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Exposure to Client Aggression and Burnout among Community Staff Who Support Adults with Intellectual Disabilities in Ontario, Canada

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Title: Exposure to Client Aggression and Burnout among Community Staff Who Support Adults with Intellectual Disabilities in Ontario, Canada
Language: English
Authors: Hensel, J. M., Lunsky, Y., Dewa, C. S.
Source: Journal of Intellectual Disability Research. Sep 2012 56(9):910-915.
Availability: Wiley-Blackwell. 350 Main Street, Malden, MA 02148. Tel: 800-835-6770; Tel: 781-388-8598; Fax: 781-388-8232; e-mail: cs-journals@wiley.com; Web site: http://www.wiley.com/WileyCDA/
Peer Reviewed: Y
Page Count: 6
Publication Date: 2012
Document Type: Journal Articles
Reports - Research
Descriptors: Human Services, Mental Retardation, Burnout, Foreign Countries, Severity (of Disability), North Americans, Behavior Problems, Stress Variables, Work Environment, Aggression, Correlation, Case Studies, Surveys, Scores, Measures (Individuals), Employee Attitudes, Adults, Incidence, Well Being, Intervention
Geographic Terms: Canada
Assessment and Survey Identifiers: Maslach Burnout Inventory
DOI: 10.1111/j.1365-2788.2011.01493.x
ISSN: 0964-2633
Abstract: Background: Studies have shown that staff who support adults with intellectual disabilities (ID) are exposed to challenging behaviour in their work including client aggression. Exposure to aggressive behaviour has been associated with staff stress and burnout. Study samples have been small however, and there has been very little data exploring this issue among North American staff. Methods: A cross-sectional survey which included demographics, measures of frequency and severity (including perceived severity and a standardised severity score) of exposure to client aggression and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was completed by 926 community staff who support adults with ID in Ontario, Canada. Relationships between demographic variables and exposure to aggression were examined with descriptive statistics. Pearson correlations were used to analyse exposure variables and MBI-HSS scores. Results: Nearly all staff reported being exposed to client aggression in the prior 6 months. Mean MBI-HSS scores were comparable to previously published data in similar populations with the exception of a higher score in the personal accomplishment domain. All measures of exposure to aggression were significantly positively correlated with MBI-HSS scores in the emotional exhaustion and depersonalisation dimensions of burnout. Conclusions: The prevalence of burnout in this North American sample is comparable to what has been reported in similar populations in other locations, although these staff may have a higher sense of accomplishment with regard to their work. Findings from this large sample support the evidence that exposure to client aggression affects staff emotional well-being but is by no means the only important factor. Further study is needed to explore the differences and similarities reported here as well as other contributing factors which will guide the implementation of effective strategies to improve staff well-being. (Contains 2 tables.)
Abstractor: As Provided
Number of References: 26
Entry Date: 2012
Accession Number: EJ976390
Database: ERIC
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  Value: <anid>AN0078911087;eul01sep.12;2019Jun05.04:49;v2.2.500</anid> <title id="AN0078911087-1">Exposure to client aggression and burnout among community staff who support adults with intellectual disabilities in Ontario, Canada. </title> <p>Background  Studies have shown that staff who support adults with intellectual disabilities (ID) are exposed to challenging behaviour in their work including client aggression. Exposure to aggressive behaviour has been associated with staff stress and burnout. Study samples have been small however, and there has been very little data exploring this issue among North American staff. Methods  A cross‐sectional survey which included demographics, measures of frequency and severity (including perceived severity and a standardised severity score) of exposure to client aggression and the Maslach Burnout Inventory – Human Services Survey (MBI‐HSS) was completed by 926 community staff who support adults with ID in Ontario, Canada. Relationships between demographic variables and exposure to aggression were examined with descriptive statistics. Pearson correlations were used to analyse exposure variables and MBI‐HSS scores. Results  Nearly all staff reported being exposed to client aggression in the prior 6 months. Mean MBI‐HSS scores were comparable to previously published data in similar populations with the exception of a higher score in the personal accomplishment domain. All measures of exposure to