The Prevalence of Job Stress and its Relationship with Burnout Syndrome among the Academic Members of Lorestan University of Medical Sciences.

INTRODUCTION: Burnout syndrome is one of the consequences and the results of occupational or job stress emerged in the form of emotional exhaustion feeling, depersonalization and decrement personal accomplishment. The aim of this study was to determine the occupational stress and its relationship with burnout syndrome in the academic members of Lorestan University of Medical Sciences.
METHODS: This descriptive cross-sectional survey was conducted on 111 of the faculty members via multistage sampling. Data were collected by the questionnaire of Maslach Burnout Inventory (MBI), and Osipow Occupational Stress Inventory (OSI- R). Data were analyzed by using descriptive statistics as well as analytical statistics such as chi square, Kruskal-Wallis, Mann Whitney tests and Pearson correlation coefficient.
RESULTS: The results showed that the most of the participants had a low level of burnout three dimensions including emotional burnout (72.1%), depersonalization (81.1%), and the decrement of personal accomplishment (56.8%). Moreover 79.3% of samples had a low occupational stress, but there was a meaningful relationship between occupational stress and dimensions of burnout syndrome with an exception for the intensity of decrement of personal accomplishment.
CONCLUSION: Academic members were in an appropriate condition concerning burnout syndrome and occupational stress. However by applying some strategies to decrease stress and determining stress resources, we can improve their psychological health of academic members.

Introduction

Every one's job, as a source of providing life needs, a factor of creating identity and social relationship, is considered as the most important reasons of tenseness.[1]

Occupational stress is a physical and mental response emerged through interaction of an individual with working environment and mismatching his or her‏ work needs with his or her abilities and demands. This tenseness occurs in all jobs, but this issue receives especially much more attention and importance in the jobs when they are dealing with human health.[2] One of the important issues affecting on professors performance and their efficiencies is a mental pressure resulting from their gradual burnout. Mental pressure is considered as a great impact on teachers' job, particularly on teaching-learning process, and constantly included physical, emotional and attitudinal burnout that is often created by consuming extra energy that professors use to encounter and adapt themselves with these pressures.[3]

Creativity reduction, reluctance to work, lack of concentration on work, easily irritated and an aggressiveness towards coworkers, lack of self-confidence, extreme tiredness coming from work and increasing mistakes are the outcomes of stress and mental work pressure and finally lead to unproductivity and inefficiency in any organization.[4]

According to Cordes and Dougherty's view, a series of such stressful occupational factors cause the occupational burnout that is one of the main and significant consequences of occupational stress. Occupational burnout is a psychological process which is the result of a long-term pattern of unsafe and unsound interaction between an individual and his or her workplace or atmosphere.[5]

Occupational burnout was first defined by Freudvennberger in the early 1970. He described occupational burnout as a mood of tiredness and exhaustion resulting from laborious working without any motivations.[6]

The most common definition of occupational burnout belongs to Maslach and Jackson. They describe it as a psychological syndrome consisting of three dimensions of feeling burnout or emotional tiredness (a feeling of tiredness resulted from working with others), depersonalization‏ (indicating an interpersonal dimension of occupational burnout that a person becomes reluctant to his personal responsibilities and aggressive and careless to clients in his workplace), and reduction of personal efficiency (the employee feels that his or her work is not productive).[7]

Maslash and Liter consider some effective factors as the causes of occupational burnout such as the less and more amount of work, less and more control level over the work, low reward, discrimination in workplace, lack of suitable social relationship, and the conflict among the values of the workplace.[8]

These factors cause a lot of problems for family, social, individual and organizational life that the most important of them are as follow; absence, leaving the workplace, lateness or tardiness behavior different psychological complaints, changing job , and interpersonal conflict with colleagues.[9]

Nowadays, Occupational burnout is a common problem in all the systems of the health care, in another words, based on the available census, one in seven person gets occupational burnout at the end of the day.[10]

Keeping up with the importance of the issue, investigating the process of burnout and occupational stress has taken a lot of attentions in recent years so that a large number of researches have been done in Iran and all over the world. For example, Saberi[11]and Badri Gargari[10] in the different works studied teachers' occupational burnout and Zeighami[2] & Shakerinia[12] investigated the relationship between stress and nurses' occupational burnout. Data extracted from different studies that has been done recently by using Maslash's‏ occupational burnout questionnair different jobs indicated an increasing outbreak of the occupational burnout in the most of these job groups. The findings of Arefi's and et al., research showed that the amount of occupational burnout was low in faculty members based on the dimensions of emotional fatigue and depersonalization, but about half of the faculty felt a reduced personal accomplishment in their jobs.[13]

