title: Sources of burnout among healthcare employees as perceived by managers.
abstract: OBJECTIVE
  This paper is a report of a study to investigate healthcare managers' perspectives on factors contributing to the increase of healthcare employees on sick leave for burnout symptoms.
  
  
  BACKGROUND
  Current turbulent healthcare reorganization has resulted in structural instability, role conflicts and vague responsibility commitments, all of which contribute to increasing numbers of sick days caused by burnout symptoms. Managers' perceptions of burnout sources are important as these perceptions guide the actions taken to prevent burnout.
  
  
  METHODS
  Interviews were carried out with 30 healthcare managers, with different occupational backgrounds and from different units. The data were collected in Sweden in 2003 and analysed using thematic qualitative content analysis.
  
  
  RESULTS
  According to the healthcare managers, continuous reorganization and downsizing of healthcare services has reduced resources and increased demands and responsibilities. These problems are compounded by high ideals and expectations, making staff question their own abilities and worth as well as making them feel less confirmed and less valued as people. The main finding indicates that healthcare employees are thrown into a spiralling sense of inadequacy and an emerging sense of pessimism and powerlessness.
  
  
  CONCLUSIONS
  To understand and influence people's actions, one has to understand their perceptions and thoughts - their explanatory models. This study shows the complexity and interconnection between sources of burnout as perceived by healthcare managers, and highlights the encouragement of realism without the destruction of enthusiasm as an important factor in management and healthcare practice.
authors.affiliation: Department of Nursing, Umeå University, Umeå, Sweden. ann-louise.glasberg@nurs.umu.se
authors.forename: Ann-Louise
authors.initials: AL
authors.lastname: Glasberg
authors.forename: Astrid
authors.initials: A
authors.lastname: Norberg
authors.forename: Anna
authors.initials: A
authors.lastname: Söderberg
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000523:psychology*; D005260:Female; D006270:Health Facility Administrators / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D013222:State Medicine / Q000458:organization & administration*; D013548:Sweden; D017132:Workplace / Q000523:psychology*