Burnout and physical and mental health among Swedish healthcare workers

Reproductive health and burn-out among female physicians: nationwide, representative study from Hungary

Background

There is a worldwide rising tendency of women deciding to become physicians; hence, one of the most remarkable fields of investigation is the wellbeing of female doctors. The aim of this study was to describe female physicians’ reproductive health in Hungary and to explore the potential correlation between their reproductive disorders and burnout symptoms. Up to our present knowledge, there have not been any studies investigating the correlation between reproductive disorders and burnout of female physicians; therefore, our study represents a unique approach.

Methods

Data in this representative cross-sectional epidemiological study were obtained from online questionnaires completed by 3039 female physicians. Participants in a representative nationwide survey (Hungarostudy, 2013) served as controls (n = 1069). Differences between physicians and the control group were disclosed by chi-square test. Correlations between certain factors of reproductive health and the three dimensions of burnout were detected by Pearson correlations and X² test. Binary logistic regression analysis was used to determine the association between burnout and reproductive health.

Results

Female physicians were more often characterised by time-to-pregnancy interval longer than one year (18.4% vs. 9.8%), were bearing more high-risk pregnancies (26.3% vs.16.3%), and were more likely to be undergoing infertility therapy (8.5% vs. 3.4%) and experiencing miscarriage (20.8% vs. 14.6%) during their reproductive years, compared with the general female population. With the exception of miscarriages, the difference remained significant in all comparisons with the professional control group. Both high-risk pregnancies and miscarriages of doctors were associated with depersonalisation (p = 0.028 and p = 0.012 respectively) and personal accomplishment (p = 0.016 and p = 0.008 respectively) dimensions of burnout. Results of the multivariate analysis showed that, beside traditional risk factors, depersonalisation acted as an important explanatory factor in case of high-risk pregnancies (OR = 1.086).

Conclusions

There is a circulatory causality between burnout and the development of reproductive disorders. Burnout is an important risk factor for high-risk pregnancies and miscarriages, and it has a negative effect on the outcome of pregnancies. At the same time, women suffering from reproductive disorders are more likely to develop burnout syndrome. Improvement of working conditions and prevention of burnout in female doctors are equally important tasks.

The mediating effects of burnout on the relationship between anxiety symptoms and occupational stress among community healthcare workers in China: a cross-sectional study

Background

Several occupational stress studies of healthcare workers have predicted a high prevalence of anxiety symptoms, which can affect their quality of life and the care that they provide. However, few studies have been conducted among community healthcare workers in China. We attempted to explore whether burnout mediates the association between occupational stress and anxiety symptoms.

Methods

A cross-sectional survey was completed in Liaoning Province, China from November to December 2012. A total of 1,752 healthcare workers from 52 Community Health Centers participated in this study, and all participants were given self-administered questionnaires. These questionnaires addressed the following aspects: the Zung Self-Rating Anxiety Scale, the Chinese version of the effort-reward imbalance scale and the Maslach Burnout Inventory–General Survey. Finally, the study included 1,243 effective respondents (effective response rate, 70.95%). Hierarchical linear regression analysis, performed with SPSS 17.0, was used to estimate the effect of burnout.

Results

The prevalence of anxiety symptoms among the community healthcare workers was 38.0%. After adjusting for demographic characteristics, the effort–reward ratio and overcommitment positively predicted anxiety symptoms. Meanwhile, the effort–reward ratio and overcommitment were positively related to the emotional exhaustion and cynicism subscales of burnout. In addition, the emotional exhaustion and cynicism subscales were positively related to anxiety symptoms. Thus, there is a link between burnout, occupational stress and anxiety symptoms.

Conclusions

Burnout mediates the effect of occupational stress on anxiety symptoms. To effectively reduce the impact of occupational stress on anxiety symptoms, burnout management should be considered.

Measuring production loss due to health and work environment problems: construct validity and implications

OBJECTIVE

The aim was to validate two measures of production loss, health-related and work environment-related production loss, concerning their associations with health status and work environment factors.

METHODS

Validity was assessed by evaluating the construct validity. Health problems related and work environment-related problems (or factors) were included in separate analyses and evaluated regarding the significant difference in proportion of explained variation (R) of production loss.

RESULT

health problems production loss was not found to fulfill the criteria for convergent validity in this study; however, the measure of work environment-related production loss did fulfill the criteria that were set up.