The academic members, due to their educational and researching duties, consume a lot of mental energy and it is thought that they are among the groups exposed to harm of occupational burnout. So concerning the negative effects of occupational burnout and a pressure on personal accomplishment and physical and mental health of individuals, consequently, the reduction of quality, efficiency, and outcomes of their occupations, and also regarding the limited number of studies investigating the outbreak of occupational stress and its relationship with academic's occupational burnout, therefore the aim of this study was to determine the occupational stress outbreak and its relationship with burnout syndrome in the academic members of Lorestan University of Medical Science

Materials and methods

This descriptive correlational survey January and June, 2009. The participants included 111 academic members taking their internship period, or those were in their service obligation, contracted, formal, formal experiment, and permanent employment status. The participants‏ were selected by multistage sampling from medicine, nursing, health, and paramedic colleges affiliated Lorestan University of Medical Sciences.

Data collection was done by a self-report and multi-section questionnaire. The first section contained personal and occupational characteristics of the participants such as age, gender, marital status, work experience, employment status, the college, administrative and managing responsibility, native or non-native employee, academic rank, and basic and clinical sciences. The second part was the Maslash's 22-question questionnaire of occupational burnout. It contained 9 questions in dimension of emotional tiredness, 8 questions in the decrement of personal accomplishment dimension, and 5 questions in depersonalization dimension that they were considered as the three dimensions of occupational burnout. This tool had been designed to evaluate the frequency and the intensity of the three dimensions of occupational burnout. The frequency of related feelings were measured by a seven-point scale (i.e. never, daily, several times a week, weekly, several times a month, monthly, and several times a year) and the intensity of these feelings was graded by six- point Likert scale‏ (Very low, low, considerable, fairly high, high, and very high). Having added the scores extracted from the questions of each three dimension, two final scores were obtained, one for the frequency scale and the other for the intensity scale; it should be said by referring to this rule that as the sum of scores in the emotional tiredness and depersonalization sections is more and the sum of the decrement of personal accomplishment scores is less, occupational burnout will be more, therefore the scores of these sections cannot be added.

If the scores of emotional tiredness dimension were less than 17, between the range of 18-29, and more than 30, it would be represented as low, average, and extremely occupational burnout respectively. In depersonalization dimension, the scores less than 5, between 6-11, and more than 12, respectively indicated low, average, and severe occupational burnout. In the decrement of personal accomplishment dimension, the scores more than 40, between 34-39, and less than 33 were respectively considered as low, average, and severe occupational burnout.[14]

In Iran, several studies have confirmed the validity and reliability of this tool and Alfa Cronbach coefficient for the whole test was r=0.83 and for each subscale of emotional tiredness was r=0.88, for personal accomplishment r=0.76 and for depersonalization r= 0.79.[15] The reliability of the questionnaire used in this research was also obtained by coefficient of Cronbach's Alfa (r=0.78).

The third section of the research was Osipow's Standard Job Stress Questionnaire that contained six dimensions including role overload, role insufficiency, role ambiguity, role boundary, responsibility, physical environment; each of these dimensions was graded based on the Likert's 5- point scale (i.e., never, sometimes, often, usually, more often) that represented of 1 to 5 points respectively. According to the obtained scores, the individuals were divided into the following groups: without stress, normal, average stress, and severe stress. This questionnaire was investigated and evaluated by many Iranian researches studying job stress and the results of various studies showed that the mentioned questionnaire is reliable and useful to investigating job stress.[16] Its internal reliability was r= 0.82 by using coefficient of Cronbach's Alfa. Data collections of this questionnaire were through attending in different departments and handing it in anonymous. In order to take ethical considerations into account, the aim of the research was explained to the participants and their personal and private information was kept confidentially and the principle of trustworthy was highly regarded in this study. Analysis was done by SPSS (version 13), using statistical tests such as Qui square, Kruskal-Wallis, Mann Whitney tests, Pearson correlation coefficient, and descriptive statistics like mean and standard deviation.

