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The Relationship With Patients: "Emotional Labor" and Its Correlates in Hospital Employees

The Relationship With Patients: "Emotional Labor" and Its Correlates in Hospital Employees

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goal i s to make a patient's hospitalization period more "human ", as it were,
starting with the acceptance-at-the-hospital phase, through residence at the
structure, to the discharge moment, when the sick person leaves the hospital.
Hospitals are thus conceived as services that, beyond fulfilling their therapeu­
tic mission, care for their customers by paying attention to the quality of the
relationship patients have with health-care operators. In sum, the overall ade­
quacy of the therapeutic system is evaluated not only in terms of quality of
medical care proper but also as regards its ability to establish satisfactory rela­
tionships with customers. To the latter end, employees are required to express
both affective neutrality (symbolized, for instance, by the white uniforms hos­
pital workers wear) , and involvement and commitment toward their custom­
ers, establishing positive human contacts with them: listening carefully to
their queries, making them feel at ease, reassuring those who are anxious. In
fact, the very first help action performed by health care personnel toward cus­
tomers, that of listening to patients' problems, is at the same time the very first
opportunity to convey the message that the structure is able to supply an ap­
propriate "answer" to the problem/question they have. A fundamental aspect
of the workload of hospital workers is thus monitoring the relationship they es­
tablish with patients, how they shape their communication with them, so as to
achieve the required quality, not unlike what happens in most interpersonal
relationships.
As Hochschild (1 983) discovered, the emotional style with which one offers
service
is an integral part of the service itself, so much so that business orga­
a
nizations try to govern and control it by means of (more or less explicit) ex­
pression rules that dictate what emotions must be expressed. Such emotion­
related job-role requirements are a crucial rather than a sporadic aspect of
working roles in many so-called "helping professions," that is, in service jobs
that imply employee-customer interactions, such as in hospital, school, bank,
and public office jobs. The most general hypothesis of this study was that emo­
tion-related job-role requirements trigger emotion regulation processes, whose
nature, frequency, and consequences in turn contribute to defining, individu­
ally and socially, life quality parameters. For instance, not conforming to emo­
tional demands might induce dissatisfaction, lower self-esteem, and burnout
in employees, and induce employee-client conflict, complaints to the organiza­
tion, and so forth. A specific hypothesis was that hospital workers (similarly to
other service employees, but possibly to a more demanding extent given the
peculiar nature of their working context) as part of their job role are asked to
comply with the organization's emotion-style requirements. Thus, if the
worker, when interacting with a customer, feels emotions that are discrepant
with job-required emotions, he or she ought to engage in regulatory processes
to express the prescribed emotions. If workers engage in such regulatory proc­
esses, from the organization's viewpoint they are emotionally competent. Such
emotional compliance, however, as we discuss next, is associated with precon-

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ditions (e.g., the worker must be aware of a discrepancy state, and be able and
motivated to engage in regulatory processes) , as well as to psychophysical con­
sequences.
Additionally, this chapter (as part of a larger research project; e.g., Zam­
muner & Canato, 2000; Zammuner, Lotto, & Galli 2002) , aims to help ground
the well-known concept of "emotional labor," explored mainly within the so­
ciological tradition, within the framework provided by emotion theories, espe­
cially in relation to emotion-regulation concepts. This theoretical gap between
traditionally distinct fields of inquiry has, however, lessened in very recent
writings (e.g., Ashkanasy, Hartel, & Zerbe, 2000; Fisher & Ashkanasy, 2000) ,
which also testify to the upsurge of interest in the emotions, and underlying
processes, that we experience in relation to that important part of life that we
spend at work.

