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An Intervention to Reduce Work-Related Burnout in Teachers

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DOI: 10.1080/10803548.2005.11076661 · Source: PubMed

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International Journal of Occupational Safety and Ergonomics (JOSE) 2005, Vol. 11, No. 4, 423–430

An Intervention to Reduce Work-Related

Burnout in Teachers
Dorota Żołnierczyk-Zreda

Central Institute for Labour Protection – National Research Institute, Warszawa, Poland

The objective of the study was to develop and evaluate a 2-day burnout intervention program focused
at enhancing coping with stresses observed in teachers’ work. Karasek’s job stress model was used as the
theoretical framework. The aim of the intervention was to teach participants to deal better with high job demands
and low job control. Some cognitive-behavioural methods of overcoming workload and enhancing a sense of
self-mastery and relations with students were introduced in the workshop. 59 teachers were randomly assigned
to an experimental or to a control group. Results showed that emotional exhaustion, perceived workload and
somatic complaints decreased significantly in the intervention group. The greatest effect of the intervention
was observed with regard to increased behavioural job control. It was concluded that teaching participants
how to manage their work environment better could help them in changing their perception of stressful job
characteristics, reducing emotional exhaustion and somatic complaints.

work-related burnout psychosocial work conditions somatic complaints intervention

1. INTRODUCTION oneself negatively with regard to one’s competence

and productivity and a lowered sense of self-efficacy.
Work-related burnout has been the focus of increased Depersonalization refers to negative, cynical or
research attention in recent years. Research on excessively detached responses to other people at
burnout has mainly covered people-oriented work. According to Maslach et al.’s [2] modified
professionals, like teachers, social workers, nurses, conception, depersonalization was renamed
doctors; however, burnout may affect any kind of cynicism; reduced personal accomplishment was
occupation [1]. People-oriented professionals’ work re-labelled reduced efficacy or ineffectiveness.
demands a great deal of emotional, cognitive and The Maslach Burnout Inventory (MBI) has been
physical energy. These overloading and conflicting the most popular tool for measuring burnout in
demands may lead to emotional exhaustion, mental empirical research [5, 6]. It is often pointed out that
weariness and physical fatigue, which are generally the use of a total score to represent burnout should
labelled as burnout [2, 3]. be avoided (e.g., 7, 8, 9]. Emotional exhaustion has
According to Maslach and Jackson [4] first been shown in meta-analytic reviews as the core
conceptual approach toward burnout, it is component of the MBI [6].
a syndrome with three dimensions: emotional A review of the literature on burnout [2, 3, 6,
exhaustion, reduced personal accomplishment and 10] shows it is a consequence of one’s exposure
depersonalization. Emotional exhaustion, which to chronic job stress. Qualitative and quantitative
is the feeling of being depleted of one’s emotional overload, role conflict and ambiguity, lack of control
resources, is regarded as the basic individual stress over one’s work and lack of social support are the
component of the syndrome [2]. Reduced personal stresses that may lead to burnout [3, 5]. According
accomplishment indicates a tendency to evaluate to another popular approach to job burnout, it results

Correspondence and requests for offprints should be sent to Dorota Żołnierczyk-Zreda, Central Institute for Labour Protection – National
Research Institute, ul. Czerniakowska 16, 00-701 Warszawa, Poland. E-mail: <dozol@ciop.pl>.
424 D. ŻOŁNIERCZYK-ZREDA

from perceptions of organizational inequity, which accomplishments increased at a 2-month follow-

