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Prosocial Motivation, Stress and Burnout Among Direct Support Workers Robert Hickey School of Policy Studies, Queen’s University, Kingston, ON, Canada Accepted for publication 24 December 2012 Aim This study explores whether the desire to engage in work that is beneficial to others moderates the effects of stress on burnout. Method Based on a survey of 1570 direct support professionals in Ontario, this study conducted linear regression analyses and tested for the interaction effects of prosocial motivation on occupational stress and burnout. Results Prosocial motivation significantly moderated the association of emotional exhaustion (EE) and role boundary stress with depersonalization (DP). Prosocial motivation also moderated the effects of role ambiguity stress with a direct support worker’s sense of personal accomplishment. In contrast, prosocial motivation magnified feelings of EE when interacted with a sense of personal accomplishment. Conclusions Prosocial motivation plays an important role in explaining the relatively low levels of DP in the sector. The study advances our understanding of the key components of burnout among direct support workers. Keywords: burnout, direct support worker, intellectual and developmental disabilities, prosocial motivation, stress Introduction Direct support workers in services for people with intellectual disabilities love the work they do. In a survey among 1570 direct support workers in Ontario, 95% reported being satisfied or very satisfied with the nature of the work (Hickey 2010). However, stress and burnout among staff remain an important area of concern (Hastings et al. 2004; Skirrow & Hatton 2007), especially among workers who are exposed to challenging behaviours (Rose & Rose 2005; Dilworth et al. 2011; Hensel et al. 2011). There is an extensive literature on staff stress and burnout in the field of intellectual disability services (Skirrow & Hatton 2007; Devereux et al. 2009; Hickey 2011). Despite this extensive body of work, Devereux and his colleagues found that our theoretical understanding of work stress among direct support staff is limited (Devereux et al. 2009). This study seeks to advance our understanding of the experiences of stress and burnout among direct support workers. The primary objective of this study is to explore the role of prosocial motivation (Grant 2007), the desire to engage in work that is beneficial to others, among direct support workers. Specifically, this study tests the moderating effects of prosocial motivation in the experiences of stress and burnout in disability services. There is general consensus in the literature that support workers play a critical role in the lives of people with intellectual and developmental disabilities (Hatton et al. 2004; Hastings 2010). Because of the critical role that direct support staff play in the personal outcomes of people supported, concerns over low wages and high turnover rates (Braddock & Mitchell 1992), stress and burnout (Rose 1995; Innstrand et al. 2002; Skirrow & Hatton 2007; Devereux et al. 2009) and other workforce challenges (Hewitt & Larson 2007) result in threats to the quality of services. The underlying assumption to the research on staff stress is that distress and burnout lead to deteriorating staff performance and negative outcomes for people supported. An important limitation into the study of work stress in the field of intellectual disabilities has been the general focus on negative stressors and negative outcomes. Given the overwhelming satisfaction among staff with the nature of direct support work, the role of prosocial motivation in the experience of work stress and burnout would address this gap and make an important contribution to the literature. In particular, the relational dimension of direct support work has not received as much attention © 2013 John Wiley & Sons Ltd 10.1111/jar.12058 Journal of Applied Research in Intellectual Disabilities 2014, 27, 134–144 Published for the British Institute of Learning Disabilities

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Page 1: Prosocial Motivation, Stress and Burnout Among Direct Support Workers

Prosocial Motivation, Stress and BurnoutAmong Direct Support WorkersRobert Hickey

School of Policy Studies, Queen’s University, Kingston, ON, Canada

Accepted for publication 24 December 2012

Aim This study explores whether the desire to engage in

work that is beneficial to others moderates the effects of

stress on burnout.

Method Based on a survey of 1570 direct support

professionals in Ontario, this study conducted linear

regression analyses and tested for the interaction effects

of prosocial motivation on occupational stress and

burnout.

Results Prosocial motivation significantly moderated the

association of emotional exhaustion (EE) and role

boundary stress with depersonalization (DP). Prosocial

motivation also moderated the effects of role ambiguity

stress with a direct support worker’s sense of personal

accomplishment. In contrast, prosocial motivation

magnified feelings of EE when interacted with a sense

of personal accomplishment.

Conclusions Prosocial motivation plays an important role

in explaining the relatively low levels of DP in the sector.

The study advances our understanding of the key

components of burnout among direct support workers.

Keywords: burnout, direct support worker, intellectual

and developmental disabilities, prosocial motivation,

stress

Introduction

Direct support workers in services for people with

intellectual disabilities love the work they do. In a

survey among 1570 direct support workers in Ontario,

95% reported being satisfied or very satisfied with the

nature of the work (Hickey 2010). However, stress and

burnout among staff remain an important area of

concern (Hastings et al. 2004; Skirrow & Hatton 2007),

especially among workers who are exposed to

challenging behaviours (Rose & Rose 2005; Dilworth

et al. 2011; Hensel et al. 2011). There is an extensive

literature on staff stress and burnout in the field of

intellectual disability services (Skirrow & Hatton 2007;

Devereux et al. 2009; Hickey 2011). Despite this

extensive body of work, Devereux and his colleagues

found that our theoretical understanding of work stress

among direct support staff is limited (Devereux et al.

2009). This study seeks to advance our understanding of

the experiences of stress and burnout among direct

support workers. The primary objective of this study is

to explore the role of prosocial motivation (Grant 2007),

the desire to engage in work that is beneficial to others,

among direct support workers. Specifically, this study

tests the moderating effects of prosocial motivation in

the experiences of stress and burnout in disability

services.