Results

According to the results, the average age of the studied subjects (departments) was 41.38 years old and the average of their work experience was 10.5 year. 70% of the participants were male, 87% were married, 46.3% had a formal experiment and or permanent employment, 58.5% were native, 48% having MSc and PhD education with administrative responsibilities, 61.8% were assistant professors, and 63.6% teaching in different grades in basic sciences. Members of 158 members the faculty were students and at the time of the study were absent. In spite of frequent attendance of 22 persons to fill out the questionnaire, they decided not to take part in the research. Finally, 111 questionnaires were filled out and returned by the participants. Based on the findings, the mean and the standard deviation of the scores were 14.07 (8.23) for emotional tiredness, 38.59 (7.36) for personal accomplishment, and 3.14 (5.62) for depersonalization. 72.1% of the studied subjects in emotional tiredness dimension, 56.8% in decrement of personal accomplishment dimension, and 81.1% in depersonalization dimension had a low level of scores. The results indicated that the half of participants in the decrement of personal accomplishment dimension were moderate to severe situation, but, the most of them the level of emotional exhaustion and depersonalization of participants were at low (Table 1).

Table 1

Frequency, mean, and standard deviation of three dimention of occupational burnout in academic members

The amount of burnout	Severe	Average	Low	Sum
The domains (scopes) of burnout	N (%)	N (%)	N (%)	N (%)	Mean (SD)
Emotional tiredness	5 (4.5)	26 (23.4)	80 (72.1)	111 (100)	14.07 (8.32)
Decrement of personal accomplishment	25 (22.5)	23 (20.7)	63 (56.8)	111 (100)	8.35 (7.63)
Depersonalization	10 (9)	11 (9.9)	90 (81.1)	111 (100)	3.41 (5.26)

The results of the research showed that the total score of job stress in 3.9 percent of men without stress, 96.1% with a low stress, and average and severe amount of stress in men were not observed. In addition, 91.2% of women with low stress, 8.8% with average, and the amounts without stress and severe level were also not reported; in the end, the above findings indicates that 20.7% of the studied subjects were without any stress, 79.3% of them had a low level of job stress, and the severe and average level of stress were not observed in this study (Table 2). The results showed that there was a positive correlation between job stress and burnout dimensions in terms of frequency and intensity of emotional exhaustion, intensity and frequency of depersonalization and frequency of decrement of personal accomplishment (r=0.375, P=0.001). It means as job stress get more in the studied subjects, with respect to the amount of occupational burnout, will have a higher level of it. But there was no correlation (P=0.452, r= 0.072) between job stress and the intensity of decrement of personal accomplishment (Table 3). Regarding to the findings, there was no significant relationship between jobs tress and occupational burnout with personal and occupational variables of the studied subjects such as gender, marital status, employment status, the college they served, administrative and managing responsibility, and academic rank.

Table 2

The intensity of occupational burnout dimensions between males and females

Occupational burnout dimensions	Severe		Average		Low		Without
	Male	Female	Male	Female	Male	Female	Male	Female
Role overload	0	9 (26.5)	54 (70.1)	6 (17.6)	17 (22.1)	19 (55.9)	6 (7.8)	0
Role insufficiency	16 (20.8)	0	42 (54.5)	9 (26.5)	19 (24.7)	25 (73.5)	0	0
Role ambiguity	34 (44.2)	18 (52.9)	31 (40.3)	10 (29.4)	9 (11.7)	0	0	0
Role boundary	15 (19.5)	1 (2.9)	42 (54.5)	15 (44.1)	20 (26)	18 (52.9)	0	0
Role responsibility	3 (3.9)	3 (8.8)	58 (75.3)	16 (47.1)	10 (13)	14 (41.2)	6 (7.8)	1 (2.9)
Physical environment	4 (5.2)	0	17 (22.1)	3 (8.8)	55 (71.4)	31 (91.2)	0	0
Total stress score	0	0	0	3 (8.8)	74 (96.1)	31 (91.2)	3 (3.9)	0

Table 3

The relationship between Occupational burnout dimensions and job stress score

Variables	P	Pearson correlation coefficient
Emotional tiredness frequency & job stress score	0.001	0.538
Emotional tiredness intensity & job stress score	0.001	0.501
Depersonalization frequency & job stress score	0.001	0.375
Depersonalization intensity & job stress score	0.001	0.388
Personal accomplishment frequency & job stress score	0.001	0.308
Personal accomplishment intensity & job stress score	0.452	0.072

