Burnout, Work Burnout, Work Engagement and Engagement and

PerformancePerformance

Evangelia Demerouti, PhDEvangelia Demerouti, PhD

Athens, May 2004Athens, May 2004

OutlineOutline

• Burnout: backgroundBurnout: background

• Measurement of BurnoutMeasurement of Burnout

• Research FindingsResearch Findings

• Engagement Engagement

• Burnout InterventionsBurnout Interventions

Burnout: ‘discovery’Burnout: ‘discovery’

• Since 1974 (Freudenberger)Since 1974 (Freudenberger)• Definition: Syndrome of emotional Definition: Syndrome of emotional

exhaustion, depersonalisation, and exhaustion, depersonalisation, and reduced personal accomplishment that reduced personal accomplishment that can occur among people who do can occur among people who do “people work” of some kind“people work” of some kind (Maslach, (Maslach, 1982)1982)

• Main cause: Emotional demands posed Main cause: Emotional demands posed by clientsby clients

Burnout: reasons for interestBurnout: reasons for interest

• Negative consequences for employees Negative consequences for employees (lack of interest in work – existential (lack of interest in work – existential doubts)doubts)

• Consequences for clients (low quality of Consequences for clients (low quality of service)service)

• High costs for organizationsHigh costs for organizations• Its excessive spread (around 20% of Its excessive spread (around 20% of

the employees)the employees)• Important social problem but still Important social problem but still

unclear conceptunclear concept

Causes of burnoutCauses of burnout

• Work pressure Work pressure • Emotional demandsEmotional demands• Role problemsRole problems• Work-family conflictWork-family conflict• Social supportSocial support• FeedbackFeedback• Participation in decision making Participation in decision making

Consequences of burnoutConsequences of burnout

Individual levelIndividual level• DepressionDepression• Psychosomatic complaintsPsychosomatic complaints• InfectionsInfections

Work-related attitudesWork-related attitudes• Job satisfactionJob satisfaction• Organizational commitmentOrganizational commitment• Turnover intentionTurnover intention

Organizational level Organizational level • AbsenteeismAbsenteeism• TurnoverTurnover

Burnout and PersonalityBurnout and Personality

• Neuroticism Neuroticism • Low extraversionLow extraversion• Low hardinessLow hardiness• External locus of controlExternal locus of control• Low self-esteemLow self-esteem• Type A personalityType A personality• Passive coping style Passive coping style

Depression vs. Burnout Depression vs. Burnout (clinical)(clinical)

DepressionDepression• Depressive moodDepressive mood• Unhappiness, Unhappiness,

displeasuredispleasure• Weight lossWeight loss• FearfulnessFearfulness• Sleeping problems Sleeping problems

(wake up early)(wake up early)• Guilt feelingsGuilt feelings• Suicide thoughtsSuicide thoughts• Indecisiveness Indecisiveness • Attribution of the Attribution of the

problem: sicknessproblem: sickness• GeneralGeneral• Low vitality Low vitality

BurnoutBurnout• Anger, aggressionAnger, aggression• Low pleasureLow pleasure• No weight symptomsNo weight symptoms• No fearfulnessNo fearfulness• Sleeping problems Sleeping problems

(difficulty to fall asleep)(difficulty to fall asleep)• Guilt feelings Guilt feelings • No suicide thoughtsNo suicide thoughts• Indecisiveness Indecisiveness

(complaint) (complaint) • Attribution of the Attribution of the

problem: workproblem: work• Work-relatedWork-related• Moderate vitalityModerate vitality

Occupation-independent Occupation-independent conceptualisation of burnoutconceptualisation of burnout

• Related to traditional work stressorsRelated to traditional work stressors• Work stressors better predictors than Work stressors better predictors than

‘working with people’ ‘working with people’ (Schaufeli & Enzmann, (Schaufeli & Enzmann, 1998)1998)