There is general consensus in the literature that

support workers play a critical role in the lives of

people with intellectual and developmental disabilities

(Hatton et al. 2004; Hastings 2010). Because of the

critical role that direct support staff play in the personal

outcomes of people supported, concerns over low wages

and high turnover rates (Braddock & Mitchell 1992),

stress and burnout (Rose 1995; Innstrand et al. 2002;

Skirrow & Hatton 2007; Devereux et al. 2009) and other

workforce challenges (Hewitt & Larson 2007) result in

threats to the quality of services. The underlying

assumption to the research on staff stress is that distress

and burnout lead to deteriorating staff performance and

negative outcomes for people supported. An important

limitation into the study of work stress in the field of

intellectual disabilities has been the general focus on

negative stressors and negative outcomes. Given the

overwhelming satisfaction among staff with the nature

of direct support work, the role of prosocial motivation

in the experience of work stress and burnout would

address this gap and make an important contribution to

the literature. In particular, the relational dimension of

direct support work has not received as much attention

© 2013 John Wiley & Sons Ltd 10.1111/jar.12058

Journal of Applied Research in Intellectual Disabilities 2014, 27, 134–144

Published for the British Institute of Learning Disabilities

Page 2: Prosocial Motivation, Stress and Burnout Among Direct Support Workers

as have concerns over tasks and resources (Hastings

2010). To address this gap and explore the relational

aspect of direct support work, we have drawn from the

growing body of research on prosocial motivation as a

buffer to burnout in the workplace.

Methods

Design

The purpose of this study is to test the moderating

effects of prosocial motivation on the association

between stress and burnout. Theoretically, this study

brings the concept of prosocial motivation into the

scholarship on stress and burnout in the sector. The

study is based on data drawn from a survey that was

conducted among direct support employees between

May and June of 2010. The survey was part of a larger

study to evaluate strategic human resource initiatives

among disability service providers in Ontario, Canada.

The research project, including the procedures, the

survey instrument and related methodologies, was

reviewed and approved by the General Research Ethics

Board at Queen’s University.

Participants

Researchers recruited sixteen agencies that provide a

variety of services and supports to people with

intellectual disabilities to participate in the study. The

sixteen agencies were part of a pilot initiative to

introduce a model of behavioural core competencies

among direct support staff in the sector. Agencies had to

demonstrate an ability to manage change in order to be

selected as a pilot site. Thus, human resource functions

at pilot site agencies may have been more developed

among the participating agencies than for agencies in the

sector as a whole. However, selection criteria for pilot

site agencies did target a representative cross-section of

service providers – large and small, union and non-

union, urban and rural, as well as regional

representation across Ontario. Direct support workers at

the sixteen pilot site agencies were invited to participate

in the survey. The total population of direct support

workers at these agencies, including both full-time and

part-time employees, was estimated to be 4000.

A total of 1570 completed and usable surveys were

returned. This represents an estimated response rate of

40% of the targeted direct support workforce at the pilot

agencies. Response rates varied across agencies from a

low of 4% to a high of 99%. The vast majority of

respondents filled out paper copies of the survey which

were returned via post. Some 10% of surveys were

returned electronically using a fillable PDF form. The use

of the electronic version of the survey by respondents

appeared concentrated at small agencies in which

electronic messages were the dominant form of internal

communications. The lowest proportion of respondents

was from small agencies (6.8%). Respondents from

medium-large agencies (42.5%) were the most numerous.

Most respondents (79%) worked for agencies located in

urban areas and most were unionized (88%).

Women comprised the vast majority of survey

respondents (84%). Average tenure in the sector was

slightly more than eleven (11) years. Most survey

respondents (55%) reported working full-time, while a

significant proportion (45%) worked part-time or on a

casual basis for the agency where the survey was

distributed. Direct support employees worked an average

of nearly 32 h/week. Combining multiple part-time jobs

into full-time work in the field appeared to be fairly

common given that 273 (18.3%) respondents reported

working at more than one agency in the past month. The

hourly pay rate for direct support workers averaged

$19.78, above the minimum wage in Ontario ($10.25) but

well below the average hourly wage for the general

workforce in Ontario, $23.53 (Statistics Canada 2012).

Procedures

Local teams of managers and direct support employees

distributed the survey packets. The survey packets

included a cover letter with information about the

purpose of the survey, the research ethics protocols, the

survey itself and a pre-stamped envelope, so that

participants could return the survey directly to researchers

at Queen’s University. To increase participation, the

surveys were also distributed electronically as fillable PDF

forms by agencies which had employee e-mail addresses.

Participation in the survey was voluntary and strictly

confidential.

Measures

Personal characteristics and work-related information

The survey collected data on a range of demographic

and personal characteristics including gender, educa-

tional attainment and tenure in the sector. Additional

control variables included information on the emotional

disposition of workers. The Positive and Negative Affect

Schedule (PANAS) is a 20-item self-report measure

© 2013 John Wiley & Sons Ltd, 27, 134–144

Journal of Applied Research in Intellectual Disability 135

Page 3: Prosocial Motivation, Stress and Burnout Among Direct Support Workers

developed by Watson et al. (1988). The measure consists

of two, ten-item mood scales which have been found to

be internally reliable (a = 0.87), relatively uncorrelated

and stable (Watson et al. 1988). The scale measurement

reflects the positive or negative disposition of individuals.

Individuals scoring high in the negative affect measure

experience sadness, distress and unpleasurable

engagement with the environment. The positive affect

scale measures the extent to which an individual

experiences enthusiasm and a pleasurable engagement

with the environment.

The survey collected data on a number of work-related

characteristics including the number of hours worked

and whether the respondent worked for multiple service

providers in the past month. Agency characteristics, such

as size and union status, were added to the data set

based on the individual profiles of the service providers

which were matched with the individual respondents’

indication of the agency at which they worked.

The survey measured nine distinct dimensions of job

satisfaction (Spector 1997) based on single-item scales:

satisfaction with the nature of work, relationship with

supervisor, relationships with co-workers, pay, benefits,

advancement opportunities, training, communication

and overall satisfaction. The survey measured these nine

domains of job satisfaction using a 5-point Likert

scale ranging from 0 (very dissatisfied) to 4 (very

satisfied). The survey questions were drawn from the

Job Satisfaction Survey (Spector, 1985) and the Job

Satisfaction Index (Schriesheim & Tsui 1980).

Affective organizational commitment (Allen & Meyer

1990) was included as another control variable for the

employee’s relationship with the organization. The

Affective Commitment Scale is an 8-item construct

which measures an employee’s emotional attachment to,

involvement in, and identification with an organization.

