title: Lived experiences of the time preceding burnout.
abstract: OBJECTIVE
  This paper reports a study to illuminate the complex interaction between person and their life world during the burnout development period.
  
  
  BACKGROUND
  Burnout is a construct describing the psychological state resulting from ineffective strategies for coping with enduring stress in both client and non-client work. Role conflict and role ambiguity, or long-term stress and frustration caused by strain in daily life, promote or exacerbate burnout, indicating that the person's entire life world is involved. There is still a lack of description of lived experiences of the time preceding manifest burnout.
  
  
  METHODS
  Data were collected from interviews with eight people suffering from burnout and analysed using a phenomenological method.
  
  
  RESULTS
  The essential meaning of the phenomenon of burnout is understood as being trapped with stimulating challenges as a self-nourishing drive on one side and with responsibilities and demands on the other. This essence can be illuminated by its eight constituents: inner incentive, feeling responsible, threatened self-image, cutting off, bodily manifestations, psychological manifestations, fatigue and reaching the bottom line.
  
  
  CONCLUSIONS
  The lived experiences of the time preceding manifest burnout are an ambiguous struggle. Cutting off is understood as a mean to shelter the threatened self-image in a state of vulnerability and weakened strength. Accordingly, a better understanding of how to reach behind the defence of 'cutting off' and thus help to open up for consolation and self-acceptance is an essential skill for nurses, health care professionals and others encountering the burnout sufferers. Furthermore this study illuminates early signs of burnout and an important issue is how to strengthen the individuals' ability to shelter their need for recovery and restitution.
authors.affiliation: Department of Public Health Science, Karolinska Institutet, Stockholm, Sweden. mirjam.ekstedt@ipm.ki.se <mirjam.ekstedt@ipm.ki.se>
authors.forename: Mirjam
authors.initials: M
authors.lastname: Ekstedt
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Fagerberg
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D002055:Burnout, Professional / Q000175:diagnosis / Q000451:nursing / Q000523:psychology*; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D018582:Sick Leave; D013315:Stress, Psychological / Q000523:psychology