(118) Converging Evidence for a Novel Framework of Burnout Using Conservation of Resources Theory

Introduction: In Conservation of Resources (COR) theory, people are intrinsically motivated to protect resources, such as objects, mental states or conditions of value; and to acquire new resources. COR asserts that mental stress arises from the loss or threat of loss of resources, and that more stress arises from resource loss than is reduced by equal resource gain. Drivers of burnout include dimensions of resource loss, including high workload demands, strained team culture, and emotional and physical exhaustion. We examined work and mental health factors related to the gain or loss of social / emotional resources as predictors of burnout in PICU team members. We employed Bronfenbrenner’s ecological approach accounting for influences of environments in which behavior occurs.

Methods: RNs, NPs and physicians at an academic pediatric intensive care unit (PICU) were surveyed using validated assessments of resource loss and gain (PHQ-9, ProQOL, PFI, PCL-5, CD-RISC-10, TeamSTEPPS). 54 of 92 respondents provided complete data. Hierarchical multiple regression analysis with forced step entry was conducted. Quality of team function was conceptualized as an omnibus context factor so entered in the 1st step. Aggregated resource loss factors (RLF), including interpersonal disengagement, exhaustion, stress intensity and depression were entered in the second step, and resource gain factors (RGF), including compassion satisfaction, personal fulfillment, and personal resilience were entered in the third step.

Results: Team dysfunction predicted 14% of burnout variability, F (1, 52) = 8.36, p < 0.01. RLF predicted an additional 46% of burnout variability, F (4, 48) = 13.9, p < 0.001. RGF accounted for 9.8% of variability, F (3, 45) = 4.9, p < 0.01. Unique predictors of burnout were the RLF team dysfunction, interpersonal disengagement, and exhaustion, buffered by the RGF compassion satisfaction.

Conclusions: Consistent with COR, RLF contributed more to the development of PICU team member burnout than RGF, both in terms of magnitude of variance explained as well as number of unique predictors. Institutions seeking to reduce burnout may be better served by focusing resources on team function and measures to limit team member exhaustion and work demand over individual fortitude in the face of unrelenting stress.