indicates that individuals consider the outcome up after a coping skills training program. Van
of their work (e.g., salary, status, appreciation) Diedendronck et al. [24] proved that a 5-week
as disproportionate to their input into work (e.g., intervention aimed at reducing perceptions of
time, attention, effort) [11, 12]. inequity in the relationship with the organization
Numerous studies confirmed the relationship helped to reduce burnout and absenteeism and
between depression, anxiety and subjectively to diminish the deprived feelings in health care
reported health-related problems and burnout, professionals. Freedy and Hobfoll [25] found a
including circulatory and heart problems, significant reduction in emotional exhaustion in
musculoskeletal pains, gastrointestinal problems, an experimental group of nurses who were taught
sleep disturbances, recurrent headaches [13, 14, how to use social support and individual mastery
15]. Several studies showed that burnout has been resources.
linked to some negative organizational outcomes, However, there are also studies that have
including increased turnover and absenteeism failed to reduce burnout or that suffered from
[16, 17], lower organizational commitment [3] methodological limitations such as lack of control
and self-reported use of violence [18]. It has been groups [22, 26, 27].
stressed that adverse organizational conditions
are more significant in the aetiology of burnout The present study
than personality factors like negative affectivity
The aim of this study was to audit those stresses that
and low self-esteem [2, 3]. Given these negative might lead to workplace burnout in teachers and
outcomes of burnout, it is not surprising that a to develop an intervention focused at ameliorating
number of interventions to combat this dangerous their coping with these stresses. The instrument
syndrome have been developed. However, most for stress monitoring based on Karasek’s model
burnout interventions reported in the literature of job stress was used in the study. The broadened
are individual-oriented [10]. They usually version of this model [28] differentiates between
combine various methods such as cognitive stress the three key work dimensions: demands, control
management, time management and social skills and social support, and looks for determinants of
management. workers’ health and motivation in the interaction
West, Horan and Games [19] used the three of these characteristics. Particularly, a situation of
kinds of stress management approaches for women high demands, low control and low social support
from various helping professions. They found that is viewed as stressful for a worker. Numerous
stress inoculation training decreased emotional studies examining Kareem’s model show that
exhaustion, the level of anxiety and systolic blood although its basic assumption of international
pressure, and improved personal accomplishment. impact of the aforementioned job characteristics
Corcoran and Bryce [20] showed that a 4-week on health and well-being still remains a matter
interpersonal skills and rational emotive therapy of discussion, the linear relations between
training had helped social workers in decreasing demands, control and social support, and health
the level of emotional exhaustion. In Higgins’s are commonly found [29, 30]. The present study
study [21], a cognitive behavioural programme has examined changes in teachers’ perception of
that included assertiveness training turned out job stress (namely, the three job characteristics),
to be effective in lowering emotional exhaustion burnout symptoms and somatic complaints due to
in working women. Schaufeli [22] showed the intervention aimed at enhancing coping with
that a 3-day burnout workshop consisting of the stresses which dominated in a group study.
relaxation, interpersonal skills training and some In order to identify such stresses, the measures
cognitive elements resulted in a significant obtained during pre-intervention tests (T1) were
decrease in emotional exhaustion in a group compared to the norms developed for the Polish
of nurses. Additionally, Rowe [23] found that population of eight professions [31]. It turned
emotional exhaustion decreased, and personal out that high scores in job demands (particularly

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 AN INTERVENTION TO REDUCE BURNOUT 425

workload—8 sten, intellectual and psychosocial consists of 22 statements and three subscales:
demands—7 sten) and very low level of job emotional exhaustion (9 items), personal
control (3 sten) were observed in the studied accomplishment (8 items) and depersonalization
group of teachers. The outcome concerning social (5 items). The scale of frequency was taken into
support reached an average level of 5 sten. account; the items were rated on a 6-point scale
It was hypothesized that due to the intervention, (from 0—never to 6—every day). High scores
the perception of these job characteristics would of emotional exhaustion and depersonalization,
improve and burnout symptoms would decrease. and low scores of personal accomplishment were
Because high job demands have been related to indicative of burnout. Cronbach’s alpha internal
emotional exhaustion and health complaints in consistency coefficient for emotional exhaustion
previous studies [32], it was hypothesized that the was α = .80 (T1) and α = .79 (T2), for personal
intervention could help in ameliorating somatic accomplishment it was α = .76 (T1) and α = .78
health of the participants of the intervention. (T2), and for depersonalization it was α = .57 (T1)
and α = .58 (T2).
Intensity and frequency of somatic symptoms
2. METHOD
were assessed using the scale of Widerszal-Bazyl’s
[34] questionnaire, which examines 30 frequently
encountered health complaints.
2.1. Measures
Both intensity and frequency were estimated on
The teachers completed a battery of questionnaires a 6-point scale (0—never, 6—every day for the
to assess demographic variables, job stress, frequency scale, and 0—no pain, 6—very strong
burnout and somatic complaints. pain for the intensity scale). Cronbach alpha
Demographic variables included age, gender, internal consistency coefficients for intensity and
years of experience. frequency were α = .91 (T1), α = .92 (T2), and
Teacher’s stress was assessed using the α = .90 (T1), α = .91 (T2) respectively.
Psychosocial Working Conditions Questionnaire
[31]. This is a 36-item questionnaire with five
subscales, three of which were used in the study: 2.2. Procedure

