Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
A psychiatric nurse is a registered nurse (RN) with expertise in mental illness. Psychiatric
nurses, like other nurses, conduct assessments and interviews. However, the focus is on the
patient’s feelings, emotions and reactions to the environment. A psychiatric nurse evaluates the
patient’s symptoms, daily living habits, patterns of illness, support and family life; like other
workers these nurses experience fatigue and burnout at work but on a highly different level.
Nurses are more prone to develop burnout and a major cause of it is the nature of the occupation.
Sources of stress for staff nurses in psychiatric wards include hard and inflexible policy, work
assignments appropriately to people, not to satisfy training needs, inadequate remuneration,
suicide terrified patients, conflicts between colleagues, the complexity of needs patients and their
disease is lack of recovery. There is a number mental health institutions scattered throughout the
Philippines either a private one or a public one. It is a misconception to many that some of the
nurses only entered this field for the sake of it, what they do not know is that there are some that
got this job to really help patients.
Burnout can be experienced by anyone at any time of the year. The term “burnout
syndrome” was first described in the year 1970s by Herbert J. Freudenberger. He defined it as
“the extinction of motivation or incentive, especially where one’s devotion to a cause or
relationship fails to produce the desired results” (Tartakovsky, 2015). Freudenberger first used
the term burnout to describe the feeling of failure and exhaustion that can be observed in social
workers that worked in institutions, and it was the result of immoderate requirements of energy,
effort, and qualifications. Burnout is a state of physical, mental, and emotional exhaustion that
often results from a combination of very high expectation and persistent situational stress.
Burnout not only affects psychiatric nurses' ability to provide optimal patient care, but its
consequences extend to the nurse's psychological and physical health.
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
Each person has their own coping behaviour which is their own response to
psychological stress that may be triggered by burnout. Nursing is one of the stressful professions
mainly because it deals with human beings and their reported sickness. The presence of
workplace stress among nurses is considered as a cost factor on the health care organization.
As for the gaps in literature for burnout, one stated that there remains considerable work
to be done in integrating the range of perspectives on burnout among mental health workers.
Another one stated that job-independent factors might have contributed to the high workforce
stress rates observed and that their study did not address positive attitudes towards work, such as
job satisfaction. There are no recent literatures regarding psychiatric ward nurses locally. For
almost all the literatures the generalizations are limited.
The goals of this research is for the readers (1) to be informed of what psychiatric ward
nurses experience in terms of burnout, work performance, and coping behaviour; and (2); to
know the different and similar coping behaviours they do; and (3) the enhance the perspectives
of society about psychiatric ward nurses.
Based on research, there are limited sources in terms of public psychiatric ward nurses in
the Philippines because of this gap the researchers have not conceptualized it in term of the
Public psychiatric ward setting here in the Philippines. Also, most of the studies are outdated.
And there are limited numbers of public psychiatric ward here in Metro Manila.
The researchers choose public psychiatric ward nurses due to lack of attention given to
these nurses. There are limited sources where you can find public psychiatric ward nurses here in
the Philippines.
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
One significance of this study is that it would inform the audience about what dimension
of burnout is most likely experienced by the Filipino public psychiatric ward nurses; another one
would be that they will also be aware what common coping behaviours they use to manage their
burnout. This would also be an eye-opener for the administrations of the respective institutions to
be aware of what their psychiatric ward nurses experience. Another one is that this would be a
source for future researchers that also want to study public psychiatric ward nurses here in the
Philippines.
Review of Related Literature
Burnout
Burnout has been defined as a three-dimensional syndrome which includes: 1) Emotional
exhaustion (feeling emotionally drained by one’s contact with other people); 2)
Depersonalization (negative feelings and cynical attitudes toward the recipient of one’s services
or care) and, 3) Reduced personal accomplishment (a tendency to negatively evaluate one’s own
work). According to Maslach, Burnout is a syndrome and a phenomenon that most Psychiatric
ward nurses experience with their work environment and how they deal with their patients. This
syndrome is a condition in which low power and ability, and willingness and desire to work is
reduced. It is their physical and emotional exhaustion and if not acknowledge or treated, this
burnout syndrome can cause nurses to have depression and would have negative approach to
their patient, would show a lack of commitment, and are less capable of providing adequate
services, especially along dimensions of decision making and initiating involvement with clients.
