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An Organisational Approach to Stress and Burnout in Health Care Services

Salt, H. (1999). An Organisational Approach to Stress and Burnout in Health Care Services. (Unpublished Doctoral thesis, City, University of London)


The relationships between interpersonal sources of stress, support and health outcome for four HIV care teams were studied using a questionnaire survey design. Additional qualitative information was obtained from individual interview with participants and a team discussion day. There were limitations, however, to the interpretation of the data obtained in this study. This was because of the constraints of cross-sectional survey design as well as the relatively small numbers of participants for some analyses.

Overall, the results obtained in this study suggested that collegial relationships are important mediators of stress at work. Multidisciplinary team sources of stress in particular were found to be related to increased GHQ-12 caseness. Manager and same profession colleague support were found to be related to reduced perceptions of stress from manager, same profession colleagues and multidisciplinary team sources of stress; but not from client and client's family sources of stress. Personality differences appeared to contribute to conflict and stress in same profession teams. Differences in professional orientation, lack of leadership structure, power imbalance, task and role ambiguity, and competition for resources and clients appeared to be central to conflict and stress in multidisciplinary teams. Multidisciplinary team and manager sources of stress were higher for participants who had been in HIV care services for more than 6 years. HIV professionals who had been in the HIV speciality for longer also rated the multidisciplinary team as less supportive. Length of time in service was also associated with decreased self efficacy, age being taken into account. It was concluded that changes in HIV service structure, resources, client contact and collegial relationships in recent years, related to improved effects of combination anti-retroviral drug therapies for service users, might have been particularly stressful for the HIV staff in this study.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine
Departments: School of Health & Psychological Sciences > Psychology
School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses
Doctoral Theses
[thumbnail of Salt thesis 1999 PDF-A.pdf]
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