2007; Patrick &. Lavery 2007). ... that arise (Patrick & Lavery 2007). We found that the age ..... Flynn L., Thomas-Hawkins C. & Clarke S.P. (2009). Organizational ...
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THE BURNOUT AND EXHAUSTION LEVELS OF NURSES WORKING IN HAEMODIALYSIS UNITS Sevgi Sun Kapucu1, Yeliz Akku¸s2, Nuran Akdemir1, Yasemin Karacan3 1 Internal Medicine Nursing, Nursing Department, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey 2 Kafkas University Kars School of Health, Kars, Turkey 3 Stem Cell Transplantation Unit, Hacettepe University, Ankara, Turkey
Kapucu S., Akku¸s Y., Akdemir N., Karacan Y. (2009). The burnout and exhaustion levels of nurses working in haemodialysis units. Journal of Renal Care 35(3), 134–140.
SUMMARY Aim: The aim of the study was to determine the burnout and exhaustion levers of nurses working in haemodialysis units. Method: The study was a cross-sectional and descriptive one. A total of 95 nurses working at the 17 dialysis centres in the centre of the Ankara Province were included. The data were collected using a questionnaire defining the socioeconomic characteristics of the nurses and the Maslach Burnout Inventory (MBI) and evaluated using the Mann–Whitney U test. Results: Haemodialysis nurses’ emotional burnout score was 16.03±6.28, the depersonalisation score 4.72±3.20 and the personal accomplishment score 20.97±4.61. Their emotional burnout and personal accomplishment level was significantly higher in those considering leaving the profession, nurses who did not find the profession suitable and those working in units where no precautions were taken against infectious disease (p 0.05).
DISCUSSION We found that the number of years of employment did not influence the exhaustion status. Other studies have obtained similar and dissimilar results. Some studies have found higher exhaustion levels with increased years of employment (Maslach et al. 2001; Demir et al. 2003) while some studies have found the opposite (Taycan et al. 2006; Kaya et al. 2007; Patrick & Lavery 2007). These varied results may be due to the nurses originating from different fields with different experiences and the personal characteristics of the nurses in the different studies. Increased work duration may increase the work experience of nurses and help them to cope better with negative situations that arise (Patrick & Lavery 2007). We found that the age of nurses did not influence their exhaustion levels (p >0.05). Other studies have also found no influence of age on exhaustion (Dolunay 2002; Meltzer & Huckabay 2004; Kennedy 2005). However, there are some Mean MBI scores (X ± SD) EE DP 16.03 ± 6.28 4.72 ± 3.20
PA 20.97 ± 4.61
15.14 ± 5.83 19.04 ± 6.92 p = 0.011*
4.55 ± 3.19 5.33 ± 3.23
20.86 ± 4.57 21.38 ± 4.81 p = 0.327*
14.73 ± 5.50 19.07 ± 7.00 p = 0.002*
4.37 ± 2.95 5.57 ± 3.64 p = 0.204a
21.34 ± 4.57 20.10 ± 4.65 p = 0.235*
15.24 ± 6.15 18.54 ± 6.11 p = 0.03*
4.54 ± 3.12 5.31 ± 3.44 p = 0.469*
21.69 ± 4.26 18.59 ± 5.01 p = 0.00*
p = 0.352a
Table 3: Nurses’ mean MBI scores by professional characteristics and precautions taken at the unit. *The independent sample t-test was used. a The Mann–Whitney U test was used. EE: emotional exhaustion, DP: depersonalization, PA: personal accomplishment.
© 2009 European Dialysis and Transplant Nurses Association/European Renal Care Association
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studies that have shown higher levels of exhaustion occurring at a younger age, this may be due to an idealist approach and the discovery that the workplace does not meet the higher expectations of the profession (Demir 1999; Arıkan 2007; Alacacioglu et al. 2008). Most of the nurses in our study were married and marital status did not influence exhaustion levels. This again may be due to the characteristics of the participants, working conditions and the satisfaction individuals get from marriage. Having a family can increase satisfaction from one field of life and give an individual an aim and a reason to exist, thus positively affecting professional accomplishment. Various studies have reported different results (Maslach et al. 2001; Taycan et al. 2006; Alacacioglu et al. 2008; Ilhan et al. 2008). The rate of chronic disease was 22.1% in the nurses in our study and having a chronic disease did not influence exhaustion levels. Melamed et al. (1999) reported a possible increased predisposition to disease with exhaustion due to increased cortisone secretion. Ilhan et al. (2008) have also determined that ill health increases exhaustion. Working willingly in the workplace is one of the factors that decrease exhaustion (Demir 1999; Arıkan et al. 2007). This concurred with our findings. There was a statistically significant difference between working willingly and lower exhaustion levels (p >0.05). Arikan et al. (2007) also found lower levels of stress and exhaustion in dialysis unit nurses than intensive care and clinical nurses. Technology is advancing rapidly at present and dialysis procedures are developing in parallel with the technology. Adapting to this change requires constant training of patients and dialysis unit nurses so that they are updated on new information and procedures. Some nurses (61.4%) in our study had not received dialysis training before working at the dialysis unit but we found no association between dialysis training status and exhaustion levels of the nurses. Environmental problems in the unit were noted by 50.5% of the nurses in our study (Table 2). Several studies have shown the effect of an ergonomically planned unit on work performance and the decrease in stress and exhaustion levels. An inappropriate work environment may lead to exhaustion and also to the sick building syndrome (Oren et al. 2001; Aiken et al.
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2002; Rossberg & Friis 2004; also available at:http://www. devonline.gov.uk/index/information_and_services/environmental_ health/eh-healthandsafety-intro/eh-hs-guidance/eh-hs-sickbuilding.htm). Some units participating in the study were found not to receive adequate sunlight, and Alimoglu and Donmez (2005) found in their study that sunlight has a beneficial effect on decreasing exhaustion. Most nurses in our study reported that their unit had a problem with infectious diseases that were considered to be health threatening, as shown in Table 2. Akdemir et al. (2006) reported that hepatitis was seen as a problem in 56.7% of the units in their study examining the problems in dialysis units. This result is similar to our findings. Nurses considered that caring for patients with infectious diseases such as hepatitis presented a problem. However, as it has been stated, precautions against infectious diseases had been taken in 76.8% of the units. It could be considered that even though there are enough materials and procedures in place for individual protection against infectious diseases, the nurses still consider this to be a problem due to their inadequate knowledge regarding protection against these diseases. This is a problem that could be minimised by more education of the nurses. Dialysis unit staff do encounter many health-threatening risks but this study found that most units did take precautions against infectious disease. The mean emotional exhaustion and personal accomplishment scores were different between the groups according to whether the precautions had been activated in the individual units (Table 3; p