Allen & Meyer (1990) found the measure to be reliable

(a = 0.86) and superior to the Organizational

Commitment Questionnaire (Mowday et al. 1979). The

current study found an acceptable, but lower reliability

coefficient (a = 0.749).

Occupational stress and burnout

The survey measured occupational stress using the

Occupational Role Questionnaire (ORQ) developed by

Osipow (1998) as one part of the Occupational Stress

Inventory (OSI-R). The measure is conceptually based

on several distinct work roles that have been associated

with stress in the literature (McLean 1974). The ORQ

measures six distinct types of occupational stress using

ten-item scales. Four measures of occupational stress

were included in this survey: Role overload (RO)

measures the extent to which job demands exceed

resources. Role insufficiency (RI) compares job

requirements to a worker’s training, skills and sense of

recognition. The clarity of the work role in terms of

expectations and evaluation criteria is measured by

role ambiguity (RA). Role boundary (RB) measures the

degree to which a direct support worker feels caught

between conflicting demands and supervisory factions.

Excluded from the current survey were the ORQ

measures for physical environment and responsibility.

Osipow (1998) reports normative data on the measures

based on a sample of 983 adults. High scores on the

ORQ suggest significant levels of occupational stress.

Benchmark levels based on the normative sample were

set at T-scores of 70 which represented 2% of the

sample population. Osipow reported alpha coefficients

of 0.72 or greater for the ORQ scales (26). Reliability

coefficients of the same scales in the current study were

similar except for role overload (a = 0.599).

Prosocial motivation is conceptually defined as the

desire to engage in work, which is beneficial to others

(Batson 1987; Grant 2007). Prosocial motivation was

measured using a six-item scale developed by Grant

(2007). Prosocial motivation is distinct from intrinsic

motivation in several important ways (Grant 2008). Most

importantly, prosocial motivation is explicitly based on

the desire to achieve a beneficial impact on others. In

contrast, intrinsically motivated employees are focused

on the work process and see work as an end in itself

(Amabile 1993). Grant (2008) reported reliability

coefficients for this scale (a = 0.91), which were found to

be the same in the current study.

The Maslach Burnout Inventory (MBI) is a well-

known, 22 item scale for measuring three distinct

characteristics of burnout (Maslach et al. 1996). These

subscales include feelings of emotional exhaustion (EE),

depersonalization (DP) and a lack of personal

accomplishment. Maslach et al. (1996) adapted the

original survey construct for use in the human services

sector (MBI-HSS). There is an extensive body of research

that explores the construct validity and reliability of the

burnout measure (Schaufeli & Vandierendonck 1993;

Maslach & Leiter 1997; Schaufeli et al. 2009). The MBI

scale has been used to study staff in the field of

intellectual disability services (Devereux et al. 2009).

Similar to previous factor analyses conducted on the

MBI subscales (Chao et al. 2011), reliability tests in the

current study indicated acceptable constructs for EE and

personal accomplishment. However, the reliability tests

© 2013 John Wiley & Sons Ltd, 27, 134–144

136 Journal of Applied Research in Intellectual Disability

Page 4: Prosocial Motivation, Stress and Burnout Among Direct Support Workers

resulted in questionable results for DP (a = 0.648), and

therefore, some caution is warranted in interpreting the

results for this component of burnout.

Analytic strategy

We used SPSS (IBM Corporation, Somers, NY, USA) 20

to conduct statistical analyses of the data. First, the

researchers explored the univariate characteristics of the

data to generate a descriptive profile of the sample

population. We examined correlation matrices to test

bivariate relationships across all variables used in the

models. The multivariate analytic strategies involved

ordinary least squares linear regression analyses using

each subscale of the MBI as a dependent variable,

entering the control, independent and interaction

variables in blocks. The first block of control variables

included personal characteristics, work-related factors

and job satisfaction measures. The second block of

independent variables consisted of the four measures of

occupational stress, the two components of burnout not

serving as the dependent variable and the prosocial

motivation measure.

Conceptually, the models examine the impact of

prosocial motivation as a moderator variable (Baron &

Kenny 1986; Farmer 2012). To test the moderator effects

of prosocial motivation on the relationship between

stress and burnout, the models include interaction terms

for the moderator and predictor variables (Cleary &

Kessler 1982). The third block of variables included

the interaction terms for prosocial motivation with the

other independent variables. Using block entry of

the variables, we tested for the relative change in the

explanatory power of the base model (a) with the

addition of independent variables (model b) and inter-

action terms (model c). To address multicollinearity

between the main effects and the interaction terms, we

centred the independent and moderator variables

(Aiken & West 1991). Graphical computational tools

were also used to further explore the interactions of the

predictor and moderator variables (Aiken & West 1991;

Preacher et al. 2006).

The purpose of this study was twofold. First, we

sought to understand the direct effects of occupational

stress on burnout, controlling for a range of personal

and work-related factors. Second, by introducing the

concept of prosocial motivation into the study of stress

and burnout, we tested the potential moderating effects

of this positive characteristic of the direct support

workforce.

Results

We began the analyses of the independent and

dependent variables by first examining the bivariate

correlations. This allowed us to see the basic

associations between the variables and to identify

significant overlaps or confounding relationships in the

constructs. Table 1 provides the means, standard

deviations and Pearson’s correlation coefficients for the

independent and dependent variables in this study. As

in previous studies of burnout (Skirrow & Hatton 2007;