CONCLUSION

The measure of work environment-related production loss can be used to screen for production loss due to work environment problems as well as an outcome measure when evaluating the effect of organizational interventions.

High job demands and lack of time: a future challenge in occupational therapy

OBJECTIVE

The aim of this study was to identify work-related stress factors that contributed to work-related stress among Swedish occupational therapists and to investigate the association between work-related stress, demographic factors, and perceived overall stress.

METHODS

A postal questionnaire and a letter of invitation were sent to 807 Swedish occupational therapists, selected at random and representing 10% of occupational therapists working in Sweden. The response rate was 59%. A stress index presenting 49 stress factors graded on a scale from 1 (indicating no source of stress) to 6 (definitely a source of stress) was included. In addition, the level of perceived overall stress during the last two weeks was scored on a rating scale with the end points 0 (no stress) and 10 (extreme stress).

RESULTS

The main findings indicated that lack of resources and lack of time were the main stressors. "Working at a superficial level due to lack of time" was the only variable associated with high overall stress when both work-related and personal factors were included. Professional identity and clarity concerning the role were graded low with regard to stress.

CONCLUSIONS

Work-related stress is just one aspect of the overall stress experienced but knowledge about its consequences highlights the importance of further studies.

The relation between burnout and sleep disorders in medical students

OBJECTIVE

The aim of this study is to assess the mutual relationships between burnout and sleep disorders in students in the preclinical phase of medical school.

METHODS

This study collected data on 127 medical students who filled in the Maslach Burnout Inventory-Student Survey, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Beck Depression Inventory, and Beck Anxiety Inventory. Hierarchical logistic regressions tested the reciprocal influence between sleep disorders and burnout, controlling for depression and anxiety.

RESULTS

Regular occurrence of emotional exhaustion, poor sleep quality, and excessive daytime sleepiness affected 60, 65, and 63% of medical students, respectively. Emotional exhaustion and daytime sleepiness influenced each other. Daytime sleep dysfunctions affected unidirectionally the occurrence of cynicism and academic efficacy. The odds of emotional exhaustion (odds ratio (OR)=1.21, 95% confidence interval (CI)=1.08 to 1.35) and cynicism (OR=2.47, 95% CI=1.25 to 4.90) increased when daytime sleepiness increased. Reciprocally, the odds of excessive daytime sleepiness (OR=2.13, 95% CI=1.22 to 3.73) increased when emotional exhaustion worsened. Finally, the odds of academic efficacy decreased (OR=0.86, 95% CI=0.75 to 0.98) when daytime sleepiness increased.

CONCLUSIONS

Burnout and sleep disorders have relevant bidirectional effects in medical students in the early phase of medical school. Emotional exhaustion and daytime sleepiness showed an important mutual influence. Daytime sleepiness linked unidirectionally with cynicism and academic efficacy.

Prevalence of Burnout among Nurses in a Community Hospital in Singapore: A Cross-Sectional Study

Introduction:

Burnout among nurses is a significant problem in healthcare establishments and has negative implications on clinical outcomes. International studies have shown the prevalence of burnout ranged from 30% to 80%. However, this is unknown amongst nurses in a community hospital in Singapore. Our objectives are to determine the prevalence of burnout among nurses at a community hospital in Singapore as well as explore the factors associated with burnout.

Methods:

The nurses, from a community hospital with palliative, rehabilitation, chronic sick and nursing home services, self-administered the Professional Quality of Life Scale to determine the level of burnout. An anonymous survey was included to collect demographics and variables that were postulated to be associated with burnout.

Results:

With a response rate of 51.4%, the prevalence of burnout was found to be 33.3%. Nurses working in the rehabilitation wards had higher odds of burnout (p=0.026). Multivariate analysis indicated increased number of years working as a nurse (p = 0.006) and whether work interferes “sometimes” & “often” with family commitments (p = 0.006 & 0.028 respectively) to be significantly associated with burnout.

Conclusion:

The prevalence of burnout was found to be comparable to that of a tertiary hospital and this deserves further attention. In conclusion, this research reveals the extent of nursing burnout in intermediate and long term care sector as well as identifies factors associated with burnout.

