THE STUDY ON MEDICAL WORKERS’ EMOTIONAL BURNOUT SYNDROME

The article is important because the problem of emotional burnout is particularly actual one for health professionals in Ukraine and around the world at the moment. The medical staffs of medical departments are exposed to excessive stress on a daily basis in the course of their professional activities due to constant and direct contact with patients who need urgent care or are in a critical psychological state. These circumstances in most cases cause negative emotions, excessive mental stress and physical fatigue. The article purpose was to study of the syndrome of “emotional burnout” and the peculiarities of its manifestation in health professionals depending on gender. The conducted empirical study was devoted to the psychological manifestations of medical workers’ emotional burnout among (depending on genders); it was organised in 2020. The special socio-psychological study included 60 medical workers (30 women-nurses and 30 male doctors) with 5 or more years of experience working in medical institutions in Kyiv. The following psychological techniques were used in the empirical study: V.V. Boyko’s method determining the level of "emotional burnout"; J. Greenberg’s method studying burnout; Maslach Burnout Inventory for “person – person” professions; S.A. Budassi’s method for self-assessment; Cattell 16PF Questionnaire. The study results allowed us to draw the following conclusions. Analyzing the link between gender and emotional burnout, we should say that women in a stressful situation are more prone to psychosomatic and psychovegetative disorders, and men are prone to personal alienation (depersonalization). In addition, women’s syndrome is manifested not only through “resistance” symptoms - inadequate selective emotional response and reduction of professional responsibilities, but also through experienced traumatic circumstances - a symptom of the "stress" phase, while men’s emotional burnout unfolds only via the “resistance” symptoms. Prospects for further research: to consider the problem of burnout factors appeared at medical workers’ professional path in a new perspective. Based on the obtained results, we can say that many of the studied health professionals needed specialized psychological care to overcome the emotional burnout syndrome.

mental stress and physical fatigue, hostility to work, a general vague sense of anxiety, which contributes to the depletion of the psycho-emotional sphere and the development of "professional and emotional burnout". Among the symptoms that appear first, we can distinguish a general feeling of fatigue, a hostile attitude to work, a general uncertain feeling of anxiety, and the perception of work as one that is constantly becoming more complicated and less productive.
A medical worker can easily get angry, irritated and feel broken, focus on details and be extremely negative about all events. The anger they feels can lead to suspicion. An employee may think that employees may get rid of them.
This condition can be exacerbated by feelings of "noninvolvement", especially if the employee has previously participated in all events. In addition, anyone who tries to help, give advice, is annoying. Serious manifestations of "emotional burnout" are behavioural changes and rigidity.
If a person is usually talkative and unrestrained, they may become quiet and estranged. Conversely, a person who is usually quiet and reserved can become very talkative, enter into a conversation with anyone. The victim of "emotional burnout" can become rigid in thinking. A rigid worker is closed to changes because it requires energy or risk, which is a great threat to an already exhausted person.
A healthcare professional who experiences the effects of emotional burnout may try to overcome the situation by avoiding colleagues and patients, physically and spiritually distancing themselves from them. Avoidance and distancing can manifest in many ways. For example, an employee may be absent from work. The can communicate impersonally with colleagues and clients, can reduce their own torment to contact with them. A healthcare professional eventually falls into depression and begins to perceive the situation as "hopeless." They may resign or change their profession altogether.

Analysis of recent research and publications.
Gender is a social category that defines the totality of all the characteristics that distinguish people depending on gender; is a set of somatic, reproductive, social-cultural and behavioural characteristics.
Medicine is one of the areas of human activity, where quality issues and its evaluation are of particular importance. The main task of social professions is to perform work not for personal consumption, but for the benefit of society; this approach is certainly applied for the medical profession.
Professional and emotional burnout is a syndrome that develops against the background of chronic stress, which leads to depletion of personal resources of emotional energy of a working person. Emotional burnout occurs as a result of the internal accumulation of negative emotions without proper "discharge" or "release" from them. The professional activities of health professionals pose a potential threat to the development of emotional burnout (Sweileh, 2020).
