org/10.1111/jan.13497
48. Muthén, B. O. (1993). Goodness of Fit with Categorical and Other Non-Normal Variables. K. A. Bollen, & J. S. Long içinde, Testing Structural Equation Models (s. 205-243). Newbury Park: Sage Publications.
49. NCBI. (t.y.). National Center For Biotechnology Information. Retrieved from https://www.ncbi.nlm.nih.gov/ adresinden alındı (Erişim Tarihi: 10.11.2021).
50. Pallant, J. (2011). SPSS Survival Manual: A step by step guide to data analysis using SPSS. Crows Nest, Australia: Allen & Unwin.
51. Payne, A., Koen, L., Niehaus, D. J. H., & Smit, I. M. (2020). Burnout and job satisfaction of nursing staff in a south african acute mental health setting. South African Journal of Psychiatry, 26, 1–6. https://doi.org/10.4102/sajpsychiatry.v26i0.1454
52. Peterson, M., Smith, P., Akande, A., Ayestaran, S., Bochner, S., Callan, V., . . . Viedge, C. (1995). Role Conflict, Ambiguity, and Overload: A 21-Nation Study. Academy of Management Journal, 38(2), 429-452.
53. Phillips, C. (2020). Relationships between workload perception, burnout, and intent to leave among medical-surgical nurses. International Journal of Evidence-Based Healthcare, 18(2). https://doi.org/10.1097/XEB.0000000000000220
54. Prasad, K., McLoughlin, C., Stillman, M., Poplau, S., Goelz, E., Taylor, S., … Sinsky, C. A. (2021). Prevalence and correlates of stress and burnout among U.S. healthcare workers during the COVID-19 pandemic: A national cross-sectional survey study. EClinicalMedicine, 35. https://doi.org/10.1016/j.eclinm.2021.100879
55. R Core Team. (2020). R: A language and environment for statistical computing. R Foundation for Statistical Computing. Vienna, Austria. https://www.R-project.org/ adresinden alındı
56. Rajan, D. (2018). Negative impacts of heavy workload: a comparative study among sanitary workers. Sociology International Journal, 2(6). https://doi.org/10.15406/sij.2018.02.00086
57. Revelle, W. R. (2021). psych: Procedures for Personality and Psychological Research. Evanston, Illinois, USA. https://CRAN.R-project.org/package=psych Version = 2.1.6 adresinden alındı
58. Rosseel, Y. (2012). lavaan: An R Package for Structural Equation Modeling. Journal of Statistical Software, 48(2), 1-36. https://www.jstatsoft.org/v48/i02/ adresinden alındı
59. RStudio. (2021, Eylül 1). RStudio | Open source & professional software for data science teams. Kasım 5, 2021 tarihinde RStudio: https://www.rstudio.com/ adresinden alındı
60. Safdar, A., Susilaningsih, F. S., & Kurniawan, T. (2019). Relationship Between Workload Performance and Job Satisfaction. Jurnal Keperawatan Padjadjaran, 7(3). https://doi.org/10.24198/jkp.v7i3.1178
61. Sarmiento, T. P., Spence Laschinger, H. K., & Iwasiw, C. (2004). Nurse educators’ workplace empowerment, burnout, and job satisfaction: Testing Kanter’s theory. Journal of Advanced Nursing, Vol. 46. https://doi.org/10.1111/j.1365-2648.2003.02973.x
62. Savalei, V., & Rhemtulla, M. (2013). The Performance of Robust Test Statistics with Categorical Data. British Journal of Mathematical and Statistical Psychology, 66(2), 201-223.
63. Schaufeli, W. B., Leiter, M. P., & Maslach, C. (2009). Burnout: 35 years of research and practice. Career Development International, Vol. 14. https://doi.org/10.1108/13620430910966406
64. Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. Methods of psychological research online, 8(2), 23-74.
