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A Model of Hope as a Protective Measure to Lower Burnout and Secondary Traumatic Stress among Employees Working in Developmental and Intellectual Disabilities Services

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Title: A Model of Hope as a Protective Measure to Lower Burnout and Secondary Traumatic Stress among Employees Working in Developmental and Intellectual Disabilities Services
Language: English
Authors: Christina R. Miller (ORCID 0000-0002-6821-027X), Angela B. Pharris, Chan M. Hellman, Joshua Swann
Source: Journal of Applied Research in Intellectual Disabilities. 2024 37(2).
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 9
Publication Date: 2024
Document Type: Journal Articles
Reports - Research
Descriptors: Burnout, Stress Variables, Developmental Disabilities, Labor Force Development, Caseworkers, Social Work, Intellectual Disability, Positive Attitudes, Work Environment, Resources
DOI: 10.1111/jar.13184
ISSN: 1360-2322
1468-3148
Abstract: Background: Burnout and secondary traumatic stress (STS) are problems for the workforce supporting people with developmental disabilities. This study investigated hope as a potential protective resource for burnout and STS among the developmental disability services workforce. Method: One hundred and fifty-two non-supervisor caseworkers from a state agency, developmental disabilities division were recruited to participate in an anonymous web-based survey. Results: The analyses showed that hope was negatively associated with the three dimensions of STS (intrusion, avoidance, and arousal) and burnout. Controlling for tenure in the workforce and STS, the results of the hierarchical regression analyses showed that hope accounted for a significant incremental variance to burnout. Conclusion: These findings provide support for emerging literature showing hope as a protective resource to workforce burnout.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1412952
Database: ERIC
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  Value: <anid>AN0175502844;e0301mar.24;2024Feb20.05:26;v2.2.500</anid> <title id="AN0175502844-1">A model of hope as a protective measure to lower burnout and secondary traumatic stress among employees working in developmental and intellectual disabilities services </title> <p>Background: Burnout and secondary traumatic stress (STS) are problems for the workforce supporting people with developmental disabilities. This study investigated hope as a potential protective resource for burnout and STS among the developmental disability services workforce. Method: One hundred and fifty‐two non‐supervisor caseworkers from a state agency, developmental disabilities division were recruited to participate in an anonymous web‐based survey. Results: The analyses showed that hope was negatively associated with the three dimensions of STS (intrusion, avoidance, and arousal) and burnout. Controlling for tenure in the workforce and STS, the results of the hierarchical regression analyses showed that hope accounted for a significant incremental variance to burnout. Conclusion: These findings provide support for emerging literature showing hope as a protective resource to workforce burnout.</p> <p>Keywords: burnout; developmental disabilities; hope; intellectual disabilities; secondary traumatic stress</p> <hd id="AN0175502844-2">INTRODUCTION</hd> <p>Individuals in helping professions, particularly those that serve vulnerable populations such as children and adults with developmental disabilities, are at higher risk of a multitude of negative outcomes caused by regular exposure to traumatic and emotionally draining work experiences (Rienks, [<reflink idref="bib69" id="ref1">69</reflink>]; Senreich et al., [<reflink idref="bib72" id="ref2">72</reflink>]). Those stressors are often linked to negative consequences of the profession and are attributed to burnout (Kozak et al., [<reflink idref="bib46" id="ref3">46</reflink>]) and secondary traumatic stress (STS) (Jacobowitz et al., [<reflink idref="bib38" id="ref4">38</reflink>]). While often grouped together, burnout and STS are distinct psychological states. Job burnout is categorised as an 'occupational illness' (Finkelstein et al., [<reflink idref="bib25" id="ref5">25</reflink>]), while STS is associated with the stress that results from frequent exposure to the traumatic experiences of others (Boamah et al., [<reflink idref="bib3" id="ref6">3</reflink>]; Senreich et al., [<reflink idref="bib72" id="ref7">72</reflink>]). Studies have demonstrated the negative outcomes associated with both psychological states in a variety of helping professions (Caringi et al., [<reflink idref="bib10" id="ref8">10</reflink>]; Cieslak et al., [<reflink idref="bib12" id="ref9">12</reflink>]; Harris et al., [<reflink idref="bib31" id="ref10">31</reflink>]; Hastings et al., [<reflink idref="bib33" id="ref11">33</reflink>]; Johnson et al., [<reflink idref="bib39" id="ref12">39</reflink>]; Lizano & Mor Barak, [<reflink idref="bib50" id="ref13">50</reflink>]; Travis et al., [<reflink idref="bib80" id="ref14">80</reflink>]). More recent studies have featured similar responses from professionals working with adults with developmental disabilities (Boamah et al., [<reflink idref="bib3" id="ref15">3</reflink>]; Keesler, [<reflink idref="bib41" id="ref16">41</reflink>]; Lee et al., [<reflink idref="bib48" id="ref17">48</reflink>]). This study explores the role of hope as a potential protective resource to prevent burnout and STS among the developmental disability workforce.</p> <hd id="AN0175502844-3">JOB BURNOUT</hd> <p>Burnout is a unique psychological state that describes the adverse response to occupational stressors, characterised as exhaustion and disengagement from work (Demerouti et al., [<reflink idref="bib15" id="ref18">15</reflink>]). Job burnout is associated with distress when the job tasks become overwhelming and challenges are not resolved, which leads to the depletion of emotional energy for work‐related tasks (Demerouti et al., [<reflink idref="bib15" id="ref19">15</reflink>]). Studies on burnout in related human service settings have demonstrated the link between job demands, job stress, and the intent to leave, making job burnout a serious concern for employers who wish to sustain a strong workforce (Boyas et al., [<reflink idref="bib6" id="ref20">6</reflink>]; Conrad & Keller‐Guenther, [<reflink idref="bib13" id="ref21">13</reflink>]; Kim & Kao, [<reflink idref="bib44" id="ref22">44</reflink>]). Prior studies on job burnout have established that there are both individual employee characteristics and organisational characteristics that contribute to job burnout.