health - related professionals are at high risk of job burnout which will in turn lead to effects on health services provision .
the present study was conducted to define job burnout and its association with personal characteristics among the midwives working in isfahan , iran .
this descriptive correlational study was performed on 193 midwives working in health centers and hospitals in isfahan .
the data was collected by a researcher - made personal characteristics questionnaire as well as maslach burnout inventory .
in the present study , the highest frequencies of job burnout dimensions were for the low levels of emotional exhaustion ( 58% ) and depersonalization ( 65.8% ) , and high levels of personal performance ( 58% ) .
there was a significant inverse association between age and depersonalization ( p = 0.02 ) .
however , no significant relations were found between job burnout dimensions and variables of marital status , number of children , level of education , and residential status .
although the results of this research showed a low prevalence of job burnout among midwives , the stressful nature of midwifery as a profession necessitates educational intervent .
job burnout syndrome , as a recent professional issue , is considered as the main feature of occupational stress , and a delayed reaction to chronic stressors in the work place .
this psycho - cognitive syndrome comprises three dimensions of emotional exhaustion and mental power discharge , depersonalization ( negative reaction accompanied with ignoring the clients ) , and the decline of personal performance ( losing capability and success at work ) .
job burnout results in numerous inappropriate mental and psychical effects such as depression , reduction of job satisfaction , criticizing the clients and losing empathy , decline of professional function , increase of family and interpersonal problems , irregularity in patient care and eventually , absence from work .
it also imposes a 4% waste of work hours to organizations and thus brings about financial loss by wasting millions of dollars each year .
previous research has showed health professions ( such as midwifery ) to be at the highest risk of occupational complications , such as job burnout , compared to other occupations .
individuals are believed to experience different levels of job burnout based on personal and occupational factors .
some studies have evaluated the association between personal characteristics and job burnout and reported controversial findings .
for instance , talaei et al . found a significant association between job burnout subscales and variables such as age and education .
however , alparslan and doganer demonstrated that age , marital status and number of children had no effects on job burnout .
likewise , toubaei and sahraeian concluded that job burnout was not significantly associated with age . in another study , bahri bynabaj et al . reported that although there was not a significant association between job burnout and the variable of age , marital status and level of education were significantly related with job burnout .
some other researchers have believed personal factors not to be able to influence job burnout .
therefore , considering the existing controversies and the high prevalence of job burnout in modern societies resulting in leaving jobs , reduction of working forces and their outcome in economy and production of the country , further studies seem necessary . on the other hand ,
the midwives are important members of health providing team whose high quality health services play a key role in health indexes such as life expectancy and maternal mortality . in addition , having a crucial responsibility , midwives can be predisposed to job burnout that consequently causes diminished quality of patient care and low quality and quantity of health services . the present study was thus conducted to define job burnout and its association with personal factors ( age , marital status , number of children , level of education , and residential status ) amongst midwives in order to reduce job burnout and to promote the quality of care they provide .
this descriptive correlational study included all midwives working in health centers , and university and private hospitals in isfahan ( iran ) as well as isfahan charity center in 2011 .
the inclusion criteria were having at least one year of working experience , no history of mental and psychotic problems and not being exposed to acute stressful events . in order to collect data , subjects filled out a researcher - made personal factor questionnaire and maslach burnout inventory ( mbi ) .
mbi includes 22 questions on three components of emotional exhaustion , personal performance , and depersonalization .
the personal factor questionnaire was based on a seven - item likert scale in which scores of 06 were respectively associated with never , several times a year , once a month , several times a month , once a week , several times a week , and every day .
after scoring the questions for each subject , total scores of each dimension was summed up and categorized as low , moderate , or high . in order to do so
, high , moderate , and low scores were respectively considered as over 30 , 1829 , and 17 in emotional exhaustion , over 12 , 611 , and 6 in depersonalization , and over 40 , 3439 , and 33 in personal performance .
the scores of subscales were not addable since in two subscales of emotional exhaustion and depersonalization , high scores showed job burnout but in the subscale of personal performance , lower scores indicated job burnout .