aggression were significantly positively correlated with MBI‐HSS scores in the emotional exhaustion and depersonalisation dimensions of burnout. Conclusions  The prevalence of burnout in this North American sample is comparable to what has been reported in similar populations in other locations, although these staff may have a higher sense of accomplishment with regard to their work. Findings from this large sample support the evidence that exposure to client aggression affects staff emotional well‐being but is by no means the only important factor. Further study is needed to explore the differences and similarities reported here as well as other contributing factors which will guide the implementation of effective strategies to improve staff well‐being.</p> <p>Keywords: burnout; challenging behaviour; intellectual disability; aggression</p> <p>Staff who support individuals with intellectual disabilities (ID) are at risk for job burnout ([<reflink idref="bib6" id="ref1">6</reflink>]; [<reflink idref="bib18" id="ref2">18</reflink>]; [<reflink idref="bib5" id="ref3">5</reflink>]) – a state of physical and emotional exhaustion that develops under conditions of ongoing stress in the workplace. Burnout affects work productivity and job satisfaction and may also permeate the well‐being of the individual outside of the workplace, at times leading to more serious mental health problems including major depression or substance use and associated disability ([<reflink idref="bib6" id="ref4">6</reflink>]; [<reflink idref="bib18" id="ref5">18</reflink>]).</p> <p>A systematic review of studies on burnout among staff who support individuals with ID has shown overall burnout rates, compared to published normative values from a range of human service occupations, are somewhat lower and appear to be trending downwards over time ([<reflink idref="bib24" id="ref6">24</reflink>]). However, the study of burnout in this population remains an important area of concern given the potential impact it has on staff well‐being and service provision ([<reflink idref="bib8" id="ref7">8</reflink>]; [<reflink idref="bib24" id="ref8">24</reflink>]).</p> <p>Among many factors that have been studied as precipitants for the development of burnout in ID support staff, exposure to challenging client behaviour has been an area of focus because it is somewhat unique to this population ([<reflink idref="bib8" id="ref9">8</reflink>]). Challenging behaviour can range from disruptive or socially inappropriate behaviour, tantrums and non‐compliance to overt aggression towards property, self or others ([<reflink idref="bib1" id="ref10">1</reflink>]) and is prevalent in samples of individuals with ID in both hospitals and community settings ([<reflink idref="bib23" id="ref11">23</reflink>]; [<reflink idref="bib4" id="ref12">4</reflink>]; [<reflink idref="bib26" id="ref13">26</reflink>]; [<reflink idref="bib16" id="ref14">16</reflink>]; [<reflink idref="bib1" id="ref15">1</reflink>]; [<reflink idref="bib25" id="ref16">25</reflink>]; [<reflink idref="bib3" id="ref17">3</reflink>]). In a literature review, [<reflink idref="bib8" id="ref18">8</reflink>]) found evidence for 'reasonably strong associations between staff exposure to challenging behaviours and staff stress'. However, existing studies have included small samples only and there is a paucity of data from North America and, in particular, Canada. The aim of this paper is to report the association between frequency and severity of exposure to client aggression and burnout found among a large provincial sample of community staff who support adults with ID in Ontario, Canada. To the best of our knowledge, this is the largest sample to date in North America and worldwide to examine this important issue.</p> <hd id="AN0078911087-2">Methods</hd> <p>A cross‐sectional survey was conducted by the study authors with input from relevant stakeholders and staff who provide services to adults with ID in Ontario, Canada. Community agencies and networks received a standardised information letter explaining the project and inviting them to participate in the study. When an agency agreed, additional details were provided for dissemination to their staff including the survey as an online link or printable version. Staff participation in the study was voluntary and anonymous. Ethics approval for this study was granted by the Research Ethics Board at the Centre for Addiction and Mental Health in Toronto, Canada.