Besides, no significant relationship was seen between the dimensions of occupational burnout such as emotional tiredness and decrement of personal accomplishment, and totals score of job stress with age and work experience. But there was a negative correlation between depersonalization dimension and age and work experience. So as their age and work experience were more, the level of depersonalization was lower; and the individuals had a better situation in the viewpoint of depersonalization. From the results it can be understood that there was a significant relationship between occupational burnout in intensive and frequent aspects of emotional tiredness, the frequency of depersonalization, and the frequency of personal accomplishment among the faculty busy working in different grades of basic and clinical sciences; that is, occupational burnout in the aspect of intensity and frequency of emotional tiredness and frequency of depersonalization was lower in the faculty working in basic science grades than the individuals working in the clinical science grades, and the personal accomplishment was more in the frequency, but there was no significant relationship between the total score of job stress and the grade of teaching.

No relationship was observed between occupational burnout (except in the aspect of personal accomplishment frequency) and the score of job stress with their educational levels. The frequency of personal accomplishment in post specialists was at the lowest level and had the highest amount of occupational burnout among experts, PhD and MSc, and professional doctors, the personal accomplishment with a slight difference within these groups had respectively been increased (Tables 4 and 5).

Table 4

The relationship between job stress and occupational burnout based on subscales of occupational burnout

Variables	Job stress score	DI	DF	PAI	PAF	ETI	ETF
Gender
Male	141.38 ( 21.9)	8.88 (5.17)	8.49 (5.53)	27.96 (10.21)	17.10 (7.86)	22.84 (8.63)	19.09 (8.42)
Female	144.41 (19.04)	8.21 (4.30)	8.23 (4.64)	27.09 (9.45)	16.91 (7.19)	23.97 (7.69)	21.56 (8.21)
P	0.486	0.505	0.813	0.672	0.903	0.514	0.154
Age
P & Pearson Correlation Coefficient	P=0.990r=-0.001	P= 0.021r=- 0.219	P=0.031r=- 0.205	P= 0.637r=- 0.045	P=0.943r=-‏ 0.007	P=0.229r=-‏ 0.115	P=0.273r=- 0.105
Marital status
Single	141.36 (21.36)	8.74(4.93)	8.35 (5.33)	28.01 (10.01)	16.75 (7.57)	22.88 (8.24)	19.47 (8.54)
Married	148.23 ( 18.29)	8.27(4.92)	8.8 (4.87)	25.67 (9.66)	18.93 (8.02)	25.13 (8.91)	22.67 (7.18)
P	0.234	0.730	0.762	0.399	0.305	0.333	0.232
Native or non-native
Native	139.25 (20.57)	7.92(4.14)	7.45 (4.03)	26.11 (10.75)	15.91 (6.94)	22.34 (7.71)	19.03 (8.11)
Non-native	146.47 ( 21.16)	9.70(5.68)	9.72 (6.39)	29.75 (8.38)	18.59 (8.31)	24 .34 (9.07)	20.60 (8.81)
P	0.074	0.059	0.024	0.050	0.066	0.214	0.423

Emotional tiredness (ET), decrement of personal accomplishment (DPA), and depersonalization (D)

Table 5

The relationship between job stress and occupational burnout based on subscales of occupational burnout according to the academic characteristic of the participants

