The burnout epidemic during the COVID-19 pandemic: The role of LMX in alleviating physicians' burnout
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Abstract
During COVID-19 pandemic, physicians are being exposed to unprecedented adverse working conditions that lead to increased occurrence of burnout. While supportive leadership is considered effective in preventing burnout, little is known about the role of leadership in extreme situations. rawing on leader-member exchange (LMX) theory, we
hypothesize that high-LMX relationships lead to lower levels of burnout, as they shape physicians’ perceptions of psychosocial job demands and resources. We also contend that this effect will be stronger for frontline physicians, as they are more exposed to job stressors. In a field study with 2,708 Brazilian physicians, we found support to the
alleviating role of LMX, but contrary to what we predicted, we found that this effect is weaker for frontline physicians. Overall, our findings reinforce the importance of establishing high-quality relationships between supervisors and
medical staff to mitigate the experience of burnout, however, they also highlight that extreme conditions, such as the COVID-19 pandemic, might constrain the beneficial effects of leadership behaviors.
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References
Alves, M. G. D. M., Chor, D., Faerstein, E., Lopes, C. D. S., & Werneck, G. L. (2004). Versão resumida da" job stress scale": Adaptação para o português. Revista de Saúde Pública, 38, 164-171. doi: 10.1590/S0034-89102004000200003
Bakker, A., Demerouti, E., & Euwema, M. (2005). Job resources buffer the impact of job demands on burnout. Journal of Occupational Health Psychology, 2, 170-180. doi: 10.1037/1076-8998.10.2.170
Bakker, A. B., & Demerouti, E. (2007). The job demands-resources model: State of the art. Journal of Managerial Psychology, 22, 309-328. doi: 10.1108/02683940710733115
Bakker, A. B., & Demerouti, E. (2008). Towards a model of workengagement. The Career Development International, 13(3), 209–223. doi: 10.1108/13620430810870476
Bansal, P., Bingemann, T. A., Greenhawt, M., Mosnaim, G., Nanda, A., Oppenheimer, J., Sharma, H., David Stukus, D., & Shaker, M. (2020).
Clinician wellness during the Covid-19 pandemic: Extraordinary times and unusual challenges for the allergist/immunologist. Journal of Allergy and Clinical Immunology Practice, 8(6), 1781-1790. doi:
1016/j.jaip.2020.04.001
Bundy, J., Pfarrer, M. D., Short, C. E., & Coombs, W. T. (2017). Crises and crisis management: Integration, interpretation, and research development. Journal of Management, 43(6), 1661-1692.
Carlson, D. S., & Perrewé, P. L. (1999). The role of social support in the stressor-strain relationship: An examination of workfamily conflict. Journal of Management, 25(4), 513-540. doi: 10.1177/0149206316680030
Côrtes, M., Souza, M., & Puente-Palacios, K. (2019). Multidimensional measure of leader-member exchange: Psychometric properties of its Brazilian version. Psico-USF, 24(3), 569-581. doi: 10.1590/1413-82712019240313
Demerouti, E., Bakker, A., Nachreiner, F., & Schaufeli, W. (2001). The job demands-resources model of burnout. Journal of Applied Psychology, 86(3), 499-512. doi: 10.1037/0021-9010.86.3.499
Demerouti, E., Mostert, K., & Bakker, A. B. (2010). Burnout and work engagement: A thorough investigation of the independency of both constructs. Journal of Occupational Health Psychology, 15(3), 209–222. doi:10.1037/a0019408
Dicke, T., Stebner, F., Linninger, C., Kunter, M., & Leutner, D. (2018). A longitudinal study of teachers’ occupational well-being: Applying the job demands-resources model. Journal of Occupational Health Psychology, 23(2), 262–277. doi: 10.1037/ocp0000070
Epitropaki, O., & Martin, R. (2005). From ideal to real: A longitudinal study of the role of implicit leadership theories on leader-member exchanges and employee outcomes. Journal of Applied Psychology, 90(4), 659-676. doi: 10.1037/0021-9010.90.4.659
Epitropaki, O, Kapoutsis, I., Ellen, B. P., III, Ferris, G. R., Drivas, K., & Ntotsi, A. (2016). Navigating uneven terrain: The roles of political skill and LMX differentiation in prediction of work relationship quality and work outcomes. Journal of Organizational Behavior, 37, 1078-1103. doi: 10.1002/job.2100