Prevalence and course of somatic symptoms in patients with stress-related exhaustion: does sex or age matter

BACKGROUND

Both mental and somatic symptoms are commonly reported in patients with stress-related problems. We have explored the prevalence of somatic symptoms in patients seeking medical care for stress-related mental health problems and followed the course of illness alongside with that the patients receive multimodal treatment.

METHOD

This study comprises data from 228 patients (69% women, mean age 43 years) who fulfilled the criteria for Exhaustion Disorder (ED). Somatic symptoms were assessed at baseline and after 3, 6, 12 and 18 months using the one-page questionnaire Primary Care Evaluation of Mental Disorders. Prevalence of different symptoms was compared between men and women and patients, over and below 40 years of age, and possible predictors of recovery were explored.

RESULTS

Tiredness and low energy are the core symptom reported by the patients. Almost all (98%) reported at least one somatic symptom and 45% reported six symptoms or more, which was similar for men and women. Nausea, gas or indigestion are the most common symptoms (67%) followed by headaches (65%) and dizziness (57%). The number of symptoms reported was significantly related to the severity of mental health problems. The only difference between the sexes was that "chest pain" and "pain or problems during sexual intercourse" were more common among males. Patients over forty more often reported "pain in arms, legs or joints, knees, hips" and this was also the only symptom that did not significantly decline during treatment. Neither sex, age, symptom duration before seeking medical care, education or any other predictor tested was shown to predict recovery in patients reporting six symptoms or more.

CONCLUSION

A heavy burden of somatic symptoms was generally seen in most patients with stress-related exhaustion. Somatic symptoms are equally common in males and females and in younger and older patients. The somatic symptoms seem to be mostly stress-related since all symptoms, except musculoskeletal pain, reduce with individualised treatment designed for stress-related mental problems. This study brings to attention the complicated burden of both somatic and mental symptoms in patients with stress-related exhaustion, raising several clinical implications of interest to discuss.

Hierarchies of health: health and work-related stress of managers in municipalities and county councils in Sweden

OBJECTIVE

The aim of this study was to investigate the risk of poor health and stress among male and female managers working at different levels in the public sector.

METHODS

A cross-sectional study using register data. A modified Poisson regression approach was used to examine the risk of stress and illness in relation to management level and sex; 1088 managers participated and were categorized into different management levels and sexes.

RESULTS

The results showed a clear hierarchy of health in relation to managerial level and sex with several significant statistical differences. Women with lower-level management positions suffered to a greater extent from poor health and stress.

CONCLUSIONS

Organizations should focus not only on developing individuals in their managerial roles but also on improving the conditions that allow managers to remain healthy and less stressed.

The web of silence: a qualitative case study of early intervention and support for healthcare workers with mental ill-health

Background

There is a high rate of stress and mental illness among healthcare workers, yet many continue to work despite symptoms that affect their performance. Workers with mental health issues are typically ostracized and do not get the support that they need. If issues are not addressed, however, they could become worse and compromise the health and safety, not only of the worker, but his/her colleagues and patients. Early identification and support can improve work outcomes and facilitate recovery, but more information is needed about how to facilitate this process in the context of healthcare work. The purpose of this study was to explore the key individual and organizational forces that shape early intervention and support for healthcare workers who are struggling with mental health issues, and to identify barriers and opportunities for change.

Methods

A qualitative, case study in a large, urban healthcare organization was conducted in order to explore the perceptions and experiences of employees across the organization. In-depth interviews were conducted with eight healthcare workers who had experienced mental health issues at work as well as eight workplace stakeholders who interacted with workers who were struggling (managers, coworkers, union leaders). An online survey was completed by an additional 67 employees. Analysis of the interviews and surveys was guided by a process of interpretive description to identify key barriers to early intervention and support.

Results

There were many reports of silence and inaction in response to employee mental health issues. Uncertainty in identifying mental health problems, stigma regarding mental ill health, a discourse of professional competence, social tensions, workload pressures, confidentiality expectations and lack of timely access to mental health supports were key forces in preventing employees from getting the help that they needed. Although there were a few exceptions, the overall study findings point to many barriers to supporting employees with mental health issues.

Conclusions

In order to address the complex knowledge, attitudinal, interpersonal and organizational barriers to action, a multi-layered knowledge translation strategy is needed, that considers not only mental health literacy and anti-stigma interventions, but addresses the unique context of the work environment that can act as a barrier to change.