Chao et al. 2011; Rose 2011), direct support workers in

this study reported relatively low levels of burnout

compared with other human service sectors. Based on

the normative benchmarks for the survey instrument

Table 1 Means, standard deviations and correlation coefficients

Mean SD PSM

Role

overload

Role

insufficiency

Role

ambiguity

Role

boundary

Emotional

exhaustion

Depersona-

lization

Personal

accomplishment

Prosocial motivation 39.09 3.53 – – – – – – –

Role overload 27.89 5.83 �0.013 – – – – – –

Role insufficiency 24.24 8.46 �0.192** 0.119** – – – – –

Role ambiguity 18.37 5.97 �0.219** 0.234** 0.469** – – – –

Role boundary 20.27 6.45 �0.112** 0.367** 0.430** 0.564** – – –

Emotional

exhaustion

16.83 10.27 �0.154** 0.483** 0.389** 0.347** 0.469** – –

Depersonalization 3.36 4.18 �0.225** 0.255** 0.263** 0.260** 0.380** 0.508** –

Personal

accomplishment

38.77 6.77 0.426** �0.026 �0.404** �0.380** �0.288** �0.314** �0.340**

**Correlation is significant at the 0.0001 level (two-tailed). PSM:Prosocial motivation

© 2013 John Wiley & Sons Ltd, 27, 134–144

Journal of Applied Research in Intellectual Disability 137

Page 5: Prosocial Motivation, Stress and Burnout Among Direct Support Workers

(Maslach et al. 1996), most support staff reported low

(54%) or average (28%) levels of EE, while 17% of

respondents reported high levels of this component of

burnout. The average rate of DP in the sample (3.36)

was well below the low threshold for the scale (6). A

total of 3.9% of survey respondents scored in the high

range for this component of burnout. The average rate

for personal accomplishment (38.77) in the sample was

at the high end of the middle third for the scale (32-38).

Respondents reported higher levels of role overload

stress (27.89) compared with the normative levels (24.88)

reported by Osipow (1998). In contrast, reported average

stress levels were slightly lower than the normative

benchmarks for role insufficiency (24.24 compared with

25.09), role ambiguity (18.37 compared with 21.16) and

role boundary (20.27 compared with 22.76).

Correlations across these variables were statistically

significant (P < 0.0001) but of moderate strength. An

important exception to this was found with role overload

which did not display a significant correlation with

prosocial motivation or personal accomplishment. The

correlation coefficients between prosocial motivation and

other variables of interest were relatively low, except for

personal accomplishment (0.426, P < 0.001). The

strongest correlations were between role boundary and

role ambiguity (0.564, P < 0.001). Osipow (1998) reported

the same level of correlation between these two

constructs of stress. The correlation found between DP

and EE (0.51, P < 0.001) was similar to that reported by

Maslach et al. (1996) (0.52). These levels of correlation did

not suggest that any of the independent variables should

be excluded from the models.

Regression results

Tables 2, 3 and 4 display the regression results for each

of the three dependent variables in this study: EE, DP

and personal accomplishment (PA). The regression

analyses used ordinary least squares and entered the

control, independent and interaction variables in blocks.

The first block (a) in each table includes only the

control variables. The second block (b) introduced the

independent variables and the third block (c) added the

interaction terms. There were a number of variables that

were included in the regression models, but not

reported in the tables. These variables included personal

characteristics (educational attainment and sector

tenure) and organizational characteristics (agency size

and union status) which we found to have small effects

that were not statistically significant in any of the

models.

Table 2 Emotional exhaustion

Model

EE(a) EE(b) EE(c)

Standardized coefficients

Block 1

Personal and work-related characteristics

Gender 0.006 �0.011 �0.009

Aboriginal 0.028 0.003 0.003

Disabilities 0.037 0.027 0.027

Visible minority 0.028 0.050 0.050

Immigration status 0.024 0.021 0.021

Positive affect �0.141*** �0.119*** �0.115***

Negative affect 0.391*** 0.247*** 0.247***

Hours worked 0.064* 0.037 0.039

Hourly pay 0.059* 0.010 0.007

Multi-agency work 0.024 �0.006 �0.004

Affective org commitment �0.066* �0.010 �0.032

Job satisfaction

Nature of work �0.003 0.029 0.032

Relations with supervisor 0.020 0.007 0.010

Relations with co-workers �0.017 0.002 0.001

Pay �0.095*** �0.033 �0.030

Benefits 0.073* 0.065* 0.063*

Advancement opportunities 0.025 0.004 0.000

Training �0.001 0.019 0.015

Communication �0.088** �0.079** �0.080**

Overall satisfaction �0.177*** �0.133*** �0.132***

ΔR2 0.451*** 0.091*** 0.089***

Block 2

Stress and burnout

Role overload 0.275*** 0.462

Role insufficiency 0.066 0.275

Role ambiguity �0.062* 0.245

Role boundary 0.017 �0.208

Prosocial motivation 0.016 0.490*

Emotional exhaustion – –

Depersonalization 0.247*** 0.237

Personal accomplishment �0.068* 0.552*

ΔR2 0.122*** 0.007*

Block 3

Interaction terms

psm 9 ro �0.149

psm 9 ri �0.292

psm 9 ra �0.269

psm 9 rb 0.230

psm 9 ee –

psm 9 dp 0.013

psm 9 pa �0.797**

ΔR2 0.004

Model

Adjusted R2 0.433 0.556 0.557

ΔR2 0.122*** 0.004

*P < 0.05, **P < 0.01, ***P < 0.001. PSM:Prosocial motivation

© 2013 John Wiley & Sons Ltd, 27, 134–144

138 Journal of Applied Research in Intellectual Disability

Page 6: Prosocial Motivation, Stress and Burnout Among Direct Support Workers

Table 3 Depersonalization

Model

DP(a) DP(b) DP(c)

