@2024 Afarand., IRAN

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ISSN: 1027-1457    Scientific Journal of Forensic Medicine 2020;26(4):233-238

Background
The prerequisite for the development of any organization is to have healthy and efficient human resources. Numerous factors affect the physical and mental health of employees of organizations as well as their efficiency, which one of the most important of these factors is job burnout. Burnout is a syndrome conceptualized as resulting from chronic stress burnout consists of three sub-dimensions: emotional exhaustion, depersonalization, and a sense of ineffectiveness and lack of accomplishment [1].
Previous Studies
…[2]. In general, job burnout refers to negative changes in attitudes, mood, and behavior as a response to job stress [2]. Mild burnout is not a mental disorder, but it develops slowly and may turn into a mental disability. …[3]. Forensic medicine employees face several stressors in their workplace given the fundamental and decisive role of forensic medicine in the review of judicial cases in terms of the sensitivity of the situation and dealing with annoying scenes of crime [4]. Anxiety tolerance has been increasingly seen as an important structure in the development of new insights into the onset and maintenance of psychological trauma as well as its prevention and treatment [5]. Empirical evidence shows that people with incomplete emotional and meta-emotional abilities are more likely to develop behavioral problems in their workplace [6]. ...[7-9].
Aim(s)
This study investigated the significant relationship between job burnout, distress tolerance, and meta-emotional dimensions in forensic medicine employees.
Research type
This is a descriptive study.
Research society, place and time
This study was carried out between 180 employees of the Forensic Medicine Department of Mashhad (56 females and 124 males) in 2020-2021.
Sampling method and number
The available sampling method was used for sampling. After fulfilling the research conditions (history of more than one year; signing a written consent to participate in research and having minimum education of diploma), 45 people (26 women and 19 men) participated in the study voluntarily.
Used devices&materials
Demographic questionnaire: Included age, gender, work experience, and education. The Maslach Burnout Questionnaire: This questionnaire was designed by Maslach and Jackson [10]. The questionnaire had 47 questions, but the number was reduced to 25 questions after the factor analysis, and this version was introduced as the final version. This questionnaire has three subscales, which are emotional burnout, depersonalization, and personal problems. Also, in this questionnaire, the symptoms of job burnout were measured based on the severity and the frequency of the symptoms. Azizi et al. [11] examined the reliability of the three scales in this questionnaire. They reported the alpha coefficient of emotional erosion, depersonalization, and personal problems by 0.88, 0.62, and 0.77, respectively. Also, the validity of this questionnaire was confirmed by the confirmatory factor analysis. The scaling of the Maslach Burnout Questionnaire is based on the 7-points Likert scale, which is scored from never (0) to every day (6) based on the frequency and severity. Questions of 4-7-9-12-17-18-19-21 are scored from top to down. The emotional burnout subscale included the questions of 1-2-3-6-8-13-14-16-20, the depersonalization subscale included the 5-10-11-15-22 questions, and the subscale of the lack of personal fulfillment included the questions of 4-7-9-12-17-18-19-21 [11]. Beer and Moneta's positive metacognition and meta-emotional questionnaire [12]: The items of Beer and Moneta's positive metacognition and meta-emotional questionnaire express metacognitive beliefs about cognitive and emotional processes in facing challenging situations. The items of the questionnaire are derived from interviews conducted in qualitative studies. There are 18 items that each subject responds to them by 5-items Likert scale from strongly agree to strongly disagree. The items in this questionnaire were allocated to three subscales, which are: a) trust to silencing the racing thoughts and stable emotions; b) trust to the interpretation of emotions as a symptom, avoid immediate reactions and adjusting mind to solve the problem; c) trust to set the flexible objectives hierarchies. The range of the items for the relevant factors is as follows: 0.51-0.81 for factor 1 (trust to silencing conservative thoughts and feelings); 0.45-0.72 for factor 2 (trust to interpreting feelings as a symptom, avoiding immediate reaction, and adjusting the mind to solve the problem) and 0.57-0.78 for factor 3 (self-confidence in setting a hierarchy of flexible and practical goals). Cronbach's alpha coefficients were high with 0.85, 0.76, and 0.85 for factors 1, 2, and 3, respectively. Overall, the final 18-items of the questionnaire appear to have good construct validity and good internal consistency. Item 1 included 1-4-10-13-16 questions, item 2 included 5-8-11-14-17 questions and item 3 included 6-9-12-15-18 questions. Its scoring is ranged from the opposite (1) to completely agree (5). Questions of 1-4-10-13-16 are scored in the top to down approach. Items 2 and 3 indicate positive meta-emotion, and item 1 indicates negative meta-emotion, and the total score is obtained from the sum of the second and third factors and the inverse score of the first factor. Anxiety Tolerance Questionnaire [13]: It has 15 items and four