CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
       The term “burnout” was identified thirty years ago to describe a state of fatigue and frustration among health and service workers arising from excessive demands on their resources. According to Maslash & Leiter (2008) is a prolonged response to chronic emotional and interpersonal stressors on the job, and is defined by the three dimension of exhaustion, cynicism and inefficacy. Leiter &  Maslash (2009) also saw it as a cumulative negative reaction to constant occupational stressors relating to the misfit between workers and their desired jobs. with this understanding it can be deciphered that burnout is a psychological syndrome response to chronic stressors in the work place that leads to, physical & emotional exhaustion, cynicism and detachment and feelings of ineffectiveness and lack of accomplishment. Exhaustion is mainly related to an individual’s experience of stress, which is in turn related to a decline in emotional and physical resources.                 
According to Leiter & Maslack (2003). “The experience of exhaustion reduces worker’s initiative while progressively limiting their capacity for demanding work” while cynicism refers to a detachment from work in reaction to the overload of exhaustion, and the burnout component perceived professional inefficacy refers to the feelings of ineffectiveness and lack of achievement productivity at work and also lack of confidence in one’s work. Most workers in the health sector have encountered occupational stressors in their working environment that often makes them care professionals such as the Doctors, Nurses, lab scientists, pharmacists, social workers and psychologists (Leiter & Malash 2009).
          When an individual is psychologically burned out due to occupational stress and depression, frustration set in the working environment and this affects the individuals psychological, physical and mental wellbeing. The nation of wellbeing is examined in two aspects, those being subjective wellbeing and psychological well-being, subjective well-being corresponds to the hedonistic view predicting the individual’s elusion from pain and approach to pleasure, while psychological well-being corresponds to ensuring the individuals personal development and realizing one’s potentials, going beyond the search of pleasure which include psychological and spatial health (Shanhun, 2010).
            In recent years increasing attention has been paid to the phenomenon of burnout particularly in human service professions, psychological burnout appears to be a response to interpersonal stressors on the job, in which an overload of contact with people result in changes in attitudes and behaviors towards them (Schaufeh, Leiter & Maslash 2008). Burnout can show up as poor job performance, impersonality with patients and lack of motivation. Health problems such as high blood pressure, insomnia, depression or addiction can also be sign of burnout and it’s as a result most people in the health care professions carry their job home with them; it’s good to really care about your patients. But if you don’t know how to distance yourself at times, it will be a problem “(Synder,2007).
          Also burnout which is as a result of prolonged stress in the work place, is globally considered as a risk factor for worker’s health and safety. More specifically the health care, sector is a constantly changing environment, and the working conditions in the hospitals are increasingly becoming demanding and stressful .Several studies; studies focusing on the health sector have shown that health care professionals are exposed to a variety of severe occupational stressors, such as time pressure, low social support at work, a high work load, uncertainty  concerning patient treatment and predisposition to emotional responses due to exposure to suffering, frustration, depression anxiety and anger, and in this case health care workers are at a high risk of experiencing severe distress, burnout and both mental and physical illness . (Peterson, Demerouts, Bergstom, Samielsson, Asbsg, & Nigren, 2008).
         According to Demerouti, Bakker, Nachrainer & Schaufele (2001), the syndrome of burnout is more prevalent among human service providers. The two core dimensions of burnout can be distinguished as emotional exhaustion and depersonalization. Burnout is a syndrome characterized by emotional exhaustion that results in depersonalization and decreased personal accomplishment at work. The emotional exhaustion clinicians may develop a sense of cynical detachment from work and view people, especially patients as objects, such that clinicians no longer feel effective at work because they have lost sense of their ability to contribute meaningfully in the past few years, the growing prevalence of burnout syndrome among health care personal has gained attention as potential threat to health care quality and patient safety.
          Burnout is common among health care workers and the characteristics of the health care environment contributing work processes, role conflict and poor relationship between groups and with leadership, when these are combined with leadership and personal disposing factors and the emotional intensity of clinical work, they put clinicians at risk. Burnout is viewed as a threat to patient’s safety because depersonalization is presumed to result in poorer interaction with patients, clinicians aremore likely to subjectively rate patient’s safety lower in their organization and to admit having mistaken or delivered standardized care at work.
           Burnout complaints among nurses have not been consistently related to occupational species stressors such as confrontation with death and dying and interactions with difficult situations. More specifically, psychological burnout has three syndromes which are emotional, depolarization and a reduced sense of personal accomplishment that can occur among individuals who work with people in some capacity. As described above, burnout is studied in three different types, “emotional" this refers to over extended and drained by one’s contact with other people” depersonalization “this refers to an unfeeling and callous response towards people who are usually the recipients of one’s service or care and reduced personal accomplishment” this refers to a deadline in one’s feeling of competence and successful achievement in one’s work with people. These three aspect of syndrome have been the causes and outcomes.
          Burnout individuals simultaneously experience high levels of chronic fatigue, and distance themselves emotionally and cognitively from their work activities employees with higher levels of burnout are more likely to experience a hold range of psychological and physical health problems including anxiety, depression, sleep disturbance, memory impairment (Peterson, Demerouts, Bergstom, Samielsson, Asbsg, & Nigren, 2008). Consequently, burnout employees are likely to display one or more withdrawal behaviours such as lateness, absence or turnover according to (Maslach, Schaufeli & Leiter 2001). Clinically, burnout employees may get justified absence leaves from work. However other burnout employees remain at work which leads to a form, existence more psychological and physical health problems, and this influences their behavior at work in a significant way.