TREC recently published a study led by TREC Trainee Stephanie Chamberlain in the International Journal of Nursing Studies. In this study, we explored how factors, like the work environment, influence burnout in care aides working in nursing homes (long-term care homes) in Western Canada.

Burnout is a psychological condition that results from work-related stress. We measured burnout using what is known as the Maslach Burnout Inventory (MBI), a well-known measure, which considers three components of burnout:

1. Emotional exhaustion - depletion of physical and emotional resources
2. Cynicism - negative feelings towards one’s job, and
3. Lack of professional efficacy - feeling of accomplishment and meaning in your work.

We tested a number of factors that we thought might influence burnout including the work environment (organizational context), personal characteristics of care aides, and their exposure to dementia-related responsive behaviours.

We used survey data from TREC 1.0, collected between 2007-2012. In this study, we had surveys from 1,194 care aides from 30 nursing homes located in urban areas of Alberta, Manitoba, and Saskatchewan.

Key Findings

1. Care aides reported moderate-to-high levels of emotional exhaustion and cynicism but also high levels of professional efficacy

In our sample, 43% reported high levels of emotional exhaustion and 46% reported high levels of cynicism; however, 91% reported high levels of professional efficacy. These findings suggest that although care aides were likely to feel emotionally exhausted and cynical about their work, they also continued to find meaning in their work and to see its value.

2. Language and job satisfaction were both linked to burnout but in different ways

Nearly half of all care aides spoke English as a second language; these care aides were more likely report greater emotional exhaustion and cynicism. On the other hand, care aides who reported higher job satisfaction also reported less emotional exhaustion and cynicism and greater professional efficacy.

3. Care aides frequently experience dementia-related responsive behaviours and these increase feelings of burnout

Care aides experienced an average of 3 dementia-related responsive behaviours (verbal, physical, sexual actions) in their last 5 shifts before taking the survey. Those who experienced a greater number of responsive behaviours also reported higher levels of emotional exhaustion and cynicism.

4. The work environment (what we call organizational context) was found to be an important influence on burnout among care aides

Care aides who reported not having enough physical space to do their jobs experienced higher levels of emotional exhaustion. Meanwhile, care aides who reported a supportive work culture, who received feedback their team's performance on data, and who were engaged in formal team activities (such as regular staff meetings) had lower levels of cynicism. A supportive work culture and access to resources was also associated with higher feelings of accomplishment and meaning in their work.  

Future Work

We have a series of future studies planned to better understand burnout. One area that we are especially interested in is how staff burnout affects resident outcomes. We will be conducting a systematic review to see what research has already been done in this area and will follow up with a study using TREC data on staff (nursing and care aide) and residents.