Standardized coefficients

Block 1

Personal and work-related characteristics

Gender 0.069* 0.059* 0.050

Aboriginal 0.072* 0.053 0.0652

Disabilities 0.028 0.019 0.021

Visible minority �0.089** �0.085** �0.086**

Immigration status 0.028 0.013 0.021

Positive affect �0.090*** 0.021 0.016

Negative affect 0.322*** 0.137*** 0.132***

Hours worked 0.021 0.000 �0.002

Hourly pay 0.030 �0.001 0.002

Multi-agency work 0.061* 0.045 0.044

Affective org commitment �0.049 �0.005 �0.006

Job satisfaction

Nature of work �0.104*** �0.089** �0.091**

Relations with supervisor 0.039 0.057 0.072*

Relations with co-workers �0.041 �0.022 �0.027

Pay �0.037 0.011 0.012

Benefits 0.015 �0.019 �0.015

Advancement opportunities 0.136*** 0.110** 0.106**

Training �0.076** �0.071* �0.069*

Communication �0.012 0.041 0.047

Overall satisfaction �0.108** �0.040 �0.039

ΔR2 0.276*** 0.046*** 0.046***

Block 2

Stress and burnout

Role overload �0.008 �0.506

Role insufficiency �0.011 �0.419

Role ambiguity �0.014 �0.439

Role boundary 0.144*** 1.128**

Prosocial motivation �0.062* �0.062

Emotional exhaustion 0.359*** 1.763***

Depersonalization – –

Personal accomplishment �0.096** �0.207

ΔR2 0.105*** 0.036***

Block 3

Interaction terms

psm 9 ro 0.549

psm 9 ri 0.402

psm 9 ra 0.421

psm 9 rb �1.000*

psm 9 ee �1.396***

psm 9 dp –

psm 9 pa 0.145

ΔR2 0.020***

Model

Adjusted R2 0.252 0.355 0.371

ΔR2 0.105*** 0.020***

*P < 0.05, **P < 0.01, ***P < 0.001. PSM:Prosocial motivation

Table 4 Personal accomplishment

Model

PA(a) PA(b) PA(c)

Standardized coefficients

Block 1

Personal and work-related characteristics

Gender 0.000 0.033 0.036

Aboriginal 0.051 0.074** 0.077**

Disabilities 0.015 0.000 0.001

Visible minority 0.078* 0.072* 0.070*

Immigration status �0.099** �0.092** �0.089**

Positive affect 0.386*** 0.227*** 0.230***

Negative affect �0.150*** �0.074* �0.073*

Hours worked 0.084** 0.058* 0.052

Hourly pay 0.005 0.020 0.019

Multi-agency work �0.042 �0.044 �0.045

Affective org commitment 0.096** 0.083* 0.082*

Job satisfaction

Nature of work 0.097** 0.068* 0.069*

Relations with supervisor 0.002 �0.063* �0.056

Relations with co-workers 0.014 0.017 0.018

Pay 0.049 0.051 0.050

Benefits �0.044 �0.035 �0.035

Advancement opportunities �0.048 �0.039 �0.038

Training �0.012 �0.032 �0.032

Communication �0.011 �0.057 �0.061

Overall satisfaction 0.006 �0.013 �0.013

ΔR2 0.331*** 0.086*** 0.085***

Block 2

Stress and burnout

Role overload 0.089** 0.240

Role insufficiency �0.063 �0.185

Role ambiguity �0.196*** �0.945**

Role boundary �0.013 0.028

Prosocial motivation 0.214*** 0.068

Emotional exhaustion �0.092* 0.317

Depersonalization �0.087** �0.225

Personal accomplishment – –

ΔR2 0.097*** 0.056***

Block 3

Interaction terms

psm 9 ro �0.162

psm 9 ri 0.119

psm 9 ra 0.732*

psm 9 rb �0.044

psm 9 ee �0.405

psm 9 dp �0.134

psm 9 pa �ΔR2 0.006

Model

Adjusted R2 0.309 0.404 0.406

ΔR2 0.097*** 0.006

*P < 0.05, **P < 0.01, ***P < 0.001. PSM:Prosocial motivation

© 2013 John Wiley & Sons Ltd, 27, 134–144

Journal of Applied Research in Intellectual Disability 139

Page 7: Prosocial Motivation, Stress and Burnout Among Direct Support Workers

Emotional Exhaustion

As shown in Table 2, most personal and work-related

characteristics did not have a statistically significant

association with EE. Positive and negative affect were

significant in the expected directions. Hours worked

and hourly pay were both positively associated with EE,

but the relative effects were minor. Several components

of job satisfaction were significant across all three

models. Satisfaction with communication (b = �0.080,

P < 0.01) and overall satisfaction (b = �0.132, P < 0.001)

appeared as significant and negatively associated with

EE. In contrast, satisfaction with benefits was positively

associated with EE (b = 0.063, P < 0.01).

With the addition of the independent variables, EE(b)

explains a significant portion of the variance of EE

(R2 = 0.556). Role overload (b = 0.275, P < 0.001) had the

most significant direct association on feelings of EE.

Depersonalization had the same relative association

with EE as negative affect (b = 0.247, P < 0.001).

Following the addition of the interaction terms in model

EE(c) for EE, both role overload and DP were no longer

found to be significant. The only interaction term

found to be statistically significant was with personal

accomplishment (P < 0.01). However, caution should be

used in interpreting these data as the addition of the

interaction terms did not result in a significant change

in R2 in the full model.

Depersonalization

Control variables measuring personal characteristics

displayed a somewhat different pattern in the models

using the DP scale as the dependent variable as shown

in Table 3. Gender was marginally significant in models

DP(a) and DP(b) (P < 0.05), but was not found to be

statistically significant in the full model. Direct support

workers who self-identified as visible minorities were

significantly and negatively associated with feelings of

DP. Negative affect remained significant across all three

models, but positive affect was rendered statistically

insignificant with the addition of the independent

variables. Satisfaction with the nature of work in the

field (b = �0.091, P < 0.01) and training (b = �0.069,

P < 0.05) were both negatively associated with DP.

Surprisingly, satisfaction with advancement

opportunities (b = 0.106, P < 0.01) and with relations

with supervisors (b = 0.072, P < 0.05) were both found

to be positively associated with DP when controlling for

other factors. Two interaction terms were found to be

significant, role boundary stress (b = �1.000, P < 0.05)

and EE (b = �1.396, P < 0.001). The addition of the

interaction terms did result in a statistically significant

improvement in the explanation of variance of DP in the

full model (ΔR2 = 0.097, P < 0.001).

Personal Accomplishment

In the last set of regression analyses using personal

accomplishment as the dependent variable (Table 4), a

range of personal characteristics were consistently

significant. People of Aboriginal descent (b = 0.077,

P < 0.001) and visible minorities (b = 0.070, P < 0.05)

had a stronger sense of personal accomplishment when

controlling for other factors. Foreign-born workers

(b = �0.089, P < 0.01) and negative affect (b = �0.073,

P < 0.05) were both negatively associated with feelings

of personal accomplishment. The association of positive

affect was large and significant (b = 0.230, P < 0.001).