65. Shan, Y., Shang, J., Yan, Y., Lu, G., Hu, D., & Ye, X. (2021). Mental workload of frontline nurses aiding in the COVID-19 pandemic: A latent profile analysis. Journal of Advanced Nursing, 77(5), 2374–2385. https://doi.org/10.1111/jan.14769
66. Soto-Rubio, A., Giménez-Espert, M. D. C., & Prado-Gascó, V. (2020). Effect of emotional intelligence and psychosocial risks on burnout, job satisfaction, and nurses’ health during the covid-19 pandemic. International Journal of Environmental Research and Public Health, 17(21). https://doi.org/10.3390/ijerph17217998
67. Stuart, E. H., Jarvis, A., & Daniel, K. (2008). A ward without walls? District nurses’ perceptions of their workload management priorities and job satisfaction. Journal of Clinical Nursing, 17(22). https://doi.org/10.1111/j.1365-2702.2008.02316.x
68. The R Foundation. (2020, Ekim 10). The R Project for Statistical Computing. Kasım 5, 2021 tarihinde R Project: https://www.r-project.org/ adresinden alındı
69. Thode, H. C. (2002). Testing For Normality. New York: Mercel Dekker Inc.
70. Van Ham, I., Verhoeven, A. H., Groenier, K. H., Groothoff, J. W., & De Haan, J. (2006). Job satisfaction among general practitioners: A systematic literature review. European Journal of General Practice, Vol. 12, pp. 174–180. https://doi.org/10.1080/13814780600994376
71. Visser, M. R. M., Smets, E. M. A., Oort, F. J., & De Haes, H. C. J. M. (2003). Stress, satisfaction and burnout among Dutch medical specialists. CMAJ, 168(3), 271–275.
72. Vocational Psychology Research. (1977). Minnesota Satisfaction Questionnaire (Short-Form). Minneapolis: University of Minnesota.
73. Wang, B. (2021). bda: Binned Data Analysis. R package version 15.2.5. https://CRAN.R-project.org/package=bda adresinden alındı
74. Watson, A. G., McCoy, J. V., Mathew, J. A., Gundersen, D. A., & Eisenstein, R. M. (2019). Impact of physician workload on burnout in the emergency department. Psychology, Health and Medicine, 24(4). https://doi.org/10.1080/13548506.2018.1539236
75. Weiss, D. J., Dawis, R. V., England, G. W., & Lofquist, L. H. (1967). Manual for the Minnesota Satisfaction Questionnaire (Cilt Minnesota Studies in Vocational). Minneapolis: University of Minnesota.
76. Wickham, H., & Hester, J. (2020). readr: Read Rectangular Text Data. R package version 1.4.0. https://CRAN.R-project.org/package=readr adresinden alındı
77. Wickham, H., Averick, M., Bryan, J., Chang, W., McGowan, L. D., François, R., . . . Yutani, H. (2019). Welcome to the tidyverse. Journal of Open Source Software, 4(43), 1686. doi:10.21105/joss.01686
78. Wickham, H., François, R., Henry, L., & Müller, K. (2020). dplyr: A Grammar of Data Manipulation. R package version 1.0.2. https://CRAN.R-project.org/package=dplyr adresinden alındı
79. Wu, Y., Wang, J., Luo, C., Hu, S., Lin, X., Anderson, A. E., … Qian, Y. (2020). A Comparison of Burnout Frequency Among Oncology Physicians and Nurses Working on the Frontline and Usual Wards During the COVID-19 Epidemic in Wuhan, China. Journal of Pain and Symptom Management, 60(1). https://doi.org/10.1016/j.jpainsymman.2020.04.008
80. Yazıcıoğlu, Y., & Erdoğan, S. (2004). SPSS Uygulamalı Bilimsel Araştırma Yöntemleri. Ankara: Detay Yayincilik.
81. Yılmaz, V., & İlhan Dalbudak, Z. (2018). Aracı Değişken Etkisinin İncelenmesi: Yüksek Hızlı Tren İşletmeciliği Üzerine Bir Uygulama. Uluslararası Yönetim İktisat ve İşletme Dergisi, 14(2), 517-534.
82. Zeytinoglu, I. U., Denton, M., Davies, S., Baumann, A., Blythe, J., & Boos, L. (2007). Deteriorated external work environment, heavy workload and nurses’ job satisfaction and turnover intention. Canadian Public Policy, 33(SUPPL.). https://doi.org/10.3138/0560-6GV2-G326-76PT
83. Zhou, Y., Wang, W., Sun, Y., Qian, W., Liu, Z., Wang, R., … Zhang, X. (2020). The prevalence and risk factors of psychological disturbances of frontline medical staff in china under the COVID-19 epidemic: Workload should be concerned. Journal of Affective Disorders, 277, 510–514. https://doi.org/10.1016/j.jad.2020.08.059