There are no exact meaning of burnout because gender, age, and location of where they work can
affect the way they see and feel burnout. Good Leadership in the work place is important to
lessen the emotional exhaustion of nurses in acute general hospitals. Burnout not only affects
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
psychiatric nurses' ability to provide optimal patient care, but its consequences extend to the
nurse's psychological and physical health.
Burnout is caused by stress at work and the environment of their work place. The
inability to belong or adjust to that environment may cause the nurses to have Burnouts. There
are variables that this article considers for the nurses to reduce or lower the rate of burnout such
as Age, duration of total period of nursing, prior military training, locus of control, sense of
general well-being, adjustment capabilities, and emotional maturity. Not wanting the job or
profession can also cause burnout for nurses because they are trying to do what they don’t want
to do, Maslach & Leiter (2004) proposed that burnout develops as the result of mismatches
between professionals and their job contexts in several areas of working life. Specifically,
mismatch occurs when the process of establishing a psychological ‘contract’ with one’s job
leaves critical issues unresolved, or when working relationships change in such a way as to feel
unacceptable to the worker.
There are three components of burnout which are emotional exhaustion,
depersonalization, and diminished personal accomplishment. Same as the first article burnout is
caused by the atmosphere of the work place or the environment where the nurses normally work.
The work load of the nurses, hours they spend in working, opportunities at work and also how
many days in a week do they normally work can also cause burnout. Melchior et al. (2007) also
supports this study about how nurses can have burnout on their job, according to them increased
workload, lack of independence, unclear roles and responsibilities, and lack of support from
nurses are associated with this phenomenon. In the Caribbean most of the nurses their according
to the article are mostly affected by this phenomenon which is Burnout and the quality of their
work were also affected due to burnout. From the study of Maslach during 1979 until the more
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
studies about burnout on Mental institution and general hospital nurses today ( 2016) the rate of
burnout on nurses in Mental Institutions and general hospital have increased due to the increase
number of patients and decrease number psychiatric ward nurses, they handle more patients
today than the previous years.
Work Performance
Not many people know but psychiatric nurses can also be infected or be harmed by their
patients. Since patients are very unpredictable. Nurses confront potential exposure to infectious
diseases, patients that are hard to handle, back injuries, and many more. They are also subject to
hazards such as stress, shift work, work load, and violence in the workplace. With these
hazardous effects nurses that are working in the institution can negatively impact their job
performance.
With the existence of burnout among the nurses in a mental institution, the work
performance of each decreases. Work performance may be negative if the nurses does not feel
satisfied with his or her work or if he or her feels any burnout in working. Work performance can
be seen on the attendance of the nurses and the evaluation done by the chief of nurses. It is
through the attendance it can seen if they go to work every day or if absenteeism happens. And
with the evaluation that the chief of nurses would know how the nurses are performing at work.
Coping Behavior
Coping is a vital part of any person’s survival in today’s fast-paced healthcare
environment. Lazarus and Folkman (1984) noted, “Coping serves two overriding functions:
managing or altering the problem with the environment causing distress (problem-focused
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
coping), and regulating the emotional response to the problem (emotion-focused coping)” coping
is an activity we do to seek and apply solutions to stressful situations or problems that emerge
because of our stressors. Actually, the term "coping" is more associated with "reactive coping",
because in general, we see coping as a response to a stressor.
Coping is a central part of this process includes overt and covert response to threat or
danger usually directed towards overall reduction of stress. Coping behaviors are connected to
different problems that a nurse in a psychiatric ward experiences like work-related stress, fatigue
and many more. Coping is viewed in this formulation as having two major functions: the
regulation of emotion and distress (emotion focussed coping) and the management of problem
that is causing the stress (problem focussed coping) these two functions of coping have been
recognised by numerous investigators (Kann, Wolfe, Quinn, Snood and Rosenthal, 1964) and
have long been implicitly recognised by clinicians.