</p> <p>Staff were asked about their experience of client aggression in the prior 6 months. Client aggression was defined as '<emph>any verbal, non‐verbal or physical behaviour displayed by the client that was threatening or caused harm to self, others or property</emph>'. Frequency of aggression was rated on a 5‐point scale from 'never' to 'almost every day'. Respondents were asked to indicate the most severe form of aggression by the client directed towards them (the staff member), aggression towards other staff or clients, client self‐injurious aggression and property aggression that they had either experienced or witnessed on 3‐ and 4‐point scales ranging from none to verbal or physical aggression causing injury or damage. This measure of exposure to aggression has been used previously in similar populations ([<reflink idref="bib9" id="ref19">9</reflink>]) and can produce a standardised exposure measure (standardised severity) by summing the z‐transforms of individual item responses. In addition, staff rated their perceived severity on a numerical scale from 1 (least severe) to 100 (most severe).</p> <p>To assess burnout the survey included the Maslach Burnout Inventory – Human Services Survey (MBI‐HSS) ([<reflink idref="bib17" id="ref20">17</reflink>]). This 22‐item survey assesses the three core components of burnout (emotional exhaustion: EE, depersonalisation: DP and sense of personal accomplishment: PA) and there are well‐established cut‐offs for high, moderate and low scores in each dimension. It has also demonstrated good construct validity and reliability among a sample of community direct care staff working with adults who have ID ([<reflink idref="bib11" id="ref21">11</reflink>]).</p> <p>Descriptive statistics (chi‐squared and ANOVA) were used to examine demographic variables and their relationship to exposure to client aggression. Measures of exposure and MBI‐HSS dimension scores were analysed using Pearson correlations.</p> <hd id="AN0078911087-3">Results</hd> <p>The survey was completed by 926 community staff. The majority of staff (78%) worked at least some time in residential or respite programmes, 11% worked in day programmes, and 10% in supported independent living environments. Many staff indicated that they worked in multiple settings (mean 1.48, range 1 to 7). The demographic and employment characteristics of the sample are summarised in Table 1. The frequency of client aggression experienced has been reported in detail elsewhere ([<reflink idref="bib13" id="ref22">13</reflink>]). In brief, the majority of staff indicated that they had been exposed to aggression in the prior 6 months with 25% being exposed nearly every day and only 8% reporting no exposure at all. Approximately 20% of staff had experienced physical aggression towards themselves which resulted in personal physical injury and 20% had witnessed aggression causing physical injury in another. Forty per cent witnessed client self‐injurious behaviour which resulted in the client sustaining a physical injury and 40% also witnessed property aggression causing physical injury or damage. The mean perceived severity score was 53 out of 100 (± a standard deviation of 35). There were no statistically significant associations between measures of exposure to aggression (frequency, perceived severity or standardised severity) and gender, marital status, years of experience, being foreign‐born or having a specialised degree. Full‐time staff tended to experience more frequent aggression approaching significance (<emph>F</emph><subs>1</subs> = 3.55, <emph>P</emph> = 0.060), but it was no more severe. Advancing age was significantly negatively correlated with all measures of exposure.</p> <p>1 Demographic and employment characteristics of survey respondents</p> <p> <ephtml> <table><thead valign="bottom"><tr><th><bold>Variable</bold></th><th><bold>Number of staff (%)</bold></th></tr></thead><tbody valign="top"><tr><td>Gender</td><td /></tr><tr><td> Male</td><td>163 (17.7)</td></tr><tr><td> Female</td><td>756 (82.3)</td></tr><tr><td>Age in years [mean (SD)]</td><td>39.7 (11.1)</td></tr><tr><td>Marital status</td><td /></tr><tr><td> Married/common‐law</td><td>609 (66.2)</td></tr><tr><td> Single/never married</td><td>188 (20.4)</td></tr><tr><td> Divorced/widowed/separated</td><td>123 (13.4)</td></tr><tr><td>Foreign‐born</td><td>108 (11.7)</td></tr><tr><td>Years of experience</td><td /></tr><tr><td> Less than 2 years</td><td>67 (7.2)</td></tr><tr><td> 2–5 years</td><td>172 (18.6)</td></tr><tr><td> 6–10 years</td><td>179 (19.4)</td></tr><tr><td> 11–20 years</td><td>231 (25.0)</td></tr><tr><td> Over 20 years</td><td>276 (29.8)</td></tr><tr><td>Specialised degree or training*</td><td>581 (63.8)</td></tr><tr><td>Hours worked†</td><td /></tr><tr><td> Full‐time (>20 h/week)</td><td>843 (91.1)</td></tr></tbody></table> </ephtml> </p> <p>1 *  Included degrees or training relevant to current work (i.e. degrees in direct care services work, personal support work or nursing).</p> <p>2 †   All hours may not have been worked at the same work setting.</p> <p>Mean burnout scores were 18.7 (±11.5) in EE, 4.7 (±4.9) in DP and 36.9 (±7.5) in PA. The per cent of workers who scored in the high ranges indicative of burnout were 24%, 7% and 18% in EE, DP and PA respectively.