Variables	Job stress score	DI	DF	PAI	PAF	ETI	ETF
Work experience
Sig & Pearson Correlation coefficient	P=0.990r=-0.001	P=0.058r=- 0.181	P= 0.036r=- 0.200	P=0.863r=0.017	P= 0.943r=- 0.007	P=0.666r=- 0.041	P=0.631r=-‏ 0.046
Employment status
Formally permanent	‏------	7.65 (4.41)	7.52 (5.11)	27.25 (10.12)	17.60 (8.52)	21.87 (7.59)	19.12 (7.75)
Formally experimental	‏------	7.82 (2.64)	7 (1.55)	29.64 (7.34)	16.45 (7.13)	21.54 (6.56)	18.73 (7.66)
Contracted	‏-----	9.59 (5.44)	9.82 (6.56)	27.26 (11.26)	16.85 (6.81)	25.53 (9.85)	21.79 (9.98)
Service obligation		9.86 (5.86)	8.67 (4.16)	27.24 (7.77)	17.9 (8.06)	22.19 (8.06)	18.76 (7.19)
Internship period		7.6 (2.88)	8 (5.10)	31.8 (14.34)	11.6 (3.78)	25.6 (5.55)	19.40 (8.90)
P		0.146	0.115	0.946	0.924	0.126	0.269
Education level
M.Sc. & doctor	139.5 (21.22)	7.79 (4.12)	7.24 (3.31)	25.89 (10.05)	18.63 (8.38)	23.84 (7.11)	23.03 (7.54)
Doctor of specialist	141.18 (14.59)	8.65 (5.91)	7.82 (4.72)	17.29 (8.29)	19.82 (7.53)	15.82 (5.39)	15.82 (5.39)
Expert/specialist	145.19 (24.90)	9.88 (5.26)	9.56 (6.16)	28.17 (10.89)	17.49 (6.99)	23.76 (9.60)	20.05 (8.77)
Post specialist	142.8 (14.93)	7.67 (3.33)	8.93 (6.79)	28.47 (10.43)	11.53 (3.72)	23.8 (8.19)	20.87 (11.24)
P	0.686	0.229	0.240	0.528	0.020	0.354	0.180
Academic rank
Instructor	139.22 (21.78)	7.83 (4.54)	7.28 (3.39)	25.89 (10.15)	17.97 (8.03)	24.06 (7.21)	21 (7.68)
Assistant professor	144.03 (20.32)	9.01 (4.76)	8.99 (5.83)	28.09 (9.55)	16.04 (7.17)	22.81 (8.79)	19.49 (8.89)
Associate professor	141.43 (25.25)	9.71 (7.87)	8.71 (6.97)	33.14 (11.81)	22 (8.52)	22.43 (9.96)	17.43 (7.11)
P	0.541	0.432	0.288	0.184	0.097	0.748	0.504
The grade they teach
Clinical	22.86 (144.69)	4.74 (9.27)	6.13 (9.44)	11.09 (28.80)	6.32 (15.34)	8.77 (24.81)	9.87 (21.71)
Basic sciences	139.6 (18.58)	8 (5.5)	7.25 (3.77)	26.44 (8.40)	18.95 ( 8.55)	21.35 (7.46)	17.73 (5.71)
P	0.204	0.174	0.028	0.215	0.011	0.028	0.012
Workplace
Nursing	144.69 (20.71)	8.77 (4.85)	8.31 (4.37)	25.31 (10.70)	15.62 (6.65)	26.08 (9.22)	25.08 (10.25)
Medicine	143.04 (20.95)	8.84 (4.95)	8.76 (5.76)	28.1 (9.82)	14.59 (17.48)	23.12 (8.63)	19.46 (8.45)
Health or sanitation	132.38 (21.31)	8.69 (5.60)	7.54 (3.15)	24.46 (6.13)	20 (8.77)	21.08 (5.69)	17.54 (5.11)
Paramedics	150.20 (20.49)	5.80 (1.79)	5.4 (0.89)	35.8 (15.04)	20.04 (8.99)	22.20 (6.61)	18.40 (4.67)
P	0.279	0.619	0.506	0.134	0.303	0.485	0.094
Having administrative responsibility
	141.33 (18.51)	7.98 (4.53)	7.63 (5.04)	28 (10.15)	16.9 (7.95)	21.55 (6.78)	18.76 (7.94)
	23.08 (143.13)	5.17 (9.27)	5.39 (9.08)	9.85 (27.43)	7.43 (17.17)	9.28 (24.58)	8.72 (20.77)
P	0.655	0.170	0.147	0.766	0.856	0.055	0.212

Emotional tiredness (ET), decrement of personal accomplishment (DPA), depersonalization (D)

Discussion

According to the results, the occupational burnout among the academic members of Lorestan University of Medical Sciences was more than the average level in emotional tiredness dimensions while‏ the personalization was less than the average level. The results of Shanafel et al.,[17]study on the doctors of faculty, in the department of internal medical science of Rochester, Minnesota, showed that the most of the participants were at a low level from occupational burnout point of view in the depersonalization dimension, while the decrement of personal accomplishment dimension was at high level, which was in line with this research. The studies are also consistent with Arefi's et al., results concerning the occupational burnout of the educational principals[13]and Saberi's et al., research on the occupational burnout of teachers.[11] It seems that the spiritual and valuable dimension of education is an important factor for individuals to adapt themselves with job stresses coming from education-research duties. Individuals' interest, reputation, and social position can be considered as the effective factors of occupational burnout as well.

Stress measurement of the studied subjects put emphasis on this point that the faculty did not have average and severe occupational stress. This result is in line with Ahmadi et al., findings who studied mental pressure of the faculty in Isfahan University of Medical sciences. They reported the job stress less than the average level.[18]Probably, because the task of faculty members is to promote knowledge and research in the community and it was relevant to their expertise and interest led to them feel less stress.