</p> <p>Employee characteristics that may be more vulnerable to job burnout have often been the focus of research. An important variable of interest has been job tenure, with some studies finding that early‐career employees are the most at risk for burnout, while other studies find that staff who have worked three or more years have the highest job burnout (Leake et al., [<reflink idref="bib47" id="ref23">47</reflink>]; Phillips et al., [<reflink idref="bib67" id="ref24">67</reflink>]). Employees' level of education has also been examined. In a study of child welfare professionals, employees with a bachelor's degree were significantly more likely to experience job burnout than peers with master's degrees (Leake et al., [<reflink idref="bib47" id="ref25">47</reflink>]). The individual employee's feelings of autonomy and supervisory support have been found to be an antecedent of job burnout as well (Boyas & Wind, [<reflink idref="bib5" id="ref26">5</reflink>]; Phillips et al., [<reflink idref="bib67" id="ref27">67</reflink>]). Testing the hypothesis that job demands and lower job resources attributed to burnout in child welfare work, Lizano and Mor Barak ([<reflink idref="bib50" id="ref28">50</reflink>]) found that job strain was linked to emotional exhaustion and decreased job satisfaction. Early models in helping professions suggest a sequencing model, whereas job stress leads to emotional exhaustion, depersonalization, and reduced job competence (Travis et al., [<reflink idref="bib80" id="ref29">80</reflink>]).</p> <p>Organisational characteristics have also been a focus of research on job burnout. Employees who work in organisations in which they have lower levels of perceived work control, lower job satisfaction, and higher job demands significantly correlate to higher levels of burnout and intent to leave the job (Kozak et al., [<reflink idref="bib46" id="ref30">46</reflink>]; O'Brien et al., [<reflink idref="bib61" id="ref31">61</reflink>]). Other organisational factors contributing to job burnout include ambiguity and role conflict, and inadequate supervision or a sense of work‐related injustice (Edu‐Valsania et al., [<reflink idref="bib21" id="ref32">21</reflink>]).</p> <p>Burnout has been reported among professionals working with adults with developmental disabilities. Specifically, professionals who reported difficulty at work, role ambiguity, and less involvement at work were more likely to leave their jobs (Finkelstein et al., [<reflink idref="bib25" id="ref33">25</reflink>]). Workplaces with limited organisational support and inadequate staff training have negatively impacted the quality of life for direct care staff (Korsitas et al., [<reflink idref="bib45" id="ref34">45</reflink>]; Rose et al., [<reflink idref="bib71" id="ref35">71</reflink>]). Turnover rates for direct care staff working with people with developmental disabilities vary greatly and have been found to range from 18% to 76% (Bogenshutz et al., [<reflink idref="bib4" id="ref36">4</reflink>]). High turnover is linked with organisational strain, increases in medical mistakes (Montgomery et al., [<reflink idref="bib57" id="ref37">57</reflink>]), lower quality of care (Weigl et al., [<reflink idref="bib81" id="ref38">81</reflink>]), interruptions in care (Friedman, [<reflink idref="bib27" id="ref39">27</reflink>]), increased work for remaining employees (Braddock et al., [<reflink idref="bib7" id="ref40">7</reflink>]), and an overall reduction in the quality of life for individuals with intellectual and developmental disabilities (Friedman, [<reflink idref="bib27" id="ref41">27</reflink>]).</p> <hd id="AN0175502844-4">SECONDARY TRAUMATIC STRESS</hd> <p>STS is the naturally occurring emotional toll that occurs from hearing about the firsthand trauma experience of another (Devilly et al., [<reflink idref="bib18" id="ref42">18</reflink>]; Figley, [<reflink idref="bib24" id="ref43">24</reflink>]). STS rates among professionals who work with adults with developmental disabilities have been found to range from 12.4% (Boamah et al., [<reflink idref="bib3" id="ref44">3</reflink>]) to 23% (Keesler et al., [<reflink idref="bib42" id="ref45">42</reflink>]). STS can manifest suddenly with symptoms like those of individuals who experienced the trauma firsthand, resulting in PTSD (Bride, [<reflink idref="bib8" id="ref46">8</reflink>]; Rienks, [<reflink idref="bib69" id="ref47">69</reflink>]). These symptoms could include sleeplessness, increased blood pressure, depression, emotional numbness, low motivation, oversensitivity, and memory loss (Rienks, [<reflink idref="bib69" id="ref48">69</reflink>]). Higher levels of personal trauma and more prolonged exposure to traumatised clients are linked to more frequent symptoms of secondary trauma among professionals (Hensel et al., [<reflink idref="bib35" id="ref49">35</reflink>]; Ludick & Figley, [<reflink idref="bib51" id="ref50">51</reflink>]). Symptoms of STS have also been reported from both direct and indirect client contact. Activities such as reading case documents and client files or having conversations with client's family members have also been attributed to secondary trauma in professionals who work with people with developmental disabilities (Boamah et al., [<reflink idref="bib3" id="ref51">3</reflink>]). A combination of exposure to both the trauma narratives that can negatively impact staff (Boamah et al., [<reflink idref="bib3" id="ref52">3</reflink>]) and the challenging behaviours displayed by people with developmental disabilities who have experienced trauma (McNally et al., [<reflink idref="bib56" id="ref53">56</reflink>]; Rojahn et al., [<reflink idref="bib70" id="ref54">70</reflink>]) can put staff at risk for developing both STS and/or PTSD (Jacobowitz et al., [<reflink idref="bib38" id="ref55">38</reflink>]).