Medical workers' emotional burnout syndrome of is a specific type of professional deformity of people who work in close emotional contact with patients in providing them with professional care. This is a mechanism of psychological protection developed by an individual in the form of complete or partial exclusion of emotions (reduction of their energy) in response to certain traumatic influences. It is characterized by: 1) a feeling of emotional exhaustion (a person cannot give themselves to work as before); 2) dehumanization (tendency to develop a negative attitude towards patients); 3) negative self-education in professional termslack of sense of professionalism (Chemali, Ezzeddine, Gelaye, Dossett, Salameh, Bizri, et al., 2019).
The occurrence of emotional burnout correlates with a tendency to emotional rigidity, intense internalization (perception and experience) of the circumstances of professional work, weak motivation of emotional impact in professional activities, the presence of moral defects and disorientation (Elbarazi, Loney, Yousef, Elias, 2017). The development of emotional burnout is associated with existing chronic intense psycho-emotional activities: intense communication, reinforcement of emotions, intense perception, processing and interpretation of information and decision-making, as well as poor organization and planning, lack of necessary resources, bureaucratic moments, conflicts with the leader, colleagues, psychologically difficult contingent with which the professional in the field of communication deals.
Healthcare professionals point to many factors as stressors that cause emotional burnout: intense work rhythms, constant reorganizations, the role of uncertainty and related conflicts, lack of career growth, inadequate forms of support and control, insufficient ability to influence working conditions (Dugani, Afari, Hirschhorn, Ratcliffe, Veillard, Martin, et al., 2018).
In recent years, society's attitude toward health workers has changed, with patient demands increasing and criticism increasing. The results provide an opportunity to consider in a new perspective the problem of studying the burnout factors in the context of the professional path of an individual health worker.
Existing research (Bresesti, Folgori, De Bartolo, 2020;Roy, 2018) indicate that most of the studied health professionals need specialized psychological care to overcome the syndrome of emotional burnout.
Analysis of psychoprophylaxis and correction of the negative manifestations of emotional burnout showed that, in foreign practice, approaches to its treatment or reduction of its severity are mostly related to techniques taken from the field of coping with stress, which have been effective in overcoming burnout in medical workers.
Strategies to overcome burnout that are based on modifications of the work structure, according to researchers, are the simplest and most effective in reducing the syndrome manifestations (Panagioti, Geraghty, Johnson, Zhou, Panagopoulou, Chew-Graham, et al., 2018). In this regard, it is proposed to limit the number of patients with whom each health worker works; to distribute evenly the most difficult and ungrateful work among team members; to set aside time during the working day for relaxation activities, after which employees restore energy levels; to involve additional employees in work in organizations, for example, volunteers, etc.
As shown in recent researches (Aryankhesal, Mohammadibakhsh, Hamidi, Alidoost, Behzadifar, Sohrabi, et al., 2019;Pastrik, 2017;Horoshkina, 2015), a high level of "exhaustion" was formed at women health workers more often (30%) than that at men (19%). Analysis of the indicators of the second phase -"resistance" showed that its development was characteristic mostly for women (16%) and only 4% of male health workers had this characteristic. As for the "stress" phase, its high level was found only at men (4%). Thus, we can conclude that at deep development of emotional burnout syndrome, male and female medical employees, working in medical institutions, almost equally respond to stressors being at the first, second phases -"exhaustion" and "resistance". However, men are more likely to respond to being at the third syndrome phase -"stress".
An in-depth analysis of the symptoms of each phase will allow us to reveal in more detail the relationship between emotional burnout and gender.
Highlighting previously unsolved parts of the general problem to which the article is devoted: to study of the emotional burnout syndrome and the peculiarities of its manifestation in health professionals depending on gender. This is the study purpose.
Research methodology and organization. Research work was conducted during 2020. The special sociopsychological study included 60 medical workers (30 women-nurses and 30 male doctors) with 5 or more years of experience working in medical institutions in Kyiv.

Presentation of the main research material and
discussion. According to the study results shown in Table   1, the "traumatic circumstances" symptom of the "stress" burnout phase was experienced more often by women health workers (62%) than by men (30%); in addition, anxiety and depression was also greater at women (22%) than at men (10%).