Both affective organizational commitment and satis-

faction with the nature of work were positively associated

with feelings of personal accomplishment. While most

forms of stress were found to be significant in model PA

(b), only RA stress and its associated interaction term

with prosocial motivation were significant in the full

model. Once again, caution is required with the

interpretation of the full model because the addition of

the interaction terms did not result in a statistically

significant change in the R2 term.

Moderator effects

To further explore the moderating effects of prosocial

motivation on burnout in direct support workers, the

regression results were used to generate graphical

depictions of the moderator effects (Aiken & West 1991;

Preacher et al. 2006). Figure 1 displays the moderating

effects of prosocial motivation on EE and DP. Prosocial

motivation (PSM) appears to buffer the relationship

between EE and DP. Depersonalization scores are lower

for direct support workers who reported high prosocial

motivation levels. The difference in the relative levels of

DP is especially pronounced among the staff who

reported high levels of EE.

Figure 2 displays the moderating effects that prosocial

motivation had on role boundary stress and DP. The

level of DP was more acute among direct support staff

reporting low prosocial motivation when interacted with

role boundary stress.

Figure 3 displays the striking and unexpected results

which suggest that prosocial motivation is associated

with higher levels of EE when interacted with a worker’s

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140 Journal of Applied Research in Intellectual Disability

Page 8: Prosocial Motivation, Stress and Burnout Among Direct Support Workers

reported sense of personal accomplishment. Direct

support workers who reported low levels of personal

accomplishment but who also reported high levels of

prosocial motivation experienced EE much more acutely

than workers with low prosocial motivation. While a

greater sense of personal accomplishment mitigated the

feelings of EE, high prosocial motivation was still

associated with higher levels of EE.

Prosocial motivation moderated the relationship

between RA stress and personal accomplishment. As

shown in Figure 4, without a strong sense of prosocial

motivation, increases in the level of RA stress were

associated with significantly lower feelings of personal

accomplishment.

Discussion

The most significant finding to emerge from this study

is the buffer effect that prosocial motivation has on

moderating the association between EE and DP. Second,

the study provides greater empirical understanding

of the distinct experiences of burnout which direct

support workers have in their relationships with the

organizations which employ them compared with the

people for whom they provide support. The findings

suggest that organizational factors, especially workload

stress and related environmental factors contribute to

EE and reflect the distress an employee feels in her

relationship with an organization. Such distress may not

develop into DP and impact the relationship between

that same employee and the person supported if the

employee is prosocially motivated.

Depersonalization reflects an acute level of stress in

the relationship between staff and the person they

support. Emotional exhaustion and role boundary stress

are both positively associated with DP when controlling

for other factors. While EE was still associated with DP,

prosocial motivation served as a powerful buffer

against the deterioration of the employee’s relationship

with the person supported. For this reason, EE among

staff may not result in negative outcomes for people

supported.

The direction of the moderating effects of prosocial

motivation between EE and DP cannot be determined

by the current research design. Rather than a buffering

–4

–3.5

–3

–2.5

–2

–1.5

–1

–0.5

0

0.5

1

Low High

Dep

erso

naliz

aon

Role boundary stress

Low PSM

High PSM

Figure 2 Moderating effects of Prosocial motivation (PSM) on

role boundary stress and depersonalization.

104

105

106

107

108

109

110

111

112

113

Low High

Emo

onal

exh

aus

on

Personal accomplishment

Low PSM

High PSM

Figure 3 Moderating effects of Prosocial motivation (PSM) on

personal accomplishment and emotional exhaustion.

–4

–3

–2

–1

0

1

2

3

Low High

Dep

erso

naliz

aon

Emo onal exhaus on

Low PSM

High PSM

Figure 1 Moderating effects of Prosocial motivation (PSM) on

emotional exhaustion and depersonalization.

–25

–20

–15

–10

–5

0Low High

Pers

onal

acc

ompl

ishm

ent

Role ambiguity stress

Low PSM

High PSM

Figure 4 Moderating effects of Prosocial motivation (PSM) on

role ambiguity stress and personal accomplishment.

© 2013 John Wiley & Sons Ltd, 27, 134–144

Journal of Applied Research in Intellectual Disability 141

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effect, prosocial motivation may enhance the experience

of EE among prosocially motivated employees who

experience DP. In this way, contrary to previous

research (Grant & Sonnentag 2010), prosocial motivation

does not appear to directly buffer against EE.1 In fact,

workers with high levels of prosocial motivation in this

study experienced more acute levels of EE when

prosocial motivation was interacted with personal

accomplishment. For workers motivated to engage in

meaningful work, this could reflect the tensions between

service idealism and service capacity. When the desire

to engage in work that is beneficial to others encounters

organizational constraints, employees experience EE.

Given the moderating effects that prosocial motivation

has on the relationship between EE and DP, prosocial

motivation appears more important for staff-client

relations than it is for the relationship between a direct

support worker and the organization which employs

her.

Conclusions

Relationships are central to the work experiences of

direct support employees in intellectual disability

services. Positive aspects of the relationship between

direct support workers and the people whom they

support have a significant impact on the experience of

work stress and burnout among staff in the sector. This

study has important implications for work stress

theories, especially in the areas of emotional overload

and burnout. Most significantly, the study demonstrates

that prosocial motivation serves to buffer the support

relationship from the stresses direct support workers

experience in the employment relationship and work

environment.

This study also has important implications for human

resource practices in the human services sector.

Behavioural competencies which focus on values-based

work practices and support prosocial motivation among

direct support workers reduce feelings of DP in the sector.

Human resource strategies that provide training

opportunities beyond mandated health and safety

requirements to include value-based reflections on the

nature of the work also appear to mitigate DP in the sector.

While value-based competencies are prominent in the

relationship between staff and the people they support,

traditional labour market and workload concerns remain

central to work stress and EE. Organizations can partially

address the negative effects of poor compensation and

high workloads by improving communication practices.