EMOTION REGULATION AND EMOTIONAL LABOR
The Emotional Labor Concept
We discuss emotion regulation as it occurs within work contexts. Hochschild
(1983), a sociologist, originally addressed this issue and termed emotional la­
bor the regulation performed by employees in work-setting contexts requiring
employees' interactions with customers. Her theoretical approach very much
drew on Goffman's ( 1959) dramaturgical impression-management perspec­
tive. Hochschild's emotional labor construct was meant to capture the fact
that, in many kinds of service jobs, employees must manage their feelings and
their emotional expressions so as to meet their employer'sleeling and display
rules, defining what emotion a person ought to feel and express to others
(Ekman, 1 972, 1984; Hochschild, 1983) . In a customer-oriented service soci­
ety, where products provided to clients are at least in part intangible, organiza­
tions do need to focus greater attention on the quality of their services, includ­
ing the quality of customers' interaction with service providers. As several
studies confirm, customers' evaluations of interpersonal aspects of their inter­
action with service providers contribute to defining their judgments of service
quality; this evaluation, in turn, tends to reflect employees' feelings about their
job and their organization (e.g., Pugh, 1998; Rafaeli & Sutton, 1 987). Organi­
zations may explicitly instruct or train workers about their job emotional re­
quirements, control the quality of employees' emotional service performance,
and reward or "punish" them accordingly.
However, not all service sectors, nor all job roles in them, require emotional
labor to the same extent and frequency, nor do they require employees to dis­
play emotions of the same nature. For instance, medical personnel (e.g.,
nurses) have to express positive emotions most of the time (e.g., hope, encour-

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agement, joy) and empathize with patients' feelings and worries, a s well as, at
times, display negative emotions (e.g., anger at a patient for not following med­
ical prescriptions) ; front-line employees, such as receptionists and bank­
counter workers, typically are required to express positive emotions (e.g.,
friendliness) ; "control-role jobs" (e.g., workers' supervisors, bill collectors)
might need to alternate between negative, in-control emotions such as anger,
contempt, and indignation, and positive emotions such as encouragement,
pride, and satisfaction (e.g., Best, Downey, & Jones, 1 997) . In sum, the specific
nature of a service sector, and that of a job role, are likely to be crucial variables
in predicting various aspects of the required, and performed, emotional labor.
Emotional Labor as a Process of Emotion Regulation
Within Work Contexts
In this chapter we use the term emotional lahor to refer to emotion regulation
that occurs within work contexts. However, as stated earlier, to better under­
stand the construct itself, possibly defining it more precisely, we think it is
necessary to conceptualize it with reference to the very concept of emotion
regulation, both in general and in specific terms-that is, in relation to a num­
ber of distinct regulation aspects that need to be considered when studying
emotional labor.
For emotion theorists, emotion regulation is "part and parcel" of the emo­
tion process (see especially Frijda, 1 986), potentially activated at any of its
phases, such as when an event is to be appraised as good or bad for oneself, or a
felt emotion is judged for its personal significance, or its degree of personal or
contextual legitimacy , or is to be expressed to others. In other words, assuming
that an emotion is a multicomponential process (Scherer, 1984) , regulation
can, in principle at least, influence every component of the emotion experience:
appraisal, physiological reaction, facial expression, and so on. Regulation may
moreover influence the antecedent of an emotion (e.g., when a person avoids
an event known to cause in him or her an unwanted emotion), and its conse­
quences (e.g., when a person refrains from engaging in a vindictive behavior).
Regulation of the felt emotion, or of its expression, is called for when the emo­
tion conflicts with known internalized norms, or with contextually salient ones,
or when a person experiences a dysphoric emotion.
Distinct Aspects of Emotion Regulation
In the social sciences, emotion regulation processes are referred to by a variety
of terms, including emotional control, emotion inhibition, self-regulation,
self-control, emotion-focused coping, and, as already noted, emotional labor
(for theoretical reviews and empirical data, as well as for a discussion of as­
pects that here cannot be touched on, see, e.g., Campos, Campos, & Barrett,

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1989; Ekman, 1972; Frijda, 1986, 1999; Gross, 1999; Gross & Levenson, 1993;
Keltner & Gross, 1999; Lazarus, 199 1 ; Mesquita & Frijda, 1992; Pennebaker &
Hoover, 1986; Russell, 199 1 ; Saarni, 1993; Salovey et al., 1993; Zammuner,
1 995, 1 996, 2000a). This terminological variety points to differences not only in
what "objects" distinct disciplinary traditions select to study, and with what
theoretical or applied concerns they do so (e.g., consider the coping and stress
traditions; see Gross, 1998) , but also in how the process is conceptualized,
overall reflecting the complexity of regulation issues. What we focus on, and
how we conceptualize it, will bring forward this or that aspect of regulation. It
is therefore important to specify what regulation "aspects" we need to con­
sider when studying emotional labor, a contextualized regulation process. We
next simply list the most crucial aspects, supplying hypothetical and simplified
examples of health care employees' regulatory actions, or regulation-related
evaluations, in their interaction with a patient P:










