The mediating effect of severity of client aggression on burnout between hospital inpatient and community residential staff who support adults with intellectual disabilities

Authors

  • Jennifer M Hensel MD,

    FRCPC, Research Fellow, Corresponding author
    1. Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
    2. Department of Psychiatry, University of Toronto, Toronto, ON, Canada
    • Correspondence: Jennifer Hensel, Research Fellow, C/O Dr. Carolyn Dewa, Suite 300, 455 Spadina Ave, Toronto M5S 2G8, Ontario, Canada. Telephone: +1 416 535 8501 ext. 7612.

      E-mail: jennifer.hensel@camh.ca

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  • Yona Lunsky PhD, C. Psych,

    Research Head and Associate Professor
    1. Department of Psychiatry, University of Toronto, Toronto, ON, Canada
    2. Dual Diagnosis Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
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  • Carolyn S Dewa MPH, PhD

    Research Head and Full Professor
    1. Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
    2. Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Abstract

Aims and objectives

To compare exposure to client aggressive behaviour, perceived self-efficacy in managing this behaviour and burnout between community residential group home and specialised hospital inpatient staff who provide care for adults with intellectual disabilities (ID). To assess the mediating role of aggression exposure on burnout in these two staff groups.

Background

Aggressive behaviour is a common indication for admission to hospital so these staff typically experience more frequent and severe forms compared to staff working in the community. There have been mixed results in few studies examining burnout and perceived self-efficacy between these two groups.

Design

This study used a demographically matched sample of cross-sectional survey data from community residential group home and hospital staff who care for adults with ID in Ontario, Canada.

Methods

Exposure to aggression, perceived self-efficacy and burnout were compared for 42 matched pairs using descriptive statistics. A mediation analysis was used to examine the role of aggression severity in the relationship between care setting and burnout.

Results

Hospital staff were exposed to more severe client aggression and scored higher in emotional exhaustion (EE). There were no differences in perceived self-efficacy. Severity of aggression was a partial mediator of the higher EE among hospital staff.

Conclusions

Exposure to more severe forms of client aggression among hospital staff contributes, at least in part, to them feeling more emotionally exhausted. This study contributes to further understanding exposure to aggression in these different settings and the impact it can have on emotional outcomes.

Relevance to clinical practice

There may be a role for policy and resource development aimed at reducing aggression and preventing or managing the associated emotional consequences. This is particularly true in hospitals, where aggression is most severe.

Ancillary