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Burnout in nurse faculty: Relationships with management style, collegial support, and work load in collegiate programs
Burnout in Nurse Faculty: Relationships with Management Style, Collegial Support, and Work Load in Collegiate Programs MARGARET JORGENSEN D I C K , P H D , R N *
in this descriptive-correlational study, burnout among faculty in collegiate nursing programs and its relationships to management behavior of the dean, collegial support, and faculty work load was investigated. A mail survey was used with a stratified random cluster sample of full-time faculty from 28 schools. The findings Indicated that the Maslach Burnout inventory is a useful tool for measuring burnout in nurse faculty, that the scores of nurse faculty do exhibit a broad range of burnout with the mean scores being significantly lower but in the same range of moderate burnout as professionals in other human service organizations. Significant negative relationships (P < .001) were found between burnout and collegial support, participative management style, and positive feedback by the dean. Significant positive relationships (P < .001) were found between burnout and arbitrary punitive feedback by the dean. No significant relationships (P > .3) were found between burnout and total timecommltment or the extent of curriculum revision. Multiple regression indicated that while both are significant, collegial support is a stronger predictor of burnout than management style. These findings indicate that collegial support, positive feedback from the dean, and a participatory management Style are more important for protecting faculty members from burnout than attention to the work load. (Index words: Education, nursing, faculty issues, burnout) J Prof Nuts 2:252-260, 1986.
HE PURPOSEof this study was to investigate the level of burnout in faculty in collegiate schools of nursing and its relationship to selected organizational variables in these schools. Nurse faculty have been presumed to experience high levels of burnout resulting from their extensive contact with students in frequently tense situations, the conflicting demands of academia, and the historically authoritarian structure within schools of nursing. However, the occurrence of burnout among nurse faculty has not been empirically assessed. Burnout is a job-related condition occurring in inclividuals who have previously functioned at an adequate level. I It is a syndrome with three dimensions. Exhaustion is depletion of emotional or psy-
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* College of Nursing, Clemson University. Address correspondence and reprint requests to Dr. Dick: College of Nursing, Cremson University, Clemson, SC 29631. 252
chological reserves with loss of interest, loss of trust, and general fatigue unrelieved by rest. A negative shift in attitudes toward others is characterized by a gradual withdrawal from and blaming of clients, work, and co-workers. A negative attitude toward oneself includes loss of sense of personal accomplishment, with feelings of failure and inability to cope. ~ Burnout and the Organization
Selye described the General Adaptation Syndrome as a three-part reaction to stressors which all human beings undergo.~ Within this framework, the individual's adaptation energy is finite. Despite rest and recuperation after episodes of exhaustion the energy level does not return to normal. Burnout is an instance of the "stage of exhaustion" where, due to prolonged or excessive amounts of exposure to stressots within the job setting, the individual is unable to adapt and altered physio-psychological states occur. While stressors may occur outside of the job setting as well, burnout is job-related. Burnout is a response to prolonged emotional stress in which the individual expresses emotional and/or physical exhaustion, decreased productivity, and excessive depersonalization. Two major research emphases have developed in describing and accounting for burnout. The first, with a psychiatric emphasis, has been to identify those factors within individuals that make them susceptible to burnout. Factors that have been identified are excessiveidealism, overcommitment, and inability to compromise. 4.~ The second emphasis has been to identify factors in the job setting or organization that are related to the development of burnout. Within this emphasis burnout is seen as the end product of unrelieved stress in the work setting. This stress occurs when there is a discrepancy between the individual's needs and what the environment offers. The works of Maslow and Alderfer, on needs basic to all humans, point out that when basic needs for existence are met higher
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order n6eds for belonging, esteem, and growth become important. If the environment does not support or interferes with meeting these needs, stress will occur. 6,7 Stress will be worsened when individuals perceive themselves to be unable to exert control in reducing the discrepancy, s According to Likert, an organizational climate that is high in supportiveness, communication, and participation will foster achievement of needs for belonging, trust, and accomplishment, as well as contribute to perception of one's ability to control or influence the situation.9 There is no published research dealing with burnout and components of the organization in schools of nursing. There is, however, research with other professional groups which identifies three important components of the organization as correlates of burnout. Maslach and Pines in several different settings have identified positive feedback from supervisors, a sense of control, and excessivework load that returns little satisfaction as most important in the occurrence of burnout. 2.~°-~2For the'purposes of this study in academic settings, these factors included management style, collegial support, and work load. Management style has multiple components, but research has indicated that the most important aspects are the extent to which individuals perceive they participate in decisions, and the type of feedback received. According to Likert, management style ranges on a continuum from very authoritative to participatory. Authoritarian management is characterized by attempts at tight control, downward communication, and decision-making centered at top management levels. Participatory management includes multidirectional communication and trust, and participation in decision making, in goal setting, and in evaluation.9 Armstrong, working with personnel in child abuse treatment centers, found an increase in burnout to be related to centralization of decision making, nonsupportive leadership, poor communication, and formalized enforcement of rules. ~3 Similar results were found in studies of nurses and air traffic controllers. ''.~4 In addition to general management style, research has shown that the type of feedback given by managers is an important modifier of burnout. Several studies with nurses, social workers, social service managers, and teachers found that burnout was related to absence of immediate and behavior-related feedback. 4.~' In these studies lack of feedback was interpreted, by subjects, as unresponsiveness and a negation of one's efforts.'Positive feedback served to confirm the sense of competency and thus self-
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esteem. Negative feedback was seen as helpful if given in a sensitive and constructive manner; it helped to identify weaknesses and ways of correcting them. Those who received consistent feedback had a clear sense of job priorities and evaluation criteria, which was related to a sense of control. Management feedback that is arbitrary and punitive also gives feedback to the subordinate; however, it is unrelated to specific efforts, behaviors, or work of subordinates. It is autocratic in nature, designed to ensure conformity rather than provide coaching, guidance, and support. 1~ Chemiss reported that those who developed burnout identified their supervisors as supercritical, overbearing, or always ready to jump on mistakes. 4 When feedback focuses on failures or problems without recognition of positive efforts there is interference with the ability to identify and judge successes. As clarity of expectations, coupled with a sense of participation in decisions, helps to meet needs for esteem and accomplishment, support from one's colleagues has also been found to be related to lower levels of burnout. 4.1~.~6In studies with professionals in nursing, social service, teaching, and government administration, subjects who found support from their co-workers maintained more positive feelings toward clients, work, co-workers, and their own accomplishments. 4.H.~7 The support described consisted of help to work through technical and client problems, positive feedback, and ability to share stresses and joys. Collegial support refers to the character of interaction between faculty members based upon understanding, trust, and openness of communication. Ideally, collegial interaction provides a reference group for measurement of achievement and improvement, for validation of concerns and actions, for support against organizational pressures, and for a sense of control over professional behaviors. .8 When collegial support is present it provides for needs to belong to a group and esteem among one's peers. 4.'6 In addition to management style and collegial support excessivework load has been shown to be related to burnout. This relationship has been identified in other settings such as social service agencies and intensive care units. 2.''-'3 In these studies, burnout was higher when there was extensive, unrelieved contact with multiproblem clients. However, individuals whose jobs included some activities without this intense contact did not suffer burnout at the same rate. Faculty, with a variety of responsibilities within their work loads, might be expected to have a lower
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level of burnout than other human service professionals. At the same time, nurse faculty are generally under heavy pressures to establish themselves within higher education. The response to these pressures has been to increase the work load of the faculty in response to each new demand. The result is large numbers of contact hours with students, timeconsuming team teaching, long preparation hours with hospital staff and patients, and requirements to keep up their own clinical skills. 19.2°Within these increasing expectations is a focus on curriculum development, an activity which may be little valued by academia as a whole. 21 High work loads, and efforts which do not receive anticipated recognition, were expected to be related to burnout in nurse faculty. This greatly simplified model of the relationship between organizational components and burnout includes only management style of the dean, collegial support, and work load. It does not include other facets of the work environment or the environment outside of the work setting, or various coping skills of the individual which may influence the appearance of burnout. (It is assumed that these exist in the population, but they are not included here.)