</p> <p>Scores in EE and DP were significantly positively correlated with each other (see Table 2) and negatively with PA (of note: PA is interpreted in the opposite direction to the other two dimensions of burnout). Frequency of aggression, standardised severity and perceived severity were all significantly positively correlated with EE and DP. Only standardised severity was weakly but significantly positively associated with PA, indicating a higher severity score was associated with a greater sense of personal accomplishment.</p> <p>2 Correlations between frequency and severity of aggression and Maslach Burnout Inventory scores</p> <p> <ephtml> <table><thead valign="bottom"><tr><th /><th><bold>Frequency</bold></th><th><bold>Standardised severity</bold>†</th><th><bold>Perceived severity</bold>§</th><th><bold>EE</bold></th><th><bold>DP</bold></th><th><bold>PA</bold></th></tr></thead><tbody valign="top"><tr><td>Frequency</td><td>–</td><td>0.613**</td><td>0.545**</td><td>0.247**</td><td>0.165**</td><td>0.037</td></tr><tr><td>Standardised severity†</td><td>–</td><td>–</td><td>0.616**</td><td>0.194**</td><td>0.122**</td><td>0.077*</td></tr><tr><td>Perceived severity§</td><td>–</td><td>–</td><td>–</td><td>0.322**</td><td>0.216**</td><td>0.041</td></tr><tr><td>EE</td><td>–</td><td>–</td><td>–</td><td>–</td><td>0.634**</td><td>−0.293**</td></tr><tr><td>DP</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>−0.259**</td></tr><tr><td>PA</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td><td>–</td></tr></tbody></table> </ephtml> </p> <ulist> <item>3 * <emph>P</emph> < 0.05, ** <emph>P</emph> < 0.01.</item> <item>4 †   Standardised severity is a standardised score which was calculated by summing z‐transforms of staff ratings of aggression towards themselves, aggression towards others, client self‐injurious aggression and property aggression.</item> <item>5 §   Perceived severity is the staff's rating of the aggression experienced on a numerical scale out of 100.</item> <item>6 PA is interpreted in the reverse direction of EE and DP, i.e. higher PA correlates with a higher sense of personal accomplishment and therefore a less burnt out state.</item> <item>7 EE, emotional exhaustion; DP, depersonalisation; PA, sense of personal accomplishment.</item> </ulist> <hd id="AN0078911087-4">Discussion</hd> <p>The findings of this study indicate that despite a high frequency of exposure to client aggression over a 6‐month period the majority of staff are managing reasonably well. There are, however, between 7% and 24% staff who are possibly burnt out or at high risk of becoming so depending on which dimension of burnout is considered. Compared to other studies that have used the MBI‐HSS to assess burnout in similar populations in other parts of the world ([<reflink idref="bib20" id="ref23">20</reflink>]; [<reflink idref="bib24" id="ref24">24</reflink>]; [<reflink idref="bib2" id="ref25">2</reflink>]; [<reflink idref="bib14" id="ref26">14</reflink>]; [<reflink idref="bib19" id="ref27">19</reflink>]; [<reflink idref="bib21" id="ref28">21</reflink>]), the EE and DP scores reported here are comparable. Similar to recent findings ([<reflink idref="bib19" id="ref29">19</reflink>]), PA in this sample is higher than most.</p> <p>The positive association between exposure to client aggression and burnout, particularly in the EE and DP dimensions of the MBI, supports the literature ([<reflink idref="bib8" id="ref30">8</reflink>]; [<reflink idref="bib9" id="ref31">9</reflink>]; [<reflink idref="bib2" id="ref32">2</reflink>]; [<reflink idref="bib14" id="ref33">14</reflink>]; [<reflink idref="bib19" id="ref34">19</reflink>]). An interesting finding is the small but significant association between the standardised severity score and a higher sense of PA. [<reflink idref="bib14" id="ref35">14</reflink>]) found that staff exposed to more aggression experienced less associated fear and felt better able to manage it; however, other studies have not found this ([<reflink idref="bib22" id="ref36">22</reflink>]; [<reflink idref="bib19" id="ref37">19</reflink>]). Furthermore, Hastings & Horne ([<reflink idref="bib10" id="ref38">10</reflink>]) have proposed that the positive perceptions that staff in this field have for their work and clients may serve an adaptive function which has some protective value for stress. One limitation of the standardised score is that it does not account for the frequency of exposure, nor the individual's perception of the experience which may be important. While PA was also positively correlated with these other measures of exposure in this study, it was not significant. These concepts require further evaluation to determine to what degree they are true of this North American population and if there are associated practical implications. It is unclear if other potential differences in training, staff support or cultural factors may also play a role in these findings.