According to Antonovsky (1987), a strong sense of coherence is not a particular coping
style, and the stressors life imposes are many and varied. To adopt one pattern of coping
consistently is precisely to fail to respond to the nature of the stressor, and hence to decrease the
chances of successful coping. The results of coping in the sample show that the emotionoriented and problem-oriented coping strategies are employed equally, as there are minimal
differences in their mean values. The prevailing ways of coping stress in the sample, after
assessment of the indicators in the scales, are planful problem solving (characterizes problemoriented coping strategy), self-controlling and positive reappraisal (characterizes emotionoriented coping strategy), which may indicate that these ways of coping are used by the sample
more frequently. Their coping behavior helps them to balancing their stress from work and their
willingness to help their patient or other people. Nursing focuses on activities that relate to
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
diagnosis and treatment of human responses to health and illness phenomena. However, inherent
in this caring occupations are numerous sources of built-in stress that become occupational
hazards for nurses. A person’s coping behavior plays an important role in resolving difficult
conflict situations that may arise in various spheres of life. In Heim’s (1988) opinion, coping
behavior shows itself in the cognitive and emotional actions that a person takes to overcome
difficult situations and to adapt to existing circumstances.
Conceptual Framework
The goals of the study is to determine which dimension of burnout is more commonly
experienced by public psychiatric ward, what is the level of burnout that the psychiatric ward
nurses experience, and what are their common coping behaviours. The researchers would like to
show the most common burnout among public psychiatric ward nurses, and what are the most
utilized coping behaviours. Psychiatric Nursing is regarded as a straining occupation. It is known
that burnout is most commonly experience by helping professions; one of them being a
psychiatric ward nurse. Studies show a prevalence of 30% - 78% in terms of burnout being
common (Doolittle, 2013).
The thought of mental health institutions are viewed by society in a negative way. These
views may have been caused by history in which it tells how those who were suspected of having
a mental illness have been locked up in asylums and cut their brain to “treat” their illness. While
the public’s perception of mental health nurses is not always favorable, the nursing profession
also views mental health nurses in less than a favorable light. Many of the peers in other
specialties views psychiatric nurses as inferior and not real nurses, and have at times been
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
overheard by one of the authors telling non-mental health nurses that mental health nurses are
crazy.
Research has shown that mental health professionals who work with severely mentally
ill patients experience a considerable amount of stress that can end up as burnout and can be
detrimental to patient care (Sorgaard, Ryan, Hill, & Dawson, 2007).
Studies have examined burnout rates in various mental health professions, as well as
assessing burnout rates when clinicians work with particular client populations (Sorgaard et al.,
2007).
Mental health care workers face additional strain by the very nature of their professions
and as a result may be more at risk than their colleagues who work in a more physical
environment (Moore & Cooper 1996, Nolan etal. 1995). There are various factors, which are:
handling people with mental illness, the facilities of the institution, shifts, and working with
colleagues in which psychiatric ward nurses undergo that can cause difficulties. There are little
to none studies that state their definite problems they can experience. No matter what they state
some of it might not be applicable to others. People who chose this kind of profession are more
prone to factors that may give them an amount of difficulties and burnout that can leave a
negative outlook when it comes to their jobs.
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
Public Psychiatric Ward Nurses
Burnout
Disengagement and
Exhaustion
Coping Behaviours
Work Performance
-
Attendance
Absenteeism
Shifts
-
Self-distraction
Active coping
Denial
Substance use
Use of emotional
support
Use of instrumental
support
Behavioral
disengagement
Venting
Positive reframing
Planning
Humor
Acceptance
Religion
Self-blame
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
Public psychiatric ward nurses experiences burnout that can be specified into two
dimensions which are; disengagement and exhaustion. With this experiences of burnout,
psychiatric ward nurses may affect their work performance. Their coping behaviours are their
ways to deal with the said experiences. This study aims to know which among these coping
behaviours are the most utilized and which among this dimensions of burnout are the most
commonly experienced by the public psychiatric ward nurses.
