Real-time perception of demand-control and effort-reward related to daily tasks and burnout in nurses

Abstract

Background: The aim of this study is to analyse how the perception of demand, control, effort, and reward changes as a function of the task performed by ward nurses, through real-time assessment, and depending of the level of burnout. Method: A three-level hierarchical model with repeated measures design was used to assess the momentary self-report of 95 hospital ward nurses, through a smartphone programmed with random alarms, along five working days. They answered which task they were doing, following the WOMBAT classification, and the perceived level of demand, control, effort, and reward, on a 10-points single-item scale for each variable. Burnout was also assessed once, using MBI. Findings: Demand, effort, and control perception depend mostly on factors related to the moment, compared to factors related to the person (ICC: .42, .45, .40 respectively). Reward was mostly related to nurses’ factors (ICC: .59), being higher levels of burnout related to lesser reward perception in all tasks (B= -0.093; p<.001; CI=-0.13:-0.05), and documentation task the less rewarding one (M = 5.3; SE=0.64). Direct care was the task assessed as the most demanding one (M = 6.53; SE=0.46) and effortful (M = 6.24; SE=0.46) but also the one with higher level of control (M = 7.36; SE=0.7), and not less rewarding that others (M = 5.75; SE=0.65). Discussion: The main feature of burnout is the lack of perception of reward in the daily activities and not the perception of more demand and effort, nor less control.