Professor Narings Handouts from 'CHC Presents'

1. Hochschild: emotional labor
emotions at work Een foto van service with a smile: de bakker
Is nursing / caring also service work?
Gérard Näring Yes, but in a different way
Radboud University Nijmegen
Yes, but it is also more.
Open University
emotions at work 1 emotions at work 2
Hochschild: emotional labor Hochschild: emotional labor
especially in service jobs employees are often
required to show certain emotions in order to
Gevolgd door de foto van de satyr
please the customer
Dan vertellen over verwachtingen op het werk
personal costs of emotional labor in terms of
feeling emotionally drained or exhausted
emotions at work 3 emotions at work 4
Hochschild: emotional labor emotional labor
surface acting Hochschild distinguished
the display of the characteristics of an emotion Surface acting
that are regarded as appropriate, but are not
Deep acting
actually felt
Emotional consonance
deep acting
the activity that is undertaken to actually feel
an emotion that is thought to be required
Development of instrument: D-QEL.
emotional consonance largely based upon ELS by Céleste
the situation where somebody effortlessly feels Brotheridge & Raymond Lee, but we
the emotion that is required in a certain
added we added: suppression
situation
emotions at work 5 emotions at work 6
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2. emotional labor emotional labor
Is emotional labor an important concept ?
Several studies indicated:
Study in teachers.
Emotional labour is related to emotional
Job Demand Control Support Model
exhaustion or burnout
Robert Karasek
Brotheridge & Grandey, 2002; Brotheridge & Lee, Näring, G., Briët, M., & Brouwers, A. (2006). Beyond demands-control: Emotional
2003; Pugliesi, 1999; Zammuner & Lotto, 2001 Labor and Symptoms of Burnout in Teachers. Work & Stress, 20(4), 303-315
emotions at work 7 emotions at work 8
Job Demand-Control model Job Demand-Control model
o a combination of high psychological demands o Participants
with low control (autonomy) at work leads to o High School teachers
mental and physical illnesses (Karasek, 1979)
o Job Demand-Control-Support model;
social support was added (Johnson en Hall,
1988)
emotions at work 9 emotions at work 10
Variables associated with Personal Accomplishment
Variables associated with Emotional exhaustion
Predictor Beta F R2(change)
Predictor Beta F R2(change)
Step 1
Demographic variables .92 (.05) Step 1
Demographic variables 9.99*** (.06)
Age .05
Gender .01 Age -.20***
Gender -.10*
Step 2
Step 2
Work characteristics DCS 58.51*** (.41)
Work characteristics DCS 6.05*** (.06)
Quantitative demands .47***
Quantitative demands -.06
Control -.15**
Control .11*
Social support -.15**
Social support .12*
Quant-demands x Control -.07
Quant-demands x Control -.04
Step 3
Step 3
Emotional Labor 6.59*** (.04)
Emotional Labor 30.60*** (.24)
Surface acting .17***
Surface acting .06
Deep acting -.01
Deep acting .02
Suppression .03
Suppression -.08
Emotional consonance -.08 Emotional consonance .50***
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3. emotional labor
Conclusion
The study of emotional labor is relevant for our
understanding of emotional exhaustion and of
personal efficacy.
In health care another aspect of dealing with
emotions plays an important role
Emotional demand
emotions at work 13 emotions at work 14
Carlo Braccesco (1478-1501)
Emotional burden en hiding emotions
emotional burden Ybema & Smulders (2002)
emotional burden hiding
Emotional demand (Ybema & Smulders, 2002)
Painters -.78 -.26
the emotional impact that inevitably comes
Plummers, welders, -.60 -.32
with professions where there is frequent
Bricklayers, carpenters -.72 -.43
confrontation with death and suffering as in
Loaders, unloaders -.55 -.41
nurses, firemen, or ambulance drivers
Police officers, fire fighters .32 .69
Job-focused emotional labor refers to the Doctors, dentists .61 .49
emotional demands of a job (Brotheridge & Grandey, Nurses, orderlies .94 .29
2002)
.52 .35
Geriatric helpers, child caretakers
Emotional demands (de Jonge, Mulder, Nijhuis, 1999) Teacher elementary school .91 .06
“In my work, death, sickness or human Teacher high school .72 .30
suffering are very demanding” Teacher university .51 .09
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Emotional labor and emotional burden
method: subjects
in nurses
Again
three hospitals in the eastern part of the
Netherlands
Job Demand Control Support Model
860 questionnaires distributed and received 334
+ Emotional labor
back, response rate of 38.8%.