subscales that include tolerance, absorption, evaluation, and regulation. The questionnaire scared by a 5-items Likert scale from completely agrees (score 1) to completely disagree (score 5). It should be noted that question 6 is scored in reverse mode. The scores of the subscales will be obtained as follows: tolerance (1-3-5), absorption (2-4-15), evaluation (6-7-9-10-11-12), and adjustment (8-13-14). High scores on this scale indicate high distress tolerance [13]. Alpha coefficients for these subscales were 0.70, 0.72, 0.78, 0.82 and for the whole scale were 0.82, respectively. Intra-class correlation after 0.6 months was 0.61. Also, it has been found that this scale has good criterion validity and good initial convergence. In the study of Ismaili Nasab et al., Cronbach's alpha of the whole scale was 0.86. Shams et al. [11] also reported Cronbach's alpha of this questionnaire as 0.67 and reported the validity of the retest of this questionnaire as 0.79. Also, the validity of the questionnaire in this study was calculated 0.91 by Cronbach's alpha method. Ethical permission was obtained from the ethics committee of Neishabour Islamic Azad University. To comply with the research ethic, participants were assured that the information obtained would remain strictly confidential. Data were analyzed in SPSS 21 software. Mean, and percentage were used to describe the data. Kolmogorov-Smirnov test was used to assess the normality of the data. Comparisons between groups were performed using the T-test, and the significance level of all tests was considered by 0.05.
Findings by Text
The subjects filled 45 questionnaires. 46.2% of the participants had a bachelor's degree, and 39.6% of this group had a master's degree or higher. The work experience of 70% of participants was less than 15 years (Table 1). 45%, 35.2%, and 68.2% of the subjects had severe emotional burnout, moderate emotional burnout, and high lack of personal fulfillment, respectively (Table 2). The correlation coefficient of the meta-emotion dimensions and job burnout was -0.649 and had a significant and inverse relationship (p=0.009). Also, the correlation coefficient of distress tolerance and burnout was -0.684, which showed a significant and inverse relationship between these two variables (p=0.005).
Main comparison to the similar studies
In this study, the different dimensions of job burnout were used, including emotional burnout, depersonalization, and lack of personal inadequacy. Studies showed that 45% of people had high emotional burnout, and 35.2% had moderate emotional burnout. According to studies by Axia et al. [14] as well as the research of Jafari Iraqi et al. [15], the severity of burnout in military nurses was low in terms of emotional burnout and depersonalization, and it was high in terms of personal inadequacy which except for the emotional burnout dimension, the rest of the results are consistent with this study. In the United Kingdom, Lane et al. Also reported moderate burnout in the employees [16]. Regarding the existence of a significant and inverse relationship between meta-emotional dimensions and distress tolerance with burnout, it is also consistent with the studies of Hassanopour et al. [17]. It shows that people with meta-emotional dimensions and high distress tolerance are less exposed to burnout than people with less ability in these variables. Findings of this study showed that burnout in the dimension of individual inadequacy was higher than in other dimensions. Research has shown that people with mature meta-emotion can communicate better, and these people will be good companions in their work because of their advanced social skills [17].
Suggestions
Considering the factors affecting employee burnout, it is suggested that reduce the harmful effects of burnout on employees using special arrangements and organizational interventions such as increasing work stability and performance, reducing working hours, encouraging teamwork, employee participation in decision-making, job support, and more welfare services, reducing conflicts and job ambiguities.
Limitations
The research was comparative, and the results of this method, compared with methods such as experiments, do not allow the inference of causal relationships between variables. Also, the use of self-report questionnaires and the inability to control some disturbing variables were the main limitations and weaknesses of this study. Also, considering that this research has been done only in one of the forensic medicine centers, it cannot be generalized to other communities.
Conclusions
The development of any organization requires healthy and efficient human resources. Numerous factors are effective in creating the physical and mental health of employees of an organization as well as their efficiency. The most important of the factors can be the cause of burnout and psychological skills to deal with it, which indicates the need for more attention of officials to the causes of burnout and its elimination.
Acknowledgments
The present study is the result of research in forensic medicine in Mashhad, by which we are grateful to all the people who participated in this project.
Conflict of interest
This article was retrieved from the doctoral dissertation of Zohreh Honarvar at Neishabour Azad University.
Ethical Permissions
This article has the ethics code of IR.IAU.NEYSHABUR.REC.1399.001 from the ethics committee of Neishabour Azad University.
Funding Sources
This study was not sponsored.

TABLES and CHARTS

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