Regulation object(s) , namely, what is being regulated. Regulation may act
either (a) on a felt ("inner") emotion, in relation to this or that emotion
component, including how the emotional event is appraised (e.g., "P did
not mean to be rude to me"), or one's level of autonomic arousal, or (b) on
its outward, visible expression, including the facial or verbal expression of
the emotion.
Regulation motivation, namely, the extent to which a person is motivated to
regulate his or her emotions, in general, or in a specific circumstance
(e.g., "I am not the kind of person who gets upset for such a little thing";
"P is in great pain; I must be patient with him").
Regulation motives and goals, namely, what causally triggers regulation,
and what is/are the target result(s) that (consciously or not) a person tries
to achieve when regulating an emotion (e.g., "If I start getting angry this
early, I shall get crazy by lunch time!").
Regulation norms, namely, the norms that prescribe what is to be regu­
lated, when, how, and why. Job-related norms typically include feeling
rules (e.g., ''You have to be understanding with people who are in pain"),
and display rules (e.g., ''You cannot show that you are angry at P") , and
constitute a (more or less overlapping) subset of the emotion norms that
are defined according to existing sociocultural values.
Regulation processes per se, namely, both how regulation operates to
achieve its goals vis-a-vis a specific emotion (or component of it) , and
with what effects; automatic and voluntary regulation processes include,
for instance, breathing deeply to calm down; smiling, or trying to appraise
the event differently (e.g., as a challenge rather than as a threat) to feel
better; and redirecting attention to event aspects that one can cope with,
rather than to those one feels helpless about.

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Psychophysical resources in regulation, namely, what resources a person
needs in order to activate, maintain, and sustain regulation effort, and to
what extent they are available to him or her at a given moment in time, or
in general (e.g., a stressed worker, or an ill person, might not have suffi­
cient resources to engage in regulation) .
Regulation costs, namely, what psychophysical costs are associated with
regulatory efforts: For example, frequent, prolonged, or difficult to acti­
vate, sustain, and enact regulation processes might induce health risk­
conditions, such as stress, fatigue, burnout, and heart problems.

RISKAND PROTECTION FACTORS
IN THE WORKING LIFE OF HOSPITAL STAFF
Burnout
In recent years job-related stress in a variety of jobs, and its consequences,
have received increasing attention. Research has found evidence for a number
of major job stressors, including inadequate staffing, work overload, and, for
hospital workers in particular, emotional demands made by patients, and prob­
lems associated with being constantly faced with death. Among the potentially
negative consequence of chronic exposure to such job stressors, burnout, de­
fined as "a syndrome . . . that occurs frequently among individuals who do
'people work' of some kind," especially resulting from contact with people who
are suffering (Maslach & Jackson, 1981, 1984) , and caused by a prolonged pe­
riod of high stress levels, has received perhaps the greatest attention (Lee &
Ashforth, 1 996) . Burnout is characterized by physical and emotional exhaus­
tion, depersonalization (cynicism), and a low sense of personal accomplish­
ment (work realization, job satisfaction) . Although a review of the literature re­
veals considerable agreement about burnout effects (e.g., impaired health
conditions; leaving the stressful work environment) , there is considerable dis­
agreement about its causes. A central hypothesis of this study (and of the men­
tioned parallel ones; e.g., Zammuner & Canato, 2000) was that specific kinds
of emotion regulation can be, under specific conditions, subjectively taxing,
dysfunctional, thus contributing to cause burnout.
Self-Monitoring and Self-Consciousness
The likelihood that an employee will adhere to organizational emotion-norms,
and with what consequences, might be mediated by a number of personality
characteristics. For instance, a person who is motivated to behave in socially
appropriate ways would be attentive to the environment, and would try to react
in adequate ways to environmental features that cue context-adaptive behav-