At the "resistance" phase, the symptom of inadequate selective emotional response was shown much more often by women (62%) than by men (45%). Emotional and moral disorientation was experienced equally by women health workers (21%) and men health workers (21%). The sphere where emotions were saved was expanded more often at men (30%) than at women (19%). Professional responsibilities were reduced more often by women (50%) than by men (22%).
The "exhaustion" phase was described by the following burnout symptoms: "emotional deficit" and "emotional withdrawal", which was characteristic equally for men and women (22%); "personal alienation" (depersonalization), which was characteristic to a greater extent for men (42%), 22% of women also had it.
"Psychosomatic and psychovegetative disorders" existed more often at women health workers (17%) than those at male health workers (5%).
As table demonstrates, there were statistically significant differences between genders for the following symptoms of emotional burnout: personal alienation (depersonalization) (p <0.01) and psychosomatic and psychovegetative disorders (p <0.001). The obtained data show that women in a stressful situation were more prone to psychosomatic and psychovegetative disorders and men were more prone to personal alienation (depersonalization). In addition, women had not only symptoms of the "resistance" phase -inadequate selective emotional response and reduction of professional responsibilities, but also the "stress" burnout phase -experienced traumatic circumstances, while men's emotional burnout had only "resistance" symptoms.
The data obtained during the empirical study are consistent with the findings of national and foreign studies. Thus, the relationship between emotional burnout and gender is not unambiguous. Some authors argue that men feel burnout more often than women, others ones say on the contrary. Thus, it is not about representatives of what gender feel burnout more often, but rather about the specifics of emotional burnout characteristic for different genders (Pastrik, 2017;Horoshkina, 2015).
In addition, scientists determined that, in a stressful situation, men were more prone to emotional alienation, felt urgency, perceived a situation as critical, which often affected their relationships with the environment, provoked alienation from people. Men were less likely to seek social support than women, they often tried to follow the stereotype of "I have to be strong and courageous and decide everything myself".
At the same time, women in a stressful situation were more prone to emotional exhaustion, they were more emotionally open, tempted to delve emotionally into the experiences of everyone around them (both at work and at home); they endangered their emotional health and risked emotional devastation. Being exhausted emotionally and physically, women acquired psychosomatic and psychovegetative disorders (which they complained much more often compared to men). Women tended to take a maternal position both at home and at work, taking responsibility for the lives and well-being of people around them, which also led to emotional overload, physical and mental exhaustion (especially when a woman was unable to fulfil her responsibilities) (Pastrik, 2017).
The difference in men's and women's behavioural manifestations of emotional burnout can also be explained by the fact that men were dominated by instrumental values, and women were more prone to emotional Another factor influencing burnout at women was the fact that working women experienced higher workloads (compared to men) due to additional domestic and family circumstances (Horoshkina, 2015).
Health professionals' emotional burnout symptoms and phases were re-examined after a special training; the obtained data revealed a positive trend in symptoms and phases of emotional burnout, namely: the number of people with "traumatic circumstances" symptom decreased, this symptom after training had 10% of the pesrondents; no medical worker at the end of the training had "self-dissatisfaction" or "feeling of being caged" as burnout symptom; the number of anxious and depressed health workers decreased by 4%.
The "stress" phase remained almost unchanged after training; the number of medical workers with the developing symptom decreased slightly (by 4%).
The number of medical workers having "inadequate selective emotional response", as emerging and developing symptoms dropped by 4%. The number of medical workers with emotional and moral disorientation as a developing symptom decreased by 8%, and by 10% as a developing symptom. The number of respondents whose sphere of saving emotions expanded decreased by 4% and 8% for emerging and developing symptoms, respectively. The number of medical workers with "reduction of professional responsibilities" as emerging symptom decreased sharply by 12%, and as a developing symptom by 4% of medical workers.
The symptoms of the "exhaustion" phase -"emotional alienation", "emotional deficit", "personal alienation" remained almost unchanged after the training.