the employed questionnaire has been frequently confirmed by reliability of over 90% by iranian researchers .
the collected data was analyzed by descriptive ( mean , standard deviation ( sd ) , and frequency distribution ) and inferential statistical tests ( pearson s correlation test , spearman test , analysis of variance , and independent t- test ) in spss .
most subjects were married , had two children , had a bachelor s degree , and owned a house .
low levels of emotional exhaustion ( 58% ) and depersonalization ( 65.8% ) , and high levels of personal performance ( 58% ) were the most frequent levels of job burnout dimensions ( table 1 ) .
mean values of job burnout in dimensions of emotional exhaustion , depersonalization , and personal performance were 15.3 ( 9.9 ) , 5.4 ( 4.8 ) , and 39.7 ( 6.3 ) , respectively .
mean values in dimensions of emotional exhaustion , depersonalization and personal performance were respectively 13.58 ( 9.92 ) , 4.74 ( 4.44 ) , and 40.28 ( 6.39 ) in health centers .
the corresponding values in the hospitals were 16.79 ( 9.82 ) , 6.00 ( 5.17 ) , and 39.25 ( 6.34 ) .
independent t - test showed a significant association between workplace location and dimensions of emotional exhaustion ( t = 2.25 ; p = 0.01 ) and depersonalization ( t = 1.79 ; p = 0.03 ) .
however , personal performance and workplace location were not significantly related ( t = 1.12 ; p = 0.13 ) .
in addition , mean values of emotional exhaustion and depersonalization in the age group of 22 - 32 years were higher than other age groups ( 16.41 ( 10.13 ) vs. 6.50 ( 5.31 ) ) .
mean value of personal performance was equal to 38.77 ( 6.8 ) in this age group which was in a lower level compared to other subjects .
distribution of subscale levels of burnout in subjects pearson s correlation test revealed a significant inverse association between age and depersonalization .
however , no significant associations were found between age and dimensions of emotional exhaustion and personal performance .
analysis of variance showed no significant associations between marital status and subscales of emotional exhaustion , depersonalization and personal performance .
in addition , no significant relations between number of children and emotional exhaustion , depersonalization , and personal performance were indicated by pearson s correlation test .
moreover , educational level and emotional exhaustion , depersonalization and personal performance were not found to be significantly related according to spearman correlation test .
finally , independent t - test showed no significant associations between residential status and the three dimensions of job burnout ( table 2 ) .
job burnout values stratified based on the three dimensions of burnout and demographic factors ( values are presented as mean and standard deviation )
the findings of this study showed the highest frequencies of job burnout dimensions to be for low levels of emotional exhaustion and depersonalization , and high levels of personal performance , respectively .
therefore , a high percentage of the subjects in the present study seemed not to have experienced job burnout .
khaghani zadeh reported the highest frequency of the three component dimensions of job burnout amongst nurses as low levels of emotional exhaustion ( 53% ) , depersonalization ( 48% ) , as well as personal performance ( 45% ) .
indicated the highest frequency for low levels of emotional exhaustion ( 70% ) and personal performance ( 54% ) , and high levels of depersonalization ( 94.7% ) amongst physicians .
sotodeh asl and bakhtiari concluded that the highest frequencies were for moderate emotional exhaustion ( 93.2% ) , low personal performance ( 93.1% ) , and high depersonalization ( 94.1% ) amongst nurses and midwives .
however , their study generally considered nurses and midwives and did not evaluate different types of the professions . therefore , job burnout was less common amongst the studied midwives in the present study than the physicians taee et al . studied .
alparslan and doganer reported the mean values of job burnout dimensions as 17.41 , 5.03 , and 20.38 for emotional exhaustion , depersonalization , and personal performance , respectively . on the other hand , momeni et al . published 41.38 , 9.28 , and 29.31 as the mean values of emotional exhaustion , depersonalization , and personal performance , respectively .
mean values of the three dimensions of burnout in the present study were thus lower than the abovementioned studies . since depersonalization is defined as the negative reaction and ignoring the clients , lower scores of depersonalization in the midwives in the present study can possibly be due to their appropriate interpersonal communication .
it should be indicated that personal performance is felt when individuals can play a role in their related organizations , show their abilities , and attain positive attitudes about themselves and their clients . in this case
, they can have a better judgment about their job , attain more authority , and cope with their duties while feeling self - confident .
thus , high personal performance among the studied subjects may reflect their positive attitude toward their profession and their high self - confidence . on the other hand ,
high social class or other successful life backgrounds among the studied subjects seem to have helped them cope with their occupational stressors , and to have lowered their emotional exhaustion .
