Burnout among Healthcare Workers
A systemic study of 65 articles from sub-Saharan Africa which included South Africa, Ethiopia
and Nigeria done by Dubale et al. (2019), sampled from 963 articles in which 45 applied the
MBI tool. These articles met the reviewers’ criteria of having a full text, written in English
language, and were representative of the study population. The articles combined sample
population of these health professionals and provided reports on burnout among physicians,
nurses, midwifes, medical and/ or nursing students. The MBI-based burnout articles,
demonstrated 81% burnout levels among physicians in South Africa. They scored 31% on each
the MBI subscales: emotional fatigue, depersonalization and low personal accomplishment.
Meanwhile, in Ethiopia, the physicians scored 65% on the emotional exhaustion MBI subscale,
91% and 85% on low personal accomplishment and high depersonalization respectively. There
was no record of the overall burnout levels. The selected studies by Dubale et al. (2019),
revealed that nurses in Nigeria had reported 39% on emotional exhaustion, 29% on the
depersonalization aspect, while they scored 40% on low personal accomplishment.
The systemic study revealed that 46% of the nurses in South Africa had reported emotional
exhaustion. Where general healthcare professionals, and others where nurses alone were examined,
emotional exhaustion scored highest while physicians alone had depersonalization as highest of the
three aspects of burnout (Dubale et al., 2019). Majority of the respondents in the Dubale et al. (2019)
findings reported poor institutional support, staff shortage and disruptive interpersonal relationships
at the workplace as instigating burnout highest. These reviewers recommended infrastructural
transformation and programs to enhance recognition and management of stress. The implications of
the results are that burnout is a consequence of overwhelming workload and negative work-related
issues, lack of administrative support and appreciation of the employee’s efforts.
In a descriptive cross-sectional study to investigate burnout among medical workers at KNH,
Nairobi, Kokonya et al. (2014) used the Compassion Fatigue Self-Test, whose reliability range
between 0.94 to 0.86 and validity congruence of 0.91. The study selected the proportionate
allocation and simple random sampling design. It identified the 345 medical workers out of the
2402 medical doctors and nurses. The sample was drawn from those working in medicine (72%),
operating rooms (27%) and 2% from the accident and emergency department with an exclusion
criterion of 6 months in service at KNH. There were 94 males and 251 females aged between 23
and 53 years old with a median age of 33 years. This study was conducted over eight (8) weeks
in 2003 with all nurses being KNH permanent employees while 70% of the doctors were
employees of the University of Nairobi implying most were in-service trainees (Kokonya et al.,
2014). Using the SPSS version 10.0 to analyze the data, the Kokonya et al. (2014) found that the
prevalence rates of burnout were 97% and 94% among doctors and nurses respectively.
In the Kokonya et al. (2014) report, majority of the respondents were Christians and 2% each of
Muslims and other religions. The high levels of burnout were almost equal on gender basis with
males having 97% and females having 95% burnout prevalence. The findings were that the
workplace environment contributed 56% to the burnout rates, patient factors accounted for 14%.
Emotional Intelligence among Healthcare Workers
Emotional intelligence among healthcare workers is an important aspect in patient care. In a
study to assess the effect of coaching to improve the emotional intelligence among resident
doctors, better clinicians’ wellbeing and doctor-patient interpersonal relationship was reported
(Gorgas et al., 2015). Gorgas et al. (2015) conducted a randomized study with two groups of 33
resident doctors: one with 19 residents that went through a two-hour emotional intelligence
teaching session, and a control group of 14. The training session comprised of customized mini-
lectures and discussion on pre-set case scenarios. The emotional intelligence of each of the 33
participants was assessed prior, immediately after, and half year after the end of training
program. The Hay 360 Emotional Competence Inventory (Hay 360 ECI) tool was used for the
assessment. The results of this study included significant improvement from 62.6% to 74.2%
(t1,18= −3.54; p≤0.01) emotional
intelligence. The control group showed no change (initially scoring 66.8%, and 66.1% post-test,
p=0.77) in their emotional intelligence during the test periods. There was no significant
difference in gender or training. The Gorgas et al. (2019) study concluded that training in
emotional intelligence had a positive impact on the individuals and patient interaction. They
however, suggested that the training could have yielded unique results had the residents been
allowed longer time to synthesis the training content. Additional test tools too would have given
further clarity on the results. This study therefore underscores the importance of training to
improve the emotional intelligence competencies of healthcare workers.