Hypotheses The following.hypothetical statements were tested, using a descriptive correlational design with a mail out survey. 1. Nurse faculty have a level of burnout comparable to professionals in other human service settings. 2. Participatory management style is negatively related to faculty burnout. 3. Behavior contingent approval is negatively related to faculty burnout. 4. Arbitrary punitive behavior is positively related to faculty burnout. 5. Collegial support among faculty is negatively related to burnout. 6. Faculty work load is positively related to faculty burnout. 7. Management behaviors and collegial support are better predictors of faculty burnout than components of-the faculty work load.
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Method SUBJECTS
The sample was limited to faculty at National League for Nursing (NLN)-accredited schools which offer baccalaureate or both baccalaureate and graduate degrees. Schools which accepted only RNs, those also offering the ADN, and those with acting deans were eliminated from the sample pool. Thirty BSN schools and 24 BSN and graduate program schools were randomly selected. Deans at the selected schools were sent an explanatory letter and asked to provide the names, academic ranks, and business addresses of their full-time faculty. Usable lists were received from 16 BSN programs and 12 BSN and higher degree programs. The following faculty were eliminated from the 28 lists: those who held administrative positions such as assistant dean; those on part-time or leave of absence; those who were located at satellite campuses; those with adjunct status; and those who held joint appointments in other schools. After these eliminations, explanatory letters and the questionnaire were sent to all 600 faculty. Assurance of confidentiality and protection of rights were included in the explanatory letter. Sixty-eight per cent (405) of the faculty returned the questionnaires. Of the 405 responses, 374 (62.3 per cent of the total sample) were usable. Thirtyone responses were not usable because they were from faculty who were part-time, on leave, nonnurses, or greater than 50 per cent of their time was involved in administrative duties. This information was determined from the demographic data. Ninety-seven per cent of the faculty were female. They ranged in age from 26 to 66 (mean 42.9) and had one to 43 years' teaching experience (mean 6.8) at one to six different schools (mean 2.3). All four academic ranks were represented: 19 per cent instructors, 43 per cent assistant professors, 23 per cent associate professors, and 8 per cent professors. Thirtyseven per cent were tenured. The highest degree held was the master's by 68.2 per cent of the sample and the doctorate by 31 per cent. INSTRUMENTATION
Burnout was measured using the Maslach Burnout Inventory (MBI). The MBI consists of scores on three subscales. 22.23 Emotional Exhaustion contains nine items which relate to "feeling emotionally drained,
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used up, and at the end of my rope." Depersonalization is a five-item subscale which describes attitudes toward others, such as "I've become more callous, I treat some people as impersonal objects, and students blame me for their problems." Personal Accomplishment is an eight-item subscale which describes feelings of success in dealing with the job and students, such as "I deal effectively with problems, and I'm positively influencing others through my work" Burnout is reflected by high scores on Emotional Exhaustion and Depersonalization and low scores on Personal Accomplishment. Each subscale was considered individually rather than using a composite score. Reliability and validity studies are available for this instrument. 23.24 Two modifications were made. The first modification was to use only the intensity scale. Subjects were asked to respond on a seven-point scale to the question: To what degree is each of the statements like or unlike you. The second modification was to replace the word "recipient" with "students;' reducing the chances for confusion. Management style of the dean was measured with a 12-item tool adapted by Lasher from Likert's Profile of Organizational Characteristics. z~ Individual items deal with decision making, communication, support, and trust. The scale is designed to give a composite measure of management style on the continuum from authoritarian to participatory. The higher the score for the total scale, the more the style is perceived to be participatory. Positive feedback from dean to faculty member was measured with the four-item Behavior Contingent Approval scale developed by House and reported by Fulk and Wendler. 1~ It includes such items as "gives clear recognition for outstanding work" As a contrast the use of arbitrary and punitive behavior by deans was assessed. This was measured with an eight-item scale derived from the Supervisory Behavior Description Questionnaire. 1~ The items describe the extent to which the dean "rules with an iron hand, criticizes faculty in front of others, or insists that everything be done her/his way." Collegial support was assessed with a shortened version of the Survey of Collegial Communication36 This 40-item scale assessed the extent of positive interaction among faculty members including communication, trust, freedom from threat, mutual support, friendliness, and encouragement. Nurse faculty in Beyer's study ranked the items in each category for importance. The two most important items in
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TABLE 1.
Instrument Reliabilities
Scale
Cronbach Alpha
Masfach Burnout Inventory Emotional Exhaustion Depersonalization Personal Accomplishment Collegial Support Management Style Arbitrary Punitive Behavior Contingent Approval
.71274 ,86335 .66471 .65819 .95404 .89868 .91207 .93888
each category were used, resulting in a 16-item composite measure of collegial support. Cronbach alphas were computed for each of the preceding instruments (Table 1). Faculty work load was measured in two ways. Time commitment was measured by asking faculty to indicate the average number of hours per week spent in clinical supervision, classroom teaching, course preparation, committee work, research and writing, counseling or conferencing, service to the profession, and administrative duties. The second measure of faculty work load was the extent of curriculum revisions. Faculty were asked to indicate which level of revision was currently underway in their school: no revisions, minor revision in individual courses, moderate revisions with restructuring within the current framework, or major revisions involving changing philosophy, framework, and courses. Results
The Maslach Burnout Inventory has been used with groups of human service workers, nurses in clinical areas, and teachers. However, it has not been used with nurse faculty. To test its usefulness with nurse faculty a factor analysis of the MBI was done with principal factoring and varimax rotation37 Three factors accounting for 87 per cent of the variance were identified. Nineteen of the 22 items loaded in the manner identified by Maslach and Jackson3~ The discrepancy of these three loadings did not warrant efforts to revise the MBI from the subscale structure developed by Maslach and Jackson. All subsequent analyses were done with this original subscale structure. Scores from nurse faculty ranged from very low to very high on all three subscales, with the means (see Table 2) indicating moderate Emotional Exhaustion and Depersonalization and high Personal Accomplishment. To test the first hypothesis, burnout scores of nurse
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Comparison of MBI Subscale Scores of Nurse Faculty and Mixed Group of Social Service Workers with Graduate Education
MBI Subscales
Mean
Standard Deviation
Critical Ratio
Emotional Exhaustion Nurse Faculty (n = 359) Social Service (n = 709)
27.41 32,51
10.55 13.02
6,88* *
Depersonalization Nurse Faculty (n = 363) Social Service (n = 709)
9.93 10.89
4.55 8.03
2.49*
Personal Accomplishment Nurse Faculty ( n = 3 6 3 ) Social Service (n = 709)
43.34 40.44
6.15 7.24
6.83**
* P < .05. * * P < .001.