• Burnout symptoms parallel to Burnout symptoms parallel to phenomena in non-service occupations phenomena in non-service occupations (e.g., fatigue, alienation, withdrawal, efficacy) (e.g., fatigue, alienation, withdrawal, efficacy)

• Artefact of the utilized research Artefact of the utilized research designs: alternative hypotheses designs: alternative hypotheses untesteduntested

Measurement of Measurement of BurnoutBurnout

Two ways of diagnosis Two ways of diagnosis

• (Company) doctors using diagnostic (Company) doctors using diagnostic session - decision treesession - decision tree

• Questionnaire (self-reports)Questionnaire (self-reports)

MBI MBI OLBIOLBI

• Emotional ExhaustionEmotional Exhaustion (9): feelings of being (9): feelings of being emotionally emotionally overextended and overextended and drained by othersdrained by others

• DepersonalizationDepersonalization (5): (5): feelings of callous, feelings of callous, cynical and detached cynical and detached responses toward clientsresponses toward clients

• Reduced Personal Ac-Reduced Personal Ac-complishmentcomplishment (8): (8): decline in one’s feelings decline in one’s feelings of competence and of competence and successful achievement successful achievement in work with peoplein work with people

• ExhaustionExhaustion (7): (7): feelings of emotional feelings of emotional emptiness, overtaxing emptiness, overtaxing from work, strong need from work, strong need for rest and a state of for rest and a state of physical exhaustionphysical exhaustion

• Distancing from workDistancing from work (8): distancing oneself (8): distancing oneself from one’s work, from one’s work, negative attitudes and negative attitudes and behaviours toward work behaviours toward work in general, work in general, work contents and objectcontents and object

Oldenburg Burnout InventoryOldenburg Burnout Inventory

• Positive and negative worded itemsPositive and negative worded items• Only the core dimensions of burnoutOnly the core dimensions of burnout• Not context-specificNot context-specific• Based on theory and not on empirical Based on theory and not on empirical

findingsfindings• Cut-off scores: - clinical burnoutCut-off scores: - clinical burnout

- above the 75 - above the 75 percentile on percentile on

both both dimensions dimensions

Demerouti, 1999

Example items OLBI & MBI-GSExample items OLBI & MBI-GS

• Exhaustion (OLBI)Exhaustion (OLBI)• ““After my work, I usually feel worn out and weary” After my work, I usually feel worn out and weary” • ““After my work, I usually feel totally fit for my leisure activities” (R).After my work, I usually feel totally fit for my leisure activities” (R).• Distancing from work (OLBI)Distancing from work (OLBI)• ““I usually talk about my work in a derogatory way”I usually talk about my work in a derogatory way”• ““I get more and more engaged in my work” (R)I get more and more engaged in my work” (R)• (1 = totally disagree, 4 = totally agree)(1 = totally disagree, 4 = totally agree)

• Exhaustion (MBI-GS)Exhaustion (MBI-GS)• ““I feel burned out from my work”, “I feel tired when I get up in the I feel burned out from my work”, “I feel tired when I get up in the

morning and have to face another day on the job”. morning and have to face another day on the job”. • Cynicism (MBI-GS)Cynicism (MBI-GS)• ““I have become less enthusiastic about my work”, “I have become I have become less enthusiastic about my work”, “I have become

more cynical about whether my work contributes anything”. more cynical about whether my work contributes anything”. •   Professional efficacy (MBI-GS)Professional efficacy (MBI-GS)• ““I feel I am making an effective contribution to what this organization I feel I am making an effective contribution to what this organization

does”, “In my opinion, I am good at my job”.does”, “In my opinion, I am good at my job”.• (0 = never, 6 = every day)(0 = never, 6 = every day)