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iors. Snyder (1974) , describing a personality type that tends to adapt to his or
her environment, defined self-monitoring as "self-observation and self-control
guided by situational cues to social appropriateness." High self-monitors are
very concerned with the image they present to others and hence frequently
scan their social environment for feedback regarding their own behaviors. In
contrast, low self-monitors evaluate the appropriateness of their own behavior
by attending to internal cues; they therefore tend to be more true to them­
selves, relying on their own feelings and attitudes to guide their behavior in
different situations. High self-monitors perform better than low self-monitors
in boundary-spanning roles that require attending to frequent and varied so­
cial cues as regards "desired" behaviors; they thus can be expected (Doucet,
1998; Morris & Feldman, 1996) to display greater compliance with organiza­
tional norms, feeling rules and display rules included, than low self-monitors.
Because they are likely to pay greater attention to others' emotions, and be
more "emotionally responsive," regulating their own emotions to meet others'
needs (Doucet, 1998) , they ought to perform emotional labor more easily and
with greater contextual adequacy. These hypotheses were investigated in this
study in terms of two distinct constructs: self-consciousness (Fenigstein,
Scheier, & Buss, 1975), construed as the extent to which the person directs his
or her attention to the self, and self-monitoring, conceptualized as the behav­
ioral component of self-consciousness (Forzi, Arcuri, & Kodilja, 1987) .
Empathic Concern and Perspective Taking
Empathy, a two-dimensional construct comprising a cognitive capacity to take
others' perspective, to know what another person is feeling, and empathic con­
cern, the affective sensitivity to others' feelings and concerns, "feeling what
another person is feeling" (Levenson & Ruef, 1992; Redmond, 1989), is likely
to play a crucial role in health care job roles that imply interactions with pa­
tients (needless to say, it is an essential ingredient, a crucial feature in defining
the quality of most interpersonal transactions). Empathic individuals are more
likely to be emotionally responsive to others, feeling and/or expressing greater
emotional consonance with their interactants; for example, an empathic health
care employee will adapt his or her felt and/or expressed emotions to those of
the patient.
Positive and Negative Affect
To what extent employees endorse organizational emotion norms, and with
what consequences, might be mediated by the nature of emotions a worker ex­
periences at his or her job (e.g., their hedonic tone), and by their relative fre­
quency. For instance, if a worker often feels pleasant emotions (e.g., pride,
calmness, joy), then he or she is less likely in need of regulating them than if he

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o r she feels unpleasant ones (e.g., fear, anger, sadness; felt emotions to some
extent define the "affective climate" of one's job) . We expected felt emotions
on the one hand to be a causal variable in emotion regulation, in particular as
regards its frequency and kind, and on the other hand to vary in relation to both
job-role variables (such as employees' typical workload in terms of number of
interactions with patients per day) and psychological variables. In particular,
felt emotions might (indirectly) index job satisfaction (as an antecedent of its
evaluation, and as a measure of its affective aspects; Brief & Weiss, 2002) ,
burnout, and life satisfaction. In sum, felt emotions were expected to be both
causal inputs to other psychological processes, and the result of various kinds
of events as subjectively appraised.
Life Satisfaction
If emotion regulation has relevant consequences for the individual, as we hy­
pothesize, then it ought to influence subjective evaluations of well-being. Felt
emotions, as stated earlier, do measure well-being, but do so in relation to one
rather "fluctuating" aspect of it. To assess well-being at a more global level we
asked employees for an overall life satisfaction evaluation. Previous studies
(e.g., Diener, Emmons, Larsen, & Griffin, 1985; Pavot & Diener, 1993)
showed that life satisfaction correlates negatively with dysphoric emotions, and
positively with positive emotions; in other words, measurements of life satis­
faction, positive affect, and negative affect tap dimensions of well-being that
are in part independent (Lucas, Diener, & Suh, 1 996) . Life satisfaction level
can be construed as a summary index of antecedents and consequences of
emotion regulation.

HYPOTHESES
Felt Emotions and Emotional Expressions as Regulation
Objects, and Emotional Consonance
Emotion regulation might be expected to work on either of two "complex" ob­
jects:
1. Emotion expression vis-a.-vis a patient, expression that occurs vocally
and/or face-to-face; this process was called surface acting by Hochschild
( 1 983), in that the person simply acts as though he or she feels the con­
text-required emotion (e.g., smiling to an annoying patient; putting on
an happy mask even though one is terribly sad) .
2. Felt emotions: Hochschild called this process active deep acting, assum­
ing that it involved "pumping emotions up" to actually feel the required