faculty were compared with the scores reported by Maslach and Jackson of 709 human service professionals with graduate education.23 The differences between the means of these two groupings were tested for each of the subscales of the MBI, using the Critical Ratio for "large samples from different populations. Table 2 indicates that, there were significant differences between nurse faculty and the human service professionals with graduate degrees. Nurse faculty reported a lower level of Emotional Exhaustion and Depersonalization of recipients (students), and a higher sense of Personal Accomplishment. This may be supportive of studies by Maslach 1° and Cherniss,4 where professionals who were able to vary their work loads and within their responsibilities obtain relief from continual, intense contact with clients were less likely to display evidence of burnout. The nurse faculty work loads were composed of many components, several of which did not involve direct contact with students. In this sample approximately half of a faculty member's time was spent in activities without direct student contact. Hypotheses Two through Six were tested using Pearson's correlations with the three components of burnout considered separately. The Personal Accomplishment subscale was considered in the opposite direction of Emotional Exhaustion and Depersonalization, for it is a decreased sense of personal accomplishment which is a component of burnout. The hypothesized direction of correlations and the results of analyses for Hypotheses Two through Six are presented in Table 3. Hypothesis Two said that the management style of a dean would be negatively related to burnout. The management style of nursing deans was seen by faculty to vary from completely authoritarian to
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very participatory, with a mean of 2.61 on a fourpoint scale. The hypothesis was supported. As participatory style was more common, Emotional Exhaustion and Depersonalization scores decreased and Personal Accomplishment scores increased (Table 3). While relatively low, these correlations were significant and in the predicted direction. These data were consistent with findings from nurses, 11 from airtraffic controllers,14 and from child abuse workers.l~ Each of these studies found that burnout was lower or less severe in those agencies where management practices were more open to communication, participation, and trusc Behavior contingent approval is positive feedback from the dean to faculty members related to their efforts and/or performance. Examination of frequency data indicated that 34 per cent of the faculty saw their deans as never or rarely giving this type of positive feedback. Hypothesis Three that behavior contingent approval is negatively related to burnout was supported (Table 3). These correlations were smaller than the ones between burnout and management style. However, like the previous correlations they were significant and in the direction predicted. These findings were consistent with studies done with other professional groups in other organizational settings.4.~.13 T A B L E 3.
Summary Table of Relationships Between MBI Subscales and Management Behavior, Collegial Support, and Work Load Predicted Direction
Variable
Pearson R
Emotional Exhaustion with: Management Style Behavior Contingent Approval Arbitrary Punitive Collegial Support Total Time Curdcutum Revision
- .364" * -.285** .310" * - .410" * .033ns .044ns
(-) (-) (+ ((+ (+
Depersonalization with: Management Style Behavior Contingent Approval Arbitrary Punitive Collegial Support TotaT Time Curriculum Revision
- .292" * -.257"" .215" * - .261 * * - .047ns ,042ns
(- ) (-) (+ ) (- ) (+ ) (+)
Personal Accomplishment with: Management Style Behavior Contingent Approval Arbitrary Punitive Collegial Support Total Time Curriculum Revision
,205 * * .159" * - . 117" .210* * .047ns .031ns
(+ ) (+ ) (- ) (+ ) (?) (?)
" P < .05. * * P < .01.
ns, not significant.
) ) ) )
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As a contrast the use of arbitrary and punitive behavior by deans was assessed. This is negative feedback by the dean which is usually unrelated to specific behavior of the faculty member but is aimed at punishment and producing conformity. Sixty-one per cent of the faculty scores indicated that this behavior pattern occurred rarely to never. Hypothesis Four, that burnout is positively related to arbitrary punitive behavior, was supported (see Table 3). Scores on Emotional Exhaustion and Depersonalization were significantly higher when arbitrary punitive behavior was more common. To a lesser extent a decrease in sense of Personal Accomplishment was correlated with increasing prevalence of arbitrary punitive behavior. These findings were supportive of those from Cherniss. 4 Thus, each of the management behaviors studied was found to be related to burnout. Hypothesis Five said collegial support would be related to lower levels of burnout. Collegial support included open communication, sense of trust and freedom from threat, mutual support, and friendliness. Data indicated that 23 per cent of the faculty perceived support as occurring less than to some extent, while 28 per cent viewed support as occurring to a great or very great extent. Hypothesis Five, that there would be a negative relationship between burnout and collegial support, was supported (see Table 3). Emotional Exhaustion and Depersonalization were significantly lower when faculty collegial support was perceived to be high. Personal Accomplishment scores increased with increases in perceived collegial support. Findings were consistent with studies of other human service professionalsA -.2 Hypothesis Six said that work load is positively related to burnout. Table 3 indicates that unexpected results occurred. Two measures of work load were considered. The first was the total time spent in eight components of the faculty work load. Total time in these eight areas ranged from 11 to 78 hours, with a mean of 42 hours per week. The correlations between total work load and burnout were so low as to be nonsignificant. Other researchers found that opportunities to draw back from clients and focus on other acceptable activities within the job were related to decreased burnout. 4.a2.22 It is possible that the variety within the nurse faculty work load may be more important than total time involvement. There was some support for this idea. One component of the work load involving intense work with ~tudents and frequently difficult situations is the time spent in clinical super-
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vision. The Pearson's correlation between clinical supervision was significantly correlated with Emotional Exhaustion (r -- .i86, P < .01) and Personal Accomplishment (r = -.122, P < .05). While quite small, these correlations indicated that burnout tended to increase as the extent of clinical supervision increased. Although weak, these findings may support the importance of breaks from intense work with clients. 2.1L~2 Curriculum revision is usually considered an ongoing process which is part of the faculty work load. Ninety-four per cent of the faculty were involved in some form of curriculum revision. Thkty-one per cent of these faculty described their school as engaged in major curriculum changes involving philosophy, conceptual framework, and courses. It was hypothesized that extent of curriculum revision would be positively related to burnout. This hypothesis was not supported. The last hypothesis was that management behavior and collegial support are better predictors of faculty burnout than components of the faculty work load. The previously described correlations indicated that this would probably be supported. Multiple regression analysis was used to assess the significance of the differences between these correlations. Due to multicollinearity, the three components of management behavior were combined into a new variable called "Dean's Style" using the formula: Deans' style = (behavior contingent approval minus arbitrary punitive behavior) plus management style. This gives a measure of the extent to which management behavior is positive, open, and supportive. With Emotional Exhaustion collegial support was the major predictor (beta -.322) and the combined dean's style was also a significant predictor (beta -.184). Similar results were found with Depersonalization and Personal Accomplishment. Multiple correlation coefficients were computed for the combination of collegial support and management behavior variables, and a separate multiple correlation coefficient was computed fora combination of work load variables. The difference between correlation coefficients was then tested for statistical significance, using an expansion of Fisher's R to Z transformation and the Z test (Table 4). 27 With Emotional Exhaustion, collegial support and management behaviors accounted for 21 per cent of the variance, while work load factors accounted for 3 per cent. This difference was statistically significant. A similar significant difference in the two variable sets was found in the ability to predict De-
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T A B L E 4.
