Interpersonal factors contributing to staff burnout in aged care

Burnout is a complex occupational phenomenon that is influenced by personal, interpersonal, and organisational factors. [1] In this theme, interpersonal factors refer to elements that shape how individuals engage with each other, including personal characteristics like personality traits or external influences such as cultural norms and societal expectations. [2] These factors impact the quality of communication, depth of understanding, and overall dynamics of relationships among individuals. [2] In the context of aged care, where individuals are often providing care and support to older adults, interpersonal factors can be particularly impactful on the wellbeing of aged care workers and the quality of care being delivered. [3] There are a number of interpersonal factors that can increase an individual’s susceptibility to burnout. [3, 4] 

Personal and organisational factors are discussed in separate evidence theme reports.

This evidence theme on interpersonal factors is a summary of one of the key topics identified by a scoping review of the burnout research. If you need more specific or comprehensive information on this topic, try using our PubMed searches provided below. 

The 2022 scoping review found 27 studies on interpersonal factors contributing to burnout among aged care workers. [5-31]The 2023 update found an additional three studies that contributed to this theme. [32-34]  Frequently reported interpersonal factors that contribute to staff burnout can be divided into four categories, namely, factors relating to: residents/clients and next of kins, family/friends, colleagues, and management/supervisors.

Factors related to residents/clients and next of kins

• Persistent exposure to multiple chronic conditions, heavy care-needs, [7] and challenging behaviours [15] (dementia-related behaviours [18]).
• Experiences of aggression or violence. [6, 9, 12, 22] For example, verbal or physical abuse from residents, their families, or friends. [6, 12] One study reported intense interactions with residents and families created more interpersonal conflict. [8]  
• Prolonged exposure to resident/client health deterioration. [13] One study found that failure to address emotional challenges (i.e. feelings of grief, guilt, fear, distress, angst) may lead to burnout. [13]
• Lack of religious and spiritual beliefs when dealing with resident death. [19]
• Lack of person-centred care delivery. [29, 33]
• Feeling dissatisfied with the quality of care provided to residents. [24, 27] One study specified quality of care for dementia residents. [24]

Interestingly, aged care workers with high burnout levels were more likely to condone abuse among nursing home residents. [5]

Factors related to family/friends 

• Lack of social support [25, 26] 
• Less time spent with family and friends [26] 

Factors related to colleagues

• Lack of support from colleagues [16, 21, 28, 32, 33, 35] One study found that support from colleagues increased burnout for aged care workers. [5]
• Workplace conflict [8]
• Lack of trained colleagues [14]

Factors related to management/supervisors

• Neglecting to recognise the efforts of the workforce [10, 16, 21]
• Lack of supervisor support. [17, 21, 25, 28, 30, 34]
• Feeling that they were not listened to by managers [20, 23]
• Lack of trust with supervisors [23]
• Maintaining excessive control, and not allowing workers to exercise decision-making or voice concerns over working conditions and client care quality (i.e. lack of job autonomy). [10, 11, 23, 31] One study reported that the lack of social support demonstrates decreases job autonomy and satisfaction and increases burnout levels. [10]

• Prioritise open and effective communication with colleagues, managers, and residents/clients' families.
• Take the initiative to enhance understanding of, and building skills in, dealing with responsive behaviours and end-of-life discussions.
• Develop personal coping mechanisms to manage the emotional challenges associated with caregiving.

• Implement programs that foster a sense of teamwork and community among aged care workers.
• Invest in comprehensive training programs to equip workers with the necessary skills for diverse caregiving situations.
• Implement recognition and reward systems to acknowledge the hard work and dedication of aged care workers.
• Provide managers with leadership training as strong leadership can minimise distress and create psychological safety and inclusivity among staff members. [36]

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