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Objectives: This study applied a multilevel analysis to verify the relationships among team climate, emotional labor, and physician burnout. Methods: We conducted a questionnaire survey for the physicians in Taiwanese hospitals. A total number of 530 physicians from 30 physician teams participated in this study. Hierarchical linear modeling (HLM) was used to test the multilevel hypotheses. Results: (1) deep acting of emotional labor was significantly associated with three components of burnout, while surface acting was only significantly associated with emotional exhaustion; (2) highly significant association between team climate and burnout for three components (emotional exhaustion, γ^sub 01^=-.651, p<.001; depersonalization, γ^sub 01^=-.491, p<.01; reduced personal accomplishment, γ^sub 01^=-.795, p<.001); and (3) team climate only has a significant moderating effect on the relationship between surface acting of emotional labor and emotional exhaustion (γ^sub 11^=-.446, p<.05). Conclusions: The results support the hypothesis that team climate and emotional labor have impacts on physician burnout. The findings remind hospital executives that climate of physician team help to mitigate physician burnout. In addition, the findings could help to clarify some aspects of the emotional dimensions of physicians with a view to improving the quality of service. (Taiwan J Public Health. 2014;33(3):271-289)
Key words: burnout, emotional labor, team climate, multilevel research
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INTRODUCTIONS
Job burnout is a state of exhaustion and emotional depletion that is unhealthy for the employee and is linked to absenteeism, turnover, and lower job performance [1]. Moreover, these outcomes are particularly problematic for health care professionals, where absence and decreased job performance can harm patient health as well [2]. The complexity of the tiredness situation develops negative job feelings, low professional in selfperceptive and losing of empathy for clients [3]. According to this characterization, the burnout syndrome consists of three components: emotional exhaustion, depersonalization, and reduced personal accomplishment. Emotional exhaustion refers to feelings of being over-extended and depleted of one's emotional resources. Depersonalization refers to a negative, callous or excessively detached response to other people. Reduced personal accomplishment refers to a decline in one's feeling of competence and successful achievement in one's work [4]. The operational definition that is widely used in burnout research is the three-component model.
Among the healthcare staff, physicians are at high risk of occurrence of burnout....