Comparative Regression Analyses of MBI 3ubscales on Management, Collegial, and Workload Variables
Variables
n
R
Rz
Emotional Exhaustion Collegial & Management Workload
312 357
.456 .228
.208 .052
3.33"*
DepersonaTization Collegial & Management Workload
312 357
.323 .122
.105 .015
4.26**
Personal Accomplishment Collegial & Management Workload
312 357
.217 .165
.046 .027
1.02ns
* * P <
Z
.01.
ns, not significant.
personalization scores. Collegial support and management behavior accounted for 11 per cent and work load accounted for I per cent of the variance. In predicting Personal Accomplishment there was no significant difference between the two variable composites. Neither the collegial support-management behavior grouping nor the work load variables accounted for more than .~per cent of the total variance in Personal Accomplishment scores. This would indicate that variables affecting the sense of personal accomplishment may be outside the focus of this study. The overall results of these analyses supported the hypothesis. Collegial support and management behavior were better predictors of burnout than work load components, This was consistent with the findings of Maslach, Cherniss, Pines, and Armstrong. Conclusions and Recommendations
The data support the earlier assumptions that burnout occurs among nurse faculty. Using measures of central tendency, burnout seems to be significantly lower than among other human service workers in direct client care settings. A possible explanation for this may be in the varied nature of collegiate teaching. This possibility should be further explored. That work load was unrelated to burnout was unexpected. The variety of experiences which comprise teaching responsibilities may explain this lack of relationship as well as the overall lower level of burnout among faculty. Previous studies indicated that balance in work load is more important than total number of hours.4.12Nurse faculty, while involved for long hours, spent approximately half of their time in contact with students. This information, coupled with the small relationship between clinical supervision and burnout, supports the conclusions of other re-
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searchers. These studies indicated that continuous contact in intense interpersonal relationships was a more important factor in burnout than number of hours worked or caseloads. 4.12.22Further study should include an assessment of differences between expected and actual time commitment. Curriculum revision was also unexpectedly unrelated to burnout. It is possible that curriculum revision by creating change provides a sense of growth. It is possible that curriculum revision is considered a valued activity within colleges of nursing and thus is rewarding. Further study should include the impetus behind the revision and the value placed on the revision process by the individual, the faculty group, the dean, and other groups within each university. In contrast to these work load variables, management behaviors of the dean were significantly related to burnout. As management style increasingly moves toward the participative end of the continuum burnout decreases. The faculty member's sense of control in the work setting may increase, contributing to satisfaction of needs for esteem and self-actualization. This does not necessarily mean that faculty members need, or desire, to participate in every decision. Rather, as Lasher found in several professional schools, 2~ the sense of opportunity to have a voice in decisions, when desired, is more important than actual participation in all decisions. It is important to remember that participative management includes open communication, trust in abilities of subordinates, and awareness of goals, problems, and needs at all levels. According to Likert, movement toward participative management cannot be made by simply throwing all decisions to a majority vote.9 In a similar manner, faculty who saw their deans as generally responding with positive recognition for specific performance had significantly lower burnout scores; faculty who saw their deans as arbitrary and punitive had significantly higher burnout. While these correlations were low and cannot be thought of as causal they do indicate that positive feedback based on the individual's performance may help to reduce burnout. This positive feedback serves the purposes of acknowledging the efforts of subordinates, and of allowing the individual to identify expectations and progress. Punitive feedback that focuses on failures or deviations from the rules interferes with the ability to identify and judge success. These findings are consistent with earlier research in a variety of settings. 2-4.1°.".~3.~7That the relationships between burnout and these measures of management behavior are low does not negate the im-
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portance of their direction, and the implications for management in schools of nursing. Data indicated that of the variables in this study the lack of collegial support was most important in the occurrence of burnout. Collegial support is the sense of positive interactions between faculty members: Its presence may contribute to meeting multiple needs of trust, belonging, and esteem. While the correlations between burnout and collegial support are low to moderate they are consistent with studies of social workers, teachers, nurses in clinical practice, and others in the h u m a n service area.'.4.1,. 16 The consistency with which collegial support has been shown to relate to decreased burnout appears to be deserving of greater acceptance and attention than the strength of correlations in this one study would indicate. Further study, perhaps comparing faculty in various disciplines within the same university, may provide further support for the importance of positive collegial interactions. Use of the full Survey of Collegial Communication would allow identification of specific aspects of collegial support which may relate to burnout. Results of this study indicated clear relationships between lower levels of burnout and positive managem e n t behaviors and positive collegial support. In addition there was an indication of the relative importance of these two variables. The beta weights for collegial support and a combined management behavior style were both significant, indicating that each variable contributed significantly to the prediction of burnout. However, the beta weights also indicated that collegial support was nearly twice as important as management behavior in the prediction of burnout. It is possible that collegial support is more immediately important to faculty due to its proximity. Faculty work daily with other faculty, but may interact more rarely with the dean. However, it also seems reasonable that the management behavior of the dean sets the tone for collegial support and thereby.would have a greater relationship to burnout than found in this study. Further research to better identify the nature of these relationships would be helpful. Recommendations for practice are tentative due to the correlational nature of the study. For faculty groups and individuals, efforts may be made to assess the extent to which they provide support and encouragement to each other. If these assessments indicate that collegia[ support is low then work as a group, with an uninvolved facilitator, may be help-
ful to identify and discuss the expectations that members have of each other and to identify specific areas where these expectations are either not met or are unrealistic. Deans may evaluate their interactions with faculty to identify the pattern of feedback which they use and make efforts to increase the use of positive behavior-related feedback. As with the faculty, deans may need some help with this assessment from someone less directly involved in the relationships. I also recommend that the investigation of burnout be broadened to include management style within the university as a whole. The stresses of enrollment, of funding problems, and the acceptance of nurse faculty by their colleagues in other disciplines and in the clinical area merit consideration. It will also be useful to investigate the relationship between burnout and such outcome variables as teaching effectiveness, research productivity, and turnover. In addition it would be helpful to include personal expectations and coping styles in further research. While the total variance accounted for in this study of faculty burnout was comparatively small, the nature of the relationships identified are important. It appears that burnout does occur among faculty, and that its occurrence is related to collegial support and management behaviors in a manner similar to other professional settings. This consistency across professional groups and settings contributes to an understanding of burnout. Further research would be helpful in order to make more specific recommendations for practice.
