The Cognitive Processes that Influence Burnout in Japanese Nurses

Wednesday, 24 July 2013

Takashi Ohue, RN, PhD
Department of Nursing Science, Faculty of Health Science, Hyogo University, hyogo, Japan
Michiko Moriyama, RN, PhD
Division of Nursing Science Graduate School of Health Sciences, Hiroshima University, Hirosima, Japan
Takashi Nakaya, PhD
Faculty of Health and Welfare, Prefectural University of Hiroshima, Hiroshima, Japan

Learning Objective 1: The present study aimed to examine cognitive model of burnout among nurses.

Learning Objective 2: The present study aimed to examine cognitive model of burnout among nurses.

Purpose: This study aims to clarify the cognitive processes that govern how job stressors influence burnout, using an irrational belief measure and an automatic thought measure specific to Japanese nurses.

Methods: A total of 541 nurses (21 men  and 520 women) working at 5 acute-care hospitals were asked to complete a questionnaire designed to assess burnout status (Maslach Burnout Inventory [MBI]), job stressors (Nursing Job Stressor Scale [NJSS]), automatic thoughts (the shorter version of the Japanese version of the Automatic Thoughts Questionnaire-Revised [ATQ-R]) and irrational beliefs (Irrational Belief Test for Nurses [IBTN]).

Results: In this study, the relationships between job stressors, irrational beliefs, and automatic thoughts and burnout (as defined by Ohue et al., 2011) were as follows: stressors associated with burnout included “conflict with other nursing staff,” “nursing role conflict,” “qualitative workload,” “quantitative workload,” and “conflict with patients.” Irrational beliefs associated with burnout were “dependence,” “problem avoidance,” and “helplessness.” Consequently, the hypothetical cognitive model of “stressor” → “irrational beliefs” → “automatic thoughts” → “burnout” was adopted (χ2= 368.46, df = 70, GFI = .90, AGFI = .85, RMSEA = .089, AIC = 438.463). We also performed an analysis of the direct and indirect effects of job stressors on burnout, and found a direct effect of 0.33 and an indirect effect of 0.60 × 0.70 × 0.60 = 0.25 .

Conclusion: The results clarified the relationship between job stressors and burnout, showing that irrational beliefs and automatic thoughts were cognitive factors that influenced this relationship. This cognitive process could be useful as an index for confirming the effectiveness of cognitive behavioral therapy in reducing nurses’ burnout.

Ethical considerations:The study protocol was approved by the Hiroshima University Ethics Committee in Japan. All objectives and procedures were explained in writing to participants.