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A Cross-Sectional Survey on Burnout Prevalence and Profile in the Sicilian Population of Ambulance Driver-Rescuers

Published online by Cambridge University Press:  27 January 2020

Laura Ferraro Open the ORCID record for Laura Ferraro [Opens in a new window] ,
Caterina La Cascia ,
Antonio De Santis ,
Lucia Sideli ,
Giuseppe Maniaci ,
Ilenia Maria Orlando ,
Angelo Chifari ,
Lorenzo Maniaci  and
Daniele La Barbera
Laura Ferraro*
Affiliation:
Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), Institute of Psychiatry, University of Palermo, Palermo, Sicilia, Italy
Caterina La Cascia
Affiliation:
Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), Institute of Psychiatry, University of Palermo, Palermo, Sicilia, Italy
Antonio De Santis
Affiliation:
District Health Authority (ASP) of Trapani, National Health System, Trapani, Sicilia, Italy
Lucia Sideli
Affiliation:
Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), Institute of Psychiatry, University of Palermo, Palermo, Sicilia, Italy
Giuseppe Maniaci
Affiliation:
Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), Institute of Psychiatry, University of Palermo, Palermo, Sicilia, Italy
Ilenia Maria Orlando
Affiliation:
Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), Institute of Psychiatry, University of Palermo, Palermo, Sicilia, Italy
Angelo Chifari
Affiliation:
Sicilian Emergency and Urgency Society (SEUS) 118 Service, Palermo, Sicilia, Italy
Lorenzo Maniaci
Affiliation:
Service 2, “Education and Communication,” Regional Department for Health Activities and Epidemiological Observatory, Sicily Region, Palermo, Sicilia, Italy
Daniele La Barbera
Affiliation:
Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), Institute of Psychiatry, University of Palermo, Palermo, Sicilia, Italy
*
Correspondence: Laura Ferraro, PhD Via Gaetano La Loggia, 1 90129 Palermo, Italy E-mail: [email protected]
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Abstract

Introduction:

Burnout is present at a high rate in emergency medicine. The ambulance driver-rescuers, who furnish first aid to the victims, are the non-medical part of the Italian 118-service staff. There is a lack of research on burnout risk in Italian Emergency Medical Services and, particularly, for this category of workers. The two Italian studies, including a little group of ambulance driver-rescuers, reported inconsistent findings.

Hypothesis:

This survey investigated for the first time the prevalence and exact profile of burnout in a large sample of Italian driver-rescuers. As a secondary aim, the study described how the items of the Italian version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) cluster in components in this sample.

Methods:

This cross-sectional census survey was conducted from June 2015 through May 2016 and involved all the driver-rescuers operating in Sicily, the biggest and most southern region of Italy. The subjects received a classification according to different profiles of burnout by using the Italian version of the MBI-HSS (burnout, engagement, disengagement, over-extension, and work-inefficacy). In order to explore the existence of independent factors, a Principal Component Analysis (PCA) was conducted on the survey to obtain eigenvalues >one for each component in the data.

Results:

The final sample comprised 2,361 responders (96.6% of the initial sample). Of them, 29.8% were in burnout (95% confidence interval [CI], 27.8% to 31.8%) and 1.7% presented a severe form (95% CI, 1.1% to 2.3%); 30.0% were engaged in their work (95% CI, 21.0% to 34.8%), 24.7% of responders were disengaged (95% CI, 22.9% to 26.5%), 1.2% presented an over-extension profile (95% CI, 0.8% to 1.7%), and 12.6% felt work-inefficacy (95% CI, 11.3% to 14.1%). The factors loaded into a five-factor solution at PCA, explaining 48.1% of the variance and partially replicating the three-factor structure. The Emotional Exhaustion (EE) component was confirmed. New dimensions from Personal Accomplishment (PA) and Depersonalization (DP) sub-scales described empathy and disengagement with patients, respectively, and were responsible for the increased risk of burnout.

Conclusions:

These results endorse the importance of screening and psychological interventions for this population of emergency workers, where burnout could manifest itself more insidiously. It is also possible to speculate that sub-optimal empathy skills could be related to the disengagement and work-inefficacy feelings registered.