References
1. BrillPL: The need for an operational definition of burnout. Fam Commun Health 6(4):12-24, 1984 2. MaslachC: Understanding burnout: definitional issues in analyzing a complex phenomenon, in Paine WS (Ed): Job Stressand Burnout: Research,Theory,and Intervention Perspectives. Beverly Hills, California, Sage, 1982 3. SelyeH: The Stress of Life. New York, McGraw-Hill, 1976 4. ChemissC: ProfessionalBurnout in Human ServiceOrganizations. New York, Praeger, 1980 5. Freudenberger HJ, Richelson G: Burnout: The High Cost of High Achievement. Garden City, New York, Anchor Press.' 1980 6. MaslowAH: Motivation and Personality,2d ed. New York, Harper & Row, 1970 7. Alderfer CP: Existence,Relatedness,and Growth: Human Needs in Organizational Settings. New York, Free Press, 1972 8. Zaleznick A, Kets de Vries M, HowardJ: Stress reactions in organizations: syndromes, causes, and consequences. Behav Sci 22:151-162, 1977
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9. Liker't R: The Human Organization: Its Management and Value. New York, McGraw-Hill, 1967 10. Maslach C: Burned-out. Hum Behav 5(9):16-22, 1976 11. Pines AM, Kanner AD: Nurse burnout: lack of positive conditions and presence of negative conditions as two independent sources of stress, in McConnell EA (Ed): Burnout in the Nursing Profession: Coping Strategies, Causes, and Costs. St. Louis, C.V. Mosby, 1982 12. P~es AM, Maslach C: Characteristics of staff burnout in mental health settings. Hosp Commun Psychiatry 20:233-239, 1978 13. Armstrong KL: How can we avoid burnout: a study of the relationship between burnout and worker, organizational and management characteristics in eleven child abuse and neglect projects. Child Abuse Negl 3:145-149, 1979 14. Bowers DG: What would make 11,500 people quit their jobs? Organ Dyn 11(3):5-19, 1983 15. FulkJ, WendlerER: Dimensionalityofleader-subordinate interactions: a path-goal investigation. Organ Behav Human Perf 30:241-264, 1982 16. Cronin-Stubbs D, Rooks CA: The stress, social support, and burnout of critical care nurses: the results of research. Heart Lung 14(1)31-39, 1985 17. Pines A: Changing organizations: is a work environment without burnout an impossible goal? in Paine WS (Ed): Job Stress and Burnout: Research Theory and Intervention Perspectives. BeverlyHills, California, Sage, 1982 18. Pelz DC, Anderson FM: Scientists in Organizations. Ann
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Arbor, University of Michigan, 1976 19. Bauder L: Discontent and crises at schools of nursing: the consequences of unmet human needs. WestJ Nuts Res 4:35-48, 1982 20. Solomons HC, Jordison NS, Powell SR: How faculty members spend their time. Nuts Outl 28:160-165, 1980 21. BarleyJA, Redman BK. Faculty role development in university schools of nursing. J Nurs Admin 9(5):43-47, 1979 22. Maslach C, Jackson SE: The measurement of experienced burnout. J Occup Behav'2:99-114, 1981 23. Maslach C, Jackson SE: Maslach Burnout Inventory: Research Edition Manual. Palo Alto, California, Consulting Psychologists Press, 1981 24. Iwanicki E, Schwab R: A cross validation study of the Maslach Burnout Inventory. Educ Psych Meas 41:1167-1174, 1981 25. Lasher WF: Academic governance in university professional schools. Doctoral dissertation (University of Michigan, 1975). Dissert Abstr Int 35:4194A, 1975 26. Beyer JE: Interpersonal Communication as Perceived by Nurse Educators in Collegial Interactions. Doctoral dissertation (University of Texas, 1979). Dissert Abstr Int 40:2608, 1979 27. Dick MJ: Nurse Faculty Burnout: Relationship to Collegial Support, Management Behavior, and Workload in Collegiate Schools of Nursing. Doctoral dissertation (University of Texas, 1984). Dissert Abstr Int 45:2100B, 1985
in this descriptive-correlational study, burnout among faculty in collegiate nursing programs and its relationships to management behavior of the dean, collegial support, and faculty work load was investigated. A mail survey was used with a stratified random cluster sample of full-time faculty from 28 schools. The findings Indicated that the Maslach Burnout inventory is a useful tool for measuring burnout in nurse faculty, that the scores of nurse faculty do exhibit a broad range of burnout with the mean scores being significantly lower but in the same range of moderate burnout as professionals in other human service organizations. Significant negative relationships (P < .001) were found between burnout and collegial support, participative management style, and positive feedback by the dean. Significant positive relationships (P < .001) were found between burnout and arbitrary punitive feedback by the dean. No significant relationships (P > .3) were found between burnout and total timecommltment or the extent of curriculum revision. Multiple regression indicated that while both are significant, collegial support is a stronger predictor of burnout than management style. These findings indicate that collegial support, positive feedback from the dean, and a participatory management Style are more important for protecting faculty members from burnout than attention to the work load. (Index words: Education, nursing, faculty issues, burnout) J Prof Nuts 2:252-260, 1986.
HE PURPOSEof this study was to investigate the level of burnout in faculty in collegiate schools of nursing and its relationship to selected organizational variables in these schools. Nurse faculty have been presumed to experience high levels of burnout resulting from their extensive contact with students in frequently tense situations, the conflicting demands of academia, and the historically authoritarian structure within schools of nursing. However, the occurrence of burnout among nurse faculty has not been empirically assessed. Burnout is a job-related condition occurring in inclividuals who have previously functioned at an adequate level. I It is a syndrome with three dimensions. Exhaustion is depletion of emotional or psy-
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* College of Nursing, Clemson University. Address correspondence and reprint requests to Dr. Dick: College of Nursing, Cremson University, Clemson, SC 29631. 252
chological reserves with loss of interest, loss of trust, and general fatigue unrelieved by rest. A negative shift in attitudes toward others is characterized by a gradual withdrawal from and blaming of clients, work, and co-workers. A negative attitude toward oneself includes loss of sense of personal accomplishment, with feelings of failure and inability to cope. ~ Burnout and the Organization
Selye described the General Adaptation Syndrome as a three-part reaction to stressors which all human beings undergo.~ Within this framework, the individual's adaptation energy is finite. Despite rest and recuperation after episodes of exhaustion the energy level does not return to normal. Burnout is an instance of the "stage of exhaustion" where, due to prolonged or excessive amounts of exposure to stressots within the job setting, the individual is unable to adapt and altered physio-psychological states occur. While stressors may occur outside of the job setting as well, burnout is job-related. Burnout is a response to prolonged emotional stress in which the individual expresses emotional and/or physical exhaustion, decreased productivity, and excessive depersonalization. Two major research emphases have developed in describing and accounting for burnout. The first, with a psychiatric emphasis, has been to identify those factors within individuals that make them susceptible to burnout. Factors that have been identified are excessiveidealism, overcommitment, and inability to compromise. 4.~ The second emphasis has been to identify factors in the job setting or organization that are related to the development of burnout. Within this emphasis burnout is seen as the end product of unrelieved stress in the work setting. This stress occurs when there is a discrepancy between the individual's needs and what the environment offers. The works of Maslow and Alderfer, on needs basic to all humans, point out that when basic needs for existence are met higher
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order n6eds for belonging, esteem, and growth become important. If the environment does not support or interferes with meeting these needs, stress will occur. 6,7 Stress will be worsened when individuals perceive themselves to be unable to exert control in reducing the discrepancy, s According to Likert, an organizational climate that is high in supportiveness, communication, and participation will foster achievement of needs for belonging, trust, and accomplishment, as well as contribute to perception of one's ability to control or influence the situation.9 There is no published research dealing with burnout and components of the organization in schools of nursing. There is, however, research with other professional groups which identifies three important components of the organization as correlates of burnout. Maslach and Pines in several different settings have identified positive feedback from supervisors, a sense of control, and excessivework load that returns little satisfaction as most important in the occurrence of burnout. 2.~°-~2For the'purposes of this study in academic settings, these factors included management style, collegial support, and work load. Management style has multiple components, but research has indicated that the most important aspects are the extent to which individuals perceive they participate in decisions, and the type of feedback received. According to Likert, management style ranges on a continuum from very authoritative to participatory. Authoritarian management is characterized by attempts at tight control, downward communication, and decision-making centered at top management levels. Participatory management includes multidirectional communication and trust, and participation in decision making, in goal setting, and in evaluation.9 Armstrong, working with personnel in child abuse treatment centers, found an increase in burnout to be related to centralization of decision making, nonsupportive leadership, poor communication, and formalized enforcement of rules. ~3 Similar results were found in studies of nurses and air traffic controllers. ''.~4 In addition to general management style, research has shown that the type of feedback given by managers is an important modifier of burnout. Several studies with nurses, social workers, social service managers, and teachers found that burnout was related to absence of immediate and behavior-related feedback. 4.~' In these studies lack of feedback was interpreted, by subjects, as unresponsiveness and a negation of one's efforts.'Positive feedback served to confirm the sense of competency and thus self-