1. Demands Scale with (a) intellectual demands, The quasi-experimental design of the study
(b) psychosocial demands and demands consisted of pre- (T1) and post- (T2) intervention
resulting from responsibility for safety, and measures among the experimental and the control
(c) demands resulting from overload and role groups. After completion of questionnaires at Time
conflict; 1 (T1) participants were randomly assigned either
2. Control Scale with (a) behavioural control and to the control or the treatment condition. Using
(b) cognitive control; independent-sample t tests, the treatment and the
3. Social Support Scale with (a) support form control groups were compared on demographic
superiors and (b) support form co-workers. and dependent variables. No significant differences
were found. Then, the levels of Psychosocial
Each subscale was scored on a 5-point Likert Working Conditions Questionnaire T1 measures
scale (0—to no extent, 6—to a great extent). (Table 1) were assessed, and it was concluded
Cronbach’s alpha internal consistency coefficient that the teachers suffer from high job demands
for the Demands Scale was α = .79 (T1, pre- and low job control. One participant from the
intervention) and α = .81 (T2, post-intervention), 30 participants who had started the program did
for the Control Scale it was α = .83 (T1) and not complete the intervention. A month after the
α = .81 (T2), and for the Social Support Scale it intervention ended, the post-treatment measures
was α = .96 (T1) and α = .92 (T2). (T2) were taken in both the experimental and
The MBI scale in Koniarek’s [33] adaptation the control group. In order to maintain an equal
was used to assess occupational burnout. It number of participants in the study groups, the

JOSE 2005, Vol. 11, No. 4

426 D. ŻOŁNIERCZYK-ZREDA

outcomes of one, randomly selected participant positive meanings of their work including their
from the control group, was excluded [35]. role in the process of shaping young personalities.
They were also taught how to benefit from peer
2.3. Sample support through counselling, discussing difficult
cases and also through gaining some emotional
The final experimental and control groups support from their close ones.
consisted of 29 teachers each. Overall, 58 females
and males were included. The mean age was
41.8 (SD = 7.1), the mean job tenure—18.3 years 3. RESULTS
(SD = 4.9). Most were women—69.8%; males
constituted 30.2% of the group. Means and standard deviations of the outcome
measures in the experimental and in the control
2.4. The Intervention Program groups are presented in Table 1.
Independent-sample t tests did not show any
A 2-day, 6-hrs-a-day stress management workshop
significant differences between the experimental
was organized for the participants from the
and the control groups in the pre-test scores of
experimental group. Treatment was aimed at
variables, nor did the groups differ in age, gender
improving coping with stressors related to high job
or job tenure.
demands (particularly the demands resulting from
overload, role conflict and intellectual demands) Following Bunce and Stevenson’s [36]
and to very low job control relating mainly to guidelines, repeated-measures MANOVA (Wilk’s
problems with managing relations with students. criterion) was used as the most appropriate
The first main goal of the programme was to teach method for examining whether the intervention
participants how to avoid workload. Exercises led to changes in all the study variables. In the
in time management, setting general (priorities) MANOVA analysis, time was the within-subject
and specific goals in their work were introduced variable, and intervention (1—intervention, 2—
in the workshop. The participants were also nonintervention) was the between-subject variable
taught a more realistic professional role. Through (Table 2).
some cognitive restructuring they tried to avoid The MANOVA showed a significant effect
perfectionism, and some dysfunctional beliefs of time and intervention interaction on 5 of the
like “I cannot fail”, “I have to know everything”. 10 variables included in the analysis, i.e., on
On the other hand, they were encouraged to intellectual demands, overload and role conflict,
take opportunities to participate in additional behavioural control, emotional exhaustion and
professional training and to seek professional help intensity of somatic complaints (Table 2).
from their co-workers. To better handle the strain The greatest effect was observed with regard
of working, some exercises in relaxation and to behavioural control. The perception of
detraction were introduced in the program. organizational stress related to intellectual
The second main goal of the intervention was to demands, overload and role conflict, decreased
teach the participants how to increase their sense significantly in the experimental group.
of job control through some useful interpersonal Only emotional exhaustion was significantly
and communication skills, including assertiveness. reduced due to the intervention, but the effect
Teachers learning and experimenting with skills was substantially greater in comparison with the
for coping with disruptive students’ behaviours, other effects of the intervention (Table 2). No
like overt and passive aggression, is an example. significant changes—as a result of participating in
On the other hand, some exercises in negotiating, the intervention—were found for the perception
and presenting a respectful attitude towards of social support, from both supervisors and co-
students were also introduced. In order to enhance workers. The treatment had no effect on personal
self-efficacy and a sense of self-mastery the accomplishment, depersonalization or the fre-
participants were encouraged to identify all the quency of somatic complaints.