Statement of the Problem
This study attempts to identify how burnout affects work performance of
psychiatric ward nurses and how does coping behavior affect burnout and work performance.
To be specific, the study would like to find out the answer to the following questions:
1. Which dimension of burnout is more commonly experienced by public psychiatric ward
nurses?
2. What are their coping behaviors?
3. How does coping behaviours affect the feeling of burnout?
Research Design
The researchers will use qualitative descriptive research design. According to Denzin and
Lincoln (2011), qualitative descriptive research design is an inductive and flexible nature of
research that uses inductive style of questioning and research. It is also a research that explores
attempts at gaining an understanding of underlying reasons, opinions and motivations of
concepts or phenomenon.
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
Participants
The technique that the researchers used is purposive sampling. It is where you select and
have criteria for choosing the kind of participants. Purposive Sampling would rely on the
researchers own judgment and basis to select the participants.
The participants of this study will be from the 10% of the total population of psychiatric
ward nurses in a public institution who are in service for 5-10 years within National Capital
Region. Participants would be a pure Filipino, a registered nurse, and should be a regular nurse
in the institution. Participants should not have minor medical condition or illnesses, have no
experience working abroad, and should not be living near the workplace.
Instruments
The instruments that the researchers will be using are the Oldenburg Burnout Inventory
includes positively and negatively framed items to assess the two core dimensions of burnout:
exhaustion and disengagement (from work). Exhaustion is defined as a consequence of intense
physical, affective and cognitive strain, i.e. as a long-term consequence of prolonged exposure to
certain job demands while disengagement in the OLBI refers to distancing oneself from one’s
work in general, work object and work content (e.g., uninteresting, no longer challenging, but
also “disgusting”) (Demerouti & Bakker, 2008).
The Brief COPE Inventory is the shorter form of COPE Inventory which has 60-items
wherein the Brief COPE has only 16-items. The researchers deemed it important to use the
shorter version because they do not want to take up much of the participants’ time. According to
Carver (1998), he and colleagues "tuned" some of the scales somewhat (largely because some of
the original scales had dual focuses) and omitted scales that had not appeared to be important. In
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
this way the positive reinterpretation and growth scale became positive reframing (no growth);
focus on and venting of emotions became venting (focusing was too tied to the experiencing of
the emotion, and we decided it was venting we were really interested in); mental disengagement
became self-distraction (with a slight expansion of mentioned means of self-distraction). They
also added one scale that was not part of the original inventory--a 2-item measure of self-blame-because this response has been important in some earlier work.
The researchers will also ask the attendance and/or evaluations of the nurses from the
chief of nurses.
Data Analysis
25
Average scores
20
15
Disengagement
10
Exhaustion
5
0
1
2
3
4
5
Participants according to years in service
6
Figure 1. Average scores of participants in Oldenburg Burnout Inventory
For the data analysis of their burnout, the participants are arranged from the lowest
number of years, which is 5 years, to the highest number of years, which is 10 years. For
participant 1, 3, and 5 they have a high amount of disengagement but a low amount of
exhaustion. While for participants 2, 4, and 6 have the opposite outcome. Though the difference
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
of their burnout are not that big, it still illustrated that the newer the nurse is in service the higher
the burnout. Ultimately, participant 6 who is in service for 10 years already has the overall
lowest burnout.
Top Coping Behaviours
Self-distraction
3%
Active Coping
7%
11%
Denial
9%
Substance Use
3%
9%
3%
Use of Emotional Support
Use of Instrumental Support
Behavioral Disengagement
9%
11%
Venting
Positive Reframing
Planning
8%
9%
11%
4%
3%
Humor
Acceptance
Religion
Self-blame
Figure 2. Coping behaviours in percentages
There are three coping behaviours that the participants seem to commonly use which are
positive reframing, religion and the use of emotional support. The next ones are acceptance,
active coping, humor and the use of instrumental support. The least coping behaviours are selfblame, behavioural disengagement, denial and substance use.
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
The results showed that the participants use positive coping behaviours and disregards the
negative ones. Studies show that the top behaviours seen above are affected by the Filipino
culture.