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esteem. Negative feedback was seen as helpful if given in a sensitive and constructive manner; it helped to identify weaknesses and ways of correcting them. Those who received consistent feedback had a clear sense of job priorities and evaluation criteria, which was related to a sense of control. Management feedback that is arbitrary and punitive also gives feedback to the subordinate; however, it is unrelated to specific efforts, behaviors, or work of subordinates. It is autocratic in nature, designed to ensure conformity rather than provide coaching, guidance, and support. 1~ Chemiss reported that those who developed burnout identified their supervisors as supercritical, overbearing, or always ready to jump on mistakes. 4 When feedback focuses on failures or problems without recognition of positive efforts there is interference with the ability to identify and judge successes. As clarity of expectations, coupled with a sense of participation in decisions, helps to meet needs for esteem and accomplishment, support from one's colleagues has also been found to be related to lower levels of burnout. 4.1~.~6In studies with professionals in nursing, social service, teaching, and government administration, subjects who found support from their co-workers maintained more positive feelings toward clients, work, co-workers, and their own accomplishments. 4.H.~7 The support described consisted of help to work through technical and client problems, positive feedback, and ability to share stresses and joys. Collegial support refers to the character of interaction between faculty members based upon understanding, trust, and openness of communication. Ideally, collegial interaction provides a reference group for measurement of achievement and improvement, for validation of concerns and actions, for support against organizational pressures, and for a sense of control over professional behaviors. .8 When collegial support is present it provides for needs to belong to a group and esteem among one's peers. 4.'6 In addition to management style and collegial support excessivework load has been shown to be related to burnout. This relationship has been identified in other settings such as social service agencies and intensive care units. 2.''-'3 In these studies, burnout was higher when there was extensive, unrelieved contact with multiproblem clients. However, individuals whose jobs included some activities without this intense contact did not suffer burnout at the same rate. Faculty, with a variety of responsibilities within their work loads, might be expected to have a lower
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level of burnout than other human service professionals. At the same time, nurse faculty are generally under heavy pressures to establish themselves within higher education. The response to these pressures has been to increase the work load of the faculty in response to each new demand. The result is large numbers of contact hours with students, timeconsuming team teaching, long preparation hours with hospital staff and patients, and requirements to keep up their own clinical skills. 19.2°Within these increasing expectations is a focus on curriculum development, an activity which may be little valued by academia as a whole. 21 High work loads, and efforts which do not receive anticipated recognition, were expected to be related to burnout in nurse faculty. This greatly simplified model of the relationship between organizational components and burnout includes only management style of the dean, collegial support, and work load. It does not include other facets of the work environment or the environment outside of the work setting, or various coping skills of the individual which may influence the appearance of burnout. (It is assumed that these exist in the population, but they are not included here.)
Hypotheses The following.hypothetical statements were tested, using a descriptive correlational design with a mail out survey. 1. Nurse faculty have a level of burnout comparable to professionals in other human service settings. 2. Participatory management style is negatively related to faculty burnout. 3. Behavior contingent approval is negatively related to faculty burnout. 4. Arbitrary punitive behavior is positively related to faculty burnout. 5. Collegial support among faculty is negatively related to burnout. 6. Faculty work load is positively related to faculty burnout. 7. Management behaviors and collegial support are better predictors of faculty burnout than components of-the faculty work load.
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Method SUBJECTS
The sample was limited to faculty at National League for Nursing (NLN)-accredited schools which offer baccalaureate or both baccalaureate and graduate degrees. Schools which accepted only RNs, those also offering the ADN, and those with acting deans were eliminated from the sample pool. Thirty BSN schools and 24 BSN and graduate program schools were randomly selected. Deans at the selected schools were sent an explanatory letter and asked to provide the names, academic ranks, and business addresses of their full-time faculty. Usable lists were received from 16 BSN programs and 12 BSN and higher degree programs. The following faculty were eliminated from the 28 lists: those who held administrative positions such as assistant dean; those on part-time or leave of absence; those who were located at satellite campuses; those with adjunct status; and those who held joint appointments in other schools. After these eliminations, explanatory letters and the questionnaire were sent to all 600 faculty. Assurance of confidentiality and protection of rights were included in the explanatory letter. Sixty-eight per cent (405) of the faculty returned the questionnaires. Of the 405 responses, 374 (62.3 per cent of the total sample) were usable. Thirtyone responses were not usable because they were from faculty who were part-time, on leave, nonnurses, or greater than 50 per cent of their time was involved in administrative duties. This information was determined from the demographic data. Ninety-seven per cent of the faculty were female. They ranged in age from 26 to 66 (mean 42.9) and had one to 43 years' teaching experience (mean 6.8) at one to six different schools (mean 2.3). All four academic ranks were represented: 19 per cent instructors, 43 per cent assistant professors, 23 per cent associate professors, and 8 per cent professors. Thirtyseven per cent were tenured. The highest degree held was the master's by 68.2 per cent of the sample and the doctorate by 31 per cent. INSTRUMENTATION
Burnout was measured using the Maslach Burnout Inventory (MBI). The MBI consists of scores on three subscales. 22.23 Emotional Exhaustion contains nine items which relate to "feeling emotionally drained,
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used up, and at the end of my rope." Depersonalization is a five-item subscale which describes attitudes toward others, such as "I've become more callous, I treat some people as impersonal objects, and students blame me for their problems." Personal Accomplishment is an eight-item subscale which describes feelings of success in dealing with the job and students, such as "I deal effectively with problems, and I'm positively influencing others through my work" Burnout is reflected by high scores on Emotional Exhaustion and Depersonalization and low scores on Personal Accomplishment. Each subscale was considered individually rather than using a composite score. Reliability and validity studies are available for this instrument. 23.24 Two modifications were made. The first modification was to use only the intensity scale. Subjects were asked to respond on a seven-point scale to the question: To what degree is each of the statements like or unlike you. The second modification was to replace the word "recipient" with "students;' reducing the chances for confusion. Management style of the dean was measured with a 12-item tool adapted by Lasher from Likert's Profile of Organizational Characteristics. z~ Individual items deal with decision making, communication, support, and trust. The scale is designed to give a composite measure of management style on the continuum from authoritarian to participatory. The higher the score for the total scale, the more the style is perceived to be participatory. Positive feedback from dean to faculty member was measured with the four-item Behavior Contingent Approval scale developed by House and reported by Fulk and Wendler. 1~ It includes such items as "gives clear recognition for outstanding work" As a contrast the use of arbitrary and punitive behavior by deans was assessed. This was measured with an eight-item scale derived from the Supervisory Behavior Description Questionnaire. 1~ The items describe the extent to which the dean "rules with an iron hand, criticizes faculty in front of others, or insists that everything be done her/his way." Collegial support was assessed with a shortened version of the Survey of Collegial Communication36 This 40-item scale assessed the extent of positive interaction among faculty members including communication, trust, freedom from threat, mutual support, friendliness, and encouragement. Nurse faculty in Beyer's study ranked the items in each category for importance. The two most important items in
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TABLE 1.