+ Emotional burden (Ybema & Smulders, 2002)
88 % women and 12% men with a mean age of 38
Measured with three questions
yrs
My job is emotionally demanding
My work brings me in emotionally difficult situations
I become emotionally involved in my job
emotions at work 17 emotions at work 18
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4. Criterion Emotional Exhaustion
study: expanding the DCS model Predictor Beta F R2(change)
Step 1 Control variables 1.61 .01
Age -.06
assess the contribution of
Sexe .04
job demands
Step 2 JDCS model 34.23*** (.48***)
task characteristics Job Demands
Organizational Stress Questionaire (Bergers et al., 1986).
Task Characteristics .41***
Respondents are asked to indicate how often they
Emotional burden .12**
experience difficult job demands. Questions pertain to
pace, difficulty of tasks, and amount of work. Surface acting .28**
emotional demand Deep acting .12**
emotional labor Suppression .00
Emotional consonance -.16**
support
Control -.03
control
Support -.07
to the prediction of
Note. Standardized beta-coëfficiënts are given.
emotional exhaustion * p < .05; ** p < .01; *** p < .001
emotions at work 19 emotions at work 20
Items from D-QEL
study: expanding the DCS model
Surface acting
Task characteristics are the most important
determinant of emotional exhaustion. From I fake a good mood
an emotions perspective it is not suppression, I put on a “mask” in order to express the
but the faking of emotions that seems to right emotions for my job
contribute to emotional exhaustion.
Task Characteristics .41*** Deep acting
Emotional burden .12**
I work hard to feel the emotions that I
Deep acting .12** need to show to others
Surface acting .28**
I make an effort to actually feel the
Suppression .00
emotions that I need to display toward
Emotional consonance -.16**
others
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Gross: Emotion Regulation Gross: Emotion Regulation
emotion may be regulated at five points in the
emotion generative process:
Emotional Response Emotional -> Goals
and values
cues tendencies responses
(1) selection of the situation
(2) modification of the situation
Evaluation Modulation
Antecedent-focused Response-focused
(3) deployment of attention
emotion regulation emotion regulation
(e.g. reappraisal) (e.g. suppression)
(4) change of cognitions, and
(5) modulation of experiential, behavioral, or
physiological responses.
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5. Gross: Emotion Regulation Gross: Emotion Regulation
Antecedent-focused emotion regulation (e.g.
antecedent-focused
reappraisal)
(1) selection of the situation
(2) modification of the situation,
actively strive to invoke thoughts, images, and
(3) deployment of attention
memories to induce a certain emotion
(4) change of cognitions, and (Ashforth & Humphrey, 1993)
response-focused metaphor of thinking of a difficult passenger as a
child that is not responsible for its behavior
(5) modulation of experiential, behavioral, or
physiological responses
emotions at work 25 emotions at work 26
Buddhism and law enforcement are
Emotional Labor
unusual bedfellows
Lessons from Gross
More refined measures of emotion regulation
strategies needed
Paul Bibby March 12, 2009 Sydney Morning Herald
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Emotional dissonance and burnout among cabin attendants
Personality? Heuven & Bakker, 2003
Quest for personality characteristics.
Persons with a high level of negative affectivity will not easily
display positive emotions.
Persons with a high level of introversion will not easily display
positive emotions
Agreeableness
Study in Home child protection workers: Answer is NO.
Example from cabin attendants.
