Process of burnout: structure, antecedents, and consequences

The major changes that have been witnessed in today's workplaces are challenging the mental well-being of employed people. Stress and burnout are considered to be modern epidemics, and their importance to physical health and work ability has been acknowledged world-wide. The aim of the thesis was to study the concept of burnout as a process proceeding from its antecedents, through the development of the syndrome, and to its outcomes. Several work-related factors considered antecedents of burnout were studied in different occupational groups. The syndrome of burnout is seen as consisting of three dimensions - exhaustion, cynicism and lack of professional efficacy - and different alternatives for the sequential development of these dimensions were tested. Furthermore, several indicators of the severely detrimental health and work ability outcomes of burnout were investigated in a longitudinal study design. The research questions were as follows. 1) Is burnout, as measured with the Maslach Burnout Inventory - General Survey (MBI-GS), a three-dimensional construct and how invariant is the factorial structure across occupations (Finnish) and national samples (Finnish, Swedish and Dutch)? How persistent is exhaustion over time? 2) What is the sequential process of burnout? Is it similar across occupations? How do work stressors relate to the process? 3) How does burnout relate to severe health consequences as well as temporary and chronic work disability according to hospitalization periods, sick-leave episodes and receiving disability pensions? The data were collected between 1986 and 2005. The population of the study consisted of respondents to a company-wide questionnaire survey carried out in 1996-1997 (N=9705, response rate 63%). The participants comprised 6025 blue-collar workers and 3680 white-collar workers. The majority were men (N=7494) and the average age was 43.7 years. In addition, a sample from the population had responded to a questionnaire survey in 1988, which was combined with the 1996 data to form panel data on 713 respondents. The register-based data were collected between 1986 and 2005 from 1) the company's occupational health services' records for a sample of respondents from the 1996 questionnaire survey (sick-leave data), 2) hospitalization records from the Hospital discharge register, and 3) disability pension records from the Finnish Centre for Pensions. These data were combined person by person with the 1996 questionnaire survey data with the help of personal identification numbers which were saved with the study numbers by the researchers. The results showed that burnout consists of three separate but correlating symptoms: exhaustion, cynicism and lack of professional efficacy. As a syndrome, burnout was strongly related to job stressors at work, and seemed to develop from exhaustion through cynicism to lack of professional efficacy in a similar manner among white-collar and blue-collar employees. The results also showed that exhaustion persisted even after eight years of follow-up but did not predict cynicism or lack of professional efficacy after that amount of time. Nor were job stressors longitudinally related to burnout. Longitudinal results were obtained for the severe health-related consequences of burnout. The investigated outcomes represented different phases of health deterioration ranging from sick-leaves and hospitalization periods to receiving work disability pensions. The results showed that burnout syndrome, and its elements of exhaustion and cynicism, were related to future mental and cardiovascular disorders as indicated by hospitalization periods. Burnout was also related to future sick-leave periods due to mental, cardiovascular and musculoskeletal disorders. Of the separate elements, exhaustion was related to the same three categories of disorder, cynicism to mental, musculoskeletal and digestive disorders, and lack of professional efficacy to mental and musculoskeletal disorders. Burnout also predicted receiving disability pensions due to mental and musculoskeletal disorders among initially healthy subjects. Exhaustion was related to receiving disability pensions even when self-reported chronic illness was taken into account. The results suggest that burnout is a multidimensional, chronic, work-related syndrome, which may have serious consequences for health and work ability.

Korkeakoulupolitiikan dynamiikat Suomessa

The study scrutinizes the dynamics of the Finnish higher education political system. Dynamics is understood as the regularity of interaction between actors. By actors is meant the central institutions in the system. The theoretical framework of the study draws on earlier research in political science and higher education political studies. The theoretical model for analysis is built on agenda-setting theories. The theoretical model separates two dimensions of dynamics, namely the political situation and political possibilities. A political situation can be either favourable or contradictory to change. If the institutional framework within the higher education system is not compatible with the external factors of the system, the political situation is contradictory to change. To change the situation into a favourable one, one needs either to change the institutional structure or wait for external factors to change. Then again, the political possibilities can be either settled or politicized. Politicization means that new possibilities for action are found. Settled possibilities refer to routine actions performed according to old practices. The research tasks based on the theoretical model are: 1. To empirically analyse the political situation and the possibilities from the actors point of view. 2. To theoretically construct and empirically test a model for analysis of dynamics in the Finnish higher education politics. The research material consists of 25 thematic interviews with key persons in the higher education political system in 2008. In addition, there are also documents from different actors since the 1980s and statistical data. The material is analysed in four phases. In the first phase the emphasis is on trying to understand the interviewees and actors points of view. In the second phase the different types of research material are related to each other. In the third phase the findings are related to the theoretical model, which is constructed over the course of the analysis. In the fourth phase the interpretation is tested. The research distinguishes three historical periods in the Finnish higher education system and focuses on the last one. This is the era of the complex system beginning in the 1980s 1990s. Based on the interviews, four policy threads are identified and analysed in their historical context. Each of the policy threads represents one of the four possible dynamics identified in the theoretical model. The research policy thread functions according to reform dynamics. A coalition of innovation politics is able to use the politicized possibilities due to the political situation created by the conception of the national innovation system. The regional policy thread is in a gridlock dynamics. The combination of a political system based on provincial representation, a regional higher education institutional framework and outside pressure to streamline the higher education structure created a contradictory political situation. Because of this situation, the politicized possibilities in the so-called "regional development plan" do not have much effect. In the international policy thread, a consensual change dynamics is found. Through changes in the institutional framework, the higher education political system is moulded into a favourable situation. However, the possibilities are settled: a pragmatic national gaze prevailed. A dynamics of friction is found in the governance policy thread. A political situation where political-strategic and budgetary decision-making are separated is not favourable for change. In addition, as governance policy functions according to settled possibilities, the situation seems unchangeable. There are five central findings. First, the dynamics are different depending on the policy thread under scrutiny. Second, the settled possibilities in a policy thread seemed to influence other threads the most. Third, dynamics are much related to changes external to the higher education political system, the changing positions of the actors in different policy threads and the unexpected nature of the dynamics. Fourth, it is fruitful to analyse the dynamics with the theoretical model. Fifth, but only hypothetically and thus left for further research, it seems that the Finnish higher education politics is reactive and weak at politicization.