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SMAD. Revista eletrônica saúde mental álcool e drogas

On-line version ISSN 1806-6976

SMAD, Rev. Eletrônica Saúde Mental Álcool Drog. (Ed. port.) vol.17 no.4 Ribeirão Preto Oct./Dec. 2021

http://dx.doi.org/10.11606/issn.1806-6976.smad.2021.163263 

ORIGINAL ARTICLE

 

Incidence of Burnout syndrome in Brazilian army military in the amazon region

 

 

Yonel Ricardo de Souza; Fabio Biasotto Feitosa; Gabrielle Selleri Bezerra

Universidade Federal de Rondônia, Núcleo de Saúde, Porto Velho, RO, Brazil

Corresponding author

 

 


ABSTRACT

OBJECTIVE:this study aimed to investigate the Burnout levels and possible predisposing factors among Brazilian Army military who were serving in the Brazilian Amazon.
METHOD: the sample consisted of 122 volunteer military (officers and sergeants) with a mean age of 36.80 ± 6.69 years, 53 were employed in the operational missions (border security, patrol, external and internal defense exercises) and 69 personnel who were employed in the administrative missions (internal logistics). Officers (29) and sergeants (93) were selected who served in Porto Velho, northwestern Brazil. They answered to a sociodemographic questionnaire and the Maslach Burnout Inventory, validated for Brazil.
RESULTS: scores showed that the levels of burnout in Army military who serve in the region are high. The main sociodemographic, labor, physical and social conditions that were associated with significantly higher levels of Burnout in this study were: reduced length of service, sedentary lifestyle, extra work, lower hierarchical rank and living away from relatives.
CONCLUSION: the interaction between the two instruments found that the military working in the operational area, warrant officers, sergeants, between 6 and 10 years in service, single, who do little physical activity and whose relatives live far away were the ones who had the highest Burnout levels.

Descriptors: Causality; Military Personnel; Burnout, Professional; Amazonian Ecosystem.


 

 

Introduction

The interaction between the two instruments found that the military working in the operational area, command officers, sergeants, between six and ten years in service, single, who do little physical activity and whose relatives live far away were those who had the highest levels of Burnout(1). A recent research in occupational psychology aims to address, among other issues, the dynamics of suffering and/or illnesses caused or triggered by poor working conditions(2).

Individual traits and poor working conditions can affect people's interpersonal skills(3), their ability to work, as well as bring emotional and/or physical consequences that, in their final stage, can inflict serious damage to the health of professionals, disabling them. By following this same reasoning, this work can either be a source of balance to the person - when it allows the discharge of tension - or cause pain, psychological or somatic decompensations which may lead the individual to suffer from a psychosomatic disease(4). As a consequence, stress and Burnout syndrome have been widely studied by occupational psychologists.

Burnout, a psychological syndrome resulting from chronic emotional stress at work, is one of the damaging consequences arising from a stressful working environment. It is seen as a subjective inner experience that evokes negative feelings and attitudes in the relationship of individuals with their workplace (dissatisfaction, weariness, loss of commitment), disrupting their professional performance, which leads to negative consequences to the company where they work, such as absenteeism, job abandonment and low productivity(3).

Burnout syndrome is divided into three dimensions: Emotional Exhaustion, Depersonalization and decreased personal fulfillment (Job Satisfaction). The symptoms that characterize emotional exhaustion are fatigue, emotional breakdown and negativity(5). This author also claims that depersonalization manifests itself when one deals with customers and co-workers in a cold and harsh way. On the other hand, the decline in professional fulfillment presents itself in the form of feelings of incompetence and/or perception of poor performance. In organizations where hierarchy is well-established and rule-focused, such as in the military, employees are more susceptible to develop Burnout as highlight(6).

Other authors(7-9) agree that military do a dangerous and stressful activity, which is why more advanced studies have been conducted in this group. As for the emergence of Burnout in the military context, studies(10) approach the issue. Their study found considerable differences in levels of Burnout (p<0,05), organizational commitment and psychosomatic symptoms among men and women, indicating that women are more susceptible to diseases and reactions of helplessness when confronted with organizational problems. Considering that gender was associated with different levels of Burnout in the above mentioned study, it is considered reasonable to explore possible relationships between sociodemographic variables and Burnout levels in this study.

In a longitudinal study carried out with 387 individuals on a mission of peace(8), it was analyzed the impact of non-compliance with the missions of the Army in Burnout and engagement levels of military. The authors discovered that, during the mission, Burnout levels increased (>27), while at the same time military' professional engagement levels decreased significantly (>39). The finding showed that there may be a relationship between Burnout levels in the Brazilian army, the type of professional function they exert and work overload.