More important:
Workers with a high degree of agreeableness are most likely to
suffer from emotional exhaustion.
Vlerick, P. (2001). Personality correlates of burnout: A cross-validation
Study
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6. Emotional dissonance and burnout among cabin attendants
not agreeable
Heuven & Bakker, 2003
Paulle (2005) Anxiety and intimidation in the Bronx and the Bijlmer:
An ethnographic comparison of two schools
successful teachers are capable of managing the emotional climate
of their class by showing a whole range of feelings: kindness
and empathy, but also, if necessary, anger and a certain
harshness
superficial
satisfied passengers extension D-QEL
surface acting of negative emotions
deep acting of negative emotions
principal components analysis confirmed that surface acting of
negative emotions has to be distinguished from surface acting of
positive emotions
emotions at work 31 emotions at work 32
not agreeable not agreeable: anger
Experienced teachers reported more surface acting of The Harvard Anger Report
negative emotions then inexperienced teachers
M = 5.60 and M = 5.18, t(395) = 2.54, p < .01.
the advice isn’t quite
Experienced teachers reported more emotional
“if you want to get ahead, lose it first”
consonance then inexperienced teachers
M = 7.61 and M = 7.08, t(396) = 3.87, p < .001.
important that anger is channelled constructively
There were no significant differences in surface acting,
deep acting and suppression
Positive relationship between surface acting of negative
emotions and personal accomplishment
Prof George Vaillant from Harvard Medical School in
Canisius, A. & Näring, G. (submitted) Emotional labor in the
interview with Julian Baggini in SMH
classroom: Teachers’ use of positive and negative
emotions
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Emotion work (Zapf, 1999) Emotion work (Zapf, 1999)
Measures characteristics of the job emotional exhaustion positively correlated with
positive emotions display
“How often does it occur in your job that you have to
express pleasant emotions towards your clients?”.
the requirement to display and handle
negative emotions/variety factor
negative emotions
“How often does it occur in your job that you have to
express unpleasant emotions towards your clients?” the requirement to be sensitive to the
sensitivity requirements
emotions of others
“How often does it occur in your job that you have to
consider negative moods of your clients?”. in five different samples (handicapped
emotional dissonance
children’s home, call centers, hotel business,
‘A’ can openly display his/her feelings towards clients
banking sector, and kindergartens)
—‘B’ has to display feelings towards clients which do
not match his/her true feelings. What is your job like?”.
emotions at work 35 emotions at work 36
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7. Emotional labour
Personality or Job characteristics?
Concepts measuring job characteristics or
demands seem promising Guest Editorial
How often does your work require to … Emotional labour: Just another buzz word?
Psychological demands have a strong
relationship with emotional exhaustion in International Journal of Nursing Studies 44 (2007)
nurses (de Jonge, Mulder, Nijhuis, 1999). 859–861
emotions at work 37 emotions at work 38
“Another buzz word?” Research agenda
Confusion about terminology on the emotions side
emotional labour
Emotions have been marginalised by the current emotional demands
emphasis on evidence-based practice, clinical traumatization
outcomes and national standards (Freshwater and Various concepts to measure possible effects
Stickley, 2005)
burnout
emotional exhaustion
compassion fatigue
secondary traumatization
posttraumatic stress disorder
Value and visibility of emotional labor (Staden,1998)
emotions at work 39 emotions at work 40
Another approach “Another buzz word?”
Suggestions Qualitative studies may provide themes that are important to
discuss in supervision or coaching
study interactions on a microscopically level: event
sampling methods
Themes:
ask about specific ways to change emotions, cognitive
Appearing caring
or otherwise
Nurses are human too
Giving of yourself
explicitly deal with uncomfortable and conflicting
emotions
Staden (1998). Alertness to the needs of others: Appearing
(Kelly, Ross, Gray, & Smith, 2000)
caring. A study of the emotional labour of caring
measure not only burnout but also compassion fatigue
emotions at work 41 emotions at work 42
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8. “Another buzz word?” Compassion fatigue vicarious trauma
Qualitative studies Compassion fatigue CF is based on the idea
therapeutic potential of nurses’ interpersonal of a syndrome resulting specifically from
involvement feature of ‘new nursing’
empathizing with people who are
experiencing pain and suffering (Figley, 1983,
all nurses identified emotional labor as a chief part of 1995).