The results showed a strong and positive correlation (P<0.001) within all components of occupational burnout except the intensity of personal accomplishment and job stress. It means‏ that the more job stress in the subjects, the higher level of burnout. This result is in line with Zeighami and Asgharzadeh's findings concerning the positive correlation between job stress and occupational burnout of nurses.[2]

By investigating the relationship of the six dimensions of occupational burnout and the total score of stress with individuals' variables such as age and work experience, it can inferred that individuals were at a better level with respect to their depersonalization and its amount, as their ages and work experience increased. Another research also depicted that work experience, as a result of aging, has a great effect on understanding and reduction of burnout.[19]

Saberi's et al., indicated that work experience and aging had negative correlation with occupational burnout. They stressed that aging and work experience lead to increasing the adaptive mechanisms and stabilizing individuals in educational places; and consequently decrease the occupational burnout.[11]

The results of this study showed no significant relationship between individuals' marital status and burnout and job stress. Our findings was similar to a research done in Turkey concerning the marital status and the different dimensions of burnout,[20]No significant relationship was seen between occupational burnout and employment status of the studied units while the total score of job stress in formally permanent employed, formally experimental employed, internship and contracted employed groups indicated an increasing growth respectively. This finding is in line with the research findings done by Beker et al., in concerning the faculty's job satisfaction in which the job satisfaction was at the highest level in groups employed formally and permanently.[21]

There was no difference between occupational burnout and job stress among the academic members in respect to the college they work. This finding is not in line with Ahmadi et al., studies on the faculty's occupational burnout in Isfahan University. They showed the different amount of job stress in various colleges; on the other hand, showing more frequency of mental pressure in the colleges that the faculty members were highly involving with students.[18]

The result of the present study showed that there was no difference between occupational burnout and job stress in the studied subjects with respect to being native or non-native. For individuals, being non-native, means being far away from their family can be a source of creating anxious and mental pressure. So, if this pressure were continuous and severe, it would have a considerable impact on different aspects of individuals' job. A research in the U.S. indicated that there was a meaningful relationship between these two variables and occupational burnout.[22]

With regard to having administrative responsibilities, there was no difference between occupational burnout and job stress. Occupational burnout in emotional tiredness and depersonalization dimensions of the academic members who were busy working in the sections of basic sciences was less than those working in clinical sections. It seems that a high percentage of the faculty members in clinical groups not only had educational responsibilities but also had a vital role in treatment. Hence, they were exposed to the occupational burnout resulted in both educational services and treatment affairs. Therefore, such a higher occupational burnout, regarding emotional tiredness and depersonalization dimensions, can be both emerged in the forms of anxiousness resulted in job and being reluctant to their clients that such signs were justifiable in these groups. The amount of occupational burnout with regard to the decrement personal accomplishment dimensions in the groups belonging to basic sciences could be explained by this reason that the faculties of basic sciences were under a less pressure of their workplace and clients' expectations in comparison to the clinical group members; consequently, they experienced the decrement of personal accomplishment. The results of Beker et al., showed that job satisfaction score clinical faculty members more than in comparison with basic science faculty members and those administrative posts.[21]

In general, as it was mentioned before in investigating the individual and occupational variables such as marital status, holding an administrative responsibility, being native or non-native, academic rank, and the college the faculties work, no significant relationship was observed with occupational burnout, it seemed that the low number of sampling in the research was one of the reasons.

Conclusion

The results of the current research indicated that the amount of job stress and occupational burnout is at an acceptable level in the academic members of medical sciences in Lorestan University, but it is advised not to ignore evaluating periodically and take action to have interfering approaches if necessary in order to modify and control stress and burnout which are destructive to preserving dynamic life of an organization. However, by applying some strategies to decrease stress and determining stress resources, we can improve their psychological health of academic members.

Limitations including small sample size, no response to the distributed questionnaires from some professors, and using the self-reporting methods to collect data which may decrease the generalization of the results. Finally, it is suggested to do research with a higher volume of sampling in a vast geographical scope along with qualitative and meta-analytical studies.

Acknowledgments

We thank all the faculty members of Lorestan University of Medical Sciences for their kindness and attendance in this research.

Ethical issues

None to be declared.

Conflict of interest

The authors declare no conflict of interest in this study.