The mediating effect of severity of client aggression on burnout between hospital inpatient and community residential staff who support adults with intellectual disabilities

Jennifer M. Hensel, Yona Lunsky, Carolyn S Dewa

Research output: Contribution to journalArticle

6 Scopus citations


Aims and objectives: To compare exposure to client aggressive behaviour, perceived self-efficacy in managing this behaviour and burnout between community residential group home and specialised hospital inpatient staff who provide care for adults with intellectual disabilities (ID). To assess the mediating role of aggression exposure on burnout in these two staff groups. Background: Aggressive behaviour is a common indication for admission to hospital so these staff typically experience more frequent and severe forms compared to staff working in the community. There have been mixed results in few studies examining burnout and perceived self-efficacy between these two groups. Design: This study used a demographically matched sample of cross-sectional survey data from community residential group home and hospital staff who care for adults with ID in Ontario, Canada. Methods: Exposure to aggression, perceived self-efficacy and burnout were compared for 42 matched pairs using descriptive statistics. A mediation analysis was used to examine the role of aggression severity in the relationship between care setting and burnout. Results: Hospital staff were exposed to more severe client aggression and scored higher in emotional exhaustion (EE). There were no differences in perceived self-efficacy. Severity of aggression was a partial mediator of the higher EE among hospital staff. Conclusions: Exposure to more severe forms of client aggression among hospital staff contributes, at least in part, to them feeling more emotionally exhausted. This study contributes to further understanding exposure to aggression in these different settings and the impact it can have on emotional outcomes. Relevance to clinical practice: There may be a role for policy and resource development aimed at reducing aggression and preventing or managing the associated emotional consequences. This is particularly true in hospitals, where aggression is most severe.

Original languageEnglish (US)
Pages (from-to)1332-1341
Number of pages10
JournalJournal of Clinical Nursing
Issue number9-10
StatePublished - 2014
Externally publishedYes



  • Aggression
  • Burnout
  • Community care
  • Hospital care
  • Intellectual disabilities
  • Residential group homes
  • Staff

ASJC Scopus subject areas

  • Nursing(all)
  • Medicine(all)

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