The military context is known to be more likely to produce high-demand stressors, such as physical exhaustion, exposure to climate change, prolonged absence from home, and exposure to dangerous situations(11). Theoretically, the Brazilian Amazon, with its uniquely hot and humid climate, offers ideal conditions for the emergence of Burnout in military who, in many cases, come from various parts of the country. Therefore, there may be an association between high demand stressors common in the military profession and the inhospitable climate of the Amazon context, potentiating Burnout syndrome.

Studies(12-14) have sought to investigate the levels of Burnout at the workplace in its various manifestations. However, no studies investigating the levels of Burnout among professional military serving in the Brazilian Amazon have been found in the current literature. Thus the aim of this study was to investigate the levels of Burnout among Brazilian Army officers who have served in the Brazilian Amazon. The findings to this study will enable researchers to understand the impact of working in the military in the Amazon region and to relate the levels of Burnout with different functions exerted by military.

 

Method

The research project was submitted to the Research Ethics Committee of the Federal University of Rondônia (UFRO) by Plataforma Brasil. At the same time, a request to the Army command at the Porto Velho garrison was submitted. After the project was approved (Opinion nº 516.570, December 3rd 2013) and authorized, the researchers scheduled a visit to the military organizations of the Army at the Porto Velho garrison.

This study was organized by the Laboratory of Interpersonal Relationships and Health and conducted in October 2017 in the units of the Brazilian Army located in the Amazon region, where a fixed operational and administrative personnel were stationed. The sample consisted of 122 military volunteers with an average age of 36.80 ± 6.69 years, 117 men (M) and 5 women (W), 53 of whom were employed in operational missions (border security, patrolling, external and internal defense exercises etc), and 69 military who were employed in administrative missions. All the 29 officers and the 93 sergeants chosen to take part in the research were career military.

On the scheduled date, the researchers went to the military organizations in order to gather those who would take part in the research and explain to them what the study was about. After their doubts had been cleared up, the ones who opted not to volunteer were asked to leave the room, and the ones who remained were asked to sign a Free and Informed Consent.

All the participants in the sample were given a questionnaire with sociodemographic, work, social and physical information which raised data such as age, sex, marital status, hierarchical level, working time, frequency of physical activity, extra work hours, and distance to relatives' homes. After that a sociodemographic questionnaire and the Burnout inventory (annex to the questionnaire) were given to the participants, who could complete it at their own pace. Participants were asked not to identify themselves.

At the end of the survey, all the questionnaires and inventories were gathered, sorted out and cataloged according with the socio-demographic variables and their related dimensions of Burnout measured by the attached inventory. In order to meet the principle of equity, out of a total 122 administrative personnel, only the fixed ones were considered in the comparison between genders. It is worth mentioning that all the female personnel belong to the administrative department, which means that they are, in theory, subject to the same variables of the male personnel who work in the same area.

To identify the levels of Burnout, the Maslach Burnout Inventory-General Survey(15), validated for Brazil, was used. This instrument assesses the three dimensions of the syndrome, namely emotional exhaustion, depersonalization, and low professional fulfillment, disregarding previous antecedents and the reasons that caused it. It is a 22-question questionnaire, with five response options, which encompasses the three fundamental aspects of the Burnout syndrome.

This Inventory´s result is classified in levels: Emotional Exhaustion - high level (27 points or more), medium (17 to 26), and low (less than 17); Depersonalization - high level (13 points or more), medium (seven to 12), and low (less than six); and Personal Fulfillment, for which the score is reversed - high level (31 points or less), medium (32 to 38), and low (39 points or more).

For the data analysis, the statistical package SPSS, version 20.0 was used. For the comparative analysis of the averages with obtainment of statistical significance (p < 0.05), nonparametric tests Mann-Whitney U and Wilcoxon W were used.

 

Results and Discussion

The results of the data compilation related to the sample analyzed is introduced in Table 1.

Descriptive mean scores of Burnout dimensions within the objective variables that characterized the participants is showed in Table 2.

Overall, the sample showed varying levels of Burnout in different categories. Medium level was measured in Emotional Exhaustion (EE) and in Depersonalization (D) categories. High levels, on the other hand, were verified in the Job Satisfaction category (JS). These results reinforces the theory than claims that stress is an inherent aspect of military training and that soldiers are always expected to show emotional stability, even when under intense psychological pressure(16).