Associations between confidentiality requirements, support seeking and burnout among university hospital physicians in Norway, Sweden, Iceland and Italy (the HOUPE study)

Concerns about protecting patient's privacy are experienced as a limitation in the opportunity to obtain and utilize social support by many physicians. As resources of social support can modify the process of burnout, patient confidentiality may increase risk of this syndrome by interfering with proper stress adaptation. This study investigates if experiencing limitations in seeking social support due to confidentiality concerns are associated with burnout. University hospital physicians in four European countries completed measures of burnout, (Index) of Confidentiality as a Barrier for Support (ICBS), and factors of social resources and job demands. Linear regression analysis showed that ICBS was significantly associated with the burnout dimension of Exhaustion and not with Disengagement. These findings were present when controlling for factors known to diminish or increase the likelihood of burnout. These results are the first to demonstrate that patient confidentiality is associated with burnout in the process of stress management among physicians.

Factors associated with burnout among Chinese hospital doctors: a cross-sectional study

Background

Burnout has been a major concern in the field of occupational health. However, there is a paucity of research exploring the factors related to burnout among Chinese doctors. Investigation of these factors is important to improve the health of doctors and the quality of healthcare services in China.

Methods

The study population consisted of 1,618 registered hospital doctors from Liaoning province of China. Burnout was measured using the Chinese version of the Maslach Burnout Inventory-General Survey. Occupational stress was measured using the Chinese versions of the Job Content Questionnaire and the Effort-Reward Imbalance Questionnaire. Data were collected on the respondents’ demographic characteristics and work situations. Of the doctors solicited for enrollment, 1,202 returned the completed questionnaire (555 men, 647 women), giving a response rate of 74.3%. A general linear regression model was applied to analyze the factors associated with burnout.

Results

The burnout mean scores were 11.46 (7.51) for emotional exhaustion, 6.93 (5.15) for cynicism, and 24.07 (9.50) for professional efficacy. In descending order of standardized estimates, variables that predicted a high level of emotional exhaustion included: high extrinsic effort, dissatisfaction with doctor-patient relationship, high overcommitment, working >40 h per week, low reward, and high psychological job demands. Variables that predicted a high level of cynicism included: high extrinsic effort, low reward, dissatisfaction with doctor-patient relationship, high overcommitment, low decision authority, low supervisor support, and low skill discretion. Variables that predicted a low perceived professional efficacy included: high psychological job demands, low coworker support, high extrinsic effort, low decision authority, low reward, and dissatisfaction with doctor-patient relationship.

Conclusions

These findings suggest that occupational stress is strongly related to burnout among hospital doctors in China. Strategies that aim to improve work situations and decrease occupational stress are necessary to reduce burnout, including health education, health promotion, and occupational training programs.

Development of burnout in middle-aged working women: a longitudinal study

OBJECTIVE

The present study had two aims: first, to identify developmental patterns of burnout in middle-aged women from the working population and, second, to evaluate whether work-related and individual factors are associated with concurrent changes in burnout.

METHODS

The study design was longitudinal and used a random, population-based sample of urban middle-aged women. One baseline and two follow-up assessments were carried out during a 9-year period. At baseline, 142 women participated. Complete data were available for 116 women, who constituted the sample of the present study. Burnout was assessed using the Shirom-Melamed Burnout Questionnaire (SMBQ). In order to identify typical developmental patterns (trajectories) hierarchical cluster analysis was used. Within-group changes in burnout levels over time were analyzed using repeated-measures analysis of variance (ANOVA).

RESULTS

When using a variable-based approach, the results showed no significant changes in burnout over time. However, underlying these levels, six trajectories were identified. These clusters represented four different developmental patterns: high levels followed by recovery, increasing levels, increasing and diminishing levels, and stable levels.

CONCLUSIONS

In contrast to previous research suggesting that burnout is a stable construct over time, the present study identified distinct subgroups of women showing different developmental patterns of burnout during a 9-year period. Furthermore, our findings showed that the development of burnout was accompanied by concurrent changes in life stress as well as work-related and individual factors.

The influence of age on the distribution of self-rated health, burnout and their associations with psychosocial work conditions

OBJECTIVE

Self-rated health (SRH) and burnout are commonly used health indicators. This study was designed to examine the age-specific patterns of SRH and burnout and their correlations with self-reported disease symptoms, and to investigate the moderating effects of age on the associations of psychosocial work conditions with these two health measures.