Results
Based from the results of the Oldenburg Burnout Inventory, it was found out that the
participants with less years of experience, the higher the Disengagement and the lower
Exhaustion. Compared to the other participants with the higher years of experience, it was the
opposite for them. They have low Disengagement tendencies and have higher Exhaustion
tendencies.
From what the researchers have gathered, all of the psychiatric nurses are always present
in work. The chief of nurses said that they are present at work every week days and they are off
every weekends but if the institution needs more man power they are asked to work even during
their day off. It is also said that their performance is highly commendable.
As for the results of the Brief COPE Inventory, it was shown that the longer they are in
service of being a psychiatric nurse the lesser their coping behaviours. Compared to the ones
with a fewer years who only uses 2 – 3 coping behaviours.
There were 14 coping behaviours in the inventory and out of these, 3 were the most
commonly used coping behaviours; these are Use of Emotional Support is about helping to lift
someone to higher ground so he or she can see their way through the difficulty, Religion wherein
they turn to their respective higher Being and pray, and Positive Reframing is when the person
views the motives and actions of others in a positive light.
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
Overall, the results showed that the longer they have been working as a psychiatric nurse
the lower chance of them disengaging from work but has a higher chance of being more
exhausted. And the shorter they have been in service shows that they are more likely to feel
disengagement from work and is least likely to feel exhausted. Though their coping behaviours
are helping them balance out their burnout and struggles. Even if the nurses have high burnout, if
their work performance is high it is seen that their coping behaviours are effective and helpful for
them to cope with the feeling of burnout at work.
Table 1
Summary of Participants’ answers to the instruments OLBI and Brief COPE Inventory
Participants
1
2
3
4
5
6
Burnout
Disengagement
Exhaustion
20
16
17
18
19
15
18
19
18
16
12
15
5
6
2
2
7
6
2
3
7
5
6
6
7
2
6
6
2
2
8
6
2
4
6
6
6
7
6
4
6
6
4
2
6
6
2
4
8
6
6
6
8
7
5
6
5
2
8
6
2
4
5
7
6
7
8
4
5
6
2
2
6
6
2
5
6
5
4
7
3
5
5
8
6
2
5
5
4
6
7
7
6
6
8
3
Coping Behaviours
Self-distraction
Active coping
Denial
Substance use
Use of emotional support
Use of instrumental support
Behavioral disengagement
Venting
Positive reframing
Planning
Humor
Acceptance
Religion
Self-blame
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
Discussion
One aim of the study is to find out to what extent does the psychiatric ward nurses
experience burnout and what coping behaviours they commonly use. In order to investigate this,
the researchers used the standardized tests Oldenburg Burnout Inventory and the Brief COPE
Inventory.
According to Brooks (2011), being a psychiatric ward nurse is not always dangerous but
it is always unpredictable. It takes a special breed to be a nurse in psychiatric nursing. It can get
very scary, and that’s where having a team of nurses, attendants, and patient assistance can be
critical for your own safety. The work can be emotionally and physically draining.
Ms. Ledingham (2015) explained that “burnout has long been a problem in mental health
workplaces and remains so despite much research and considerable knowledge of it amongst
professional employees. Despite working in this sector employees struggle to avoid burnout.”
She continued “It is concerning that some found it difficult to recognize burnout in themselves
until signs of physical and emotional breakdown had affected their work.”
In the Oldenburg Burnout Inventory there are two dimensions that were measured, which
were disengagement and exhaustion. It was expected that one of the two would be more
experience by the participants and the data revealed that it’s neither because it all depends on
how long the participant have been in service. However, through calculating the mean it was
revealed that disengagement is 2% higher than exhaustion. The participants have a higher
tendency to detached themselves from work rather than just being exhausted from it.
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
As shown in the results, it was found out that the longer the nurse is in service the lower
for them to have burnout tendencies but it does not particularly mean they do not use various
coping behaviours. It was also found out that the longer they are in service then more likely they
use multiple coping behaviours to help with their burnout and because of this they are more
likely to have a better work performance.