Erdogan, B., Liden, R., & Kraimer, M. (2006). Justice and leader-member exchange: The moderating role of organizational culture. Academy of Management Journal, 49(2), 395-406. doi:10.2307/20159770
Fernandes, G., & Pereira, B. (2020). The challenges of funding the Brazilian health system in fighting the COVID-19 pandemic in the context of the federative pact. Revista de Administração Pública, 54(4), 595-613. doi: 10.1590/0034-761220200290x
Gerstner, C., & Day, D. (1997). Meta-analytic review of leader–member exchange theory: Correlates and construct issues. Journal of Applied Psychology, 82, 827-844. doi: 10.1037/0021-9010.82.6.827
Gottfredson, R. K., Wright, S. L., & Heaphy, E. D. (2020). A critique of the Leader-Member Exchange construct: Back to square one. The Leadership Quarterly, 101385. doi:10.1016/j.leaqua.2020.101385
Graen, G. B., & Uhl-Bien, M. (1995). Relationship-based approach to leadership: Development of leader-member exchange (LMX) theory of leadership over 25 years: Applying a multi-level multidomain perspective. Leadership Quarterly, 6, 219-247. doi: 10.1016/1048-9843(95)90036-5
Halbesleben, J., & Buckley, M. (2004). Burnout in organizational life. Journal of Management, 30, 859-879. doi: 10.1016/j.jm.2004.06.004
Halbesleben, J., & Demerouti E. (2005). The construct validity of an alternative measure of Burnout. Work & Stress, 19(3), 208-220. doi: 10.1080/02678370500340728
Hällgren, M., Rouleau, L. & Rond, M. (2018). A matter of life or death: How extreme context research matters for management and organization studies. Academy of Management Annals, 12(1), 111-153. doi: 10.5465/annals.2016.0017
Hannah, S., Uhl-Bien, M., Avolio, B., & Cavarretta, F. (2009). A framework for examining leadership in extreme contexts. Leadership Quarterly, 20(6), 897-919. doi: 10.1016/j.leaqua.2009.09.006
Harms, P., Credé, M., Tynan, M., Leon, M., & Jeung, W. (2017). Leadership and stress: A meta-analytic review. Leadership Quarterly, 28, 178-194. doi: 10.1016/j.leaqua.2016.10.006
Hesselgreaves, H., & Scholarios, D. (2014). Leader–member exchange and strain: A study of job demands and role status. Human Resource Management Journal, 24(4), 459-478. doi: 10.1111/1748-8583.12042
Hetland, H., Sandal, G. M., & Johnsen, T. B. (2007). Burnout in the information technology sector: Does leadership matter? European Journal of Work and Organizational Psychology, 16, 58-75. doi: 10.1080/13594320601084558
Hobfoll, S. E. (2002). Social and psychological resources and adaptation. Review of General Psychology, 6(4), 307–324. doi: 10.1037/1089-2680.6.4.307
Kane, L. (2020). Medscape national physician burnout and suicide report 2020. Retrieved from https://www.medscape.com/slideshow/2020-lifestyle-burnout-6012460
Karasek, R., & Theorell, T. (1990). Healthy work stress, productivity, and the reconstruction of working life. New York, USA: Basic Books.
Kelly, R. J., & Hearld, L. R. (2020). Burnout and leadership style in behavioral health care: A literature review. Journal of Behavioral Health Services & Research, 47, 581–600. doi: 10.1007/s11414-019-09679-z
Kerr, S., & Jermier, J. M. (1978). Substitutes for leadership: Their meaning and measurement. Organizational Behavior and Human Performance, 22(3), 375-403. doi: 10.1016/0030-5073(78)90023-5
Lagowska, U., Sobral, F., & Furtado, L. (2020). Leadership under crises: A research agenda for the post-Covid-19 Era. Brazilian Administration Review, 17(2), 1-5. doi: 10.1590/1807-7692bar2020200062
Lai, J., Ma, S., Wang, Y., et al. (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Network Open, 3(3), e203976. doi:10.1001/jamanetworkopen.2020.3976
Liden, R., & Maslyn, J. (1998). Multidimensionality of leader-member exchange: An empirical assessment through scale development. Journal of Management, 24(1), 43-72. doi: 10.1016/S0149-2063(99)80053-1
Lu, W., Wang, H., Lin, Y., & Li, L. (2020). Psychological status of medical workforce during the COVID-19 pandemic: A cross-sectional study. Psychiatry Research, 288, 112936. doi: 10.1016/j.psychres.2020.112936
Maslach, C., & Leiter, M. P. (2008). Early predictors of job burnout and engagement. Journal of Applied Psychology, 93, 498-512. doi: 10.1037/0021-9010.93.3.498