</p> <p>The professionals who work in this community are more likely to have frequent exposure to the trauma of the clients, which increases the probability of exposure to events that contribute to the development of secondary trauma (Boamah et al., [<reflink idref="bib3" id="ref56">3</reflink>]). People with developmental disabilities are vulnerable and experience rates of trauma significantly higher than the general population (Horner‐Johnson & Drum, [<reflink idref="bib37" id="ref57">37</reflink>]; Leeb et al., [<reflink idref="bib49" id="ref58">49</reflink>]). Individuals with developmental disabilities may also experience a longer recovery from trauma because of their limitations in sharing emotions and related experiences (Skelly, [<reflink idref="bib74" id="ref59">74</reflink>]). Thus increasing the frequency and duration of STS exposure for the professional.</p> <hd id="AN0175502844-5">PROTECTIVE FACTORS</hd> <p>Given the severe consequences of job burnout and STS exposure, researchers and practitioners often examine strategies or approaches that buffer or protect from job stress. Prior studies have identified both personal and organisational protective factors that serve as a protective mechanism for professionals working with children and adults with developmental disabilities from experiencing burnout and secondary trauma. Keesler and Troxel ([<reflink idref="bib43" id="ref60">43</reflink>]) found that the use of self‐care strategies and resilience were responsible for up to 28% of the variance in the quality of life of professionals working with adults with developmental disabilities. Higher work and social support levels are also linked to lower STS levels (Boamah et al., [<reflink idref="bib3" id="ref61">3</reflink>]). A 2020 study showed that a 32‐week implementation of mindfulness training effectively reduced stress, burnout, and secondary trauma in support staff for individuals with developmental disabilities (Singh et al., [<reflink idref="bib73" id="ref62">73</reflink>]).</p> <p>Multiple studies have also demonstrated that factors related to organisational culture can directly impact the well‐being of direct service providers and the people with developmental disabilities they serve (Disley et al., [<reflink idref="bib19" id="ref63">19</reflink>]; Gray‐Stanley et al., [<reflink idref="bib30" id="ref64">30</reflink>]). For example, co‐worker relationships are a protective factor against burnout and stress (Devereux et al., [<reflink idref="bib17" id="ref65">17</reflink>]; Disley et al., [<reflink idref="bib19" id="ref66">19</reflink>]; Gray‐Stanley et al., [<reflink idref="bib30" id="ref67">30</reflink>]). When staff members perceive they can trust each other, they tend to serve as a safeguard for each other when problems arise, reducing both depressive symptoms and work stress among staff members (Devereux et al., [<reflink idref="bib17" id="ref68">17</reflink>]; Finkelstein et al., [<reflink idref="bib25" id="ref69">25</reflink>]). Work environments and supervisory support which encourage conversations on the impact of the work among professionals, were also considered a strategy for the prevention of STS (Gray‐Stanley et al., [<reflink idref="bib30" id="ref70">30</reflink>]).</p> <p>Studies on the protective capacity of resilience also show a protective benefit of lowering levels of STS in workers (Boamah et al., [<reflink idref="bib3" id="ref71">3</reflink>]). Research has shown that higher levels of resilience and mindfulness are connected to improved employee coping and reduced burnout and turnover (Nevell & Havercamp, [<reflink idref="bib60" id="ref72">60</reflink>]). In addition, for many, finding meaning in one's work is an important contribution to well‐being as it cultivates a sense of self and identity, feelings of accomplishment, and creates a connection to others (Cartwright & Holmes, [<reflink idref="bib11" id="ref73">11</reflink>]). The research studies of protective measures suggest that the mental processes of the professional are essential contributors to employee psychological well‐being. Therefore, the potential to expand the research to other cognitive‐based protective strategies is useful for both application in the workforce and to expand the current research. One such theory with a robust body of recent research that has not been explored in this field is that of Hope Theory (Snyder, [<reflink idref="bib77" id="ref74">77</reflink>]; Snyder et al., [<reflink idref="bib78" id="ref75">78</reflink>]).</p> <hd id="AN0175502844-6">Hope theory</hd> <p>One theory that has proven useful to understanding psychological wellbeing and may be useful in understanding the prevention of burnout and STS among professionals working with adults with developmental disabilities is Hope Theory. Numerous studies have demonstrated the effectiveness of Hope Theory in predicting employee satisfaction and wellbeing (Reichard et al., [<reflink idref="bib68" id="ref76">68</reflink>]). More recently, hope theory has been examined in the context of burnout and STS among other helping professions such as healthcare professionals and employees in public child welfare settings (Feldman et al., [<reflink idref="bib23" id="ref77">23</reflink>]; Pharris et al., [<reflink idref="bib66" id="ref78">66</reflink>]). Conceptualised by Snyder et al. ([<reflink idref="bib78" id="ref79">78</reflink>]), hope is a positive motivational state based on an interactively derived sense of successful agency (goal‐directed energy) and pathways (planning to meet goals) (Snyder et al., [<reflink idref="bib78" id="ref80">78</reflink>]). So defined, hope is the affective and cognitive components that emphasise a person's thoughts about the future and their capacity to make the future better. Hope is a learned thinking pattern that manifests in overt behaviours, which can be observed (Snyder et al., [<reflink idref="bib78" id="ref81">78</reflink>]).