Implications for practice and research

• Personality characteristics are an important vulnerability factor to consider when exploring the generation of burnout.

• A better understanding of individual factors associated with burnout could allow the development of bespoke prevention programmes.

• Individual-directed and organisation-directed interventions can be combined to cope with this problem.

Context

Much has been said about the negative impact of burnout on nurses’ health, but the causes of this phenomenon are still unclear. Shimizutani and colleagues1 found that neuroticism was related to burnout, and a systematic review by Khamisa et al 2 regarding this question concluded that, in a broad perspective, burnout, job satisfaction and general health are related.

This study sought to identify the influence of personality and interpersonal variables on burnout development, addressing the vulnerability dimensions underlying this health problem. The five-factor model, one of the most used personality models, and Leary’s interpersonal circumplex model of social behaviour were used as frameworks for the study. Both models try to describe the personal and interpersonal interface of the person suffering burnout.

Findings

The results confirmed the influence of the ‘Big Five’ personality factors in burnout. Women experienced 31% less emotional exhaustion than men, contrary to other findings. Emotional exhaustion and depersonalisation decreased when interpersonal behaviour was friendly submissive or friendly. Emotional exhaustion and depersonalisation increased when interpersonal behaviour was more directed towards dominance.

Commentary

Although this was a robust study, there were some limitations. First, the recruitment of nurses from a range of clinical backgrounds can be problematic when identifying homogeneous types of stressors, common to the tasks performed in each specialty. The work also overlooked organisational or other variables that might influence burnout; a longitudinal design may also have provided a more detailed insight into the phenomenon of nurse burnout.

These limitations aside, the study provides a useful addition to the evidence base. Burnout needs a base from which it can be constructed, and personality is a good point to start from. The interaction between the mechanisms that produce burnout in nurses is complex, and must be contemplated from a long-term perspective. The causal influence of non-role tasks on developing stress over time, the lack of recovery resources after work which interferes in adequate detachment, and how these factors can generate burnout must be observed over time. Many times, stress and burnout are considered as matters generated inside the work, but the role that free time and personal tasks play in burnout development, and the lack of work recovery in this period of the day, is great. Moreover, fatigue effect is another aspect to consider when involved in nurses’ work,3 because it has to do with the way the balance between effort and reward is considered. Fatigue does not appear linearly; at the same effort, if reward increases, fatigue diminishes.

Moreover, assessment methods are evolving, and recently ecological momentary assessment has substantially improved the way nurses can be evaluated,4 by a better evaluation of the circumstances that occur just in the moment. These methods, and the required counterpart statistics, although complex, take the exploration of the interaction between momentary factors (such as demand and control) and personality and burnout variables to a promising perspective of research in the very near future. In this way, the study of these variables is not strictly subject to retrospective measures of burnout that are often deceptive and do not inform us about their interaction with state/context/moment variables. The use of these new methods will inevitably lead to a better understanding of the phenomenon of burnout and its causes.