The number of medical workers with psychosomatic and psychovegetative disorders, as an emerging symptom decreased by 2%, and as a developing symptom decreased by 4% of medical workers. The "exhaustion" phase was found at fewer medical workers: as an emerging symptom, it decreased by 6% and, as a developing symptom, it decreased by 4% of medical workers.
Thus, medical workers' burnout syndrome was represented by the "resistance" and "exhaustion" phases, but the number of medical workers with corresponding symptoms decreased slightly, which indicated the feasibility of the proposed psychological work with medical workers.
The repeated study of medical workers' burnout syndrome (with J. Greenberger's method) provided an opportunity to identify the training effectiveness (see Ta-ble 2).
As can be seen from Table 2, the analysed dynamics of medical workers' burnout levels showed that the number of medical workers with high burnout levels  The data obtained for the symptoms of health professionals' emotional burnout showed: high "emotional exhaustion" was found at fewer respondents after training (by 4%), respectively, the number of medical workers with low "emotional exhaustion" increased (4%); high and medium "depersonalization" was found at less respondents (by 2%), respectively, increased the number of medical workers with low "depersonalization" after training increased (4%).
Significant changes were found for the "reduction of personal achievements" symptom after training: the number of medical workers with high levels decreased by 12% and the number of medical workers with average symptoms increased by 12%.
Thus, the data obtained indicate the effectiveness of the proposed training for health professionals with emotional burnout.
The dynamics of medical workers' self-esteem before and after training with S.A. Budassi's method is presented in table. 4. The number of medical workers with above average (4%) and high (12%) self-esteem increased; respectively, the number of workers with low self-esteem decreased by 16%.
The dynamics of medical workers' personal factors before and after training examined with R. Cattell 16PF questionnaire is shown in tables 5 and 6. According to the data shown in Tables 5 and 6, we analyzed the psychological profiles of medical workers during the experiment. The Table 6 shows medical workers' personal factors during the experiment.
According to the results shown in table 5, the number of medical workers with average self-esteem increased by 14%, respectively, the number of medical workers with low self-esteem decreased. Medical workers' intelligence, "forthright -shrewd" factor remained unchanged during the experiment. The number of medical workers with high "trusting-suspiciousness" factor increased by 2%, with the medium factor increased by 8%, with the low factor decreased by 10%. Regarding the self-control dynamics, we obtained the following data: the number of medical workers with low self-control decreased by 12%, the number of medical workers with average self-control increased by 10%, and the number of medical workers high self-control increased by 2%. As for "relaxed -tensed" factor: the number of medical workers with low "relaxed -tensed" factor decreased by 8% and the number of medical workers middle "relaxed -  tensed" factor grew by 8%.
The Table 6 shows medical workers' psychoemotional factors during the experiment.
According to the studied dynamics of medical workers' psycho-emotional factors, we found the following data: the number of medical workers with emotional instability decreased (20%); the number of medical workers with average emotional stability increased by 10%, and the number of medical workers with high emotional stability increased by 10%. The factors of "reservedoutgoing" and "group-depended -self-sufficient' did not change. The number of tough-minded health workers decreased by 10%, and the number of health workers with average factor increased by 10%. By the "selfassured -apprehensive" factor, anxiety of health workers decreased by 14%.
The obtained results showed that many health professionals reduced signs of internal personal conflict, causing emotional burnout, which indicates the effectiveness of the proposed psychological training.
Conclusions. The conducted empirical research allowed us to analyse psychological manifestations of medical workers' emotional burnout (depending on genders). The study results have led to the following conclusions. Analyzing the link between gender and emotional burnout, we should say that women in a stressful situation are more prone to psychosomatic and psychovegetative disorders, and men are prone to personal alienation (depersonalization). In addition, women's syndrome is manifested not only through "resistance" symptomsinadequate selective emotional response and reduction of professional responsibilities, but also through experienced traumatic circumstances -a symptom of the "stress" phase, while men's emotional burnout unfolds only via the "resistance" symptoms.
Prospects for further research. The obtained results make it possible to consider the problem of burnout factors appeared at medical workers' professional path in a new perspective. Based on the obtained results, we can say that many of the studied health professionals needed specialized psychological assistance to overcome the emotional burnout syndrome.