</p> <p>Goals are the cornerstone of hope. Goals are the ideas that we have about a desired future. These can be our experiences, desires, and outcomes that comprise future expectations. In this case, we are explicitly considering goals that the individual highly desires for their own future rather than organisational goals as a whole. The second component of hope is the pathways or way power, which is defined as the mental plan or roadmap to the desired goal (Snyder, [<reflink idref="bib75" id="ref82">75</reflink>]). Opportunities for past success enhance one's sense of multiple pathways to the desired future. Therefore, as hopeful thinking increases, so does one's mental flexibility to find alternative routes in the face of adversity and barriers (Muñoz et al., [<reflink idref="bib59" id="ref83">59</reflink>]). Under stress or adversity, hopeful thinking declines, and so does one's capacity to find alternative pathways to goals when barriers and obstacles are present. The third component of hope is agentic thinking, or the mental energy that is available to pursue one's goals. Agency is the cognitive perception that you can initiate and sustain both intention and attention toward the goals. Therefore, agency represents one's potential for action (Snyder, [<reflink idref="bib75" id="ref84">75</reflink>]). Agency is made up of our thoughts such as 'I am ready to do this' or 'I am willing to try' (Snyder, [<reflink idref="bib75" id="ref85">75</reflink>]). One is considered to have higher levels of hope when all three components, goals, pathways, and agency, are activated.</p> <hd id="AN0175502844-7">Hope, burnout, and work adversity</hd> <p>Extensive research over the years has been devoted to understanding strategies that employees and organisations can use to reduce workplace stress in human service settings. More recently, attention has been given to positive psychological capital in the workplace, including Hope Theory (Avey et al., [<reflink idref="bib1" id="ref86">1</reflink>]; Feldman et al., [<reflink idref="bib23" id="ref87">23</reflink>]; Luthans & Jensen, [<reflink idref="bib52" id="ref88">52</reflink>]). Since hope has been linked to effective coping with adversity in various settings (Ong et al., [<reflink idref="bib62" id="ref89">62</reflink>]), research on the relationship between hope, burnout, and STS may reveal that hope is an important characteristic that may aid in the reduction of both negative states. Theory suggests that hope, like work engagement, may represent the psychological antithesis of burnout and secondary trauma (Duggleby et al., [<reflink idref="bib20" id="ref90">20</reflink>]; Passmore et al., [<reflink idref="bib64" id="ref91">64</reflink>]; Pharris et al., [<reflink idref="bib66" id="ref92">66</reflink>]; Snyder et al., [<reflink idref="bib78" id="ref93">78</reflink>]). Hope is theorised as an antithesis to burnout and secondary stress because employees with higher levels of hope pursue their workplace goals with energy (Mouton & Montijo, [<reflink idref="bib58" id="ref94">58</reflink>]; Reichard et al., [<reflink idref="bib68" id="ref95">68</reflink>]). Research has shown hopeful employees are more engaged and have greater job satisfaction (Bareket‐Bojmel et al., [<reflink idref="bib2" id="ref96">2</reflink>]; Karatepe, [<reflink idref="bib40" id="ref97">40</reflink>]). In human services settings, hope is associated with lower burnout (Pharris et al., [<reflink idref="bib66" id="ref98">66</reflink>]).</p> <hd id="AN0175502844-8">Current study</hd> <p>Given the problem of burnout and STS among professionals working with adults with developmental disabilities, understanding potential protective mechanisms that lower burnout may have value to developmental disability agencies seeking to improve workforce wellbeing. The current study examines the relationship between hope, STS, and burnout. Given the literature on STS, we hypothesized that the three dimensions of STS (intrusion, avoidance, and arousal) would be positively associated with burnout among professionals working with adults with developmental disabilities. The study extends the literature by examining hope as a potential protective resource to burnout among professionals working with adults with developmental disabilities. As such, we hypothesized that hope would add unique incremental variance in burnout controlling for the three dimensions of STS. If the hypotheses are supported, hope offers a potentially important framework to guide leaders interested in the workforce's well‐being.</p> <hd id="AN0175502844-9">METHOD</hd> <p></p> <hd id="AN0175502844-10">Subjects and procedure</hd> <p>In partnership with the State of Oklahoma Department of Human Services, we surveyed employees of the Developmental Disabilities division. All 487 employees in the organisation were invited to participate and were sent surveys via the internal email system of the agency: <emph>N</emph> = 152 resulting in a 31% response rate. Data were collected from all employees including agency leadership, program administrators, case managers, employees, and other direct care staff. The survey was administered via Qualtrics Survey and provided to participants via email as part of the agency's annual employee engagement survey. IRB approval was obtained from the State of Oklahoma IRB and the University of Oklahoma IRB. Responses to demographic items on the survey indicate that most of the participants were female (78.8%). Age category ranges of participants varied from 25 to 74 years, with ages 25–34 (3.3%), 35–44 (21.2%); 45–54 (30.5%), 55–64 (33.1%), and ages 65–74 (4.6%) and 7.3% not responding. Participant job tenure varied, with employees who have worked in the state agency for less than 1 year (5.7%), 1–5 years (15.9%), (26.8%) working for 6–10 years, (17.8%) for 11–15 years, and (33.8%) >16 years.</p> <hd id="AN0175502844-11">Measures</hd> <p></p> <hd id="AN0175502844-12">Adult hope scale</hd> <p>The Adult Hope Scale (M = 54.47; SD = 7.34) is an 8‐item scale that measures the extent to which the respondent feels motivated to obtain goals and whether they can construct pathways to attain those goals (Snyder, [<reflink idref="bib76" id="ref99">76</reflink>]; Snyder et al., [<reflink idref="bib78" id="ref100">78</reflink>]). A sample item includes <emph>I energetically pursue my goals</emph>. A total hope score is derived by adding the scores from the eight items. An 8‐point Likert scale, ranging from 1 = definitely false to 8 = definitely true, is used to measure the responses. Consistent with previous findings (Hellman et al., [<reflink idref="bib34" id="ref101">34</reflink>]), the reliability estimates for the total Hope Scale for this sample were adequate (α = .92).