. believed a higher social class or successful backgrounds to be effective on diminishing emotional exhaustion .
the present study found higher mean values of emotional exhaustion and depersonalization , and lower values of personal performance among midwives working in hospitals compared to those in health centers .
therefore , midwives working in hospitals seem to suffer more from job burnout possibly due to the type and intensity of occupational stress they experience at work .
moreover , a significant inverse association was observed between age and depersonalization , while emotional exhaustion and personal performance were not significantly related with age . on the other hand ,
the mean value of depersonalization was the highest in the age group of 22 - 32 . while momeni et al .
suggested various age groups of nurses to obtain different scores of depersonalization bargellini et al .
ahmadi and sheikh alizadeh and sotodeh asl and bakhtiari rejected any significant association between age and job burnout .
based on the relation between depersonalization and age in the present study , some other elements such as working conditions and obtained experiences at work may also be effective in this regard .
. believed that individuals get more prepared to cope with stressful situations at higher ages , and consequently experience less job burnout .
it can be thus concluded that 22 - 33 year - old midwives suffered more from job burnout as a result of their higher mean emotional exhaustion and depersonalization , and their lower personal performance compared to other age groups .
this issue may be due to the fact that younger individuals are more susceptible to job burnout .
not being significantly correlated with job burnout dimensions , marital status seems not to be an appropriate predictor for job burnout , i.e. individuals with different marital statuses would experience the same level of job burnout .
likewise , gonzalez and bernard and bartly did not suggest a significant association between emotional exhaustion and marital status among academic members .
consistent with the findings of alparslan and doganer , yaman and soler , and gullap et al . , the present study did not reveal a significant association between job burnout subscales and number of children .
in addition , the present study showed that despite the higher mean values of job burnout dimensions among the employees with a bachelor s degree , the relations were not significant .
similar results were previously published by alparslan and doganer , yaman and soler , mollao lu et al , and aziz nejad and hosseini .
in addition , analysis of variance showed no significant associations between the three dimensions of job burnout and residential status , which was also reported by aziz nejad and hosseini .
job burnout was lower among the midwives attending the present study compared to the abovementioned researches .
however , the prevalence of job burnout was higher among midwives working in hospitals compared to the health centers .
in addition , considering the higher mean values of depersonalization in the age group of 22 - 32 years in the present study , younger midwives need to receive more attention .
finally , the education authorities are suggested to hold related educational workshops to prevent and amend job burnout and ultimately enhance the quality of care .
 background : health - related professionals are at high risk of job burnout which will in turn lead to effects on health services provision . the present study was conducted to define job burnout and its association with personal characteristics among the midwives working in isfahan , iran.materials and methods : this descriptive correlational study was performed on 193 midwives working in health centers and hospitals in isfahan . 
 the participants were selected through cluster random sampling . 
 the data was collected by a researcher - made personal characteristics questionnaire as well as maslach burnout inventory . 
 the data was analyzed by descriptive and inferential statistical tests in spss.findings:in the present study , the highest frequencies of job burnout dimensions were for the low levels of emotional exhaustion ( 58% ) and depersonalization ( 65.8% ) , and high levels of personal performance ( 58% ) . 
 there was a significant inverse association between age and depersonalization ( p = 0.02 ) . 
 however , no significant relations were found between job burnout dimensions and variables of marital status , number of children , level of education , and residential status.conclusions:although the results of this research showed a low prevalence of job burnout among midwives , the stressful nature of midwifery as a profession necessitates educational intervent . 
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