JOSE 2005, Vol. 11, No. 4

 AN INTERVENTION TO REDUCE BURNOUT 427

TABLE 1. Descriptive Statistics of Pre- and Post-Test Scores of the Study Variables
Experimental Group Control Group
N = 29 N = 29
Variable T1 T2 T1 T2
Intellectual demands
M 34.59 31.72 35.20 35.65
SD 4.25 5.70 3.59 3.72
Psychological demands
M 33.94 32.89 34.35 35.24
SD 4.04 5.39 3.86 3.84
Overload and role conflict
M 15.69 13,24 17.62 18.72
SD 3.79 3.32 2.93 2.60
Cognitive control
M 36.01 35.61 34.92 28.27
SD 3.45 3.85 4.34 5.01
Behavioural control
M 28.06 31.89 29.55 28.27
SD 4.89 4.52 5.81 5.06
Support from supervisors
M 25.13 26.62 24.89 23.79
SD 5.71 7.47 7.06 7.71
Support from co-workers
M 26.37 25.26 25.20 25.34
SD 5.44 6.47 6.29 6.26
Emotional exhaustion
M 26.37 25.06 25.20 25.34
SD 5.44 6.47 6.29 6.26
Personal accomplishment
M 12.76 10.96 12.31 11.88
SD 1.74 1.45 1.83 1.80
Depersonalization
M 12.38 12.73 12.03 11.96
SD 1.14 .77 1.40 1.26
Intensity of somatic complaints
M 35.58 29.51 33.02 36.42
SD 14.81 11.98 19.86 18.76
Frequency of somatic complaints
M 26.88 23.20 28.18 30.41
SD 18.79 19.18 19.48 19.23
Notes. T1—pre-intervention test, T2—post-intervention test.

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428 D. ŻOŁNIERCZYK-ZREDA

TABLE 2. MANOVA Involving Time × Intervention Effects

Variable F p µ
Intellectual demands F(1, 56) = 4.340 .042 .072
Psychological demands F(1, 56) = 1.720 .190 .030
Overload and role conflict F(1, 56) = 6.470 .014 .104
Behavioural control F(1, 56) = 28.880 .000 .324
Cognitive control F(1, 56) = 1.130 .290 .021
Support from supervisors F(1, 56) = 0.419 .520 .008
Support from co-workers F(1, 56) = 0.980 .320 .018
Emotional exhaustion F(1, 56) = 9.470 .003 .152
Personal accomplishment F(1, 56) = 0.262 .616 .005
Depersonalization F(1, 56) = 0.006 .937 .000
Intensity of somatic complaints F(1, 56) = 4.340 .042 .073
Frequency of somatic complaints F(1, 56) = 3.910 .053 .065

4. DISCUSSION al. [39] suggested, on the basis of their study,

that a positive, active attitude towards one’s
The study confirmed previous findings that recipients could reinforce their positive, reciprocal
emotional exhaustion is the easiest symptom to behaviours. It is hypothesized that such reciprocal
reduce with various interventions [20, 21, 22, students’ behaviours could be the response to the
24, 25]. The components of professional efficacy positive attitude of the teachers participating in
and depersonalization were always more difficult the intervention. According to the equity theory,
to change with intervention. The short period of emotional burnout and, particularly, emotional
intervention could be the reason for not obtaining exhaustion, result from lack of reciprocity in
any significant changes in these dimensions of human relations at work [40]. The decrease in
burnout.
emotional exhaustion observed in the study
However, a surprisingly great effect of the
suggests that teachers could gain more reciprocity
intervention concerned perceived behavioural
in the relations with their students as a result of the
job control, and a somewhat smaller effect on
training. Future research should also include their
perceived workload. It is supposed that the
recipients’ assessment.
cognitive and behavioural exercises introduced in
The decrease in emotional exhaustion was
the intervention could substantially help teachers to
accompanied by a decrease in subjectively
increase their authority to make decisions on their
perceived physical symptoms, and a decrease in
job, to regulate their workload better and finally
perceived workload. This outcome is in line with
to facilitate lowering emotional exhaustion. It was
proven that environmental sense of control is an data from Demerouti et al.’s [32] study, which
important stress management resource. Brouwers showed that a high level of job demands is linked
and Tomic [37] also showed that interventions that to health impairment.
incorporate mastery experiences were likely to Although the intervention was not aimed at
reduce teachers’ emotional exhaustion. A similar any objective manipulation of job conditions, the
outcome concerning increased job control was perception of job control and job demands changed
obtained in Hatinen et al.’s study [38] after a 2- significantly due to the intervention. Perhaps
week rehabilitation program aimed at enhancing greater changes in all burnout symptoms could
individual coping resources. have taken place in this study if the intervention
Encouraging teachers to use active, non- had focused more on changing the situational and
withdrawal coping and respectful, yet assertive organizational factors that may play a greater role
attitudes towards their students has been a very in the development of burnout than on individual
important part of the intervention. Bakker et ones [2]. Meta-analysis of work stress and burnout

