Hardiness vs Alienation Personality Construct Essentially Explains Burnout Proclivity and Erroneous Computer Entry Problems in Rural Hellenic Hospital Labs

Authors: Angela–M. Paleologou, Aphrodite Dellaporta

Abstract:

Erroneous computer entry problems [here: 'e'errors] in hospital labs threaten the patients-–health carers- relationship, undermining the health system credibility. Are e-errors random, and do lab professionals make them accidentally, or may they be traced through meaningful determinants? Theories on internal causality of mistakes compel to seek specific causal ascriptions of hospital lab eerrors instead of accepting some inescapability. Undeniably, 'To Err is Human'. But in view of rapid global health organizational changes, e-errors are too expensive to lack in-depth considerations. Yet, that efunction might supposedly be entrenched in the health carers- job description remains under dispute – at least for Hellenic labs, where e-use falls behind generalized(able) appreciation and application. In this study: i) an empirical basis of a truly high annual cost of e-errors at about €498,000.00 per rural Hellenic hospital was established, hence interest in exploring the issue was sufficiently substantiated; ii) a sample of 270 lab-expert nurses, technicians and doctors were assessed on several personality, burnout and e-error measures, and iii) the hypothesis that the Hardiness vs Alienation personality construct disposition explains resistance vs proclivity to e-errors was tested and verified: Hardiness operates as a resilience source in the encounter of high pressures experienced in the hospital lab, whereas its 'opposite', i.e., Alienation, functions as a predictor, not only of making e-errors, but also of leading to burn-out. Implications for apt interventions are discussed.

Keywords: Hospital lab, personality hardiness/alienation, e-errors' cost, burnout.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1057941

References:

[1] M.G. Buchanan and M.E.P. Seligman, "Explanatory Style," NJ: Lawrence Erlbaum, 1997.
[2] Institute of Medicine. To Err is Human: Building a Safer Health System. Washington: National Academy Press, 1999.
[3] MEDMARXa, "2002 Information Summary submitted to MedMARx: U.S. National database: hospital medication error reporting", Rockville Maryland: U.S. (2003). Pharmacopeia. Accessd Sept. 2007: Available:
[4] PESYP of the Hellenic Ionian Islands, "Organizational Report", The Ministry of Health Welfare & Social Solidarity, Corfu: Hellas, 2003.
[5] C. Urquhart, R. Currell, "Reviewing the evidence on nursing record systems", Health Inform J; 11(1): 33-44, 2005.
[6] MEDMARXb, "2006 Information Summary submitted to MedMARx: National database: hospital medication error reporting", Rockville, Maryland: U.S. Pharmacopeia. 2007. Available: Accessd Sept. 2007.
[7] S.G. Ellis, and S.J Dushman-Ellis, "Accreditation of hospitals for percutaneous coronary intervention on the basis of volume or clinical outcome using MEDPAR data sets: effect on patient mortality, costs and treatment accessibility", J of Invas Card; 12:464-471, 2000.
[8] D. Bates, L. Leape, D.J. Cullen, et al. "Effect of computerized physician order entry: a team intervention on prevention of serious medication errors", JAMA, 280(15):1311-1316, 1998.
[9] J.M. Overhage, W.M. Tierney, X. Zhou, et al. "A randomized trial of ÔÇÿcorollary orders- to prevent errors of omission", J Am Med Inform Assoc, 4(5):364-375 1997.
[10] B. Kaplan, "Evaluating informatics applications: Clinical decision support systems literature review". Intern J Med Inform, 64(1):15-37, 2001.
[11] J.B. Sexton, E.J. Thomas, R.L Helmreich, "Error, stress, and teamwork in medicine and aviation: Cross-sectional surveys". BMJ, 320 (7237): 745-749, 2000.
[12] C. May, L. Gask, T. Atkinson, N. Ellis, F. Mair, and A. Esmail, "Resisting and promoting new technologies in clinical practice: the case of telepsychiatry", Soc Sci & Med, 52(12): 1889-1901, 2001.
[13] S.R. Maddi, and S.C. Kobasa, "The hardy executive: Health under stress", Homewood, IL: Dow Jones-Irwin, 1984.
[14] A.-M. Paleologou, "Expanding brief cognitive therapy for holistic longterm management: Self-help Hardiness Intervention". Paper Presented at the 28th EABCT Congress, Cork, Ireland, 1998.
[15] S.R. Maddi, "Personality theories: A comparative analysis" (5thEd.). Homewood, IL: Dorsey Press, 1988.
[16] S. R. Maddi, "The Story of Hardiness: Twenty Years of Theorizing, Research, and Practice", Cons Psychol J; 54(3): 173-185, 2002.
[17] A.-M. Paleologou, "Psychological Hardiness" In: A.-M. Paleologou (Ed.) "Clinical Psychology Orientations" Athens: Ellinika Grammata, (2001).
[18] H.D. Gustafson, J. Wyatt, "Evaluation of e-health systems & services". BMJ, 328:1150, 2004.
[19] W. Ventres., S. Kooienga, N. Vuckovic, R. Marlin, P. Nygren, V. Stewart, "Physicians, patients, Electronic Health Record: An ethnographic analysis" .Ann Fam Med, 4(2):124-131, 2006.
[20] M.P. Leiter, and C. Maslach, "Preventing burnout and building engagement: A complete program for renewal organizational", San Francisco, CA: Jossey-Bass 2000.
[21] C. Maslach, "Burnout: The cost of caring", Engelwood Cliffs, NJ: Prenice Hall, 1982.
[22] C. Maslach, "Measurement of Experienced Burnout" J Occup Beh, v.2., 1981.
[23] A. Kantas, "The occupational burnout syndrome of teachers and health professionals". Psychology (the Hellenic Journal), 3(3):71-85, 1996.
[24] D.A. Alexander, and S. Klein, "Ambulance personnel, critical incidents:Impact of accident emergency work on mental health and emotional well-being". Brit J Psychiat; 178:76-81, 2001.
[25] A.Boyle, M. Grap, J. Younger, D. Thornby, Personality hardiness, ways of coping, social support and burnout in critical care nurses. J Adv Nurs; 16: 850-857, 1991.
[26] R. Gopal, J.J. Glasheen, T.J. Miyoshi, A.V. Prochazka, "Burnout and Internal Medicine Resident Work-Hour Restrictions". Arch Intern Med., 165 (22):2595-2600, 2005.
[27] J.B. Hopkinson, C.E. Hallett and K.A. Luker, "Everyday death: How do nurses cope with caring for dying people in hospital?" Int J of Nur Studies; 42 (2): 125-133, 2005.
