Burn Out

Présente théories et questionnaire d'évaluation du coping –voir fin de texte-Modèle du stress transactionnel & Copoing F 0 E 8 Dans cette perspective, la façon de réagir face à une situation stressante, ne dépend ni de l'individu, ni de l'événement, mais résulte d'un compromis entre les caractéristiques personnelles de l'individu, et celles de la situation. Ainsi, « on ne cherche plus à décrire les réactions de stress par les événements auxquels le sujet est exposé (stresseurs), mais par la façon dont il gère la situation » (M. Bruchon-Schweitzer, 1994). On s'intéresse donc, à la manière dont les personnes réagissent face à une situation stressante, autrement dit, aux stratégies mises en place pour faire face à la situation, sinon la supporter (Coping). De cette manière, nous nous sommes tournés vers le concept du stress, afin d'en comprendre les mécanismes, mais surtout, dans le but d'appréhender la façon dont les sujets font face à des situations stressantes. Nous nous sommes très vite aperçus, au cours de nos recherches, que le stress est un concept largement étudié, et ce, dans de nombreux domaines. De plus, « ce dernier concept [le stress] figure parmi les sujets de recherche les plus fédérateurs entre les disciplines scientifiques ou cliniques, et son examen exige une approche de plus en plus pluridisciplinaire » (P. Graziani ; J. Swendsen, 2004). Néanmoins, une des approches du stress, a particulièrement retenu notre attention. Il s'agit de l'approche transactionnelle, et plus particulièrement les travaux de Marilou Bruchon-Schweitzer 1 qui, avec son équipe, propose un modèle d'analyse des stratégies d'ajustement face à l'adversité. Elle a réalisé une conceptualisation et une adaptation française de cette approche 2. C'est ainsi que, nous nous sommes intéressés à l'approche transactionnelle du stress, afin d'en saisir tous les mécanismes, et les possibilités d'action que les individus ont, face à une situation stressante. 1 1 Professeur de psychologie de la santé, à l'Université Victor Segalen Bordeaux 2 ; et spécialiste du concept de coping. 2 En effet, leurs travaux ont en partie repris le modèle proposé par Lazarus et Folkman, qui sont les fondateurs du concept de coping. Leurs travaux ont débuté en 1984, avec la publication au sein de la revue Handbook of behavior medecine, intitulés Coping and Adapation, et Stress, appraisal and coping.

Objective:To review the significant causes and effects of physician burnout in published literature. Methodology:Asystematic review was conducted for searching published literature on the causes and effects of burnout in three online databases. Inclusion and exclusion criteria were developed for final selection of papers. The selected papers were critically appraised and thematic analysis was done to identify major themes related to physician burnout. Results:Thirty-one papers were finally selected among the 2,828 identified studies. The thematic analysis revealed demographic factors, e.g. age, gender, marital status, specialty and job position; and organizational factors, e.g. workload, interpersonal demands, job insecurity and lack of resources, as significant causes of burnout. The consequences of burnout included individual and organizational effects. The individual effects of burnout included physical health problems; while organizational effects included poor job performance, low organizational commitment, and turnover intentions. Conclusion: Burnout is a recognized workplace hazard in the healthcare sector. The individual characteristics of physicians and working environment within hospitals are contributory factors of burnout. Therefore, proactive interventions should be taken at individual and institutional levels for preventing physician burnout by improving the personal lifestyle of physician and working environment in hospitals.

¡Vamos cada vez más rápido! Crecimiento y velocidad son valores cardinales para las economías capitalistas modernas. Hartmut Rosa, en la estela de la Escuela de Frankfurt, reflexiona sobre los sentimientos de vértigo y desconexión y elabora una novedosa teoría de la alienación y la temporalidad: la lógica de la aceleración social.
Durante su último viaje a China, el sociólogo y filósofo alemán pudo corroborar los procesos de aceleración y los aspectos patológicos que inducen en las sociedades contemporáneas. A través de ensayos concisos y apuntes de viaje sugestivos, Rosa propone un remedio al frenesí global: entrar en resonancia con el mundo y los demás. Este original concepto filosófico remite a una forma de relación social y con el mundo basada en el reconocimiento, la afectividad y la apertura al otro.

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The symposium will open with the discourse by the co-chair, Vincenzo Di Nicola, on “Belonging Without Boundaries: Settlers, Sojourners and Travellers in the 21st Century.” Di Nicola argues that “the 20th century saw so many displacements of peoples across borders, languages and cultures that the terms emigrants, immigrants and migrants are sprinkled across the literature of every field of human endeavour from law to literature, from politics to philosophy, and certainly from psychiatry to psychoanalysis. Things have only gotten more complex in the 21st century where the bipolar world of the Cold War and “the end of history” has given way to a multicentric, polyglot cacaphony where culture has replaced class as the dominant signifier and language has become the major expressive vehicle of that shift. In the European Union alone, there are 23 official languages, the UN has 6 official languages, and battles over language as the emblem of culture are evident among peoples affirming their identity everywhere - from Quebec to Catalonia, Rwanda to East Timor.”

Whither belonging in all this? The symposium presents belonging as a critical issue for sociocultural psychiatry and for global mental health. The notion of belonging sutures together the social questions of identity and affiliation to psychoanalytic questions of memory and representation to build a crucial construct for social psychiatry and psychotherapy in the 21st century.