Instrument Reliabilities
Scale
Cronbach Alpha
Masfach Burnout Inventory Emotional Exhaustion Depersonalization Personal Accomplishment Collegial Support Management Style Arbitrary Punitive Behavior Contingent Approval
.71274 ,86335 .66471 .65819 .95404 .89868 .91207 .93888
each category were used, resulting in a 16-item composite measure of collegial support. Cronbach alphas were computed for each of the preceding instruments (Table 1). Faculty work load was measured in two ways. Time commitment was measured by asking faculty to indicate the average number of hours per week spent in clinical supervision, classroom teaching, course preparation, committee work, research and writing, counseling or conferencing, service to the profession, and administrative duties. The second measure of faculty work load was the extent of curriculum revisions. Faculty were asked to indicate which level of revision was currently underway in their school: no revisions, minor revision in individual courses, moderate revisions with restructuring within the current framework, or major revisions involving changing philosophy, framework, and courses. Results
The Maslach Burnout Inventory has been used with groups of human service workers, nurses in clinical areas, and teachers. However, it has not been used with nurse faculty. To test its usefulness with nurse faculty a factor analysis of the MBI was done with principal factoring and varimax rotation37 Three factors accounting for 87 per cent of the variance were identified. Nineteen of the 22 items loaded in the manner identified by Maslach and Jackson3~ The discrepancy of these three loadings did not warrant efforts to revise the MBI from the subscale structure developed by Maslach and Jackson. All subsequent analyses were done with this original subscale structure. Scores from nurse faculty ranged from very low to very high on all three subscales, with the means (see Table 2) indicating moderate Emotional Exhaustion and Depersonalization and high Personal Accomplishment. To test the first hypothesis, burnout scores of nurse
256 T A B L E 2.
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Comparison of MBI Subscale Scores of Nurse Faculty and Mixed Group of Social Service Workers with Graduate Education
MBI Subscales
Mean
Standard Deviation
Critical Ratio
Emotional Exhaustion Nurse Faculty (n = 359) Social Service (n = 709)
27.41 32,51
10.55 13.02
6,88* *
Depersonalization Nurse Faculty (n = 363) Social Service (n = 709)
9.93 10.89
4.55 8.03
2.49*
Personal Accomplishment Nurse Faculty ( n = 3 6 3 ) Social Service (n = 709)
43.34 40.44
6.15 7.24
6.83**
* P < .05. * * P < .001.
faculty were compared with the scores reported by Maslach and Jackson of 709 human service professionals with graduate education.23 The differences between the means of these two groupings were tested for each of the subscales of the MBI, using the Critical Ratio for "large samples from different populations. Table 2 indicates that, there were significant differences between nurse faculty and the human service professionals with graduate degrees. Nurse faculty reported a lower level of Emotional Exhaustion and Depersonalization of recipients (students), and a higher sense of Personal Accomplishment. This may be supportive of studies by Maslach 1° and Cherniss,4 where professionals who were able to vary their work loads and within their responsibilities obtain relief from continual, intense contact with clients were less likely to display evidence of burnout. The nurse faculty work loads were composed of many components, several of which did not involve direct contact with students. In this sample approximately half of a faculty member's time was spent in activities without direct student contact. Hypotheses Two through Six were tested using Pearson's correlations with the three components of burnout considered separately. The Personal Accomplishment subscale was considered in the opposite direction of Emotional Exhaustion and Depersonalization, for it is a decreased sense of personal accomplishment which is a component of burnout. The hypothesized direction of correlations and the results of analyses for Hypotheses Two through Six are presented in Table 3. Hypothesis Two said that the management style of a dean would be negatively related to burnout. The management style of nursing deans was seen by faculty to vary from completely authoritarian to
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very participatory, with a mean of 2.61 on a fourpoint scale. The hypothesis was supported. As participatory style was more common, Emotional Exhaustion and Depersonalization scores decreased and Personal Accomplishment scores increased (Table 3). While relatively low, these correlations were significant and in the predicted direction. These data were consistent with findings from nurses, 11 from airtraffic controllers,14 and from child abuse workers.l~ Each of these studies found that burnout was lower or less severe in those agencies where management practices were more open to communication, participation, and trusc Behavior contingent approval is positive feedback from the dean to faculty members related to their efforts and/or performance. Examination of frequency data indicated that 34 per cent of the faculty saw their deans as never or rarely giving this type of positive feedback. Hypothesis Three that behavior contingent approval is negatively related to burnout was supported (Table 3). These correlations were smaller than the ones between burnout and management style. However, like the previous correlations they were significant and in the direction predicted. These findings were consistent with studies done with other professional groups in other organizational settings.4.~.13 T A B L E 3.
Summary Table of Relationships Between MBI Subscales and Management Behavior, Collegial Support, and Work Load Predicted Direction
Variable
Pearson R
Emotional Exhaustion with: Management Style Behavior Contingent Approval Arbitrary Punitive Collegial Support Total Time Curdcutum Revision
- .364" * -.285** .310" * - .410" * .033ns .044ns
(-) (-) (+ ((+ (+
Depersonalization with: Management Style Behavior Contingent Approval Arbitrary Punitive Collegial Support TotaT Time Curriculum Revision
- .292" * -.257"" .215" * - .261 * * - .047ns ,042ns
(- ) (-) (+ ) (- ) (+ ) (+)
Personal Accomplishment with: Management Style Behavior Contingent Approval Arbitrary Punitive Collegial Support Total Time Curriculum Revision
,205 * * .159" * - . 117" .210* * .047ns .031ns
(+ ) (+ ) (- ) (+ ) (?) (?)
" P < .05. * * P < .01.
ns, not significant.
) ) ) )
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As a contrast the use of arbitrary and punitive behavior by deans was assessed. This is negative feedback by the dean which is usually unrelated to specific behavior of the faculty member but is aimed at punishment and producing conformity. Sixty-one per cent of the faculty scores indicated that this behavior pattern occurred rarely to never. Hypothesis Four, that burnout is positively related to arbitrary punitive behavior, was supported (see Table 3). Scores on Emotional Exhaustion and Depersonalization were significantly higher when arbitrary punitive behavior was more common. To a lesser extent a decrease in sense of Personal Accomplishment was correlated with increasing prevalence of arbitrary punitive behavior. These findings were supportive of those from Cherniss. 4 Thus, each of the management behaviors studied was found to be related to burnout. Hypothesis Five said collegial support would be related to lower levels of burnout. Collegial support included open communication, sense of trust and freedom from threat, mutual support, and friendliness. Data indicated that 23 per cent of the faculty perceived support as occurring less than to some extent, while 28 per cent viewed support as occurring to a great or very great extent. Hypothesis Five, that there would be a negative relationship between burnout and collegial support, was supported (see Table 3). Emotional Exhaustion and Depersonalization were significantly lower when faculty collegial support was perceived to be high. Personal Accomplishment scores increased with increases in perceived collegial support. Findings were consistent with studies of other human service professionalsA -.2 Hypothesis Six said that work load is positively related to burnout. Table 3 indicates that unexpected results occurred. Two measures of work load were considered. The first was the total time spent in eight components of the faculty work load. Total time in these eight areas ranged from 11 to 78 hours, with a mean of 42 hours per week. The correlations between total work load and burnout were so low as to be nonsignificant. Other researchers found that opportunities to draw back from clients and focus on other acceptable activities within the job were related to decreased burnout. 4.a2.22 It is possible that the variety within the nurse faculty work load may be more important than total time involvement. There was some support for this idea. One component of the work load involving intense work with ~tudents and frequently difficult situations is the time spent in clinical super-
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vision. The Pearson's correlation between clinical supervision was significantly correlated with Emotional Exhaustion (r -- .i86, P < .01) and Personal Accomplishment (r = -.122, P < .05). While quite small, these correlations indicated that burnout tended to increase as the extent of clinical supervision increased. Although weak, these findings may support the importance of breaks from intense work with clients. 2.1L~2 Curriculum revision is usually considered an ongoing process which is part of the faculty work load. Ninety-four per cent of the faculty were involved in some form of curriculum revision. Thkty-one per cent of these faculty described their school as engaged in major curriculum changes involving philosophy, conceptual framework, and courses. It was hypothesized that extent of curriculum revision would be positively related to burnout. This hypothesis was not supported. The last hypothesis was that management behavior and collegial support are better predictors of faculty burnout than components of the faculty work load. The previously described correlations indicated that this would probably be supported. Multiple regression analysis was used to assess the significance of the differences between these correlations. Due to multicollinearity, the three components of management behavior were combined into a new variable called "Dean's Style" using the formula: Deans' style = (behavior contingent approval minus arbitrary punitive behavior) plus management style. This gives a measure of the extent to which management behavior is positive, open, and supportive. With Emotional Exhaustion collegial support was the major predictor (beta -.322) and the combined dean's style was also a significant predictor (beta -.184). Similar results were found with Depersonalization and Personal Accomplishment. Multiple correlation coefficients were computed for the combination of collegial support and management behavior variables, and a separate multiple correlation coefficient was computed fora combination of work load variables. The difference between correlation coefficients was then tested for statistical significance, using an expansion of Fisher's R to Z transformation and the Z test (Table 4). 27 With Emotional Exhaustion, collegial support and management behaviors accounted for 21 per cent of the variance, while work load factors accounted for 3 per cent. This difference was statistically significant. A similar significant difference in the two variable sets was found in the ability to predict De-
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T A B L E 4.