Keywords

burnoutempathyprevalencerescuerssurvey
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 2 , April 2020 , pp. 133 - 140
Copyright
© World Association for Disaster and Emergency Medicine 2020

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Footnotes

Note: Laura Ferraro and Caterina La Cascia equally contributed to this work. They both are first authors. Lorenzo Maniaci and Daniele La Barbera equally contributed in supervising this work. They both are last authors.

References

Maslach, C. Burned-out. Hum Behav. 1976;5(9):16–22.Google Scholar
World Health Organization (WHO). Burn-out an occupational phenomenon. International Classification of Diseases. WHO web site. https://www.who.int/mental_health/evidence/burn-out/en/. Accessed June 02, 2019.Google Scholar
Leiter, MP, Maslach, C. Latent burnout profiles: a new approach to understanding the burnout experience. Burn Res. 2016;3(4):89–100.10.1016/j.burn.2016.09.001CrossRefGoogle Scholar
Arora, M, Asha, S, Chinnappa, J, et al. Review article: burnout in emergency medicine physicians. Emerg Med Australas. 2013;25(6):491–495.10.1111/1742-6723.12135CrossRefGoogle ScholarPubMed
Gómez-Urquiza, JL, la Fuente-Solana, EI De, Albendín-García, L, et al. Prevalence of burnout syndrome in emergency nurses: a meta-analysis. Crit Care Nurse. 2017;37(5):1–9.10.4037/ccn2017508CrossRefGoogle ScholarPubMed
Adriaenssens, J, Gucht, V De, Maes, S. Determinants and prevalence of burnout in emergency nurses: a systematic review of 25 years of research. Int J Nurs Stud. 2015;52(2):649–661.10.1016/j.ijnurstu.2014.11.004CrossRefGoogle ScholarPubMed
O’Connor, K, Muller Neff, D, Pitman, S. Burnout in mental health professionals: a systematic review and meta-analysis of prevalence and determinants. Eur Psychiatry. 2018;53:74–99.10.1016/j.eurpsy.2018.06.003CrossRefGoogle ScholarPubMed
Johnson, S, Cooper, C, Cartwright, S, et al. The experience of work‐related stress across occupations. Journal of Managerial Psychology. 2005;20(2):178–187.10.1108/02683940510579803CrossRefGoogle Scholar
Argentero, P, Setti, I. Percezione del lavoro, contesti professionali e burnout negli operatori dell’emergenza. G Ital Med Lav Ergon. 2008;30(1):64–70.Google Scholar
Angius, P, Campana, G, Cattari, F. Burnout in emergency health care workers. G Ital Med Lav Ergon. 2011;33(3):339–342.Google ScholarPubMed
Maslach, C, Jackson, SE, Leiter, MP. Maslach Burnout Inventory Manual, 3rd Edition. Palo Alto, California USA: Consulting Psychologists Press; 1996.Google Scholar
Sirigatti, S, Stefanile, C. Adattamento e taratura per l’Italia. In: Maslach, C, Jackson, S, (eds). MBI Maslach Burnout Inventory. Manuale. Firenze, Italy: Organizzazioni Speciali; 1993:33–42.Google Scholar
Sirigatti, S, Stefanile, C, Menoni, E. Per un adattamento italiano del Maslach Burnout Inventory (MBI). Bollettino di Psicologia Applicata. 1988;29(187–188):33–39.Google Scholar
Sirigatti, S, Stefanile, C. Maslach Burnout Inventory in Italia alla luce dell’analisi fattoriale confirmatoria. Bollettino di Psicologia Applicata; 1991;200:39–45.Google Scholar
Pisanti, R, Lombardo, C, Lucidi, F, et al. Psychometric properties of the Maslach Burnout Inventory for Human Services among Italian nurses: a test of alternative models. J Adv Nurs. 2013;69(3):697–707.10.1111/j.1365-2648.2012.06114.xCrossRefGoogle ScholarPubMed
