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work, which may have a negative effect on their health. This study wanted to see if this holds true for the present Hungarian and Swedish emergency ward nurses. When it comes to work- related factors, social support, personality factors, and demographic variables the results in the literature regarding these areas in comparison to burnout has been inconclusive and since they have shown mixed results, it was decided to be of focus in this study in order to contribute to the existing literature. The psychological immune system as the personality factor was decided to reflect the personality dimension related to burnout since it is looking specifically at protective personality resources connected to environmental stress and since it has been shown that certain dimensions of personality might play an important part in burnout (Olah, 2005). Also, research in the area of burnout related to psychological immunity is scarce and accordingly this study hopes to contribute to this gap in the research on burnout and psychological immunity as the personality factor. An area which has been neglected in the research on burnout is life satisfaction. This study chose to include this variable as well since according to Lee et al. (2004) nurses’ life satisfaction could influence their work performance. Also, research regarding life satisfaction connected to burnout is scarce and therefore there is a gap in the existing literature in connection to this topic. Since the level of life satisfaction has been shown to have a negative influence on burnout (see for example Lee et al., 2004), it was decided to be looked into in detail in this study to see if the same association could be assumed in the present study. By including contributing factors on burnout like demographic variables, work-related factors, social support, personality factors, and life satisfaction, there is an improvement in the prediction of burnout. Also, by looking at two samples of nurses in two different countries, some important nation-based differences and similarities will be detected in relation to burnout in this sample. Furthermore, the variety of the measured factors possibly influencing burnout will make it possible to more reliably point out which factors might serve as protective factors in connection to burnout in this nation-based sample of emergency nurses and in light of this, give suggestions for burnout prevention. 1.2. HYPOTHESES The purpose of this study was to look at the differences in burnout among Swedish and Hungarian nurses working at emergency wards in Sweden and Hungary, and to see to which
extent demographic variables, work-related factors, social support, personalit, and life satisfaction, could be related to burnout in the two samples. This research study was intended to make propositions in variables affecting burnout, and to establish more concretely which factors are significant determinates if and when nurses are experiencing burnout. Also, this study intended to look into if some of the factors might serve as protective factors in burnout, in these nation-based samples of nurses and to give suggestions for burnout prevention. With these purposes in mind, the following hypotheses were checked in this study: H 1. Since there are differences in the hospital organization, the hospital management, the hospital equipment etc. between Hungarian and Swedish hospitals, where Hungary is suffering from a deterioration in the hospitals policy-making, financing, management, service structure, patient’s rights etc. (Piko, 1999), it is expected that these differences in hospital conditions between the two countries will contribute to higher burnout in the Hungarian nurses than in the Swedish ones. H 2. This study will look at how the nine different work-related stress factors will be related to burnout in Hungary and Sweden. It is expected that conflicts with the doctors, relationships with the patients, relationship with the patient’s relatives, workload and stress related to tasks will result in higher stress for the Hungarian nurses and give higher burnout scores for the Hungarian nurses in relation to these factors. On the other hand, death and dying, problems with the colleagues, work and private life, being unprepared and feeling inexperienced will result in higher stress for the Swedish nurses and give higher burnout scores for the Swedish nurses in relation to these factors. H 3. Life satisfaction will be investigated in this study and the differences in life satisfaction scores will be expected to be positively related to burnout. Since it has been shown that life satisfaction is higher in Sweden than in Hungary (Veenhoven, 2008), it is expected that higher life satisfaction scores will be found in this Swedish sample, and that this will be related to lower burnout scores for the Swedish nurses. Thus, it is anticipated that life satisfaction will serve as a protective factor for the Swedish nurses. H 4. The relationship between personality and burnout will be investigated in this study and more specifically, psychological immunity (as the personality factor) will be expected to have an effect on burnout. Since the psychological immunity has been shown to be higher in
Page 1 and 2: University of Eötvös Lorand Hunga
Page 3 and 4: DEDICATION TO MY PARENTS; YOUR HARD
Page 5 and 6: ABSTRACT A great deal of research h
Page 7 and 8: 3. METHOD……………………
Page 9 and 10: 1. INTRODUCTION 1.1. PURPOSE OF THE
Page 11 and 12: 1981). This questionnaire was and i
Page 13 and 14: oncology wards (Sherman, 2004). Esc
Page 15: (SWB). The meaning of SWB is how pe
Page 19 and 20: 2. LITERATURE REVIEW 2.1. THE THEOR
Page 21 and 22: different countries in Europe and t
Page 23 and 24: Foxall, Zimmerman, Standley & Benee
Page 25 and 26: nurse were both negatively connecte
Page 27 and 28: elated to stress levels and job sat
Page 29 and 30: Altun (2002) has pointed out that b
Page 31 and 32: Demerouti et al. (2005) is also arg
Page 33 and 34: Halbesleben & Buckley (2004) argued
Page 35 and 36: Brewer & Shapard (2004) conducted a
Page 37 and 38: the third dimension of the burnout
Page 39 and 40: Table 1. Amount of nurses being bur
Page 41 and 42: environmental variables at the hosp
Page 43 and 44: and stress levels could be differen
Page 45 and 46: about a patient’s treatment witho
Page 47 and 48: Potter (2006) conducted a literatur
Page 49 and 50: Lin, Hsu, Chao, Luh, Hung et al. (2
Page 51 and 52: at work are underprivileged in comp
Page 53 and 54: instructions from their supervisors
Page 55 and 56: number of years worked as a nurse w
Page 57 and 58: psychosomatic health, after demogra
Page 59 and 60: environment, and support from the s
Page 61 and 62: urnout. The factor which has been h
Page 63 and 64: Diener & Tov (2005, in Kitayama & C
Page 65 and 66: form of for example life satisfacti
Page 67 and 68:
develop burnout (see for example La
Page 69 and 70:
Simoni & Paterson (1997) have also
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the psychological immune system (Ol
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positive effect of social support i
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Several authors have shown the effe
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support especially important in rel
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(1999), Tummers et al. (2002), and
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According to Maslach (1982), when i
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2.11. HOW CAN WE PREVENT BURNOUT? 2
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work-related safety in order to dec
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in the organization are not easy to
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at work, and on the nurses’ work-
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3. METHOD 3.1 STUDY POPULATION The
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the head nurse at the second meetin
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• Satisfaction with Life scale (D
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assess people’s satisfaction with
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positive accomplishment in the nurs
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Goal Orientation 0.63 0.52 Impulse
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23,71% Number of children 0-1 2-3 4
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It was shown that the Swedish nurse
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APPENDIX 3); a robust Welch-test fo
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Table 8: ANOVA results of work stre
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In the second part of the second hy