</p> <p>Strengths of this study are its size and the multiple measures of exposure used. However, there are additional limitations to this study that should also be considered. First, it used a convenience sample of voluntary participants, which may not be fully representative of the intended population. Staff required notification of the survey from their agency or union and although anonymity was assured, there may have been other barriers to participation. Most importantly, the associations reported are based on a cross‐sectional assessment and therefore a causal link should not be inferred. Some studies have not found an association between aggression and burnout ([<reflink idref="bib21" id="ref39">21</reflink>]) and in others, additional factors including personality, coping style, cognitive variables and support and organisational issues have been proposed to mediate the relationship ([<reflink idref="bib12" id="ref40">12</reflink>]; [<reflink idref="bib15" id="ref41">15</reflink>]; [<reflink idref="bib24" id="ref42">24</reflink>]; [<reflink idref="bib2" id="ref43">2</reflink>]; [<reflink idref="bib7" id="ref44">7</reflink>]; [<reflink idref="bib19" id="ref45">19</reflink>]). This paper does not explore these other potentially relevant individual and organisational factors and indeed it would be a great challenge to comprehensively understand the relationship between all of these variables although future research should certainly attempt to do this if possible.</p> <p>To the best of our knowledge, this is the first large‐scale province‐wide North American study and largest sample to date to show a relationship between exposure to client aggression and burnout among community direct care staff who support adults who have ID. It further supports the existing evidence that the experience of client aggression affects staff psychological well‐being and therefore warrants attention. While exposure to aggressive behaviour may be inevitable, there are likely interventions which can support staff in dealing with these challenges. Further follow‐up research is needed to assess the relative contributions of other important factors in this population which will inform the methods of intervention that will support these important service providers and keep them in their workplaces longer.</p> <ref id="AN0078911087-5"> <title> References </title> <blist> <bibl id="bib1" idref="ref10" type="bt">1</bibl> <bibtext> Benson B. A. & Brooks W. T. (2008) Aggressive challenging behaviour and intellectual disability. Current Opinion in Psychiatry 21, 454 – 8.</bibtext> </blist> <blist> <bibl id="bib2" idref="ref25" type="bt">2</bibl> <bibtext> Chung M. C. & Harding C. (2009) Investigating burnout and psychological well‐being of staff working with people with intellectual disabilities and challenging behaviour: the role of personality. Journal of Applied Research in Intellectual Disabilities 22, 549 – 60.</bibtext> </blist> <blist> <bibl id="bib3" idref="ref17" type="bt">3</bibl> <bibtext> Cooper S. 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Dewa</p> <p>Reported by Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib18" firstref="ref2"></nolink> <nolink nlid="nl2" bibid="bib24" firstref="ref6"></nolink> <nolink nlid="nl3" bibid="bib23" firstref="ref11"></nolink> <nolink nlid="nl4" bibid="bib26" firstref="ref13"></nolink> <nolink nlid="nl5" bibid="bib16" firstref="ref14"></nolink> <nolink nlid="nl6" bibid="bib25" firstref="ref16"></nolink> <nolink nlid="nl7" bibid="bib17" firstref="ref20"></nolink> <nolink nlid="nl8" bibid="bib11" firstref="ref21"></nolink> <nolink nlid="nl9" bibid="bib13" firstref="ref22"></nolink> <nolink nlid="nl10" bibid="bib20" firstref="ref23"></nolink> <nolink nlid="nl11" bibid="bib14" firstref="ref26"></nolink> <nolink nlid="nl12" bibid="bib19" firstref="ref27"></nolink> <nolink nlid="nl13" bibid="bib21" firstref="ref28"></nolink> <nolink nlid="nl14" bibid="bib22" firstref="ref36"></nolink> <nolink nlid="nl15" bibid="bib10" firstref="ref38"></nolink> <nolink nlid="nl16" bibid="bib12" firstref="ref40"></nolink> <nolink nlid="nl17" bibid="bib15" firstref="ref41"></nolink>
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Items – Name: Title
  Label: Title
  Group: Ti
  Data: Exposure to Client Aggression and Burnout among Community Staff Who Support Adults with Intellectual Disabilities in Ontario, Canada
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Hensel%2C+J%2E+M%2E%22">Hensel, J. M.</searchLink><br /><searchLink fieldCode="AR" term="%22Lunsky%2C+Y%2E%22">Lunsky, Y.</searchLink><br /><searchLink fieldCode="AR" term="%22Dewa%2C+C%2E+S%2E%22">Dewa, C. S.</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+Intellectual+Disability+Research%22"><i>Journal of Intellectual Disability Research</i></searchLink>. Sep 2012 56(9):910-915.
