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Stress and burnout in healthcare workers
Karolinska Institutet.ORCID iD: 0000-0002-3790-1393
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Work-related stress (of which burnout might be an example) is one of the most common work-related health problems. Currently, psychiatric illness (particularly depression, anxiety disorders, and stress related conditions) is the most common cause for long-term sick-leave in Sweden for women, and the second largest for men. Finding adequate strategies to prevent stress and burnout therefore seems important. This thesis is based on a questionnaire survey among all employees in a Swedish County Council. The overall response rate was 65% (n = 3976). The aims of the thesis were to: (1) Investigate how four burnout categories (non-burnout, disengaged, exhausted, and burnout) are linked to constellations of work characteristics, including self-reported sickness absence, sickness presence and overtime. (2) Test the Job Demand-Resources model in a sample of Swedish healthcare workers. (3) Investigate how burnout relates to self-reported physical and mental health, sleep disturbance, memory and lifestyle factors. (4) Test the effect of participating in a reflecting peer-support group on self-reported health, burnout, and on perceived changes in work conditions. (5) Investigate the factorial structure of the Swedish translation of the Oldenburg Burnout Inventory, and its predictive validity on future long-term sickness absence. Results revealed that burnout is associated with poorer self-rated health, more depression and anxiety, overtime work, and with future long-term sickness absence as measured by register data. Burnout as a possible pathway to an exhaustion disorder is discussed. Contrary to the general belief, that job demands make all the difference, results indicated that it was the access to/lack of adequate job resources that determined whether an employee was classified as burnt out or not. Additional support for the Job Demands-Resources model was found, insofar that job demands were more closely related to exhaustion, while lack of job resources was more associated with disengagement. Reflecting peer-support groups, using a problem-based method, was tested in a randomized controlled trial, and showed positive intervention effects in self-reported health, participation and development opportunities at work, support at work, and in work demands. Based on the result in this thesis, a fair and empowering leadership, a positive social climate at work, control of decision, and support from superiors, as well as a reasonable work load appear to be important factors in the prevention of burnout. Reflecting peer-support groups using a problem-based method could be a useful and comparatively inexpensive tool in alleviating work-related stress and burnout. Further research is needed, before any conclusions about the usefulness of the method for men can be drawn.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet , 2008. , 51 p.
National Category
Medical and Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:lnu:diva-37698Libris ID: 10906109ISBN: 978-91-7409-041-3 (print)OAI: oai:DiVA.org:lnu-37698DiVA: diva2:756120
Available from: 2014-10-22 Created: 2014-10-16 Last updated: 2016-11-22Bibliographically approved
List of papers
1. Work characteristics and sickness absence in burnout and nonburnout groups: a study of Swedish health care workers
Open this publication in new window or tab >>Work characteristics and sickness absence in burnout and nonburnout groups: a study of Swedish health care workers
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2008 (English)In: International Journal of Stress Management, ISSN 1072-5245, E-ISSN 1573-3424, Vol. 15, no 2, 153-172 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to search for constellations of work characteristics that discriminate people who experience burnout from those who do not, and also from those who score high in exhaustion but not in disengagement, and vice versa. The study is based on data from 3,719 employees in a County Council in Sweden. Discriminant analysis revealed that four burnout categories (nonburnout, disengaged, exhausted, and burnout) related in different ways to self-reported work characteristics. The proportions of respondents with overtime, sickness absence, and sickness presence were higher in the burnout and the exhausted groups compared with the nonburnout group. The most common professions in the burnout group were, unexpectedly, dental nurses, secretaries, and service staff. 

National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-37697 (URN)10.1037/1072-5245.15.2.153 (DOI)
Available from: 2014-10-16 Created: 2014-10-16 Last updated: 2016-11-22Bibliographically approved
2. Burnout and physical and mental health among Swedish healthcare workers
Open this publication in new window or tab >>Burnout and physical and mental health among Swedish healthcare workers
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2008 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 62, no 1, 84-95 p.Article in journal (Refereed) Published
Abstract [en]

AIM: This paper is a report of a study to investigate how burnout relates to self-reported physical and mental health, sleep disturbance, memory and lifestyle factors.