Ileana Botezat-Antonescu’s presentation, “Belonging to the group of psychotherapy professionals: Between interdiction and proliferation in different political contexts in Romania,” demonstrates that “Belonging to a
professional group just as psychotherapists do from other part of the world (Western Europe or the Americas), was a cherished dream for many Romanian psychiatrists or clinical psychologists before December 1989. We try to follow the developmental process of psychotherapy from the belonging concept perspective toward the cultural and political
context in a communist–totalitarian and a democratic society and examine its evolution.”

Drozdstoj Stoyanov’s contribution is an empirical study of “Belonging dimensions in psychological climate and personality as predictors of vulnerability to burn-out.” His discussion highlights that, “The evidence from our pilot study as well as complementary case studies reveal the relevance of belonging as embedded in personality and psychological climate to the emergence of burn out. The following inter-connected study dimensions may elicit belonging: cooperativeness and self-transcendence in personality; cohesion and fairness in the psychological climate
at work place and depersonalization as measurement of burn out.”

Bibliography:

1. Di Nicola, Vincenzo F. (1997). A Stranger in the Family: Culture, Families, and Therapy. New York, NY and London, UK: W.W. Norton.

2. Di Nicola, Vincenzo (2004). Famiglie sulla soglia. Città invisibili, identità invisibili [Families on the threshold: Invisible cities, invisible identities]. In: Maurizio Andolfi, ed., Famiglie Immigrate e Psicoterapia Transculturale [Immigrant Families and Transcultural Psychotherapy]. Milano: FrancoAngeli, pp. 34-47.

This study aims to reveal the effects of economic anxiety and burnout levels of active tour guides in Turkey on their occupational commitment. A questionnaire survey was conducted for this purpose on 370 active tour guides. Data were analyzed using the path analysis and structural equation modeling. A negative relationship was found between the occupational commitment and burnout levels of tour guides and a
strong positive relationship was found between the burnout and economic anxiety levels; it was also observed that the economic anxiety level only had a slight positive impact on continuance commitment.

A tour guide is a person, who guides domestic and foreign tourists, who provides accurate information about the destinations visited within the scope of the tour programs, and who ensures that the tourists have an accurate social, economic, and cultural impressions about that specific region or country. Efficient fulfillment of the functions of the tour guides depends on the fact that their occupational commitment levels are high and occupational burnout and economic concern levels are low. This study aims to reveal the effects of economic concern and occupational burnout levels of active (certified) tour guides in Turkey on their occupational commitment. For this purpose, a face-to-face and online (through e-mails and social media) survey was conducted on 370 active tour guides, who were determined through stratified sampling method. Descriptive statistics of this research and the relationships between the variables were analyzed through SPSS 22.00 program; the path analysis, which was built through confirmatory factor analyses and structural equation modeling, was performed through AMOS 22.00 program. At the end of this analysis, the occupational commitment and economic concern levels of tour guides were found to be high, and the level of occupational burnout was found to be low. A negative relation was found between the occupational commitment and burnout levels of tour guides and a strong positive relation was found between the occupational burnout and economic concern levels; it was also observed that the economic concern level only had a slight positive impact on occupational commitment and its continuance commitment dimension.

Οι εκπαιδευτικοί, όλων των βαθμίδων και ειδικοτήτων, συγκαταλέγονται μεταξύ των επαγγελματικών ομάδων με τις περισσότερες πιθανότητες να βιώσουν επαγγελματική εξουθένωση. Με την έλευση των Τεχνολογιών Πληροφορίας και Επικοινωνιών - Τ.Π.Ε. στην εκπαιδευτική πράξη τα επίπεδα Technostress φαίνεται πως αυξάνονται επηρεάζοντας το διδακτικό τους έργο και τις σχέσεις μεταξύ τους και με τους μαθητές τους. Στη παρούσα συμβολή παρουσιάζονται ευρήματα, από 17 ημιδομημένες συνεντεύξεις εκπαιδευτικών της πρωτοβάθμιας εκπαίδευσης Λέσβου, που σχετίζονται με την επαγγελματική εξουθένωση και το Technostress. Τα συγκεκριμένα ευρήματα δεν είχε προβλεφτεί πως θα εντοπιστούν κατά τον αρχικό σχεδιασμό της έρευνας, πριν την είσοδο μας στο πεδίο. Η συνολική έρευνα σχετιζόταν με το ψηφιακό χάσμα και την ένταξη των Τ.Π.Ε. στη πρωτοβάθμια εκπαίδευση και ανέδειξε – μεταξύ άλλων - την ανάγκη περαιτέρω διερεύνησης του Technostress στους εκπαιδευτικούς κύκλους.

The subject of our research is the burnout of nurses confronted with the successive and repeated deaths of patients on their ward. We propose to discuss the theoretical links between burnout, stress response strategies and alexithymia. Our initial hypothesis is that the situation of working in a palliative care unit tends to reduce : - the characteristics of burn-out, particularly in terms of the three components developed by Maslach: emotional exhaustion, depersonalisation and loss of a sense of personal accomplishment; - negative, defensive and ineffective coping strategies (withdrawal, denial, guilt, alexithymia, aggression). On the other hand, working in a palliative care unit with the support of a team trained and motivated to work with the dying tends to develop more effective, positive and adaptive strategies: focus, use of social support, ¬conversion, control. The verification of this hypothesis is based on the analysis of the results obtained with the Toulousian Coping Scale and the Maslach Burnout Scale proposed to two groups of nurses, one working in a palliative care unit and the other working in a traditional cancer ward. Keywords: burnout, coping strategies, alexithymia, palliative care, curative care.