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job-congruent emotions, which can then be expressed in the service in­
teraction.
If workers are at all suited for their job, and/or their job role is not too de­
manding, their felt emotions ought to be congruent with job requirements
quite often, making regulation unnecessary because workers can simply ex­
press their "genuine emotions" (Ashforth & Humphrey, 1 993; somewhat mis­
leadingly, job-congruent emotions were referred to by Grandey, 1998, and
Hochschild, 1983, as the result of passive deep acting) . In our opinion, emo­
tional consonance/dissonance is best construed as a dimension defining
whether, and to what extent, felt emotions call for the activation of regulatory
processes: job-congruent emotions denote consonance, and job-incongruent
emotions indicate dissonance (see also Grandey, 1 998; Hochschild, 1983; Mor­
ris & Feldman, 1 996; dissonance indicated instead extent of genuine emotions
for Kruml & Geddes, 1998a). In sum, as specified later in greater detail, sur­
face and deep acting were hypothesized to be independent dimensions of emo­
tion regulation, acting on different objects, and thus indirectly measuring the
nature of the activated process. Emotional consonance was expected either to
exhibit a negative relationship with the regulation dimensions, or to be unre­
lated to them.
Hypothesis 1A.

Health care workers experience, to a greater or smaller
extent, consonant, job-congruent emotions that do not
need to be regulated, as well as job-incongruent ones
that require regulation.
Hypothesis 1 B. Emotional labor is performed by activating different reg­
ulation processes that act on different objects, namely,
suiface acting and deep acting, expected to be independ­
ent dimensions.
Hypothesis 1 C. The two regulation dimensions might hold relations of a
different nature with emotional consonance. More specif­
ically:
Hypothesis 1Ca. Regulation dimensions are negatively correlated with
emotional consonance: frequent job-congruent emotions
ought to imply infrequent regulation processes.
Hypothesis I Cb. Regulation dimensions are unrelated to emotional con­
sonance; feeling job-congruent emotions does not pre­
vent a worker from experiencing at times job-incongru­
ent emotions that need to be regulated.
Hypothesis 1D. Suiface acting and deep acting might exhibit either one of
two opposite-direction interrelations, due to the effect(s)
of mediating vanables:

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Hypothesis l Oa. Suiface acting and deep acting are positively related to
each other; for example, a highly realized worker will per­
form one or the other kind of emotional labor as re­
quired, and allowed, by the context.
Hypothesis l Ob. Suiface acting and deep acting are negatively related to
each other; for instance, if a worker has (too) many inter­
actions with patients, surface acting, ceten"s paribus, might
become the only available regulation option, thus possibly
causing emotional exhaustion, depersonalization, and
lowering the worker's level of job satisfaction. These psy­
chological effects would in turn imply that "deeper" regu­
lation is less likely, for example, because it requires psy­
chological resources unavailable to the worker.
Felt Affect, Emotional Dissonance, Regulation Processes,
Psychological Effort, Psychophysical Costs, Affect,
and Life Satisfaction
During the time spent at work, workers are likely to feel a variety of emotions.
As stated, emotional labor might be engaged in when felt emotions are disso­
nant with job requirements, a discrepancy state of affairs that might be due to
personal causes, job-related ones, or both. A central hypothesis in our ap­
proach is that emotion regulation implies a certain amount of psychophysical
effort, and therefore a psychophysical cost, with significant implications for
workers' psychological well-being (as measured, e.g., by felt burnout, fre­
quency of negative emotions, and life satisfaction) . As the original names of
emotion-labor dimensions suggest, surface acting was hypothesized to be a
"shallow" regulation process, not very costly, in that it needs not act on a
worker's "true" emotions, whereas deep acting was hypothesized to be more
effortful (Hochschild, 1 983) . Note, however, that to obtain their desired "prod­
uct," expressing job-congruent emotions, both processes imply an emotionally
effortful dual task: temporarily suppressing or masking a job-incongruent/elt
emotion (e.g., anger with an annoying patient) , and expressing a job-con­
gruent one (e.g., smiling at the annoying patient) in surface acting; suppress­
ing a job-incongruent/elt emotion (e.g., anger with an annoying patient) and
feeling a job-congruent one that can then be expressed, in deep acting. There­
fore, in principle we cannot expect surface acting to be a "better" regulatory
process, that is, less psychologically costly, than deep acting, nor vice versa
(from the organization's viewpoint, it is indifferent what process is activated,
provided the worker expresses the required emotion).
Hypotheses about how the two regulation processes are likely to differ in
terms of their psychological preconditions and effects can, however, be speci­
fied by taking into account further variables (the hypotheses stated next were