BACKGROUND: Previous research on the possible relationship between lifestyle factors and burnout has yielded somewhat inconsistent results. Most of the previous research on possible health implications of burnout has focused on its negative impact on mental health. Exhaustion appears to be the most obvious manifestation of burnout, which also correlates positively with workload and with other stress-related outcomes.

METHOD: A cross-sectional study was conducted, using questionnaires sent to all employees in a Swedish County Council (N = 6118) in 2002. The overall response rate was 65% (n = 3719). A linear discriminant analysis was used to look for different patterns of health indicators and lifestyle factors in four burnout groups (non-burnout, disengaged, exhausted and burnout).

RESULTS: Self-reported depression, anxiety, sleep disturbance, memory impairment and neck- and back pain most clearly discriminated burnout and exhausted groups from disengaged and non-burnout groups. Self-reported physical exercise and alcohol consumption played a minor role in discriminating between burnout and non-burnout groups, while physical exercise discriminated the exhausted from the disengaged group.

CONCLUSION: Employees with burnout had most symptoms, compared with those who experienced only exhaustion, disengagement from work or no burnout, and the result underlines the importance of actions taken to prevent and combat burnout.

Place, publisher, year, edition, pages
John Wiley & Sons, 2008
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:lnu:diva-37694 (URN)10.1111/j.1365-2648.2007.04580.x (DOI)18352967 (PubMedID)
Available from: 2014-10-16 Created: 2014-10-16 Last updated: 2016-11-22Bibliographically approved
3. Reflecting peer-support groups in the prevention of stress and burnout: randomized controlled trial
Open this publication in new window or tab >>Reflecting peer-support groups in the prevention of stress and burnout: randomized controlled trial
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2008 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 63, no 5, 506-516 p.Article in journal (Refereed) Published
Abstract [en]

AIM: This paper is a report of a study to test the effect of participating in a reflecting peer-support group on self-reported health, burnout and on perceived changes in work conditions.

BACKGROUND: Stress-related conditions are one of the most common causes for long-term sick-leave. There is limited evidence for the effectiveness of person-directed interventions aimed at reducing stress levels in healthcare workers. Prior research in the relationship between support and burnout show somewhat inconsistent results.

METHOD: A randomized controlled trial with peer-support groups as the intervention was conducted with 660 healthcare workers scoring above the 75th percentile on the exhaustion dimension of the Oldenburg Burnout Inventory. One hundred and fifty-one (22.9%) agreed to participate. The intervention started in 2002 with 51 participants (96.1% were women), 80 of whom constituted the control group. Potential differences in outcome measures 12 months after the intervention were compared using ancova, and data collected was completed in 2004. Qualitative content analyses were used to analyse reported experiences from group participation.

RESULTS: Statistically significant intervention effects were found for general health, perceived quantitative demands at work, participation and development opportunities at work and in support at work. Seven categories of experiences from participating were identified: talking to others in a similar situation, knowledge, sense of belonging, self-confidence, structure, relief of symptoms and behavioural change.

CONCLUSION: Peer-support groups using a problem-based method could be a useful and comparatively inexpensive tool in alleviating work-related stress and burnout.

Place, publisher, year, edition, pages
John Wiley & Sons, 2008
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:lnu:diva-37693 (URN)10.1111/j.1365-2648.2008.04743.x (DOI)18727753 (PubMedID)
Available from: 2014-10-16 Created: 2014-10-16 Last updated: 2016-11-22Bibliographically approved
4. Predictive validity of the Swedish translation of the Oldenburg Burnout Inventory on long-term sickness absence
Open this publication in new window or tab >>Predictive validity of the Swedish translation of the Oldenburg Burnout Inventory on long-term sickness absence
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(English)Manuscript (preprint) (Other academic)
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-37770 (URN)
Note

2008

Available from: 2014-10-22 Created: 2014-10-22 Last updated: 2016-11-22Bibliographically approved

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