JOSE 2005, Vol. 11, No. 4

 AN INTERVENTION TO REDUCE BURNOUT 429

interventions suggests that individually oriented 9. Koeske CF, Koeske RD. Construct validity
interventions do not take sufficient actions to of the Maslach Burnout Inventory: a critical
prevent the causes of burnout development [10]. review. J Applied Behav Sc 1989;25:131–44.
Nevertheless, in this study, a burnout symptom, 10. Burke RJ, Richardsen AM. Organizational-
two stressful job characteristics and health level interventions designed to reduce
complaints decreased regardless of the fact that no occupational stressors. In: Dewe P, Leiter
such actions were taken. Future research should M, Cox T, editors. Coping, health and
organizations. London, UK: Taylor &
focus on developing an intervention that combines
Francis; 2000. p.191–209.
both individual (coping skills) and organizational
11. Dierendonck D, Shaufelli WB, Buunk BP.
work factors to reduce work-related burnout [41].
Burnout and inequity among human service
The limitations of the present study are that no professionals: a longitudinal study. J Occup
objective measures, like absenteeism or turnover, Health Psychol 2001;1:43–52.
were included, and no follow-up measure was 12. Bakker AB, Schaufeli WB, Demerouti E,
taken to check the stability and duration of the Janssen PPM, Hulst RVD, Brouwer J. Using
observed outcomes. equity theory to examine the difference
between burnout and depression. Anxiety
Stress Coping 2000;13,247–68.
REFERENCES 13. Kahill S. Symptoms of professional burnout:
a review of the empirical evidence. Canad
1. Cordes CL, Dougherty TW, Blum M. Psychol 1988;29:284–97.
Patterns of burnout among managers and
14. Appels A, Mulder P. Fatigue and heart
professionals: a comparison of models. J
disease. The association between “vital
Organ Behav 1997;18:685–701.
exhaustion” and past, present and future
2. Maslach C, Schaufeli WB, Leiter MP. Job coronary heart disease. J Psychosom Res
burnout. Annu Rev of Psychol 2001;52: 1989;33:727–38.
397–422.
15. van Diest R, Appels A. Vital exhaustion and
3. Shirom A. Job-related burnout: a review. In: depression: a conceptual study. J Psychosom
Quick JC, Tetrick LE, editors. Handbook Res 1991:35:535–44.
of occupational health psychology. 16. Jackson SE, Schwab RL, Schuler RS.
Washington, DC, USA: American Toward an understanding of the burnout
Psychological Association; 2002. phenomenon. J Applied Psychol 1986;
4. Maslach D, Jackson S. The measurement of 71:630–40.
experienced burnout. J Occup Behav 1981; 17. Parker PA, Kulik JA. Burnout, self- and
52:397–422. supervisor-related job performance, and
5. Lee R, Ashforth BE. A meta-analytic absenteeism among nurses. J Behav
examination of the correlates of the three Med1995;18:581–99.
dimensions of job burnout. J Applied 18. Kop N, Euwema M, Schaufeli WB.
Psychol 1996:81:123–33. Burnout, job stress, and violent behaviour
6. Schaufeli WB, Enzmann D. The burnout among Dutch police officers. Work Stress
companion to study and practice: critical 1999;13:326–40.
Analysis. Washington, DC, USA: Taylor & 19. West DJ, Horan JJ, Games PA. Component
Francis; 1998. analysis of occupational stress inoculation
7. Moore JE. Why is this happening? A causal applied to registered nurses in an acute care
attribution approach to work exhaustion hospital setting. J Consult Psychol 1984;31:
consequences. Acad Manage Rev 2000; 209–18.
25:335–49. 20. Corcoran KJ, Bryce AK. Intervention in
8. Kalliath TJ, O’Driscoll MP, Gillespie DF, the experience of burnout: effects of skill
Bluedorn AG. A test of the Maslach Burnout development J Soc Serv Res 1983;7:71–9.
Inventory in 3 samples of healthcare 21. Higgins NC. Occupational stress and
professionals. Work Stress 2000;14:35–50. working women: the effectiveness of the