Loera, B, Converso, D, Viotti, S. Evaluating the psychometric properties of the Maslach Burnout Inventory-human services survey (MBI-HSS) among Italian nurses: how many factors must a researcher consider? PLoS ONE. 2014;9(12):e114987.10.1371/journal.pone.0114987CrossRefGoogle ScholarPubMed
Squires, A, Finlayson, C, Gerchow, L, et al. Methodological considerations when translating “burnout.” Burn Res. 2014;1(2):59–68.10.1016/j.burn.2014.07.001CrossRefGoogle ScholarPubMed
Vanheule, S, Rosseel, Y, Vlerick, P. The factorial validity and measurement invariance of the Maslach Burnout Inventory for human services. Stress and Health. 2007;23(2):87–91.10.1002/smi.1124CrossRefGoogle Scholar
Wheeler, DL, Vassar, M, Worley, JA, et al. A reliability generalization meta-analysis of coefficient alpha for the Maslach burnout inventory. Educ Psychol Meas. 2011;71(1):231–244.10.1177/0013164410391579CrossRefGoogle Scholar
SIS118. Home – SIS118 web site. http://www.sis118.it/. Accessed May 20, 2019.Google Scholar
Borgogni, L, Galati, D, Petitta, L, Centro Formazione Schweitzer. Il questionario Checkup organizzativo. Manuale dell’adattamento italiano. Firenze, Italy: Organizzazioni Speciali; 2005.Google Scholar
Nirel, N, Goldwag, R, Feigenberg, Z, et al. Stress, work overload, burnout, and satisfaction among paramedics in Israel. Prehosp Disaster Med. 2008;23(6):537–546.10.1017/S1049023X00006385CrossRefGoogle ScholarPubMed
Consiglio, C, Borgnoni, L, Vecchione, M, et al. Self-efficacy, perceptions of context, and burnout: a multilevel study on nurses. Med Lav. 2014;105(4):255–268.Google Scholar
Maslach, C, Schaufeli, WB, Leiter, MP. Job burnout. Annu Rev Psychol. 2001;52(1):397–422.10.1146/annurev.psych.52.1.397CrossRefGoogle ScholarPubMed
Duijts, SFA, Kant, I, Swaen, GMH, et al. A meta-analysis of observational studies identifies predictors of sickness absence. J Clin Epidemiol. 2007;60(11):1105–1115.10.1016/j.jclinepi.2007.04.008CrossRefGoogle ScholarPubMed
Cortina, JM. What is coefficient alpha? An examination of theory and applications. J Appl Psychol. 1993;78:98–104.10.1037/0021-9010.78.1.98CrossRefGoogle Scholar
Streiner, DL. Starting at the beginning. An introduction to coefficient alpha and internal consistency. Journal of Personality Assessment. 2003;80:99–103.10.1207/S15327752JPA8001_18CrossRefGoogle ScholarPubMed
SPSS Statistics for Macintosh. Version 25.0, USA, IBM Corporation, Released 2017. Armonk, New York USA.Google Scholar
Lin, M, Battaglioli, N, Melamed, M, et al. High prevalence of burnout among US emergency medicine residents: results from the 2017 National Emergency Medicine Wellness Survey. Ann Emerg Med. 2019;74(5):682–690.10.1016/j.annemergmed.2019.01.037CrossRefGoogle ScholarPubMed
Cicchitti, C, Cannizzaro, G, Rosi, F, et al. Il burnout in emergenza preospedaliera e ospedaliera. Indagine conoscitiva in due coorti di infermieri. Recenti Prog Med. 2014;105(7):275–280.Google Scholar
Golembiewski, RT, Munzenrider, RF. Phases of Burnout: Developments in Concepts and Applications. Choice Rev Online. Santa Barbara, California USA: Preager; 2013:26–5926.Google Scholar
Camerino, D, Conway, PM, Heijden, BIJM Van der, et al. Low-perceived work ability, ageing and intention to leave nursing: a comparison among 10 European countries. J Adv Nurs. 2006;56(5):542–552.10.1111/j.1365-2648.2006.04046.xCrossRefGoogle ScholarPubMed
Tomietto, M, Paro, E, Sartori, R, et al. Work engagement and perceived work ability: an evidence‐based model to enhance nurses’ well‐being. J Adv Nurs. 2019;75(9):1933–1942.10.1111/jan.13981CrossRefGoogle ScholarPubMed