METHODS

Study subjects were 20,454 male and 16,875 female employees from 2 representative surveys conducted in 2007 and 2010 in Taiwan. SRH was assessed by a single item and burnout was assessed by the general burnout subscale of the Copenhagen Burnout Inventory (CBI). Psychosocial work conditions including working hours, psychological and physical job demands, job control, job insecurity and workplace justice were assessed by a validated questionnaire.

RESULTS

Older workers were at higher risk for poor SRH which was correlated with the presence of multiple disease symptoms. In contrast, employees aged 30-40 years had higher burnout which was strongly correlated with emotional disturbance. Among all the examined work factors, low workplace justice was found to be the most predominant predictor for poor SRH and high burnout, and the associations were more profound in younger workers than in older workers.

CONCLUSION

SRH and burnout were differentially related to age, and there were evidences of moderating effects of age on the associations between psychosocial work conditions and health. Researchers and health practitioners should pay attention to the influence of age when using the measures of SRH and burnout as indicators to detect health risk in association with adverse psychosocial work conditions.

Burnout in mental health services: a review of the problem and its remediation

Staff burnout is increasingly viewed as a concern in the mental health field. In this article we first examine the extent to which burnout is a problem for mental health services in terms of two critical issues: its prevalence and its association with a range of undesirable outcomes for staff, organizations, and consumers. We subsequently provide a comprehensive review of the limited research attempting to remediate burnout among mental health staff. We conclude with recommendations for the development and rigorous testing of intervention approaches to address this critical area.

Depression in hospital-employed nurses

Depression impacts 9.4% of the adult population in the United States, and it is known to impact work performance. Nurses with depression are not only likely to suffer themselves, but their illness may have an impact on their coworkers and potentially the quality of care they provide. Thus, the purpose of this study was to determine the prevalence of depression in a random sample of hospital-employed nurses to determine individual and workplace characteristics that are associated with depression. A cross-sectional survey design of 1171 registered nurses was used. Measures included individual characteristics, workplace characteristics, work productivity, and depression (9-item Patient Health Questionnaire). Data analysis demonstrated a depressive symptom rate of 18%. The linear regression model accounted for 60.6% of the variation in the 9-item Patient Health Questionnaire depression scores. Body mass index, job satisfaction, number of health problems, mental well-being, and health-related productivity had significant relationships with depression (P < .05). Hospital-employed nurses have higher rates of depressive symptoms than national norms. Advanced practice nurses can assist with educating nurses on recognizing depression and confidential interventions, including the use of computerized cognitive-based therapy.

Influence of the duration of diabetes on the outcome of a diabetes self-management education program

BACKGROUND

Diabetes education and lifestyle modification are critical components in controlling blood glucose levels of people with type 2 diabetes. Until now, available data on the effectiveness of education with respect to the duration of diabetes are limited. We investigated whether adherence to lifestyle behavior modification prompted by diabetes education was influenced by the duration of diabetes.

METHODS

Two hundred and twenty-five people with type 2 diabetes were recruited for an intensive, collaborative, group-based diabetes education program with annual reinforcement. We divided the patients into two groups based on the duration of their diabetes prior to the education program (≤1 year [≤1Y] vs. ≥3 years [≥3Y]). Dietary habits, physical activity, and the frequency of blood glucose self-monitoring were evaluated with a questionnaire prior to education and at the follow-up endpoint.

RESULTS

The mean follow-up period was 32.2 months. The mean hemoglobin A1c (A1C) value was significantly lower in the ≤1Y group. Self-care behaviors, measured by scores for dietary habits (P=0.004) and physical activity (P<0.001), were higher at the endpoint in the ≤1Y group than in the ≥3Y group. Logistic regression analysis revealed that a longer diabetes duration before education was significantly associated with mean A1C levels greater than or equal to 7.0% (53 mmol/mol).

CONCLUSION

Diabetes duration influenced the effectiveness of diabetes education on lifestyle behavior modification and glycemic control. More-intense, regular, and sustained reinforcement with encouragement may be required for individuals with longstanding type 2 diabetes.