JOSE 2005, Vol. 11, No. 4

 430 D. ŻOŁNIERCZYK-ZREDA

two stress reduction programs. J Vocational [Psychosocial conditions of burnout

Behaviour 1986;29:66–78. frequency and level in hospital’s nurses
22. Schaufeli WB. The evaluation of a burnout working in Łódź] [unpublished manuscript].
workshop for community nurses. J Health Łódź, Poland: Instytut Medycyny Pracy;
Human Res Administ 1995;18:11–40. 1992.
23. Rowe MM. Skills training in the long-term 34. Widerszal-Bazyl M, Cieślak R, Najmiec A.
management of stress and occupational Psychospołeczne właściwości pracy
burnout. Curr Psychol. 2000;19:215–28. zawodowej, zmienne osobnicze a stres
24. van Dierendonck D, Shaufelli WB, psychologiczny i dolegliwości zdrowotne
Buunk BP. The evaluation of and individual [Psychosocial work conditions, individual
burnout intervention program: the role variables, psychological stress and somatic
of inequity and social support. J Applied complaints]. Warszawa, Poland: Centralny
Psychol 1998;3:392–407. Instytut Ochrony Pracy; 1997.
25. Freedy JR, Hobfoll SE. Stress inoculation
for reduction of burnout: a conservation of 35. Brzeziński J. Badania eksperymentalne
resources approach. Anxiety Stress Coping w psychologii i pedagogice [Experimental
1994:6:311–25. studies in psychology and pedagogy].
Warszawa, Poland: Wydawnictwo Naukowe
26. Brown L. Mental help staff groups to
Scholar; 2000.
manage work stress. Social Work with
Groups 1984;7:55–66. 36. Bunce D. Stevenson K. Statistical
27. Larson DG. Developing effective hospice considerations in the interpretation of
staff support group: pilot test of an research on occupational stress management
innovative training programme. Hospice J interventions. Work Stress 2000;3:197–
1986;2:41–55. 212.
28. Karasek R, Theorell T. Healthy work:
productivity and the reconstruction of 37. Brouwers A, Tomic W. A longitudinal
working life. New York, NY, USA: Basic study of teacher burnout and perceived self-
Books; 1990. efficacy in classroom management. Teaching
and Teacher Education 2000;16:239–253.
29. De Jonge J, Kompier MAJ. A critical
examination of the demand-control-support 38. Hatinen M, Kinnunen U, Pekkonen M,
model from a work psychological perspec- Aro A. Burnout patterns in rehabilitation:
tive. Int J Stress Manage 1997;4:235–58. short-term changes in job conditions,
30. van der Doef M, Maes S. The job demand- personal resources, and health. J Occup
control (-support) model and psychological Health Psychol 2004;3:220–37.
well-being: a review of 20 years empirical
research. Work Stress 1999;13:87–114. 39. Bakker AB, Schaufeli WB, Sixma HJ,
31. Widerszal-Bazyl M, Cieślak R. Monitoring Bosveld W, van Diendendronck D. Patients
psychosocial stress at work: development demands, lack of reciprocity, and burnout: a
of the psychosocial working conditions five year longitudinal stydy among general
questionnaire. International Journal of practitioners. J Organ Behav 2000;21:425–
Occupational Safety and Ergonomics 41.
(JOSE) 2000;Special Issue:59–70.
40. Buunk BP, Schaufeli WB. Reciprocity in
32. Demerouti E, Bakker A, de Jonge J, inrerpersonal relationships:an evolutionary
Janssen PPM, Schaufeli WB. Burnout perspective on its importance for health
and engagement at work as a function of and well-being. European Review of Social
demands and control. Scand J Work Environ Psychology 1999;10:293–322.
Health 2001;27:279–86.
33. Koniarek J. Psychospołeczne uwarunko- 41. Sęk H. Wypalenie zawodowe. Przyczyny
wania częstości występowania i poziomu i zapobieganie [Job-related burnout. Causes
wypalenia się w populacji pielęgniarek and prevention]. Warszawa, Poland: PWN;
zatrudnionych w szpitalach w Łodzi 2004.

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