The common coping behaviours they all have are Use of Emotional Support, Religion,
and Positive Reframing. With a percentage of 11% these behaviours were the most chosen by the
participants.
For Filipinos, values are an important part of their life. The researchers believe that those
values affected the results of the Brief COPE Inventory. The values or culture of the Filipinos
can be seen in the common behaviours mentioned above. They are known to be quite religious,
hold importance of their personal and social relationships, and have a fun-loving trait.
More than 86 percent of the population is Roman Catholic, 6 percent belong to various
nationalized Christian cults, and another 2 percent belong to well over 100 Protestant
denominations. (Miller, n.d.) Culturally, Filipinos are firm believers of religion and higher
Being. They turn to their respective beliefs ones they encounter problems and as such pray to
their God to help them.
They do not solely rely on spiritual beings to help them. Most of their morals or ideal was
taught to them ever since childhood and growing up it strengthened and held it close to their
heart. They love to socialize with others and through this they form a strong bond and depend on
one another in times of need. This bond they share will eventually be the road to open up and
share their struggles. After sharing, emotional supports from family or peers immediately come.
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
In some way emotional support can also be equal to Bayanihan, a Filipino value wherein you
extend a helping hand without expecting something in return.
According to the Happiness Index Report (2016), the most important factor for Filipinos
to feel satisfied at work is having good relationships with their colleagues. “It's the Filipino
culture. We're highly relational and we want to establish personal relationships with the people
we spend a third of our day with.” (Gioca, 2016)
According to the American Institute of Stress (2012), the wisdom of the ages, anecdotal
reports, numerous clinical studies, a wealth of epidemiologic data on death rates in married,
single and divorced individuals as well as sophisticated psychophysiologic and laboratory testing
all confirm that strong social and emotional support is a powerful stress buster that improves
health and prolongs life. Laboratory studies show that when subjects are subjected to stress,
emotional support reduces the usual sharp rise in blood pressure and increased secretion of
damaging stress related hormones.
In addition, David Shedd (n.d) stated that an emotionally supportive relationship is
defined by the safe sharing of personal feelings and concerns, honestly and openly, and a lack of
a feeling if being judged by the other person.
Filipinos have the tendency to have a positive perspective whenever something negative
happens. Positive reframing does not change the situation, but it can certainly reduce damage and
put things into a healthier perspective. (Breazeale, 2012) They turn an unenthusiastic situation
into an optimistic one instead of staying in that state.
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
The researchers believe that the Filipino’s culture and values are some factors of how and
why use of Emotional Support, Religion, and Positive Reframing are the top coping behaviours.
Their coping behaviours affect their burnout in way that it lessens with continuous use.
The longer they are in service, the feeling of burnout the psychiatric ward nurses feel lessen with
their selected type of coping behaviour.
Conclusion
Therefore, the researchers conclude that the longer a psychiatric nurse is in service then
most likely their burnout would be lower than those nurses who are new or just starting in the
field. Both dimension of burnout is experienced by public psychiatric ward nurses. The feeling of
burnout does not vary with the years they have rendered in the institution. With experience of
burnout on the nurses, it doesn’t affect their work performance.
Coping behaviours of the ones who have longer years are greater than those who have
shorter in being a psychiatric nurse. Psychiatric nurses use multiple coping behaviours to lessen
the burnout they feel in their type of work. The researchers’ assumptions are the longer the years
in service the more they can find ways in coping with their experiences. Since spirituality is one
of the most utilized coping behavior, with our culture and Filipino nature, we always seek for
God’s help in dealing with our problems and difficulties.
Recommendations
The following are recommendations to further improve this study.
1) In terms of related literatures, it would be better to go to different schools that have
access in different portals for researching related literatures.
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
2) Emails and texts does not apply on this kind of research, due to their busy schedule at
work, their work load, and the people they are handling (nurses, staffs, and patients). It
would be better to call the institution or go there directly to ask the chief of the institution
if you can do your research there. In that case, the chief of the institution can give you
direct schedule and instructions.
3) You can also research on public mental health workers and not focus on psychiatric ward
nurses to have more relevant findings.