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tested and overall supported in parallel studies; e.g., Zammuner & Canato,
2000; Zammuner et al., 2002) . For instance, surface acting might be the only,
or most frequently activated, regulation process a worker engages in when his
or her job role is unsatisfying or stressful; therefore, it might be the psycholog­
ically "worst" process to the extent that it reflects a "bad" job condition. On
the other hand, deep acting might reflect a psychologically "good" job condi­
tion, in that only workers who feel happy about their job, and are "emotionally
energetic," have sufficient motivation and psychological resources to regulate
their emotions when necessary; in turn, successful deep acting makes workers
feel well, more realized in their job, and so forth. To use a metaphor, frequent
surface acting might trigger a vicious circle, whereas deep acting triggers a vir­
tuous circle.
Hypothesis lAa. Emotional consonance is positively related to work real­
ization, positive affect, and life satisfaction.
Hypothesis lAb. Emotional consonance is negatively related to emotional
exhaustion, depersonalization, and, possibly, negative af­
fect.
Hypothesis 2Ba. Surface acting is positively related to emotional exhaus­
tion, depersonalization, and negative affect.
Hypothesis 2Bb. Surface acting is negatively related to work realization,
positive affect, and life satisfaction.
Hypothesis 2Ca. Deep acting is positively related to work realization, posi­
tive affect, and life satisfaction.
Hypothesis 2eb. Deep acting is negatively related to emotional exhaustion
and depersonalization, and, possibly, to negative affect.
Personal and Personality Variables
Age and gender were the personal sociodemographic variables expected to be
most relevant. Age might indirectly predict burnout, via its association with
job-related variables such as job experience (see later discussion). Gender,
given the requirements of gender roles, was expected to be a more crucial vari­
able (Fischer, 2000; Greenglass, 1995; Hochschild, 1983; Wharton, 1 993;
Wharton & Erickson, 1995; Zammuner, ZOOOa) . Because of the interpersonal
orientation requirements of their gender, women might be both more moti­
vated and accustomed than men are to regulate their dysphoric emotions vis-a­
vis other people (especially so-called "powerful" ones such as anger) , and do
so with greater expertise. Regulatory processes, moreover, might be facilitated
by women's greater empathy with others' emotions, enabling them to feel con­
textually appropriate "genuine emotions" more frequently than men do, and
perhaps with greater intensity. We expected workers' marital status and num-

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ber o f children to b e variables that might b e relevant mostly i n connection with
gender roles. For instance, we can make two competing (but simplified) hy­
potheses about a woman who is married and has one or more children (i.e., has
a family to care for, emotionally as well as in other ways) : To the extent that she
identifies with her traditional role, her emotion regulation "practice" at home
will carry over to her work context, enabling her to easily perform whatever
regulation kind is necessary, whenever necessary; or, vice versa, she might in­
adequately regulate her emotions (e.g., displaying job-incongruent emotions,
or doing surface acting) because, due to her "double" role, she suffers from
burnout, or feels unsatisfied about her job, and so forth. As regards the per­
sonality variables expected to mediate emotion regulation, high self-monitors
were expected to regulate their own emotions more than low-level ones to
meet others' demands; likewise, high self-conscious individuals were ex­
pected to experience greater emotional consonance because of their greater
skill at managing their own emotions, in particular by activating deep regula­
tion. As already stated in connection to the gender variable, empathic people
easily understand others' state of mind and tune in to their experiences, and
thus are both less likely to be in need of regulating their own emotions in order
to sympathize with others', and more likely to regulate them if necessary.
Hypothesis 3A
Hypothesis 3B.

Hypothesis 3C.
Hypothesis 3D.
Hypothesis 3E.
Hypothesis 3F.

Age is positively related to the negative dimensions of
burnout.
Women show higher empathy levels than men do, experi­
ence emotional consonance more frequently than men
do, and more often regulate their job-incongruent emo­
tions.
Self-monitoring is positively related to emotional labor,
in terms of surface and/or deep acting.
Self-consciousness is positively related to emotional con­
sonance and deep acting.
Empathy is positively related to emotional consonance
and deep acting.
High self-conscious and high self-monitoring individuals
show high empathy levels too.

Job-Related Variables
In addition to job-related psychological variables such as job satisfaction (meas­
ured by the work realization component of burnout and, more indirectly, by the
nature of felt affect, as discussed earlier), we expected emotion regulation to be
influenced by several organizational job-related variables, including job role
(e.g., doctor vs. nurse) and nature of job role. The latter is actually a compound