Theoretical Theoretical explanationsexplanations

Demand-Control ModelDemand-Control Model

Job DemandsJob Demands

AutonomyAutonomy

Karasek, 1979Karasek, 1979

Effort-Reward Imbalance ModelEffort-Reward Imbalance Model

Internal Internal DemandsDemands

SalarySalary

Siegrist, 1996Siegrist, 1996

External External DemandsDemands

Status, Self-Status, Self-esteemesteem

DevelopmentDevelopment

Inequity ModelInequity Model

InvestmentsInvestments

OutcomesOutcomes

SSchaufeli et al.chaufeli et al. 1996 1996

Job DemandsJob Demands

Work Work PressurePressure

EmotiEmotional onal DemandsDemands

Work timesWork times

Work-HomeWork-Home

Role conflictRole conflict

Job ResourcesJob Resources

AutonomyAutonomy

Social Social SupportSupport

Supervisory Supervisory CoachingCoaching

Possibilities Possibilities Self-growthSelf-growth

Skill VarietySkill Variety

BalanceBalance

Work Work pressurepressure

EmotiEmotional onal DemandsDemands

Work timesWork times

Work-HomeWork-Home

Role conflictRole conflict

AutonomyAutonomy

Social Social SupportSupport

CoachingCoaching

Possibilities Possibilities Self-growthSelf-growth

Skill VarietySkill Variety

Job Demands-Resources ModelJob Demands-Resources Model

JobResources

Support

Autonomy

-

Feedback

Etc.

JobDemands

Mental

Emotional

Physical

Etc.Organizational

Outcomes

Demerouti et al., 2001

(Impaired) Health

Motivation+

+

-

+

AssumptionsAssumptions• Unique Working Environment for every Unique Working Environment for every

occupational groupoccupational group• 2 categories: Job Demands and Job 2 categories: Job Demands and Job

Resources Resources • 2 Processes2 Processes

• Health Impairment processHealth Impairment process

• Motivational processMotivational process

• Job Resources can be Buffer against Job Job Resources can be Buffer against Job DemandsDemands

• Job Demands may undermine the Job Demands may undermine the Motivational Impact of Job ResourcesMotivational Impact of Job Resources

Research findingsResearch findings

Human services, production, ATC, N = 374Human services, production, ATC, N = 374Self-reports, observers ratings (italics)Self-reports, observers ratings (italics)

Demerouti et al., 2001Demerouti et al., 2001

Slide 26

Demerouti et al., 2000Demerouti et al., 2000

Food Processing Industry, N=214Food Processing Industry, N=214

Job Resources

Autonomy

-.68

Participation

JobDemands

WP

Reorgan

Bakker, Demerouti, De Boer & Schaufeli, 2003

Burnout

Commitment

T2 LT Absence

T2 STAbsence

.63

.58

.62

.67

.96

.92 .21

-.20

Human Services, N=146 Human Services, N=146

Emotional Demands

Job Demands

Workload

PossibilitiesDevelopment

Autonomy

Job Resources

OLBI –Exhaustion

OLBI –Disengagement

Exhaustion

Disengagement

In-Role Performance

Extra-RolePerformance

Self-rating

Work-HomeConflict

SocialSupport

Other-rating

e1

e2

e3

e4

e5

e6

e8

e7 e11 e12

Self-rating Other-rating

e8 e8

e9

e10

e9

e10

.66

.51

.68

.55

.88

.37

.86

.89

.67

-.90

-.42

-.45

.25

.90 .52

.99 .53

.68 .80-.45.26

Bakker, Demerouti & Verbeke, 2004

(Im) Balance(Im) Balance

Impaired health

Low motivation

Impaired health

Motivation

Health

Low motivation

Health

Motivation

L

H

L

H

JOB RESOURCES

JOB

DE

MA

ND

S

Study among salespersons Study among salespersons (N= 650)(N= 650)

• burned-outburned-out salespeople: lowest in-role & extra-role salespeople: lowest in-role & extra-role performance performance

• non burned-outnon burned-out salespeople: highest in-role & salespeople: highest in-role & extra-role performance extra-role performance

• customer-exhaustedcustomer-exhausted: among the highest : among the highest performers (in-role & extra-role performance) performers (in-role & extra-role performance) compensation strategycompensation strategy

• customer-depersonalizedcustomer-depersonalized: in-role performance : in-role performance uninfluenced, extra-role performance diminished uninfluenced, extra-role performance diminished loss-based selection, in a proactive mannerloss-based selection, in a proactive manner

• ineffectiveineffective: : highest similarity with the burned-out highest similarity with the burned-out group (low in- & extra-role performance) group (low in- & extra-role performance) feelings feelings of in-efficiency & poor professional self-esteemof in-efficiency & poor professional self-esteem

!!! The relationship between burnout – !!! The relationship between burnout – performance is not clear cut! performance is not clear cut!