Inovação tecnológica e cargas de trabalho dos profissionais de saúde: uma relação ambígua

Trata-se de uma revisão integrativa com objetivo de rastrear a produção científica acerca da influência da inovação tecnológica nas cargas de trabalho dos profissionais de saúde. Selecionou-se 57 publicações nas bases de interesse de 2004 a 2009. Predominaram as pesquisas de campo com abordagem qualitativa, realizadas em hospitais. Nenhum estudo teve por objetivo relacionar inovação tecnológica e cargas de trabalho. Nos estudos sobre inovação tecnológica destacaram-se publicações sobre tecnologias de informação e comunicação e novas formas de organização do trabalho; no tema cargas de trabalho predominaram estudos sobre condições promotoras de estresse e Burnout. Os achados mostraram que as inovações influenciam as cargas de trabalho de modo ambíguo, podendo aumentá-las ou diminuí-las.

Employment Satisfaction and Health Outcomes among Professional Iraqi refugees as compared to Immigrants

This study investigates employment and health outcomes in Iraqi refugees compared to Iraqi immigrants. We surveyed 148 Iraqi professional refugees and 111 Iraqi professional immigrants residing in the U.S. We hypothesized that Iraqi refugees would report lower employment and worse self-rated health as compared to Iraqi immigrants. Logistic Regression was used to test various models. Results showed that more immigrants were employed, as well as employed in their original profession as compared to refugees. Regardless of immigration status, participants' age and the way they rated their job played a larger role in health. The study is the first to demonstrate that, controlling for professional, ethnic and cultural background, there are unknown mechanisms resulting in lower employment and skilled employment in refugees as compared to matched immigrant controls. Furthermore, satisfaction with the new work appears more important than employment per se.

Long working hours and symptoms of anxiety and depression: a 5-year follow-up of the Whitehall II study

BACKGROUND

Although long working hours are common in working populations, little is known about the effect of long working hours on mental health.

METHOD

We examined the association between long working hours and the onset of depressive and anxiety symptoms in middle-aged employees. Participants were 2960 full-time employees aged 44 to 66 years (2248 men, 712 women) from the prospective Whitehall II cohort study of British civil servants. Working hours, anxiety and depressive symptoms, and covariates were measured at baseline (1997-1999) followed by two subsequent measurements of depressive and anxiety symptoms (2001 and 2002-2004).

RESULTS

In a prospective analysis of participants with no depressive (n=2549) or anxiety symptoms (n=2618) at baseline, Cox proportional hazard analysis adjusted for baseline covariates showed a 1.66-fold [95% confidence interval (CI) 1.06-2.61] risk of depressive symptoms and a 1.74-fold (95% CI 1.15-2.61) risk of anxiety symptoms among employees working more than 55 h/week compared with employees working 35-40 h/week. Sex-stratified analysis showed an excess risk of depression and anxiety associated with long working hours among women [hazard ratios (HRs) 2.67 (95% CI 1.07-6.68) and 2.84 (95% CI 1.27-6.34) respectively] but not men [1.30 (0.77-2.19) and 1.43 (0.89-2.30)].

CONCLUSIONS

Working long hours is a risk factor for the development of depressive and anxiety symptoms in women.

The influence of personal dispositional factors and organizational resources on workplace violence, burnout, and health outcomes in new graduate nurses: a cross-sectional study

BACKGROUND

The alarmingly high rate of illness-related absenteeism among nurses and recent reports of workplace violence and burnout are problematic for both the current workforce shortage and the recruitment and retention of new nurses.

OBJECTIVES

To test a model derived from Leiter and Maslach's (2004) Six Areas of Worklife Model linking workplace factors (six areas of worklife, experiences of bullying and burnout) and a personal dispositional factor (psychological capital) to new graduates mental and physical health in their first year of practice.

METHODS

A cross-sectional survey design was utilized to survey 165 Ontario nurses with one year or less experience in nursing. Participants completed measures of nurses' work environment quality, psychological capital, bullying exposure, burnout, and physical and mental health. Structural equation modelling was used to test the hypothesized model.

RESULTS

The fit indices suggested a reasonably adequate fit of the data to the hypothesized model (χ2=27.75, df=12, CFI=.97, IFI=.97, RMSEA=.09), however an additional direct path from psychological capital to emotional exhaustion substantially improved the model fit (χ2=17.94, df=11, CFI=.99, IFI=.99, RMSEA=.06). Increased psychological capital positively influenced nurses' perceived person-job fit, which in turn was negatively related to bullying exposure and emotional exhaustion, and ultimately influenced their physical and mental health.