4) Find other ways like interviews and/or tools to know and to measure work performance
of each nurses.
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
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13e7b1eab0&fileName=full_text.pdf
Occupational stress, sense of coherence, coping, burnout and work engagement of registered
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
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Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
Appendixes
24
Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
Oldenburg Burnout Inventory
Instructions: The following statements refer to your feelings and attitudes during work. Please
ENCIRCLE the number that indicates to what extent you agree with each of the following
statements by selecting the number that corresponds with the statement.
Strongly
Agree
Agree
Disagree
Strongly
Disagree
I always find new and interesting aspects in
my work
1
2
3
4
There are days when I feel tired before I
arrive at work
1
2
3
4
It happens more and more often that I talk
about my work in a negative way
1
2
3
4
After work, I tend to need more time than in
the past in order to relax and feel better
1
2
3
4
I can tolerate the pressure of my work very
well
1
2
3
4
Lately, I tend to think less at work and do my
job almost mechanically
1
2
3
4
25
Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
I find my work to be a positive
challenge
1
2
3
4
During my work, I often feel emotionally
drained
1
2
3
4
Over time, one can become disconnected
from this type of work
1
2
3
4
After working, I have enough energy for my
leisure activities
1
2
3
4
Sometimes I feel sickened by my work tasks
1
2
3
4
After my work, I usually feel worn out and
weary
1
2
3
4
This is the only type of work that I can
imagine myself doing.
1
2
3
4
Usually, I can manage the amount of my
work well
1
2
3
4
26
Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
I feel more and more engaged in my
work
1
2
3
4
When I work, I usually feel energized
1
2
3
4
27
Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
These items deal with ways you've been coping with the stress in your life. There are many ways
to try to deal with problems. These items ask what you've been doing to cope. Different people
deal with things in different ways. Each item says something about a particular way of coping.
Try to rate each item separately in your mind from the others. Make your answers as true FOR
YOU as you can. Please ENCIRCLE the number of your answer.
I've been
doing
this a
medium
amount
I haven't
been
doing this
at all
I've been
doing this
a little bit
I've been turning to work or other activities to
take my mind off things.
1
2
3
4
I've been concentrating my efforts on doing
something about the situation I'm in.
1
2
3
4
I've been saying to myself "this isn't real."
1
2
3
4
I've been using alcohol or other drugs to make
myself feel better.
1
2
3
4
I've been getting emotional support from
others.
1
2
3
4
I've been giving up trying to deal with it.
1
2
3
4
I've been taking action to try to make the
situation better.
1
2
3
4
I've been refusing to believe that it has
happened.
1
2
3
4
I've been saying things to let my unpleasant
feelings escape.
1
2
3
4
I’ve been getting help and advice from other
people.
1
2
3
4
I've been using alcohol or other drugs to help
me get through it.
1
2
3
4
I've been trying to see it in a different light, to
make it seem more positive.
1
2
3
4
I've been
doing this
a lot
28
Burnout, Work Performance and Coping Behavior of Public Psychiatric Ward Nurses
I’ve been criticizing myself.
1
2
3
4
I've been trying to come up with a strategy
about what to do.
1
2
3
4
I've been getting comfort and understanding
from someone.
1
2
3
4
I've been giving up the attempt to cope.
1
2
3
4
I've been looking for something good in what
is happening.
1
2
3
4
I've been making jokes about it.
1
2
3
4
I've been doing something to think about it
less, such as going to movies, watching TV,
reading, daydreaming, sleeping, or shopping.
1
2
3
4
I've been accepting the reality of the fact that it
has happened.
1
2
3
4
I've been expressing my negative feelings.
1
2
3
4
I've been trying to find comfort in my religion
or spiritual beliefs.
1
2
3
4
I’ve been trying to get advice or help from
other people about what to do.
1
2
3
4
I've been learning to live with it.
1
2
3
4
I've been thinking hard about what steps to
take.
1
2
3
4
I’ve been blaming myself for things that
happened.
1
2
3
4
I've been praying or meditating.
1
2
3
4
I've been making fun of the situation.
1
2
3
4
29