Maslach, C., Schaufeli, W., & Leiter, M. (2001). Job burnout. Annual Review of Psychology, 52, 397-422. doi: 10.1146/annurev.psych.52.1.397
Montani, F., Courcy, F., & Vandenberghe, C. (2017). Innovating under stress: The role of commitment and leader-member exchange. Journal of Business Research, 77, 1-13. doi:10.1016/j.jbusres.2017.03.024
Peci, A. (2020). The response of the Brazilian public administration to the challenges of the COVID-19 pandemic. Revista de Administração Pública, 54(4). doi: 10.1590/0034-761242020x
Restauri, N., & Sheridan, A. (2020). Burnout and posttraumatic stress disorder in the coronavirus disease 2019 (Covid-19) pandemic. Journal of the American College of Radiology, 17(7), 921-926. doi: 10.1016/j.jacr.2020.05.021
Sasangohar, F., Jones, S. L. Masud, F. N., Vahidy, F. S., & Kash, B. A. (2020). Provider burnout and fatigue during the Covid-19 pandemic: Lessons learned from a high-volume intensive care unit. Anesthesia & Analgesia, 131(1), 106-111. doi: 10.1213/ANE.0000000000004866
Scandura, T., & Pellegrini, E. (2008). Trust and leader-member exchange: A closer look at relational vulnerability. Journal
of Leadership & Organizational Studies, 15(2), 101-110. doi: 10.1177/1548051808320986
Schermuly, C. C., & Meyer, B. (2016). Good relationships at work: The effects of Leader–Member Exchange and Team–Member Exchange on psychological empowerment, emotional exhaustion, and depression. Journal of Organizational Behavior, 37(5), 673–691. doi: 10.1002/job.2060
Schreibera, M., & Jenny, G. (2020). Development and validation of the ‘Lebender emoticon PANAVA’ scale for digitally measuring positive and negative activation and valence via emoticons. Personality & Individual Differences, 160: 10992. doi: 10.1016/j.paid.2020.109923
Schuster, M., & Dias, V. (2018). Oldenburg burnout inventory: Validação de uma nova forma de mensurar burnout no Brasil. Ciência & Saúde Coletiva, 23(2), 553-562. doi: 10.1590/1413-81232018232.27952015
Silva, G., Saraiva, E., Ferreira, G., Peixoto Junior, R., & Ferreira, L. (2020). Healthcare system capacity of the municipalities in the State of Rio de Janeiro: Infrastructure to confront COVID-19. Revista de Administração Pública, 54(4), 578-594. doi: 10.1590/0034-761220200128x
Siu, O. L., Lu, C. Q., & Spector, P. E. (2007). Employees’ well-being in Greater China: The direct and moderating effects of general selfefficacy. Applied Psychology, 56(2), 288-301. doi: 10.1111/j.1464-0597.2006.00255.x
Sobral, F., Carvalho, J., Lagowska, U., Furtado, L., & Grobman, M. (2020). Better safe than sorry: Leadership sensemaking in the time of Covid-19. Revista de Administração Pública, 54(4), 758-781. doi: 10.1590/0034-761220200262x
Sonnentag, S., Kuttler, I., & Fritz, C. (2010). Job stressors, emotional exhaustion, and need for recovery: A multi-source study on the benefits of psychological detachment. Journal of Vocational Behavior, 76(3), 355-365. doi: 10.1016/j.jvb.2009.06.005
Tan, B. Y., Abhiram, K., Lim, L. J., Tan, M., Chua, Y. X., Tan, L., ... & Kinross, J. (2020).. Burnout and associated factors amongst healthcare workers in Singapore during the Covid-19 pandemic. Journal of the American Medical Directors Association. In press. doi:10.1016/j.jamda.2020.09.035.
Thomas, C., & Lankau, M. (2009). Preventing burnout: The effects of LMX and mentoring on socialization, role stress, and burnout. Human Resource Management, 48(3), 417-432. doi: 10.1002/hrm.20288
Tordera, N., González-Romá, V., & Peiró, J. M. (2008). The moderator effect of psychological climate on the relationship between leadermember exchange (LMX) quality and role overload. European Journal of Work and Organizational Psychology, 17(1), 55-72. doi: 10.1080/13594320701392059
Trépanier, S. G., Fernet, C., & Austin, S. (2013). The moderating role of autonomous motivation in the job demands-strain relation: A two sample study. Motivation and Emotion, 37(1), 93-105. doi: 10.1007/s11031-012-9290-9
Tummers, L.G. & Knies, E. (2013). Leadership and meaningful work in the public sector. Public Administration Review, 73(6), 859–868. doi: 10.1111/puar.12138
Xanthopoulou, D., Oerlemans, W., & Koszucka, M. (2018). Need for recovery after emotional labor: Differential effects of daily deep and surface acting. Journal of Organizational Behavior, 39(4), 481-494. doi: 10.1002/job.2245