Finally, the study suggests that managers need to rethink

the traditional forms of promotion and career

advancement in organizations. Internal career ladders

tend to remove staff from direct support roles as they

move into positions of greater managerial responsibility.

Dissatisfaction with opportunities for advancement

prevalent among staff in this study did not suggest a

desire for more managerial positions, but rather, more

meaningful and complex direct support roles requiring

more advanced skills.

There are a number of limitations to the current study.

As mentioned previously, the participating agencies in

this study, while representative across a number of

factors, may have had more developed human resources

functions than most service providers in the sector.

Another concern of the research team was the significant

variance in agency response rates, but no data were

available to test the profiles of non-respondents. The

cross-sectional nature of the survey data precludes more

rigorous statistical analyses needed to provide insight

into the casual mechanisms underlying the models. The

research design does not ensure that the measure of

prosocial motivation as a moderating variable temporally

precedes the independent variables (Farmer 2012). The

relationship may not be simple moderation, but reflect

more dynamic interaction properties.

The current study does not explicitly test any of the

specific models of work stress theory and can therefore

not offer any confirmatory proof of the underlying

processes. Rather, the main contribution of the current

study is more heuristic, connecting theories of work

stress (Devereux et al. 2009) with recent developments

in prosocial motivation theories (Grant 2007). In this

way, the study raises more questions than it answers

but offers several intriguing directions for future

research in the area of work stress among staff in

intellectual disability services. One specific implication

of the current study challenges the underlying

assumption of transactional interactions in the MBI

model. The progression of emotional overload into DP

stemming from personal interactions (Maslach et al.

1996) may not apply to the types of long-term,

interpersonal relationships developed and experienced

by direct support workers. Weak reliability ratings of

the DP scale in previous studies (Chao et al. 2011) and

1Grant & Sonnentag (2010) focused on the buffering effects of

perceived prosocial impact on beneficiaries on EE rather than

prosocial motivation itself. We explored this interaction using

the same construct variable of perceived prosocial impact, not

reported here, and did not find the buffering effect.

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142 Journal of Applied Research in Intellectual Disability

Page 10: Prosocial Motivation, Stress and Burnout Among Direct Support Workers

in the current study also point to the need for more

careful examination of this component of burnout.

More generally, this study points to the need for

additional research around the use of important

constructs used to study staff in intellectual disability

services. For example, the correlations between prosocial

motivation and other positive measures such as

personal accomplishment (0.426, P < 0.001) raise

important questions regarding the interpretation of these

constructs. If the unique characteristic of prosocial

motivation is the focus on beneficial outcomes, we would

expect to see higher correlations between prosocial

motivation and feelings of personal accomplishment.

Likewise, among the constructs of stress and burnout,

negative affect appears to have a moderate correlation

with EE (0.539, P < 0.001) but a low correlation with role

overload (0.256, P < 0.001). Exploring the relationships

between emotional dispositions and occupational

stressors remains an important area for future research.

Finally, the more fundamental challenge for future

studies of direct support staff concerns how to connect

this line of research to personal outcomes such as social

inclusion. This study has shown that prosocially

motivated staff experience lower levels of DP. However,

the important research question remains whether

prosocial motivation is associated with better personal

outcomes for people supported (Rose 2011). The

potential to empirically test the relationships between

organizational practices and data on staff with personal

outcome measures such as the Quality of Life indices

(Schalock et al. 2007) should be increasingly feasible as

service providers improve data collection practices

(Schalock & Verdugo 2012).

Acknowledgments

The author gratefully acknowledges the support of the

Developmental Services Human Resource Strategy

Steering Committee and the Shared Interest Committee.

Dr. Jacoba Lilius and Dr. Glenda Fisk helped to design

the survey instrument. Graduate students in the Master

of Industrial Relations program, Janey Cunningham,

Natalie Vogt and Morgyn Ahrens provided valuable

research assistance. This study was supported by

research grants from the Social Science and Humanities

Research Council (Grant # 410-2010-2200) and the Office

of Research Services at Queen’s University.

Conflict of interest

None.

Correspondence

Any correspondence should be directed to Robert

Hickey, School of Policy Studies, Queen’s University,

138 Union Street, Kingston, ON K7L 3N6, Canada

(e-mail: [email protected]).

References

Aiken L. S. & West S. G. (1991) Multiple Regression: Testing and

Interpreting Interactions. Sage Publications, Newbury Park, CA.

Allen N. & Meyer J. (1990) The measurement and

antecedents of affective, continuance and normative

commitment to the organization. Journal of occupational

psychology 63, 1–18.

Amabile T. M. (1993) Motivational synergy: toward new

conceptualizations of intrinsic and extrinsic motivation in the

workplace. Human Resource Management Review 3, 185–201.

Baron R. M. & Kenny D. A. (1986) The moderator mediator

variable distinction in social psychological-research –

conceptual, strategic, and statistical considerations. Journal of

Personality and Social Psychology 51, 1173–1182.

Batson C. D. (1987) Prosocial motivation: is it ever truly

altruistic? In: Advances in Experimental Social Psychology Vol. 20

(ed B. Leonard), pp. 65–122. Academic Press, San Diego, CA.

Braddock D. L. & Mitchell D. (1992) Residential Services and

Developmental Disabilities in the United States: A National Survey

of Staff Compensation, Turnover, and Related Issues. American

Association on Mental Retardation, Washington, DC.

Chao S. F., McCallion P. & Nickle T. (2011) Factorial validity

and consistency of the Maslach Burnout Inventory among

staff working with persons with intellectual disability and

dementia. Journal of Intellectual Disability Research 55, 529–536.

Cleary P. D. & Kessler R. C. (1982) The estimation and

interpretation of modifier effects. Journal of Health and Social

Behavior 23, 159–169.

Devereux J., Hastings R. & Noone S. (2009) Staff stress and

burnout in intellectual disability services: work stress theory

and its application. Journal of Applied Research in Intellectual

Disabilities 22, 561–573.

Dilworth J. A., Phillips N. & Rose J. (2011) Factors relating to

staff attributions of control over challenging behaviour.

Journal of Applied Research in Intellectual Disabilities 24, 29–38.