If the results found in this study are compared with those of Souza and Matos(17) - whose research shows the relationship between various jobs and their Burnout levels - one concludes that the military occupation in Brazil ranks above others regarding Burnout levels. The EE levels, for example, are lower only when compared to those of people working as nursing instructors; the JS levels are higher only when compared to those of people caring for victims of abuse and those working as nurses; the D levels are lower only when compared to those of nursing instructors and resident doctors. Physical and psychological demands found in the military service are higher than those in most other civilian jobs. Moreover, the military context is more conducive to high-demand stressors, such as prolonged absence from home, physical exhaustion and exposure to dangerous situations(10). These factors account for the findings in this study, and the overall result suggests the need for military training to include the teaching of psychological resources to preserve the motivation or provide resilience even in the highly stressful conditions found in the Amazon region.

The data was crossed, allowing a more detailed sample profile to be drawn. First, the study found that officers serving on operational missions did not have significantly different levels of Burnout compared to officers doing administrative work.

It is worth mentioning that both the origin of the military officers that make up both groups and the training they receive are the same. The scenario remains the same when one considers the reduced number of officers doing temporary work in administrative departments, who get exactly the same training as those officers acting in the operational area. Added to this, during the operational missions of border patrolling or the training of new recruits, military officers, working in administrative areas, are usually invited to offer their support.

As for the comparison among different hierarchy levels, the study revealed that officers showed significantly higher levels of JS when compared to warrant officers and sergeants. Brazilian Army candidates need about five years of training before they become an officer. Warrant officers and sergeants, on the other hand, need only one year of training. Even temporary officers, who have not attended the Military Academy, must have a university degree if they want to be accepted into the institution. The results presented in this research were corroborated by a study(18), which showed that the higher the educational level, the lower the chances of developing occupational stress (Burnout).

Thus Brazilian officers and sergeants in the Amazon context experienced the same levels of EE and D, and low JS - low levels of the latter mean higher levels of Burnout in every hierarchy levels. Dissatisfaction with professional competence and performance was even lower among officers. A study(19) with 3,896 physicians in which there is a relationship between the hierarchical levels, Burnout and job satisfaction were considered. They found that an increase of one point in the leadership ranking corresponds to the probability of a 3.3% decrease in Burnout and a 9% increase in job satisfaction. In the military context, the officers are those who should develop and exercise leadership, much more than the sergeants, and this may be an explanation for the conclusions of this study.

As for gender-related scores, it was not possible to produce comparative statistics among the groups due to the small number of women taking part in the study. Only about thirty years ago women were allowed to enlist in the Brazilian Army, yet they can do only administrative or health related work. In spite of this, another studies(20) did not find any significant differences in any of the Burnout categories between men and women. As a matter of fact, to this day no conclusive results on Burnout between men and women have been presented.

As for marital status, no fundamental differences were found between married or informally married, single or widowed officers. This result corroborates research which studied 120 military nurses(21). The study found that the ones who were married or in a stable union did not show any significant difference in Burnout levels when compared to the ones who were single. Having children or being divorced, however, were marital status factors which showed significant differences.

The scientific literature on the use of coping techniques to reduce the effects of Burnout syndrome is undeniable. Social support is among the eight techniques in the affective search for friends and family support(22). The social support principle can be used to explain the significantly lower levels of Burnout in EE among military officers who lived close to their relatives, as opposed to those who lived far from them. Another study which mentions social support whose focus was on the counter-productive behavior at work among 625 police officers(23).

Whether or not the spouses share the expenses and their relationship with Burnout, had no significant association with the syndrome, nor were any other similar studies found that discussed this issue. Although the cost of living is higher in the Amazon region, the officer, who serves there, receives a 20% salary increase for working in adverse conditions; when the officers go on border patrol missions, they receive an extra daily payment; they also spend less money on renting houses, since that region has many houses provided by the Army. These factors explain why a spouse, whether or not they have a job, does not have a significant impact on the level of Burnout. The average salary paid in the Amazon region is, in general, low. This explains why spouses find it unprofitable to leave their houses and work for very little money. Staying at home to look after the children and to do the daily chores seems to compensate for the increase in income.

The results of Burnout dimensions related to years of service is stated in Table 3.

The level of EE in Brazilian military officers, with time of service between six and ten years, was high and significantly different from the medium levels of those with between 21 and 25 years of career and those with more than 30 years of career. The fact that EE with time of service between six and ten years did not present significant difference with time of service between 26 and 30 years shows the increase of stress levels during the transition to retirement and later decline towards the end of the career. Consistent with these results, JS was perceived as significantly lower between six and ten years of military career and higher with more than 30 years of military career, so that from 30 years of service, Burnout levels related to job satisfaction decline from a high to a medium level. The level of D in Brazilian military officers with time of service between six and ten years was high and significantly different from the medium levels of those with time of service from 21 years. A similar study on the relationship between Burnout and length of service(24) showed a slight decline proportional to length of service after an initial peak. Within the survival strategies(22), it is verified that for the application of some techniques, such as Positive Reassessment, it is necessary to take advantage of the lessons experienced that require time for assimilation. Over time, it is believed that the military professional tends to learn how to deal more effectively with Burnout situations, thus reducing his stress load.