Reciprocal effectsReciprocal effects

• Exhaustion Exhaustion Errors Errors more JD more JD more more

ExhaustionExhaustion

• Depersonalisation Depersonalisation negative behaviour negative behaviour less less

JR JR more Depersonalisation more Depersonalisation

• Competence Competence good performance good performance more JR more JR

more Competence more Competence

• NegativeNegative or or PositivePositive Spiral... Spiral...

Exhaustion I

Job Demands I

Exhaustion II

Job Demands II

Exhaustion III

Job Demands III

PersonalAccomplishment I

PersonalAccomplishment II

Depersonalization I

Job Resources I

Depersonalization II

Job Resources II

Depersonalization III

Job Resources III

PersonalAccomplishment III

Bakker, Demerouti, van Dierendock & Schaufeli, submittedBakker, Demerouti, van Dierendock & Schaufeli, submitted

Work engagementWork engagement

Towards positive psychology

• Most psychologists are busy with sicknesses instead Most psychologists are busy with sicknesses instead of well-beingof well-being

- Publications on negative vs. positive states are 17:1 - Publications on negative vs. positive states are 17:1 (Diener et al., 1999)(Diener et al., 1999)

• Causes of sicknesses are not identical with the causes Causes of sicknesses are not identical with the causes of well-beingof well-being

• Absence of sickness does not automatically mean Absence of sickness does not automatically mean presence of well-beingpresence of well-being

• Different focus: instead of treatment and prevention, Different focus: instead of treatment and prevention, improvement and optimalization!improvement and optimalization!

Burnout vs. Engagement

Exhaustion CynicismRed.

Competence

Vigor Dedication Absorption

Work engagement: definitionWork engagement: definition

• Engagement: a positive, fulfilling, work-related state of mind that is characterized by vigor, dedication, and absorption (Schaufeli et al., 2004). It refers to a persistent and pervasive affective–cognitive state that is not focused on any particular object, event, individual, or behavior.

Dimensions

• Vigor is characterized by high levels of energy and mental resilience while working, the willingness to invest effort in one’s work, and persistence also in the face of difficulties.

• Dedication is characterized by a sense of significance, enthusiasm, inspiration, pride, and challenge.

• Absorption is characterized by being fully concentrated and happily engrossed in one’s work, whereby time passes quickly and one has difficulties with detaching oneself from work.

Work Engagement

• VigorVigor• At my work, I feel bursting with energy At my work, I feel bursting with energy

• At my job, I feel strong and vigorousAt my job, I feel strong and vigorous • DedicationDedication

• To me, my job is challenging To me, my job is challenging

• I am enthusiastic about my job I am enthusiastic about my job

• AbsorptionAbsorption• When I am working, I forget everything else around me When I am working, I forget everything else around me

• I am completely immersed in my workI am completely immersed in my work

Engaged Employees

• Take personal initiative Take personal initiative

• Generate their own positive feedbackGenerate their own positive feedback

• Are also engaged outside their workAre also engaged outside their work

• Are tired in a different wayAre tired in a different way

• Also want to do other things than Also want to do other things than

workingworking

PrevalencePrevalence

0

4

8

12

16

20

24

28

Burnout Engagement

%

Home Care, N=45.000 Home Care, N=45.000

JobResources

Support

Autonomy +

Feedback

Coaching

JobDemands

Workload

Emotions

Intimity

Work-Home

Burnout

Engagement

-

+ Client Satisfaction

Efficiency+

-

Source: Taris, Bakker et al. (in prep.)