</p> <p> <emph>Burnout</emph> (M = 35.51; SD = 9.62) was measured using the Oldenburg Burnout Inventory (OLBI; Demerouti et al., [<reflink idref="bib15" id="ref102">15</reflink>]) to assess exhaustion and disengagement, classic symptoms of burnout. The OLBI has 16 items presented in a 4‐point Likert scale (1 = strongly disagree to 4 = strongly agree). Eight items measure disengagement. An example of the eight disengagement items asks the respondent if they <emph>always find new and interesting aspects in their work</emph>. There are eight items that measure exhaustion. An item example for exhaustion asks the respondent if <emph>there are days they feel tired before they arrive at work or feel emotionally drained by the work</emph>. Internal consistency reliability for the burnout scale was.91.</p> <hd id="AN0175502844-13">Secondary traumatic stress</hd> <p>A 17‐item scale assessed the degree to which STS impacted the staff member. This scale was developed and validated by Bride et al. ([<reflink idref="bib9" id="ref103">9</reflink>]). This measure assesses the extent to which participants recognise the symptoms of secondary trauma when working with traumatised individuals. The scale identifies three subscales: intrusion (M = 9.49; SD = 3.55; sample item: <emph>Reminders of my work with clients upset me</emph>.), avoidance (M = 12.45; 4.70; sample item: <emph>I felt emotionally numb</emph>.), and arousal (M = 10.28; SD = 4.15; sample item: <emph>I had trouble sleeping</emph>.). Respondents were given a 5‐point Likert scale (1 = very often to 5 = never). Reliability estimates for the STS scale indicated acceptable levels (Intrusion α = .82; Avoidance α = .85; Arousal α = .86).</p> <hd id="AN0175502844-14">Control variable</hd> <p>Tenure was assessed by asking the participants to identify the number of years employed by the agency in five exclusive categories (less than 1 year; 1–5 years; 6–10 years; 11–15 years; 16 or more years).</p> <hd id="AN0175502844-15">Data analysis plan</hd> <p>Descriptive analysis included, mean (M), standard deviation (SD), and Cronbach's Alpha. To examine the hypotheses that (<reflink idref="bib1" id="ref104">1</reflink>) the dimensions of STS would be positively correlated with burnout, (<reflink idref="bib2" id="ref105">2</reflink>) that hope would be negatively correlated with both STS and burnout, and (<reflink idref="bib3" id="ref106">3</reflink>) that hope would account for significant variance in burnout over‐and‐above the dimensions of STS, Pearson product moment correlations (r) and hierarchical regression analyses (R) were computed. Because the hypotheses were directional in nature, the correlations were tested at the one‐tail with statistical significance criteria set at the.05 type I error rate. As a result of using listwise deletion, correlation, and regression analyses were available on a range of 140 to 152 complete data.</p> <hd id="AN0175502844-16">RESULTS</hd> <p>Prior to testing the first hypotheses of this study, the statistical assumptions of regression were assessed (Pedhazur & Schmelkin, [<reflink idref="bib65" id="ref107">65</reflink>]), with results demonstrating no violations.</p> <hd id="AN0175502844-17">Correlation of variables</hd> <p>As seen in Table 1, the STS dimensions all had moderate to strong positive relationships with burnout. Specifically, Intrusion had a significant (moderate) positive correlation with burnout. Arousal had a significant moderate correlation to burnout. Finally, Avoidance had a significant strong correlation with burnout. Hope was shown to have a strong negative correlation with burnout and small to moderate significant association with STS. These findings support the hypotheses of association among the variables.</p> <p>1 TABLE Zero‐order correlation matrix.</p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left">Variable</th><th align="left">1</th><th align="left">2</th><th align="left">3</th><th align="left">5</th><th align="left">6</th><th align="left">7</th></tr></thead><tbody valign="top"><tr><td align="left">1. Hope</td><td align="left">(.92)</td><td align="left" /><td align="left" /><td align="left" /><td align="left" /><td align="left" /></tr><tr><td align="left">2. STS: intrusion</td><td align="left">−.18<xref ref-type="fn" rid="tfn3" /></td><td align="left">(.82)</td><td align="left" /><td align="left" /><td align="left" /><td align="left" /></tr><tr><td align="left">3. STS: avoidance</td><td align="left">−.34<xref ref-type="fn" rid="tfn4" /></td><td align="left">.75<xref ref-type="fn" rid="tfn4" /></td><td align="left">(.85)</td><td align="left" /><td align="left" /><td align="left" /></tr><tr><td align="left">5. STS: arousal</td><td align="left">−.24<xref ref-type="fn" rid="tfn4" /></td><td align="left">.77<xref ref-type="fn" rid="tfn4" /></td><td align="left">.85<xref ref-type="fn" rid="tfn4" /></td><td align="left">(.86)</td><td align="left" /><td align="left" /></tr><tr><td align="left">6. Burnout</td><td align="left">−.56<xref ref-type="fn" rid="tfn4" /></td><td align="left">.41<xref ref-type="fn" rid="tfn4" /></td><td align="left">.51<xref ref-type="fn" rid="tfn4" /></td><td align="left">.38<xref ref-type="fn" rid="tfn4" /></td><td align="left">(.91)</td><td align="left" /></tr><tr><td align="left">7. Tenure (control)</td><td align="left">−.21<xref ref-type="fn" rid="tfn4" /></td><td align="left">.18<xref ref-type="fn" rid="tfn3" /></td><td align="left">.09</td><td align="left">.07</td><td align="left">.15</td><td align="left">–</td></tr><tr><td align="left">Mean</td><td align="left">54.47</td><td align="left">9.49</td><td align="left">12.45</td><td align="left">10.28</td><td align="left">35.51</td><td align="left" /></tr><tr><td align="left">SD</td><td align="left">7.34</td><td align="left">3.55</td><td align="left">4.70</td><td align="left">4.15</td><td align="left">9.62</td><td align="left" /></tr></tbody></table> </ephtml> </p> <p>1 <emph>Note</emph>: Values on the diagonal reflect Cronbach's Alpha.