Comparative Regression Analyses of MBI 3ubscales on Management, Collegial, and Workload Variables
Variables
n
R
Rz
Emotional Exhaustion Collegial & Management Workload
312 357
.456 .228
.208 .052
3.33"*
DepersonaTization Collegial & Management Workload
312 357
.323 .122
.105 .015
4.26**
Personal Accomplishment Collegial & Management Workload
312 357
.217 .165
.046 .027
1.02ns
* * P <
Z
.01.
ns, not significant.
personalization scores. Collegial support and management behavior accounted for 11 per cent and work load accounted for I per cent of the variance. In predicting Personal Accomplishment there was no significant difference between the two variable composites. Neither the collegial support-management behavior grouping nor the work load variables accounted for more than .~per cent of the total variance in Personal Accomplishment scores. This would indicate that variables affecting the sense of personal accomplishment may be outside the focus of this study. The overall results of these analyses supported the hypothesis. Collegial support and management behavior were better predictors of burnout than work load components, This was consistent with the findings of Maslach, Cherniss, Pines, and Armstrong. Conclusions and Recommendations
The data support the earlier assumptions that burnout occurs among nurse faculty. Using measures of central tendency, burnout seems to be significantly lower than among other human service workers in direct client care settings. A possible explanation for this may be in the varied nature of collegiate teaching. This possibility should be further explored. That work load was unrelated to burnout was unexpected. The variety of experiences which comprise teaching responsibilities may explain this lack of relationship as well as the overall lower level of burnout among faculty. Previous studies indicated that balance in work load is more important than total number of hours.4.12Nurse faculty, while involved for long hours, spent approximately half of their time in contact with students. This information, coupled with the small relationship between clinical supervision and burnout, supports the conclusions of other re-
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searchers. These studies indicated that continuous contact in intense interpersonal relationships was a more important factor in burnout than number of hours worked or caseloads. 4.12.22Further study should include an assessment of differences between expected and actual time commitment. Curriculum revision was also unexpectedly unrelated to burnout. It is possible that curriculum revision by creating change provides a sense of growth. It is possible that curriculum revision is considered a valued activity within colleges of nursing and thus is rewarding. Further study should include the impetus behind the revision and the value placed on the revision process by the individual, the faculty group, the dean, and other groups within each university. In contrast to these work load variables, management behaviors of the dean were significantly related to burnout. As management style increasingly moves toward the participative end of the continuum burnout decreases. The faculty member's sense of control in the work setting may increase, contributing to satisfaction of needs for esteem and self-actualization. This does not necessarily mean that faculty members need, or desire, to participate in every decision. Rather, as Lasher found in several professional schools, 2~ the sense of opportunity to have a voice in decisions, when desired, is more important than actual participation in all decisions. It is important to remember that participative management includes open communication, trust in abilities of subordinates, and awareness of goals, problems, and needs at all levels. According to Likert, movement toward participative management cannot be made by simply throwing all decisions to a majority vote.9 In a similar manner, faculty who saw their deans as generally responding with positive recognition for specific performance had significantly lower burnout scores; faculty who saw their deans as arbitrary and punitive had significantly higher burnout. While these correlations were low and cannot be thought of as causal they do indicate that positive feedback based on the individual's performance may help to reduce burnout. This positive feedback serves the purposes of acknowledging the efforts of subordinates, and of allowing the individual to identify expectations and progress. Punitive feedback that focuses on failures or deviations from the rules interferes with the ability to identify and judge success. These findings are consistent with earlier research in a variety of settings. 2-4.1°.".~3.~7That the relationships between burnout and these measures of management behavior are low does not negate the im-
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portance of their direction, and the implications for management in schools of nursing. Data indicated that of the variables in this study the lack of collegial support was most important in the occurrence of burnout. Collegial support is the sense of positive interactions between faculty members: Its presence may contribute to meeting multiple needs of trust, belonging, and esteem. While the correlations between burnout and collegial support are low to moderate they are consistent with studies of social workers, teachers, nurses in clinical practice, and others in the h u m a n service area.'.4.1,. 16 The consistency with which collegial support has been shown to relate to decreased burnout appears to be deserving of greater acceptance and attention than the strength of correlations in this one study would indicate. Further study, perhaps comparing faculty in various disciplines within the same university, may provide further support for the importance of positive collegial interactions. Use of the full Survey of Collegial Communication would allow identification of specific aspects of collegial support which may relate to burnout. Results of this study indicated clear relationships between lower levels of burnout and positive managem e n t behaviors and positive collegial support. In addition there was an indication of the relative importance of these two variables. The beta weights for collegial support and a combined management behavior style were both significant, indicating that each variable contributed significantly to the prediction of burnout. However, the beta weights also indicated that collegial support was nearly twice as important as management behavior in the prediction of burnout. It is possible that collegial support is more immediately important to faculty due to its proximity. Faculty work daily with other faculty, but may interact more rarely with the dean. However, it also seems reasonable that the management behavior of the dean sets the tone for collegial support and thereby.would have a greater relationship to burnout than found in this study. Further research to better identify the nature of these relationships would be helpful. Recommendations for practice are tentative due to the correlational nature of the study. For faculty groups and individuals, efforts may be made to assess the extent to which they provide support and encouragement to each other. If these assessments indicate that collegia[ support is low then work as a group, with an uninvolved facilitator, may be help-
ful to identify and discuss the expectations that members have of each other and to identify specific areas where these expectations are either not met or are unrealistic. Deans may evaluate their interactions with faculty to identify the pattern of feedback which they use and make efforts to increase the use of positive behavior-related feedback. As with the faculty, deans may need some help with this assessment from someone less directly involved in the relationships. I also recommend that the investigation of burnout be broadened to include management style within the university as a whole. The stresses of enrollment, of funding problems, and the acceptance of nurse faculty by their colleagues in other disciplines and in the clinical area merit consideration. It will also be useful to investigate the relationship between burnout and such outcome variables as teaching effectiveness, research productivity, and turnover. In addition it would be helpful to include personal expectations and coping styles in further research. While the total variance accounted for in this study of faculty burnout was comparatively small, the nature of the relationships identified are important. It appears that burnout does occur among faculty, and that its occurrence is related to collegial support and management behaviors in a manner similar to other professional settings. This consistency across professional groups and settings contributes to an understanding of burnout. Further research would be helpful in order to make more specific recommendations for practice.
References
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