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Engagement and exhaustion in healthcare: a network approach

Thomas Kowalewski (Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands)
Britta Ruschoff (Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands) (University of Helsinki, Helsinki, Finland)

Career Development International

ISSN: 1362-0436

Article publication date: 22 August 2019

Issue publication date: 22 August 2019




Taking a network approach, the purpose of this paper is to investigate the social antecedents of work-related engagement and exhaustion in a sample of Dutch healthcare workers, examining how employees’ structural position in the team (i.e. their centrality in the network) is associated with their engagement and exhaustion. Distinctions are made between instrumental networks (i.e. structural dependencies) and expressive networks (i.e. emotional connectedness through friendships).


Associations between job characteristics (quantitative demands, emotional demands and influence) and employees’ centrality in the instrumental and expressive networks at work with their self-reported engagement and exhaustion were examined. Network centrality was assessed though a sociometric survey by the total number of nominations each employee received (in-degree centrality) or gave (out-degree centrality) and for both networks separately.


The results show that whereas job characteristics but not network centrality were associated with exhaustion, network centrality in the expressive network but not job characteristics was associated with engagement. In-degree centrality (being nominated by many co-workers as a friend) was positively associated with engagement, whereas out-degree centrality (nominating many co-workers as a friend) was negatively associated with engagement.


The results support recent findings concerning more multifaceted antecedents of engagement and exhaustion, and underline the importance considering social network characteristics in investigations of work engagement. On a methodological level, the differing results for in-degree and out-degree centrality underline the importance of not only relying on self-reported social relationships but to also capture other-reported data.



Kowalewski, T. and Ruschoff, B. (2019), "Engagement and exhaustion in healthcare: a network approach", Career Development International, Vol. 24 No. 4, pp. 383-394.



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