</p> <ulist> <item>2 Abbreviations: STS, secondary traumatic stress.</item> <item>3 * <emph>p</emph> < .05,</item> <item>4 ** <emph>p</emph> < .01.</item> </ulist> <hd id="AN0175502844-18">Burnout</hd> <p>A hierarchical multiple regression was computed with burnout as the dependent variable (Table 2). In the first model, the three dimensions of STS were entered (Intrusion, Avoidance, and Arousal) and accounted for significant variance in burnout (<emph>R</emph><sups>2</sups> = .26; <emph>F</emph> (<reflink idref="bib4" id="ref108">4</reflink>, 136) = 11.89; <emph>p</emph> < .01). In the second model, hope was entered into the equation accounting for significant variance over‐and‐above STS (Δ<emph>R</emph><sups>2</sups> = .18; Δ<emph>F</emph> (<reflink idref="bib1" id="ref109">1</reflink>, 135) = 42.99; <emph>p</emph> < .01). In this final model, hope had a significant negative association with burnout (β = −.46; <emph>p</emph> < .01). The Avoidance dimension of STS demonstrated a significant positive association with burnout (β = .38; p < .01) though lower in strength relative to the first model (β = .62; <emph>p</emph> < .01).</p> <p>2 TABLE Hierarchical multiple regression with burnout as dependent variable.</p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left">Independent variable</th><th align="left">Total <italic>R</italic><sup>2</sup></th><th align="left">Δ<italic>R</italic><sup>2</sup></th><th align="left">β</th></tr></thead><tbody valign="top"><tr><td align="left">Step 1: (secondary traumatic stress)</td><td align="left">.26<xref ref-type="fn" rid="tfn6" /></td><td align="left" /><td align="left" /></tr><tr><td align="left">Tenure (control)</td><td align="left" /><td align="left" /><td align="left">.06</td></tr><tr><td align="left">STS: intrusion</td><td align="left" /><td align="left" /><td align="left">.12</td></tr><tr><td align="left">STS: avoidance</td><td align="left" /><td align="left" /><td align="left">.62<xref ref-type="fn" rid="tfn6" /></td></tr><tr><td align="left">STS: arousal</td><td align="left" /><td align="left" /><td align="left">−.27</td></tr><tr><td align="left">Step 2: (hope)</td><td align="left">.44<xref ref-type="fn" rid="tfn6" /></td><td align="left">.18<xref ref-type="fn" rid="tfn6" /></td><td align="left" /></tr><tr><td align="left">Tenure (control)</td><td align="left" /><td align="left" /><td align="left">−.04</td></tr><tr><td align="left">STS: intrusion</td><td align="left" /><td align="left" /><td align="left">.20</td></tr><tr><td align="left">STS: avoidance</td><td align="left" /><td align="left" /><td align="left">.38<xref ref-type="fn" rid="tfn6" /></td></tr><tr><td align="left">STS: arousal</td><td align="left" /><td align="left" /><td align="left">−.23</td></tr><tr><td align="left">Hope</td><td align="left" /><td align="left" /><td align="left">−.46<xref ref-type="fn" rid="tfn6" /></td></tr></tbody></table> </ephtml> </p> <ulist> <item>5 <emph>Note</emph>: Final adjusted <emph>R</emph><sups>2</sups> = .42.</item> <item>6 ** <emph>p</emph> < .01.</item> </ulist> <p>Because STS is presented as both a three‐factor structure and a unidimensional scale (cf. Ting et al., [<reflink idref="bib79" id="ref110">79</reflink>]), we computed a second hierarchical multiple regression using the unidimensional approach to STS. In the first model, the STS was entered into the equation and accounted for significant variance in burnout (<emph>R</emph><sups>2</sups> = .20; <emph>F</emph> (<reflink idref="bib2" id="ref111">2</reflink>, 138) = 17.02; <emph>p</emph> < .01). Next, hope was entered into the equation accounting for significant variance over‐and‐above STS (Δ<emph>R</emph><sups>2</sups> = .21; Δ<emph>F</emph> (<reflink idref="bib1" id="ref112">1</reflink>, 137) = 48.45; <emph>p</emph> < .01). In this final model, hope again had a significant negative association with burnout (β = −.49; <emph>p</emph> < .01). In this final model, STS also showed a significant positive association with burnout (β = .30; <emph>p</emph> < .01). In both hierarchical regression analyses, hope accounted for significant incremental variance and presented with the stronger standardised beta in the model.</p> <hd id="AN0175502844-19">DISCUSSION</hd> <p>This study aimed to examine the relationship between hope, STS, and burnout among the developmental disabilities workforce. We were interested in hope as a potential protective resource accounting for significant variance in burnout over‐and‐above STS. The results from the correlational analysis supported the hypothesis that STS is positively associated with burnout. That is, higher scores on the experience of intrusion, avoidance, and arousal were associated with higher scores on burnout. This finding is consistent with the STS literature (Boamah et al., [<reflink idref="bib3" id="ref113">3</reflink>]; Finkelstein et al., [<reflink idref="bib25" id="ref114">25</reflink>]; Senreich et al., [<reflink idref="bib72" id="ref115">72</reflink>]). The results of the correlation analyses demonstrated that hope has a significant negative association to both STS and burnout among the participants. A key finding to this study was the result of the hierarchical regression analysis showing that hope accounted for significant variance in burnout above‐and‐beyond the three dimensions of STS. Examination of the standardised beta coefficients shows that the STS dimension of avoidance had a significant positive association with burnout. However, in the final model including hope, the strength of the association between avoidance and burnout decreased (albeit still significant). Moreover, presented as the stronger negative association to burnout in this final model. Taken as a whole, this finding provides support for hope as a protective resource for the developmental disability workforce.