Do Low Self-Esteem and High Stress Lead to Burnout Among Health-Care Workers? Evidence From a Tertiary Hospital in Bangalore, India
	    		
		   		
		   			
		   		
	    	
    	 
    	10.1016/j.shaw.2020.05.009
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Avita R. JOHNSON
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Rakesh JAYAPPA
			        		
			        		;
		        		
		        		
		        		
			        		Manisha JAMES
			        		
			        		;
		        		
		        		
		        		
			        		Avono KULNU
			        		
			        		;
		        		
		        		
		        		
			        		Rajitha KOVAYIL
			        		
			        		;
		        		
		        		
		        		
			        		Bobby JOSEPH
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Department of Community Health, St. John's Medical College, Bangalore, 560034, India
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Original Article
 
        	
        	
            
            
            	- From:Safety and Health at Work
	            		
	            		 2020;11(3):347-352
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
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		        	Abstract:
			       	
			       		
				        
				        	 Background:Low self-esteem can be an issue among health-care workers due to the hierarchical medical system. Health-care workers are also in a high pressure environment that can lead to stress and burnout. This study was conducted to estimate the proportion of health-care workers with low self-esteem, high stress, and burnout and the factors associated with these in a private hospital in Bangalore city. 
				        	
				        
				        	Methods:This cross-sectional study included a random sample of health-care workers of various cadres – doctors, nurses, nursing aides, technicians, and workers in ancillary departments such as laundry, dietary, central sterile supply department, and pharmacy, with probability proportional to size. Rosenberg Scale for Self-esteem, Cohen's Perceived Stress Scale, and Shirom–Melamed Burnout Measure were used as study tools. 
				        	
				        
				        	Results:Among the 306 health-care workers, there were high levels of low self-esteem (48.4%), stress (38.6%), and burnout (48.7%), with the lowest levels being among doctors. Those aged younger than 30 years had significantly lower self-esteem and greater stress. 
				        	
				        
				        	Conclusions:Health-care workers with low self-esteem were nearly thrice more likely to suffer high stress, Odds Ratio (OR) = 2.84 (1.36–5.92), and those who were stressed had more than three times higher chance of experiencing burnout, OR = 3.6 (2.02–6.55). Path analysis showed that low self-esteem among health-care workers had a direct effect on burnout, as well as an indirect effect through stress (mediator variable). This study indicates the need for screening and counseling for low self-esteem, stress, and burnout as part of a periodic medical examination of all cadres of health workers.