CONCLUSIONS

The findings suggest that psychological capital and perceived person-job fit are key variables in new graduate nurses' worklife, which may contribute to decreased nurses' burnout and increased physical and mental well-being. The results support an expanded conceptualization of the areas of worklife model.

Is there a bidirectional link between insomnia and burnout? A prospective study in the Swedish workforce

BACKGROUND

Insomnia and burnout have been suggested to form a bidirectional association.

PURPOSE

The aim of this study was to investigate whether there is a bidirectional relationship between insomnia and burnout over the course of a year among individuals in the workforce.

METHOD

This study employed a prospective design, where a randomly selected sample from the general population (20-60 year; N = 1,812) filled out a survey on insomnia and burnout. In employed participants (n = 1,258), the associations between insomnia and three dimensions of burnout (Maslach Burnout Inventory-General Survey) were examined while controlling for age, gender, anxiety, and depression.

RESULTS

The bivariate correlations between insomnia and the three burnout dimensions were significant at a low level (η 0.12-0.29). The longitudinal analyses demonstrated that insomnia was not associated with the incidence of burnout and vice versa. However, insomnia was demonstrated to increase the risk for the persistence of emotional exhaustion (OR = 3.02). Further, insomnia was not associated with the persistence of professional efficacy and cynicism, and burnout was not related to the persistence of insomnia.

CONCLUSION

In summary, this investigation demonstrated that insomnia and burnout are not bidirectionally related in the working population. While insomnia was linked to the maintenance of the central part of burnout, burnout was not related to future insomnia.

Health-related quality of life and its main related factors among nurses in China

The present study is to evaluate the health-related quality of life (HRQOL) and analyze the effect of occupational stress, job burnout and coping resource on the HRQOL among nurses in China. A total of 1,012 nurses were recruited from eight hospitals of two provinces in 2008. The Chinese version of Short Form-36 Health Survey and Maslach Burnout Inventory-General Survey were used to measure the HRQOL and burnout respectively, the Occupation Stress Inventory-Revised Edition was used to evaluate occupational stressor, personal strain and coping resources. Other potential influencing factors for HRQOL were collected using a structured questionnaire. HRQOL in the nurses was lower than that in the general population. Occupational stressor, personal strain and job burnout correlated negatively with the HRQOL (p<0.05) while coping resources was positively related to the HRQOL (p<0.05). Among the predictive factors for HRQOL, occupational stressor (indicated by role insufficiency and physical environment), personal strain (indicated by physical strain and psychological strain), job burnout (indicated by emotional exhaustion and professional efficacy), length of work hours (≥10 h per day), diet irregularity and age were the main risk factors for HRQOL, while recreation and self-care were the main protective factors for HRQOL. The findings suggest occupational stress, job burnout and coping resources play important roles in HRQOL in the Chinese nurses.

Burnout, working conditions and gender--results from the northern Sweden MONICA Study

BACKGROUND

Sick-leave because of mental and behavioural disorders has increased considerably in Sweden since the late nineties, and especially in women. The aim of this study was to assess the level of burnout in the general working population in northern Sweden and analyse it's relation to working conditions and gender.

METHODS

In this cross-sectional study the survey from the MONICA-study (Monitoring of Trends and Determinants in Cardiovascular Disease) in northern Sweden 2004 was used. A burnout instrument, the Shirom Melamed Burnout Questionnaire (SMBQ), was incorporated in the original survey which was sent to a random sample of 2500 individuals with a response rate of 76%. After including only actively working people, aged 25-64 years, our study population consisted of 1000 participants (497 women and 503 men). ANOVA and multiple linear regression models were used.

RESULTS

The prevalence of a high level of burnout (SMBQ >4.0) was 13%. Women had a higher level of burnout than men with the most pronounced difference in the age group 35-44 years. In both sexes the level of burnout decreased with age. Demand and control at work, and job insecurity were related to burnout. In women the level of education, socioeconomic position, work object, and working varying hours were of importance. Interaction effects were found between sex and work object, and sex and working hours. In a multiple regression analysis almost half of the gender difference could be explained by work related and life situational factors.

CONCLUSIONS

Working life conditions contributed to the level of burnout in this actively working sample from the general population in northern Sweden. Especially in women, socioeconomic position was associated with burnout. The high level of burnout in women compared to men was partly explained by more unfavourable working conditions and life situational factors. Efforts to level out gender differences in burnout should probably focus on improving both working and socioeconomic conditions for women.