</p> <p>Hope provides a strength‐driven approach to supporting employees and reducing the negative impact of STS and burnout. As system and organisation leaders seek evidence‐informed strategies to improve employee well‐being and retention, strategically and systematically giving attention to hopeful thinking by way of identifying the employees' valued work‐related goals, identification and selection of various pathways to those goals, and supporting and sustaining agentic thinking. This could be completed during routine organisational activities such as case consultations, supervision, or other activities targeting employee support and improvement. Another strategy could include professional development or training for employees that increase awareness of the origins and tenets of hope theory. Employee training programs for people who work with adults with developmental disabilities have been found to be effective at increasing knowledge (Hogg et al., [<reflink idref="bib36" id="ref116">36</reflink>]; McKenzie et al., [<reflink idref="bib54" id="ref117">54</reflink>]; McKenzie et al., [<reflink idref="bib55" id="ref118">55</reflink>]) skills (Finn & Sturmey, [<reflink idref="bib26" id="ref119">26</reflink>]) and changing practice behaviours (McKenzie et al., [<reflink idref="bib55" id="ref120">55</reflink>]). Additionally, employee training in evidence‐based practice has been associated with both lower levels of employee stress and burnout (Graber et al., [<reflink idref="bib29" id="ref121">29</reflink>]). Employee training has the potential to increase workers' cognitive process to nurture their own hope. Burnout and STS are distinct states but often result in the same workplace behaviours of withdrawal and disengagement. The repercussions of this behaviour for professionals who work with vulnerable populations like people with developmental disabilities can be dangerous and harmful. Hope is a protective measure for both states, so when the organisation builds strategies and skills that increase goal‐setting strategies, pathways exploration, and attention to motivation and willpower, they create a protective strategy for these negative states. Prior studies have found that hope is malleable and can be nurtured by increasing awareness in training (Davidson et al., [<reflink idref="bib14" id="ref122">14</reflink>]; Feldman & Dreher, [<reflink idref="bib22" id="ref123">22</reflink>]; Marques et al., [<reflink idref="bib53" id="ref124">53</reflink>]). Supervisors who combine training in Hope Theory and the cultivation of a collaborative work environment that promotes trust and sharing between staff and incentivizes and celebrates examples of shared problem‐solving and positive interactions are investing in improved employee well‐being and retention.</p> <hd id="AN0175502844-20">Limitations</hd> <p>The current study provides data that indicates hope is a key factor that leads to lower burnout and reduced symptoms of STS. The potential limitations should be noted. First, the study used data to test the theory of a relationship between the variables, the results from such tests should only be suggestive. Indeed, this study used a correlational cross‐sectional design limiting any inference of causality. Further research using longitudinal design would further support the hypothesis. Second, additional testing of the relationship between the variables should be explored. It is possible that the relationship may be reversed where employees who experience lower burnout are more likely to have higher hope. Third, the sample was drawn from one organisation. While the theory does not suggest that employees in other states' departments of developmental disability services would have different cognitive states, further research is needed to test this assumption. As with most studies on burnout and STS the data collection was done at a single point in time. Current research needs to clarify whether those outcomes are stable over time or dynamic measures. Again, the longitudinal examination may provide more insight into those gaps.</p> <hd id="AN0175502844-21">IMPLICATIONS AND CONCLUSIONS</hd> <p>STS and burnout are associated with elevated levels of employee turnover (Kozak et al., [<reflink idref="bib46" id="ref125">46</reflink>]), negative interactions with clients (Dennis & Leach, [<reflink idref="bib16" id="ref126">16</reflink>]; Outar & Rose, [<reflink idref="bib63" id="ref127">63</reflink>]), and increased absenteeism (Harvey & Burns, [<reflink idref="bib32" id="ref128">32</reflink>]). Professionals working with children and adults with developmental disabilities need workplaces that promote hope to prevent burnout and STS. Hope is a cognitive process that can be nurtured and restored. Therefore, attention to the value of employee self‐talk and perspective‐taking about the work may have benefits. Hope has been treated in this measure as a construct for individual use, but it adds value to be considered as a core construct that could be woven into an organisation's climate and culture. If the organisation reflected a hope centred approach, the organisational values, policies, programs, and services would develop business processes that give attention to the valued goals of the employee, support pathways development, work to remove impediments that distract from goals, and build systems that intentionally restore the employee's mental energy toward the goals. In essence, a hope‐centred workplace is an employee‐centred workplace. Promoting the well‐being of employees above that of maintaining the system status quo is a laudable goal. By working toward employee well‐being and retention, agencies can prevent the harmful consequences of frequent turnover due to burnout.</p> <p>Future studies can build on the findings from this research by exploring the specific strategies leaders could use to improve hopeful thinking among the workforce. Prior studies have found decreased burnout when professionals describe their workplace as transparent, with open communication between leaders and staff (Giberson et al., [<reflink idref="bib28" id="ref129">28</reflink>]). The use of the future‐focused language of hope by way of clarifying goals and describing pathways may be a strategy that enhances feelings of transparency and effective communication. Future studies should explore the organisational factors that increase or decrease hopeful thinking in ways that impact the state of STS and burnout. In addition, future studies should explore sources of support for the cognitive process of work.</p> <hd id="AN0175502844-22">ACKNOWLEDGEMENTS</hd> <p>We would like to acknowledge the dedicated employees of the Oklahoma Department of Human Services.</p> <hd id="AN0175502844-23">FUNDING INFORMATION</hd> <p>Funding provided from a grant from the Oklahoma Department of Human Services, project no. A22‐0040.</p> <hd id="AN0175502844-24">CONFLICT OF INTEREST STATEMENT</hd> <p>We have no known conflicts of interest to disclose.</p> <hd id="AN0175502844-25">DATA AVAILABILITY STATEMENT</hd> <p>The data that support the findings of this study are available from the corresponding author upon reasonable request. The research team requested the data from the Oklahoma Department of Human Services (OKDHS). 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  Group: Ti