[28] S. Stordeur, W. D-Hoore, and C. Vandenberghe "Leadership, organisational stress and emotional exhaustion among hospital nursing staff". J Adv Nurs; 35: 533-542, 2001.
[29] C.M. Aldwin, and D.F. Gilman, "Health, Illness and Optimal Ageing". London: Sage 2004.
[30] S.R. Maddi, "The Personality Construct of Hardiness: Effects on Experiencing, Coping, and Strain". Cons Psychol J; 51(2): 83-95, 1999.
[31] C. Maslach, "Burnout Inventory Manual". Consulting Psychologists Press, CA:Palo Alto, 1986.
[32] R.J. Burke, "Toward a Phase Model of Burnout: Some Conceptual and Methodological Concerns". Group Organiz Stud; 14(1): 23-32, pp.27, 1989.
[33] R.T. Lee, B.E. Ashforth, "On the Meaning of Maslach-s Three Dimensions of Burnout". J Appl Psychol; 75(6): 743-747, pp.743, 1990.
[34] C.L. Cordes, T.W. Dougherty, "A Review and an Integration of Research on Job Burnout". Acad Manag Rev; 18(4):621-656, 1993.
[35] H. Kim, J. Ji, and M. Stoner, "Factorial Validity and Invariance of Maslach Burnout Inventory-Human Survey (MBI-HSS) across Differently Characterized Social Worker Groups". Paper Presented at the 11th Annual Conference of the Society for Social Work and Research, Jan. 11-14: San Francisco, 2007.
[36] B. Byrne, "Burnout: Testing for the validity replication and causal structure across elementary, intermediate, secondary teachers" Amer Educ Res J; 31:645-673, 1994.
[37] B. Byrne, "The nomological network of teacher burnout: A literature review and empirically validated model". In: A. Huberman & R. Vandenberghe (Eds.). Understanding and preventing teacher burnout: A source book of international research and practice (pp. 15-37). NY: Cambridge University Press, 1999.
[38] H. Coolican, "Research Methods and Statistics in Psychology" (2nd ed). Hodder & Stoughton, U.K,, 1994.
[39] J.F. Playle, "Developing research questions and searching the literature". J Comm Nurs. 14; 2: 20-24, 2000.
[40] N.Burns, and S.K. Grove, "The Practice of Nursing Research: Conduct, Critique and Utilisation". (3rd ed). W.B. Saunders Co., Philadelphia, 1997.
[41] A.Boyle, M.Grap, J.Younger, and D.Thornby, "Personality hardiness, ways of coping, social support and burnout in critical care nurses". J Adv Nurs; 16: 850-857, 1991.
[42] E. Pedhazur, L.Pedhazur-Schmelkin, "Measurement, design, and analysis: An integrated approach. Hillsdale", NJ.: Lawrence Erlbaum Assoc., 1991.
[43] M. Gatz, and M.J. Karel, "Individual Change in Perceived Control over 20 Years". Int J Behav Devel, 16(2):305-322, 1993.
[44] S.R. Maddi, M. Hightower, M. "Hardiness and Optimism as Expressed in Coping Patterns".Consulting Psychology J, 51(2): 95-106, 1999.
[45] C. May, L. Gask, T. Atkinson, N. Ellis, F. Mair, and A. Esmail, "Resisting and promoting new technologies in clinical practice: the case of telepsychiatry," Soc Sci & Med; 52(12): 1889-1901, 2001.
[46] V. Rodney, "Nurse stress associated to aggression in people with dementia: its relationship to hardiness, cognitive appraisal, coping". J Adv Nurs; 31(1): 172-180, 2000.
[47] J.P. Lemkau, R.R. Purdy, J.P. Rafferty, and J.R. Rudisill, "Correlates of burnout among family practice residents", J Med Educ; 63:682-691, 1988.
[48] R. Gopal, J.J. Glasheen, T.J. Miyoshi, A.V. Prochazka, "Burnout and Internal Medicine Resident Work-Hour Restrictions," Arch Int Med. 165(22):2595-2600 2005.
[49] C. Taylor, J. Graham, H.W. Potts, M.A. Richards, and A.J. Ramirez, "Changes in mental health of UK hospital consultants since the mid- -90s". Lancet, 366 (9487): 742-744, 2005.
[50] R. Tyssen, P. Vaglum, N.T. Gronvold, and O. Ekeberg, "Factors in medical school that predict postgraduate mental health problems in need of treatment. A nationwide and longitudinal study". Med Educ, 35:110- 120, 2001.
[51] C.Maslach, and M.P. Leiter, "The truth about burnout: How organizations cause personal stress and what to do about it". San Francisco, CA: Jossey-Bass, pp.74, 1997.
[52] S.N. Weingart, R.McL. Wilson, R.W. Gibberd, and B. Harrison, "Epidemiology of medical error". BMJ; 320:774-777, 2000.
[53] W. Ventres, S. Kooienga, N. Vuckovic, R. Marlin, P. Nygren, and V. Stewart, "Physicians, patients, Electronic Health Record: An ethnographic analysis".Ann Fam Med; 4(2):124-131, 2006.