Increased prevalence of burnout symptoms in parents of chronically ill children

AIM

To examine the prevalence of burnout symptoms in the context of parenting a chronically ill child.

METHODS

A total of 252 parents of children with Type 1 Diabetes Mellitus and 38 parents of children with Inflammatory Bowel Diseases participated in a population-based study. A control group consisted of 124 randomly selected parents of healthy children. We used self-report questionnaires to assess symptoms of burnout.

RESULTS

The main finding was that significantly more parents of children with chronic diseases (36%) scored for clinical burnout, compared with parents of healthy children (20%). Burnout symptoms were most prominent among mothers of children with diabetes, although fathers of children with diabetes and mothers and fathers of children with inflammatory bowel diseases also reported higher levels of various burnout symptoms.

CONCLUSION

Burnout may be a useful model for understanding long-term parental responses and should be acknowledged among the different types of psychological consequences of the multi-faceted experience of parenting a child with chronic illness. Gender seems to influence the risk of burnout symptoms. Continued research about other background factors, and how the parents' situation changes over time are warranted. In the clinic, we need to draw attention to the group of parents who may suffer from burnout.

Burnout and perceptions of conscience among health care personnel: A pilot study

Although organizational and situational factors have been found to predict burnout, not everyone employed at the same workplace develops it, suggesting that becoming burnt out is a complex, multifaceted phenomenon. The aim of this study was to elucidate perceptions of conscience, stress of conscience, moral sensitivity, social support and resilience among two groups of health care personnel from the same workplaces, one group on sick leave owing to medically assessed burnout (n = 20) and one group who showed no indications of burnout (n = 20). The results showed that higher levels of stress of conscience, a perception of conscience as a burden, having to deaden one’s conscience in order to keep working in health care and perceiving a lack of support characterized the burnout group. Lower levels of stress of conscience, looking on life with forbearance, a perception of conscience as an asset and perceiving support from organizations and those around them (social support) characterized the non-burnout group.

Job Burnout, Health-Related Quality of Life, and Sickness Absence in Greek Health Professionals

This study examined how job burnout was associated with sick-leave absence and quality of life in a sample of 487 nurses working in the National Health Care System. Burnout was measured with the Maslach Burnout Inventory, while quality of life was measured with Short-Form Health Survey (SF-36). Data on sick leaves were collected from hospital personnel records. Logistic regression indicated that levels of burnout (emotional exhaustion) were significant predictors of short-term (but not long-term) sickness absence. Long-term sickness absence could be predicted by poor physical health. The findings indicate that burnout not only may negatively impact on quality of life of health-care providers, but also may influence short sick leaves. Implications for the implementation of absence reduction programs are discussed.

Personality traits among burnt out and non-burnt out health-care personnel at the same workplaces: a pilot study

Stress-related illnesses, such as burnout, have increased over the last decade, but not everyone at the same workplace develops burnout, suggesting that individual factors may contribute to this phenomenon. The aim of this study was to describe patterns of personality traits among two groups of health-care personnel from the same workplaces, one group on sick leave due to medically-assessed burnout, and one group with no indication of burnout, respectively. Fourteen psychiatric- (n = 7) and elderly (n = 7)-care units, located in one specific area in a municipality in northern Sweden, participated in this questionnaire-based study. The participants (n = 40), on sick leave due to medically-assessed burnout (n = 20), and those with no indication of burnout (n = 20), respectively, completed Cattell's 16 Personality Factors Questionnaire between February and December 2004. Conventional statistical methods and partial least square regression were used to analyze data. The results showed that the burnout group had lower scores regarding emotional stability and higher scores regarding anxiety than the non-burnout group, but the results also showed a wide variation of personality traits within groups. The most important indicators for belonging to the burnout group were 'openness to changes' and 'anxiety', and for belonging to the non-burnout group, 'emotional stability', 'liveliness', 'privateness' (i.e. forthright or discreet), and 'tension'. The result indicates complex interactions between personality traits and the context in which the individual lives. It seems to be important to increase our awareness of when personality traits may constitute opportunities versus risks in dealing with one's existing circumstances.

Reflecting peer-support groups in the prevention of stress and burnout: randomized controlled trial

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.