Emotion Dysregulation and Workplace Satisfaction in Direct Care Worker Burnout and Abuse Risk

Anissa J. Maffett, Danielle N. Paull, Reid L. Skeel, Jana N. Kraysovic, Brianna Hatch, Sean O'Mahony, James I. Gerhart

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background/Objectives: Direct care workers frequently encounter difficult interactions with the patients they serve and experience frustration and burnout. The current study tested a hypothesized model in which predictors of caregiver abuse risk (emotional dysregulation, difficulty managing patient behavior, and workplace satisfaction) were mediated by symptoms of burnout. Design: The study used an online cross-sectional survey design. Setting and Participants: The study was implemented online via Qualtrics. Participants were 206 direct care workers (eg, certified nursing assistants, patient care technicians, home health aides, and medical assistants). Measurements: All respondents completed the Caregiver Abuse Screen (CASE), Difficulty with Emotional Regulation Scale (DERS-SF), and the Abbreviated Maslach Burnout Inventory. Demographic data and employment history were also collected. Correlational methods, including path analysis, were used to assess associations between study variables. Results: More than half of this heterogenous sample endorsed significant risk for engaging in patient abuse. Path analysis suggested emotional dysregulation and low workplace satisfaction were associated with greater risk of patient abuse, and these associations were partially and simultaneously mediated by burnout facets of depersonalization and emotional exhaustion. Conclusions and Implications: This study provided preliminary support for a model of caregiver abuse in which underlying difficulties regulating emotions convey risk for caregiver abuse via burnout facets including emotional exhaustion and depersonalization. Enhancing basic emotion regulation skills and reducing burnout in direct care staff may reduce the risk of abuse for older adults. Thus, providing training necessary to help direct care workers manage their own emotions in order to better recognize, understand, and respond effectively to the needs of older adults may reduce staff burnout and, consequently, lower the risk of abuse for older adults.

Original languageEnglish
Pages (from-to)1257-1261
Number of pages5
JournalJournal of the American Medical Directors Association
Issue number7
StatePublished - Jul 2022


  • Direct care workers
  • abuse
  • burnout
  • emotion regulation


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