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Gepubliceerd in:

01-04-2006

Effects of Cognitive Adaptation on the Expectation-Burnout Relationship Among Nurses¹

Auteurs: Laura Browning, Carey S. Ryan, Martin S. Greenberg, Susan Rolniak

Gepubliceerd in: Journal of Behavioral Medicine | Uitgave 2/2006

Abstract

Burnout has traditionally been thought to result from unrealistically high expectations although research has provided only equivocal support. We explored the impact of cognitive adaptation disposition, including mastery, optimism, and self-esteem, on the expectations–burnout relationship. Nurses (N = 341) who were recruited at professional conferences completed questionnaires that assessed cognitive adaptation, burnout, and initial and current expectations of control. As expected, cognitive adaptation predicted fewer unmet expectations of control, which in turn predicted lower burnout. In addition, optimism and self-esteem predicted lower burnout regardless of perceived initial expectations, whereas mastery lessened the negative consequences of initially high expectations on burnout.

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Cognitive adaptation may seem similar to hardiness. However, the two terms have remained conceptually distinct in the literature. Specifically, cognitive adaptation refers to a disposition (i.e., mastery, self-esteem, and optimism), whereas hardiness refers to certain strategies (i.e., control, challenge, and commitment) that individuals may use. Hardiness has been shown to predict lower burnout (Constantini et al., 1997). However, to our knowledge, the relationship between cognitive adaptation and burnout has not been examined.

Measures not discussed in this paper assessed work-related stressors, primary and secondary appraisal, commitment, negative emotional responses, and coping.

We conducted a confirmatory factor analysis of the three measures of cognitive adaptation disposition and the three measures of burnout in a pilot study of 104 nurses who were recruited directly from hospitals. This analysis indicated that the six measures assessed two distinct correlated constructs; the comparative fit index (CFI) = 0.98 and χ ²(8) = 11.11, p = 0.20. The analysis of a one-factor model yielded a CFI of only 0.81 and a significant χ ²(9) = 43.06, p < 0.001. The results of the pilot study concerning the role of cognitive adaptation in the expectations–burnout relationship were also consistent with those of the present study.

We report the results of analyses of covariance, examining unmet expectations by testing the effect of current expectations when initial expectations were controlled (Judd and McClelland, 1989). However, we conducted parallel analyses using the simple initial—current difference in expectations of control (i.e., unmet expectations) rather that including initial and current expectations as separate predictors. These analyses produced essentially the same results.

These analyses also revealed other significant effects. Emergency nurses and nurse practitioners combined showed stronger emotional exhaustion and depersonalization than general medical nurses, t(333) = −3.04, p < 0.01, β = −0.16, t(333) = −3.98, p < 0.001, β = −0.20, respectively. Emergency nurses and general medical nurses combined showed greater depersonalization than nurse practitioners, t(333) = −3.87, p < 0.001, β = −0.20. Those with lower income reported greater emotional exhaustion and depersonalization and less personal accomplishment (t(333) = −2.95, p < 0.01, β = −0.16, t(333) = −3.34, p < 0.001, β = −0.17, t(333) = 3.88, p < 0.001, β = 0.21, respectively).

Similar to the analyses with the composite cognitive adaptation score, individual analyses of the three cognitive adaptation dimensions showed that lower income predicted greater emotional exhaustion and depersonalization and lower personal accomplishment, all ps < 0.05. In addition, emergency nurses and nurse practitioners combined reported stronger emotional exhaustion and depersonalization than did general medical nurses, and emergency nurses and general medical nurses combined reported stronger depersonalization than nurse practitioners, both ps < 0.05. Finally, higher initial expectations consistently predicted stronger current expectations, all ps < 0.05.

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Titel: Effects of Cognitive Adaptation on the Expectation-Burnout Relationship Among Nurses1
Auteurs: Laura Browning
Carey S. Ryan
Martin S. Greenberg
Susan Rolniak
Publicatiedatum: 01-04-2006
Uitgeverij: Springer US
Gepubliceerd in: Journal of Behavioral Medicine / Uitgave 2/2006
Print ISSN: 0160-7715
Elektronisch ISSN: 1573-3521
DOI: https://doi.org/10.1007/s10865-005-9028-1

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