Social support and emotional exhaustion among hospital nursing staff

The role of three sources of social support (family as kin, co-workers as insiders, and supervisors as outsiders) on the emotional exhaustion were analyzed in a sample of 210 nurses at a general hospital in Seville, a city in the south of Spain. They were given an adaptation of the Nursing Stress Scale, (Gray-Toff & Anderson 1981), the Multidimensional Support Scale (Winefield, Winefield, Tiggemann 1992), previously adapted in a sample of nurses and the emotional exhaustion scale of the Spanish version of Maslach’s Burnout Inventory (1997). After applying a hierarchical multiple regression analysis to the data, the results confirm the main effect of the three sources and the buffering effect in the case of outsiders and kin. It suggests the need to perform studies with wider samples, which allow the analysis of professionals’ psychosocial characteristics and types of support, as well as demands in nursing job tasks. Social Support Sources and Emotional Exhaustion among Hospital Nursing Staff The hospital nursing staff (HNS) has been identified as one of the groups at risk of suffering emotional exhaustion, a preliminary stage of burnout syndrome, due to the nature, intensity and diversity of the stressors related to their job tasks (Leiter 1993, Maslach & Leiter 1997, Maslach, Shaufeli & Leiter 2001). It has been observed that social support prevents their appearance because a) it decreases the intensity of the stressors and b) it interacts with them, reducing their consequences (Maslach Shaufeli & Leiter 2001). Nevertheless, gaps remain to be solved regarding the nature of these effects, especially the differences that may be produced depending on the source of the help. The aim of this study was to examine the role of the different social support sources in the prevention of emotional exhaustion among HNS. Job Stress, Emotional Exhaustion and Social Support Studies carried out from the transactional perspective have highlighted that the job demands of HNS can increase the job stress and overwhelm personal coping resources and, consequently, unleash physical and emotional reactions. The nature of these job demands may be physical (e.g. work overload), emotional (e.g. continuous contact with suffering and death), and social (e.g. problems interacting with co-workers) (Gray-Toft & Anderson 1981, Schaefer & Moos 1993). As a consequence, both health and job performance become affected (Lazarus 1991). Among the psychological reactions which take place as a consequence of the continuous exposure to this job stress is burnout syndrome, characterized by the development of the experience of finding oneself mentally fatigued, negative attitudes towards the people to whom their work is directed, and the idea of having failed professionally (Shaufeli et al. 1996). It is a process, initiated after continuously suffering the perception of inability to face job demands with the available resources, which leads to the development of emotional exhaustion (Leiter 1993, Maslach & Leiter 1997). Afterwards, a process of depersonalization is triggered, characterized by the tendency to treat patients in a mechanical way, until finally, the professionals become less and less effective at achieving their objectives, develop feelings of incompetence and lessen their personal development (Cordes & Dougherty 1993, Lee & Asforth 1993). Emotional exhaustion is considered a dimension with high predictive value of the results of stress in the health of the active work population (Maslach, Shaufeli & Leiter 2001). Research has revealed the importance of social support in coping with job stress and preventing emotional exhaustion (Maslach, Shaufeli & Leiter 2001). Social support is defined as the mesh of social relationships and transactions (i.e. emotional, cognitive, and behavioral) whose function is to complete the personal resources to allow adaptive coping in situations of need (Sarason & Duck 2001). To analyze its role against job stress, the main and buffering effect hypotheses have been tested. The main effect postulates that social support enhances health and wellbeing irrespective of the person’s stress level because it decreases the intensity of the experience of the stress (Eisenberger, Fasolo & Davis-LaMastro 1990). The buffering effect establishes that social support interacts with job stress to reduce distress responses, in such a way that the relationship between job stress and distress is greater in individuals with low levels of support (Greenglass, Fiksenbaum & Burke 1994). Nonetheless, empirical evidence has not been able to find consistency in the results, so in some studies the main effect of support does not appear, while in others, the buffer effect (Chapell & Novak 1992) and an opposite effect have even been observed, that is, high support levels exacerbate more than alleviate the effect of stress job, producing processes of personal weakening and loss of social status (Kauffmann & Beehr 1986). These inconsistencies have been explained based on both conceptual and methodological problems, especially the consideration of support as a one-dimensional structure, which has prevented the analysis of the different role that SOCIAL SUPPORT AND EMOTIONAL EXHAUSTION AMONG HOSPITAL NURSING STAFF 97