Why is change a challenge in acute mental health wards? A cross-sectional investigation of the relationships between burnout, occupational status and nurses’ perceptions of barriers to change

Laker, C., Cella, M., Callard, F. and Wykes, T. (2019) Why is change a challenge in acute mental health wards? A cross-sectional investigation of the relationships between burnout, occupational status and nurses’ perceptions of barriers to change. International Journal of Mental Health Nursing, 28(1), pp. 190-198. (doi: 10.1111/inm.12517) (PMID:29993168) (PMCID:29993168)

Abstract

Changes in UK psychiatric wards have been difficult to implement. Specific areas of nursing staff resistance remain unclear. Previous healthcare research suggests that burnout is common and that managers’ regard changes more positively than direct care staff. We will therefore examine whether burnout and workforce characteristics influence psychiatric nurses’ perceptions of barriers to change. Psychiatric nurses (N = 125) completed perceptions measures of ‘barriers to change’ (VOCALISE: subscales included ‘powerlessness, confidence and demotivation’); and ‘burnout’ (Maslach Burnout Inventory: subscales included ‘emotional exhaustion, personal accomplishment and depersonalization ‘). Staff characteristics, such as length of employment, occupational status, education, ethnicity, gender and age, were also collected. Correlations between these measures informed random‐effects regression models, which were conducted to predict the barriers to change score and to explore differential effects in the subscales of VOCALISE. Perceptions of barriers to change (VOCALISE) were correlated with burnout (r = 0.39), occupational status (r = −0.18) and age (r = 0.22). Burnout (Coef. β: 10.52; P > 0.001) and occupational status (Coef. β: −4.58; P = 0.05) predicted VOCALISE. Emotional exhaustion (Coef. β: 0.18; P < 0.001) and low personal accomplishment (Coef. β: 0.21; P = 0.001) predicted powerlessness. Emotional exhaustion predicted low motivation regarding changes (Coef. β: 0.11; P = 0.005). Low confidence predicted high levels of depersonalization (Coef β: 0.23; P = 0.01). Direct care staff expressed significantly more powerlessness (Coef. β: −2.60; P = 0.02) and significantly less confidence (Coef. β: −3.07; P = 0.002) than managers. For changes to be successful in psychiatric wards, burnout will need to be addressed. Future change strategies may consider involving direct care staff to improve perceptions of barriers to change.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Callard, Professor Felicity
• Authors: Laker, C., Cella, M., Callard, F., and Wykes, T.
• College/School: College of Science and Engineering > School of Geographical and Earth Sciences
• Journal Name: International Journal of Mental Health Nursing
• Publisher: Wiley
• ISSN: 1445-8330
• ISSN (Online): 1447-0349
• Published Online: 11 July 2018
• Copyright Holders: Copyright © 2018 The Authors
• First Published: First published in International Journal of Mental Health Nursing 28(1): 190-198
• Publisher Policy: Reproduced under a Creative Commons License