Crowe, RP, Bower, JK, Cash, RE, et al. Association of burnout with workforce-reducing factors among EMS professionals. Prehosp Emerg Care. 2018;22(2):229–236.10.1080/10903127.2017.1356411CrossRefGoogle ScholarPubMed
Chao, S, McCallion, P, Nickle, T. Factorial validity and consistency of the Maslach Burnout Inventory among staff working with persons with intellectual disability and dementia. J Intellect Disabil Res. 2011;55:529–536.10.1111/j.1365-2788.2011.01413.xCrossRefGoogle ScholarPubMed
Boudreaux, E, Jones, GN, Mandry, C, et al. Patient care and daily stress among Emergency Medical Technicians. Prehosp Disaster Med. 1996;11(3):188–193.10.1017/S1049023X0004293XCrossRefGoogle ScholarPubMed
Gil-Monte, P. Factorial validity of the Maslach Burnout Inventory (MBI-HSS) among Spanish professionals. Rev Saude Publica. 2005;39(1):1–8.10.1590/S0034-89102005000100001CrossRefGoogle ScholarPubMed
Holmes, M, Wang, H. 423 association between physician empathy and patient real-time satisfaction. Ann Emerg Med. 2017;70(4):S165–166.10.1016/j.annemergmed.2017.07.302CrossRefGoogle Scholar
Ali, K, Shayne, P, Ross, M, et al. Evaluation of the patient satisfaction performance of emergency medicine resident physicians in a large urban academic emergency department. Ann Emerg Med. 2013;62(4):S139.10.1016/j.annemergmed.2013.07.215CrossRefGoogle Scholar
Carney, D, Mongelluzzo, J, Foster, A, et al. 379 TF understanding emotions: combating burnout with empathy during emergency medicine residency. Ann Emerg Med. 2017;70(4):S148–149.10.1016/j.annemergmed.2017.07.349CrossRefGoogle Scholar
Barger, LK, Runyon, MS, Renn, ML, et al. Effect of fatigue training on safety, fatigue, and sleep in Emergency Medical Services personnel and other shift workers: a systematic review and meta-analysis. Prehosp Emerg Care. 2018;22(sup1):58–68.10.1080/10903127.2017.1362087CrossRefGoogle ScholarPubMed
Patterson, PD, Weaver, MD, Frank, RC, et al. Association between poor sleep, fatigue, and safety outcomes in Emergency Medical Services providers. Prehosp Emerg Care. 2012;16(1):86–97.10.3109/10903127.2011.616261CrossRefGoogle ScholarPubMed
Holland, M. The dangers of detrimental coping in Emergency Medical Services. Prehosp Emerg Care. 2011;15(3):331–337.10.3109/10903127.2011.561406CrossRefGoogle ScholarPubMed
Chng, CL, Eaddy, S. Sensation seeking as it relates to burnout among emergency medical personnel: a Texas study. Prehosp Disaster Med. 1999;14(4):240–244.10.1017/S1049023X00027709CrossRefGoogle ScholarPubMed
Palmer, RG, Spaid, WM. Authoritarianism, inner/other directedness, and sensation seeking in firefighter/paramedics: their relationship with burnout. Prehosp Disaster Med. 1996;11(1):11–15.10.1017/S1049023X0004228XCrossRefGoogle ScholarPubMed
Ricciardi, M, Valsavoia, R, Russo, M, et al. The effects of different levels of exposure on persistence of stress disorders in rescue volunteers: the case of the ATR 72 air disaster in Palermo. Giornale Italiano di Psicopatologia. 2011;17(3):303–308.Google Scholar
Donnelly, E. Work-related stress and posttraumatic stress in Emergency Medical Services. Prehosp Emerg Care. 2012;16(1):76–85.10.3109/10903127.2011.621044CrossRefGoogle ScholarPubMed
Boerner, K, Gleason, H, Jopp, D. Burnout after patient death: challenges for direct care workers. J Pain Symptom Manage. 2017;54(3):317–325.10.1016/j.jpainsymman.2017.06.006CrossRefGoogle ScholarPubMed
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