Farmer C. (2012) Demystifying moderators and mediators in

intellectual and developmental disabilities research: a primer

and review of the literature. Journal of Intellectual Disability

Research 56, 1148–1160.

Grant A. M. (2007) Relational job design and the motivation to

make a prosocial difference. Academy of Management Review

32, 393–417.

Grant A. M. (2008) Does intrinsic motivation fuel the prosocial

fire? Motivational synergy in predicting persistence,

performance, and productivity. Journal of Applied Psychology 93,

48–58.

© 2013 John Wiley & Sons Ltd, 27, 134–144

Journal of Applied Research in Intellectual Disability 143

Page 11: Prosocial Motivation, Stress and Burnout Among Direct Support Workers

Grant A. M. & Sonnentag S. (2010) Doing good buffers against

feeling bad: prosocial impact compensates for negative task

and self-evaluations. Organizational Behavior and Human

Decision Processes 111, 13–22.

Hastings R. P. (2010) Support staff working in intellectual

disability services: the importance of relationships and

positive experiences. Journal of Intellectual & Developmental

Disability 35, 207–210.

Hastings R. P., Horne S. & Mitchell G. (2004) Burnout in direct

care staff in intellectual disability services: a factor analytic

study of the Maslach Burnout Inventory. Journal of Intellectual

Disability Research 48, 268–273.

Hatton C., Emerson E., Robertson J., Gregory N., Kessissoglou

S. & Walsh R. N. (2004) The Resident Choice Scale: a

measure to assess opportunities for self-determination in

residential settings. Journal of Intellectual Disability Research 48,

103–113.

Hensel J. M., Lunsky Y. & Dewa C. S. (2011) Exposure to client

aggression and burnout among community staff who support

adults with intellectual disabilities in Ontario, Canada.

Journal of Intellectual Disability Research 56, 910–915.

Hewitt A. & Larson S. (2007) The direct support workforce in

community supports to individuals with developmental

disabilities: Issues, implications, and promising practices.

Mental Retardation and Developmental Disabilities Research

Reviews 13, 178–187.

Hickey R. (2010) Core Competencies Pilot Evaluation: Initial Report.

Queen’s University, Kingston.

Hickey R. (2011) The role and practices of direct support

workers in promoting greater social inclusion, choice, and

independence: An exploratory review of the literature.

Multidimensional Assessment of Providers and Systems

(MAPS), Queen’s University.

Innstrand S. T., Espnes G. A. & Mykletun R. (2002) Burnout

among people working with intellectually disabled persons: a

theory update and an example. Scandinavian journal of caring

sciences 16, 272–279.

Maslach C. & Leiter M. P. (1997) The Truth About Burnout: How

Organizations Cause Personal Stress and What to Do About It.

Jossey-Bass, San Francisco, CA.

Maslach C., Jackson S. E. & Leiter M. P. (1996) Maslach Burnout

Inventory Manual. 3rd edn. Consulting Psychologists Press,

Palo Alto, CA.

McLean A. A. (1974) Occupational Stress. Thomas, Springfield, IL.

Mowday R. T., Steers R. M. & Porter L. W. (1979) Measurement

of organizational commitment. Journal of Vocational Behavior

14, 224–247.

Osipow S. H. (1998) Occupational stress inventory, revised edition

(OSI-R). Psychological Assessment Resources Inc., Odessa, Fla.

Preacher K. J., Curran P. J. & Bauer D. J. (2006) Computational

tools for probing interactions in multiple linear regression,

multilevel modeling, and latent curve analysis. Journal of

Educational and Behavioral Statistics 31, 437–448.

Rose J. (1995) Stress and residential staff: towards an integration

of existing research. Mental Handicap Research 8, 220–236.

Rose J. (2011) How do staff psychological factors influence

outcomes for people with developmental and intellectual

disability in residential services? Current Opinion in Psychiatry

24, 403–407.

Rose D. & Rose J. (2005) Staff in services for people with

intellectual disabilities: the impact of stress on attributions of

challenging behaviour. Journal of Intellectual Disability Research

49, 827–838.

Schalock R. L. & Verdugo A. (2012) A Leadership Guide for today’s

Disabilities Organizations: Overcoming Challenges and Making

Change Happen. Paul H. Brookes Publishing Co., Baltimore.

Schalock R. L., Gardner J. F. & Bradley V. J. (2007) Quality of

Life for People with Intellectual and Other Developmental

Disabilities: Applications Across Individuals, Organizations,

Communities, and Systems. AAIDD, Washington, DC.

Schaufeli W. B. & Vandierendonck D. (1993) The construct-

validity of 2 burnout measures. Journal of Organizational

Behavior 14, 631–647.

Schaufeli W. B., Leiter M. P. & Maslach C. (2009) Burnout:

35 years of research and practice. Career Development

International 14, 204–220.

Schriesheim C. & Tsui A. (1980) Development and validation of

a short satisfaction instrument for use in survey feedback

interventions. Paper Presented at the Western Academy of

Management Meeting.

Skirrow P. & Hatton C. (2007) ‘Burnout’ amongst direct care

workers in services for adults with intellectual disabilities: a

systematic review of research findings and initial normative

data. Journal of Applied Research in Intellectual Disabilities 20,

131–144.

Spector P. E. (1985) Measurement of Human-Service Staff

Satisfaction - Development of the Job-Satisfaction Survey.

American Journal of Community Psychology 13, 693–713.

Spector P. E. (1997) Job Satisfaction : Application, Assessment,

Causes and Consequences. Sage, Thousand Oaks, etc.

Statistics Canada (2012) Labour force survey estimates (LFS),

wages of employees by job permanence, union coverage, sex

and age group, unadjusted for seasonality. CANSIM Table

282-0073. S. Canada. Ottawa.

Watson D., Clark L. A. & Tellegen A. (1988) Development and

validation of brief measures of positive and negative affect:

the PANAS Scales. Journal of Personality and Social Psychology

54, 1063–1070.

© 2013 John Wiley & Sons Ltd, 27, 134–144

144 Journal of Applied Research in Intellectual Disability