  Data: A Model of Hope as a Protective Measure to Lower Burnout and Secondary Traumatic Stress among Employees Working in Developmental and Intellectual Disabilities Services
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  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Christina+R%2E+Miller%22">Christina R. Miller</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-6821-027X">0000-0002-6821-027X</externalLink>)<br /><searchLink fieldCode="AR" term="%22Angela+B%2E+Pharris%22">Angela B. Pharris</searchLink><br /><searchLink fieldCode="AR" term="%22Chan+M%2E+Hellman%22">Chan M. Hellman</searchLink><br /><searchLink fieldCode="AR" term="%22Joshua+Swann%22">Joshua Swann</searchLink>
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  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Journal+of+Applied+Research+in+Intellectual+Disabilities%22"><i>Journal of Applied Research in Intellectual Disabilities</i></searchLink>. 2024 37(2).
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  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
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  Label: Peer Reviewed
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  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 9
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2024
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Burnout%22">Burnout</searchLink><br /><searchLink fieldCode="DE" term="%22Stress+Variables%22">Stress Variables</searchLink><br /><searchLink fieldCode="DE" term="%22Developmental+Disabilities%22">Developmental Disabilities</searchLink><br /><searchLink fieldCode="DE" term="%22Labor+Force+Development%22">Labor Force Development</searchLink><br /><searchLink fieldCode="DE" term="%22Caseworkers%22">Caseworkers</searchLink><br /><searchLink fieldCode="DE" term="%22Social+Work%22">Social Work</searchLink><br /><searchLink fieldCode="DE" term="%22Intellectual+Disability%22">Intellectual Disability</searchLink><br /><searchLink fieldCode="DE" term="%22Positive+Attitudes%22">Positive Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Work+Environment%22">Work Environment</searchLink><br /><searchLink fieldCode="DE" term="%22Resources%22">Resources</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1111/jar.13184
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1360-2322<br />1468-3148
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Burnout and secondary traumatic stress (STS) are problems for the workforce supporting people with developmental disabilities. This study investigated hope as a potential protective resource for burnout and STS among the developmental disability services workforce. Method: One hundred and fifty-two non-supervisor caseworkers from a state agency, developmental disabilities division were recruited to participate in an anonymous web-based survey. Results: The analyses showed that hope was negatively associated with the three dimensions of STS (intrusion, avoidance, and arousal) and burnout. Controlling for tenure in the workforce and STS, the results of the hierarchical regression analyses showed that hope accounted for a significant incremental variance to burnout. Conclusion: These findings provide support for emerging literature showing hope as a protective resource to workforce burnout.
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  Label: Entry Date
  Group: Date
  Data: 2024
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  Label: Accession Number
  Group: ID
  Data: EJ1412952
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1412952
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    Identifiers:
      – Type: doi
        Value: 10.1111/jar.13184
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 9
    Subjects:
      – SubjectFull: Burnout
        Type: general
      – SubjectFull: Stress Variables
        Type: general
      – SubjectFull: Developmental Disabilities
        Type: general
      – SubjectFull: Labor Force Development
        Type: general
      – SubjectFull: Caseworkers
        Type: general
      – SubjectFull: Social Work
        Type: general
      – SubjectFull: Intellectual Disability
        Type: general
      – SubjectFull: Positive Attitudes
        Type: general
      – SubjectFull: Work Environment
        Type: general
      – SubjectFull: Resources
        Type: general
    Titles:
      – TitleFull: A Model of Hope as a Protective Measure to Lower Burnout and Secondary Traumatic Stress among Employees Working in Developmental and Intellectual Disabilities Services
        Type: main
  BibRelationships:
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      – PersonEntity:
          Name:
            NameFull: Christina R. Miller
      – PersonEntity:
          Name:
            NameFull: Angela B. Pharris
      – PersonEntity:
          Name:
            NameFull: Chan M. Hellman
      – PersonEntity:
          Name:
            NameFull: Joshua Swann
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2024
          Identifiers:
            – Type: issn-print
              Value: 1360-2322
            – Type: issn-electronic
              Value: 1468-3148
          Numbering:
            – Type: volume
              Value: 37
            – Type: issue
              Value: 2
          Titles:
            – TitleFull: Journal of Applied Research in Intellectual Disabilities
              Type: main
ResultId 1