the nurse’s role in making patients feel ‘safe’,
Vicarious trauma results from exposure to
‘comfortable’, and ‘at home’
clients’ material, empathic engagement with
“Clinical and emotional skills come with the experiences
of the job and you have to get in contact with your clients and a sense of responsibility for them
emotions and how the patient feels”
and culminates in not only cognitive, but also
affective and relational changes (McCann &
Gray (2009). The emotional labor of nursing – Defining and
managing emotions in nursing work Pearlman, 1990).
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Compassion Compassion fatigue test
Contrast to emotional labor as measured with Compassion Satisfaction Fatigue (CSF) test
Dutch-QEL or Emotional Labor Scale
1. estimate of compassion
not ‘trying to feel’ but most often genuine with 2. risk of burnout and compassion fatigue
an inevitable impact 3. degree of satisfaction derived from helping
not only while facing the patient but beyond others
the workplace: at home (Figley, 1995; Figley & Stamm, 1996)
changes the caregiver: meanings, basic
beliefs about life and death, schema’s
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Professional Quality of Life Scale Compassion fatigue
Professional Quality of Life Scale (Pro-QOL) Few studies on the incidence and prevalence
6. I feel invigorated after working with those I [help].
7. I find it difficult to separate my personal life from my Consequences in cancer care providers
life as a [helper]. Empathy may be comprised by compassion fatigue
8. I am losing sleep over traumatic experiences of a Practitioners may not be as emotionally connected to
person I [help]. the patients as might be desirable
9. I think that I might have been “infected” by the (Simon et al., 2005)
traumatic stress of those I [help]
19. Because of my work as a [helper], I feel exhausted Najjar, Davis, Beck-Coon, Carney Doebbeling (2009). Compassion
fatigue: A review of the research to date and the relevance to cancer-
care providers. Journal of Health Psychology, 14(2), 267-277
emotions at work 47 emotions at work 48
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9. Management of Compassion fatigue Management of Compassion fatigue
Comparison with other Personal Strategies
professions:
Professional Strategies
Organizational Strategies
psychotherapist
Soldiers after missions
(Pearlman & Saaktvine, 1995)
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Management of Compassion fatigue Management of Compassion fatigue
Personal Strategies Personal Strategies
Identifying and making sense of disrupted schemas Professional Strategies
Striking an appropriate work-life balance Undertaking regular professional supervision
Undertaking a personal psychotherapy Developing and maintaining professional networks
Identifying healing activities Having a realistic tolerance of failure
Attending to spiritual needs Being aware of work and personal goals
Professional Strategies Organizational Strategies
Organizational Strategies
(Pearlman & Saaktvine, 1995) (Pearlman & Saaktvine, 1995)
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Compassion fatigue
Management of Compassion fatigue
Personal Strategies Compassion fatigue not only takes a toll on cancer –
care providers but also on the workplace
Professional Strategies
Organizational Strategies
Developing a workplace environment that is as
comfortable as possible
Ensuring a culture of support and respect within the
workplace that relates to emplyees as well as patients
Najjar, Davis, Beck-Coon, Carney Doebbeling (2009). A review of the
research to date and the relevance to cancer-care providers.
(Huggard, 2003) Journal of Health Psychology, 14(2), 267-277
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10. To keep in mind
There is a limit to the amount of emotion work Thank you for your attention
that we can require from workers
Emotional labor is not only about the display
of positive emotions, but also about real
emotions and about uncomforting emotions
Emotion work often consists of painful
changes in cognitions, beliefs, schema’s
Agreeableness might be a risk factor /
Cognitions beliefs about what caring/nursing
comprises
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