The recommendation for continued development of emotional intelligence among healthcare
workers was supported by (Nagel, Towell, Nel, & Foxall, 2016). Their respondents were 30
critical care nurses in a hospital in Gauteng, South Africa. The critical care setting being
emotion-laden as is emergency department setting, the study established that improved emotional
intelligence in such environment was essential. The respondents were subjected to completing
the short form of the Trait Emotional Intelligence Questionnaire (TEIQue-SF). In the Global
emotional intelligence range using this tool is 30 to 210, and the respondents had a mean of
148.9 with 94 being the lowest score and the highest scoring 197. The respondents scored
themselves on a Likert scale of 1-7 on each indicator.
They recorded an average of 4.10 on sociability factor referring to aspects of self-awareness,
self-control (4.89) representing ability to regulate emotional pressures, and emotionality (5.24)
that indicated strengths in interpersonal relationships. The fourth factor was well-being. These
high scores, attributed to enhanced emotional intelligence concurrent with continued professional
development, subsequently led to better nursing care and handling work pressures effectively.
References
Mohammad I. M, (2014). An investigation into the occupational stress of males and females
secondary school Teachers of Srinagar City in Jammu & Kashmir.
Arikewuyo, M.O. (2004). Stress management strategies of secondary school teachers in
Nigeria.
Educational Research, 46, 195-207.
Austin V, Shah, S. (2005). Teacher stress and coping strategies used to reduce
stress.
Occupational Therapy International, 12, 63-80.
Louw, D.A., George, E & Esterhuyse, K. (2011). Burnout amongst urban secondary school
teachers in Namibia. Bhartiyam International Journal of education and Research.
Brown, Z; Denise L.; (1999). Coping with teacher stress: A research synthesis for pacific
educators. Pacific Resources for Education and Learning, 1-32.
Bruce, S. (2007). Physiology and Neurobiology of Stress and Adaptation: Central Role of
the Brain.
Caroline, A; Moses, W., (2011). Factors contributing to stress among Public Secondary
School Teachers in Vihiga County, Kenya, International Journal of Current Research,
pp.190-193
Centre for Emergency and Development Practice (CENDEP), 2008. The Kenya Free
Primary Education Policy (FPE). An Assessment on the Impact and Sustainability of Free
Primary Education in Migwani Division
Chaplain, R. (1995). Stress and job satisfaction: A study of English primary school
teachers.
Educational Psychology, 15, 473- 490.
Chan, D.W. (2002). Stress, self-efficacy, social support, and psychological distress
among prospective Chinese teachers in Hong Kong. Educational Psychology, 22, 557-569.
Cochran, W.G. (1963). Sampling Techniques, 2nd Ed., New York: John Wiley and Sons, Inc.
Lovibond, S.H.; Lovibond, P.F., (1995). Depression, Anxiety and Stress Scale
Emsley, R.; Emsley, L.; Seedat, S.; (2009). Occupational disability on psychiatric
grounds in N South African school-teacher
Ferreira, L.; Peiró J.M.; González M.G.; Martín I; (2006). Work related stress and well-being:
The roles of direct action coping and palliative coping. Scandinavian Journal of Psychology,
47, 293-302.
International Regional Information Network, (2003).
International Journal of Academic Research in Progressive Education and Development
Johnson, S.; C. Cooper.; S. Cartwright.; C. Millet (2005). The experience of work-related
stress across occupations. Journal of Managerial Psychology, 20(1/2), 178–187.
Jennings, P.A.; Mark, G; (2009). The prosocial classroom: teacher Social and emotional
competence in relation to Student and classroom outcomes. Review of Educational Research,
79(1), 491–525.
(Kendi, 2005 in Megosa, 2004, Willis, 2005). Impact of occupational stress on head teachers’
task in secondary schools of Kisumu County, Kenya.
Kenya Projects Organization, KENPRO, (2012). Factors Contributing to Occupational Stress
and Coping Mechanisms among Primary School Teachers in Ngong Division of Kajiado
North District.
Krüger, I. (1993). Performance power: transforming stress into creative energy. Tempe,
Arizona: Summit Records Inc.
Kyriacou, C: Sutcliffe, J.: (1978). A model of teacher stress. Educational Studies, 4, 1-6.
Kyriacou, C. (1987). Teacher stress and burnout: an international review. Educational
Research, 29 (2): 146 – 152.