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would be found in the Swedish sampl
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The Monitoring-Creating-Executing S
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4.6.3. Findings for Burnout and Per
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Table 17: Robust Test of Equality o
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Approach-Belief System (r=0.260, p
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p
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Approach-Belief System (1.01) and t
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Marital status Table 23: Burnout me
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generalized to other hospitals in S
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feeling inexperienced would result
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sample. Another researcher who foun
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5.3. BURNOUT AND LIFE SATISFACTION
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the findings in connection to life
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salaries of health care system pers
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urnout simply shows that the area o
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feel supported at home and feel the
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and that lower personality scores g
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connection between age and burnout.
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connection to them was not thought
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and young nurses working in the int
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extensively researched all around t
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what if the Hungarian nurses would
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immunity between different countrie
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care workers (usually nurses). In s
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more efficient if they would be dir
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Aries, M. & Ritter, I. Z. (1999). N
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Brooks I. & Swailes S. (2002). Anal
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Chang, E. M., Bidewell, J. W., Hunt
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Cronin-Stubbs, D. & Rooks, C. A. (1
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Diener, E., Suh, E., Lucas, R. E. &
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Ghorpade, J., Lackritz, J. & Singh,
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Hupcey, J. E. (1998). Clarifying th
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Lakin, B., Leon, S. C. & Miller, S.
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Leiter, M. P. (1993). In Halbeslebe
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Maslach, C. (1982). Burnout: a soci
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Murrells, T., Robinson, S. & Griffi
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Piko, B. F. (1999). Work-related st
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Sherman, D. W. (2004). Nurses’ St
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Taris, T. W., Schreurs, P. J. G. &
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Wright, T. A. & Cropanzano, R. (199
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a. Age…………..years old b. Wh
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6.I do not particularly like differ
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4) I am interested in how you feel
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APPENDIX C ORIGINAL SPSS OUTPUTS Se
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Cases Reliability Scale: ALPHA Case
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Cases Case Processing Summary N % V
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RELIABILITY /VARIABLES=pici7 pici23
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Cases Case Processing Summary N % V
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Reliability Statistics Cronbach's A
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Section 6: Correlations of the test
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Emotional exhaustion_ mbi Depersona
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Table 11: Robust Tests of Equality
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ience d Worklo ad Stress related to
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Table 17: Coefficients(a) Unstandar
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Table 23: Excluded Variables(b) Par
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Table 30: Test of Homogeneity of Va
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a Predictors in the Model: (Constan
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5 6 country 4,870 ,772 ,342 6,305 ,
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Social support questionnaire ,145(b
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Being unprepaired and feeling inexp
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Social mobilizing capac. subscale_P
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Section 16: Correlations of the PIC
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Table 48: Correlations: (Group numb
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Positive thinking subscale_PIC I Se
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Positive thinking subscale_PICI Sen
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Approach-Belief System Monitoring-C
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Approach-Belief System Monitoring-
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Model 1 Variables Entered Work stre
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Change and Challenge orient. subsca
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Married -,160(c) -2,798 ,006 -,208
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Relationship with the patient’s r
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More than 5 years worked as a nurse
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Work and private life ,006(b) ,079
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Social creation capac. subscale_PIC
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6 7 Residual 6334,172 172 36,827 To
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Self-Efficacy subscale_PICI ,109(a)
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Significant other subscale_ social
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Stress related to tasks -,109(d) -1
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7 Age Relationship with patients Wo
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Estimate S.E. C.R. P Label Burnout
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country ss ws ls PIC Burnout PIC ,0
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Table 106: ECVI Model ECVI LO 90 HI
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coun try 2,41 8 dp -,723 ss ls PICI
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Table 120: tandardized Indirect Eff
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ment_mbi Emotional exhaustion_mbi D
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Personal accomplishment _mbi single
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2 Model 1 2 Married . a Dependent V
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Number of years at the current work
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edu Total How many years have you w
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Table 160: Chi-Square Tests Value d
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Death, dying Conflic ts with doctor
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Death, dying Conflic ts with doctor
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** Correlation is significant at th
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Estimate S.E. C.R. P Label e12 2,40
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APPMONSYS CREEXSYS SELFREGSYS Goal
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Table 184: RMSEA Model RMSEA LO 90
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Table 192: Correlations: (Group num
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APPMONSYS CREEXSYS SELFREGSYS Self-
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Table 204: NCP Model NCP LO 90 HI 9
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