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  Label: Availability
  Group: Avail
  Data: Wiley-Blackwell. 350 Main Street, Malden, MA 02148. Tel: 800-835-6770; Tel: 781-388-8598; Fax: 781-388-8232; e-mail: cs-journals@wiley.com; Web site: http://www.wiley.com/WileyCDA/
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  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 6
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2012
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Human+Services%22">Human Services</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+Retardation%22">Mental Retardation</searchLink><br /><searchLink fieldCode="DE" term="%22Burnout%22">Burnout</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Severity+%28of+Disability%29%22">Severity (of Disability)</searchLink><br /><searchLink fieldCode="DE" term="%22North+Americans%22">North Americans</searchLink><br /><searchLink fieldCode="DE" term="%22Behavior+Problems%22">Behavior Problems</searchLink><br /><searchLink fieldCode="DE" term="%22Stress+Variables%22">Stress Variables</searchLink><br /><searchLink fieldCode="DE" term="%22Work+Environment%22">Work Environment</searchLink><br /><searchLink fieldCode="DE" term="%22Aggression%22">Aggression</searchLink><br /><searchLink fieldCode="DE" term="%22Correlation%22">Correlation</searchLink><br /><searchLink fieldCode="DE" term="%22Case+Studies%22">Case Studies</searchLink><br /><searchLink fieldCode="DE" term="%22Surveys%22">Surveys</searchLink><br /><searchLink fieldCode="DE" term="%22Scores%22">Scores</searchLink><br /><searchLink fieldCode="DE" term="%22Measures+%28Individuals%29%22">Measures (Individuals)</searchLink><br /><searchLink fieldCode="DE" term="%22Employee+Attitudes%22">Employee Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Adults%22">Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Incidence%22">Incidence</searchLink><br /><searchLink fieldCode="DE" term="%22Well+Being%22">Well Being</searchLink><br /><searchLink fieldCode="DE" term="%22Intervention%22">Intervention</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Canada%22">Canada</searchLink>
– Name: SubjectThesaurus
  Label: Assessment and Survey Identifiers
  Group: Su
  Data: <searchLink fieldCode="SU" term="%22Maslach+Burnout+Inventory%22">Maslach Burnout Inventory</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1111/j.1365-2788.2011.01493.x
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0964-2633
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Studies have shown that staff who support adults with intellectual disabilities (ID) are exposed to challenging behaviour in their work including client aggression. Exposure to aggressive behaviour has been associated with staff stress and burnout. Study samples have been small however, and there has been very little data exploring this issue among North American staff. Methods: A cross-sectional survey which included demographics, measures of frequency and severity (including perceived severity and a standardised severity score) of exposure to client aggression and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was completed by 926 community staff who support adults with ID in Ontario, Canada. Relationships between demographic variables and exposure to aggression were examined with descriptive statistics. Pearson correlations were used to analyse exposure variables and MBI-HSS scores. Results: Nearly all staff reported being exposed to client aggression in the prior 6 months. Mean MBI-HSS scores were comparable to previously published data in similar populations with the exception of a higher score in the personal accomplishment domain. All measures of exposure to aggression were significantly positively correlated with MBI-HSS scores in the emotional exhaustion and depersonalisation dimensions of burnout. Conclusions: The prevalence of burnout in this North American sample is comparable to what has been reported in similar populations in other locations, although these staff may have a higher sense of accomplishment with regard to their work. Findings from this large sample support the evidence that exposure to client aggression affects staff emotional well-being but is by no means the only important factor. Further study is needed to explore the differences and similarities reported here as well as other contributing factors which will guide the implementation of effective strategies to improve staff well-being. (Contains 2 tables.)
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  Label: Abstractor
  Group: Ab
  Data: As Provided
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  Label: Number of References
  Group: RefInfo
  Data: 26
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2012
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  Label: Accession Number
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  Data: EJ976390
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ976390
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        Value: 10.1111/j.1365-2788.2011.01493.x
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      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 6
        StartPage: 910
    Subjects:
      – SubjectFull: Human Services
        Type: general
      – SubjectFull: Mental Retardation
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      – SubjectFull: Burnout
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      – SubjectFull: Foreign Countries
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      – SubjectFull: Severity (of Disability)
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      – SubjectFull: North Americans
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      – SubjectFull: Behavior Problems
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      – SubjectFull: Stress Variables
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      – SubjectFull: Adults
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      – SubjectFull: Canada
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      – SubjectFull: Maslach Burnout Inventory
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    Titles:
      – TitleFull: Exposure to Client Aggression and Burnout among Community Staff Who Support Adults with Intellectual Disabilities in Ontario, Canada
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            NameFull: Hensel, J. M.
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            NameFull: Lunsky, Y.
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            NameFull: Dewa, C. S.
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