The results of the Burnout dimensions according to frequency of physical exercises is showed in Table 4.

The results presented in this study on the variations of Burnout dimensions according to the frequency of physical activity showed significant results in all dimensions, EE, JS and D. Participants who answered that only practice physical activities sometimes, perceived more EE signs, less JS and more D. The scientific literature corroborates with these findings when relating stress and physical activity. In a similar study(25), found significantly higher levels of occupational stress in sedentary individuals when compared to individuals who used to perform physical activity on a regular basis. Another study(26) involving workers and the stress/sedentary lifestyle relationship showed that exposure to sedentary behavior in men is associated with a higher chance of perceiving stress.

The results of the dimensions according to frequency of extra work hours is stated in Table 5.

The dynamics of the dimensions of Burnout, when taking into account the extra workload, showed significant differences between the groups. Military officers, who responded that they often work overtime, were perceived as having significantly high EE and D rates, against the average levels of those who reported never or only sometimes doing work after hours. However, the JS dimension did not present a conclusive pattern in this study.

Although studies(16,27) specifically relate the increased workload in the military occupation to the increase in Burnout, the results of this study partially support this assertion. The lack of significant statistical differences in Burnout's EE and D dimensions, when the extra workload becomes routine (almost always/no time), seems to indicate a psychological adaptation of the individual to the new routine. The breakdown of the occupational routine tends to lead the individual to a situation of negative stress(28). The assimilation of extra activity as part of the military's routine may explain the drop in indices at the last frequency level.

 

Conclusion

In this study, it was found that the military occupation presents average to high levels of Burnout according to the international evaluation protocol classification and in comparison with other occupations. The main socio-demographic, labor, physical and social conditions associated with significantly higher levels of Burnout in this study were: less time of service; sedentary lifestyle; extra work; inferior hierarchical position and living far from relatives.

It should be emphasized that the human psyche is extremely complex and that the simple evaluation of an attribute cannot alone characterize whether the military has more or less potential to develop Burnout.

This study sought to contribute to the literature in the sense of citing what factors may be predisposing to Burnout in the military, especially in inhospitable environments such as the Amazon region. In this way, commanders and health professionals will have more precise instruments in the manipulation of workers' illness factors.

As limitations of this study, it is understood that other intervening factors influence occupational stress in the Amazon, but could not be measured in the inventory, such as the hot and humid climatic conditions of the region, which lead the newly arrived military and the family to excessive wear and tear, the lack of urban structure in the localities of that region and the lack of their basic services, such as health and education.

Finally, it is suggested that military institutions invest more in actions that enhance the job satisfaction of their officers, considering it was found in this study that this dimension of Burnout was considered at the "high" level in almost all assessments and in every attribute studied.

 

References

 

 

Corresponding author:
Yonel Ricardo de Souza
E-mail: yonel.souza@gmail.com

Received: Jun 26th 2020
Accepted: Jan 16th 2021

 

 

Author's contribution
Study concept and design: Yonel Ricardo de Souza, Fabio Biasotto Feitosa.
Obtaining data: Yonel Ricardo de Souza.
Data analysis and interpretation: Yonel Ricardo de Souza, Fabio Biasotto Feitosa, Gabrielle Selleri Bezerra.
Statistical analysis: Fabio Biasotto Feitosa.
Drafting the manuscript: Yonel Ricardo de Souza.
Critical review of the manuscript as to its relevant intellectual content: Fabio Biasotto Feitosa, Gabrielle Selleri Bezerra.
All authors approved the final version of the text.
Conflict of interest: the authors have declared that there is no conflict of interest.

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Corresponding author:
Yonel Ricardo de Souza
E-mail: yonel.souza@gmail.com

Received: Jun 26th 2020
Accepted: Jan 16th 2021

 

 

Author's contribution
Study concept and design: Yonel Ricardo de Souza, Fabio Biasotto Feitosa.
Obtaining data: Yonel Ricardo de Souza.
Data analysis and interpretation: Yonel Ricardo de Souza, Fabio Biasotto Feitosa, Gabrielle Selleri Bezerra.
Statistical analysis: Fabio Biasotto Feitosa.
Drafting the manuscript: Yonel Ricardo de Souza.
Critical review of the manuscript as to its relevant intellectual content: Fabio Biasotto Feitosa, Gabrielle Selleri Bezerra.
All authors approved the final version of the text.
Conflict of interest: the authors have declared that there is no conflict of interest.

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