Slide 42

Burnout interventionsBurnout interventions

Overview of the strategiesOverview of the strategies

IndividualIndividualOrganizationOrganizationFocusFocusAimAim

IdentificationIdentification

PrimaryPrimarypreventionprevention

SecundarySecundarypreventionprevention

TreatmentTreatment

Organisational strategiesOrganisational strategies

IdentificationIdentification

PrimaryPrimarypreventionprevention

SecondarySecondarypreventionprevention

TreatmentTreatment

• Risk inventarisationRisk inventarisation• ScreeningScreening

• Regulation of work pressureRegulation of work pressure• Job design / task contentJob design / task content

• Conflict managementConflict management• Management DevelopmentManagement Development

• Contact company doctorContact company doctor• Social-medical team Social-medical team

Individual strategiesIndividual strategies

IdentificationIdentification

PrimaryPrimarypreventionprevention

SecondarySecondarypreventionprevention

TreatmentTreatment

• Self-monitoringSelf-monitoring• Self-assessmentSelf-assessment

• Didactic stress managementDidactic stress management• Work-Family balanceWork-Family balance

• Time managementTime management• Relaxation trainingRelaxation training

• Social medical supervisionSocial medical supervision• PsychotherapyPsychotherapy

Success (meta-analysis)Success (meta-analysis)

Van der Klink et al. (2000)Van der Klink et al. (2000)

kk

1818

1717

88

55

NN

858858

982982

470470

14631463

dd

.08.08 non-sign.non-sign.

.51.51 moderatemoderate

.35.35 smallsmall

.68.68 moderatemoderate

EffectEffect

Cogn. therapyCogn. therapy

RelaxationRelaxation

MultimodalMultimodal

OrganizationOrganization

Critical success factorsCritical success factors

• Stepwise systematic approachStepwise systematic approach• Adequate diagnosis and analyses Adequate diagnosis and analyses

of the problemsof the problems• Combination of work- and person-Combination of work- and person-

oriented approachesoriented approaches• Active participation of all involving Active participation of all involving

parties parties • Commitment of the topCommitment of the top

Kompier & Cooper (1999)Kompier & Cooper (1999)

JDR-questionnaire

Project team

Project

Acquisition

Training Consultants

Data viaInternet

Report

Interventions

Follow-upJDR-ProjectJDR-Project

JDR-questionnaire

Project team

Project

Acquisition

Training Consultants

JDR-ProjectJDR-Project

Data viaInternet

Report

Interventions

Follow-up

Individual Feedback

Feedback Well-BeingFeedback Well-Being

1

2

3

4

5

6

7

8

9

10

Exhaustion Cynicism Motivation Happiness

Client Norm group

Source: Source: www.hcmg.co.uk

Feedback Job DemandsFeedback Job Demands

1

2

3

4

5

6

7

8

9

10

Mental Emotional Physical WHI

Client Norm group

Source: Source: www.hcmg.co.uk

Feedback Job ResourcesFeedback Job Resources

1

2

3

4

5

6

7

8

9

10

Coaching Autonomy Support Self-growth

Client Norm group

Source: Source: www.hcmg.co.uk

Summary and FutureSummary and Future

• Burnout: Syndrome of our times Burnout: Syndrome of our times

• More clarity regarding causality & consequences More clarity regarding causality & consequences

• Multi-dimensional approachesMulti-dimensional approaches

• JDR-model: flexible and static structureJDR-model: flexible and static structure

• Scientific - Integration Scientific - Integration

• Practice – Application to organizations, teams, and Practice – Application to organizations, teams, and individualsindividuals

• Future ResearchFuture Research

• Longitudinal, positive health indicators, reciprocal Longitudinal, positive health indicators, reciprocal relations, burnout contagion and crossover, international relations, burnout contagion and crossover, international researchresearch

E.Demerouti@fss.uu.nlE.Demerouti@fss.uu.nl

Thank you for your attention!Thank you for your attention!