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Work related factors and sick leave after rehabilitation in burnout patients: experiences from the REST-project
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Research and Development Department, Jämtland County Council, Östersund, Sweden.
Umeå University, Faculty of Social Sciences, Department of Sociology.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
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2011 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 21, no 1, 23-30 p.Article in journal (Refereed) Published
Abstract [en]

Introduction The aim of this study was to investigate the impact of psychosocial working conditions and coping strategies at work on change in sick leave level for patients on long-term sick leave due to burnout.

Methods A cohort sample of patients (n = 117) on long-term sick leave due to burnout was analyzed. The patients answered a questionnaire at baseline and sick leave information was collected from the Swedish Social Insurance Agency at baseline and at follow-up 2 years later. Two groups were formed depending on whether the patients had "improved" and reduced their sick leave level (56%) or if the sick leave level was "unchanged" (44%) at follow-up. The association between change in sick leave and predictors measuring psychosocial working conditions and coping strategies at work were analyzed using logistic regression.

Results The predictor, low control at work, was associated with unchanged sick leave at follow-up. When background characteristics were taken into account, usage of covert coping towards supervisors and covert coping towards workmates, respectively, also predicted unchanged sick leave level. High overcommitment was of borderline significance and associated with a reduced sick leave level at follow-up.

Conclusions Patients with burnout who have experienced low control at work and used covert coping towards supervisors and/or workmates have a higher risk of not reducing their sick leave after rehabilitation. The workplace may contribute to a reduction of sick leave lengths with a more flexible work environment and improvement in communication strategies for employees and supervisors.

Place, publisher, year, edition, pages
2011. Vol. 21, no 1, 23-30 p.
Keyword [en]
Burnout, professional, Cohort, Control, Coping, Overcommitment, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-37895DOI: 10.1007/s10926-010-9250-8ISI: 000287505100004PubMedID: 20552390OAI: oai:DiVA.org:umu-37895DiVA: diva2:370926
Available from: 2010-11-18 Created: 2010-11-18 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Psychosocial work factors and burnout: a study of a working general population and patients at a stress rehabilitation clinic
Open this publication in new window or tab >>Psychosocial work factors and burnout: a study of a working general population and patients at a stress rehabilitation clinic
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background The psychosocial work environment affects our health (e.g., sick leave and mortality rates). Research on psychosocial work factors and burnout has focused on specific workplaces or occupations and rarely evaluated in the general population or used longitudinal designs. In Sweden, the diagnosis of exhaustion disorder (closely related to burnout) is a common cause for sick leave. The effects of psychosocial work environments on the process of returning to work has not been studied in this specific patient group. The overall aims of this thesis were to (1) assess the level of burnout in a working general population and investigate the importance of psychosocial work factors and sex on burnout, and (2) study reduction of sick leave and experiences of returning to work in burnout patients, with special attention towards psychosocial work factors.

Methods An occupationally active subset (n=1000) of the 2004 Northern Sweden MONICA survey was used in a cross-sectional study. A five-year follow-up of this population was also performed (n=626). Level of burnout was measured using the Shirom Melamed Burnout Questionnaire (SMBQ). Burnout patients were studied for the second thesis aim. A cohort of 117 patients from the REST project was investigated using a baseline questionnaire and sick leave data at two-year follow-up. Grounded Theory was used for an in-depth interview and analysis of 12 employed patients.

Results Cross-sectional results from the working general population showed that women have higher levels of burnout than men. In both sexes, work demands, work control, and job insecurity were associated with burnout levels. Among women, education, socioeconomic position, work object, and working hours were also important. Work factors in combination with situational life factors explained about half the difference in burnout level between women and men. Longitudinal results show that burnout levels decrease with age in both sexes, although the changes occur at an earlier age for men. A constant job strain, increased job insecurity, and a worsened economic situation are related to an increase in burnout level. When studying risk factor accumulation, each additional risk factor exposure increases the burnout level.

In burnout patients, low work control and use of covert coping towards supervisors and workmates predicts unchanged sick leave levels after a twoyear period. Borderline significance was found between work overcommitment and reduced sick leave. Both personal resources and external support are described as important factors when regaining the ability to work. Perceived validation, insights into the situation and adaptive coping skills increase the chance of regaining the ability to work. External support, particularly from the workplace, is also important.

Conclusion There are links between psychosocial work factors and burnout levels in a working general population and sick leave levels in burnout patients. Socioeconomic position and working conditions are important for the level of burnout among working women. In the working population, age differences occur between the sexes; women reduce their burnout levels later in life than men. In the burnout patient population, coping patterns and control at work predict sick leave levels after two years. Both internal resources and external support are important when burnout patients describe the process of regaining the ability to work. The workplace and the work environment are important in preventing working people from becoming burned out and in easeing return to work after sick leave. A person’s coping pattern is also important in reduction of sick leave.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2011. 54 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1439
Keyword
Burnout, exhaustion disorder, psychosocial work factors, coping, social support, demands, control, job strain, job insecurity, sick leave, return to work, working population, epidemiology, grounded theory
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
urn:nbn:se:umu:diva-47623 (URN)978-91-7459-269-6 (ISBN)
Public defence
2011-10-21, Hörsal Betula, Byggnad 6M, Norrlands universitetssjukhus, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2011-09-30 Created: 2011-09-26 Last updated: 2012-11-07Bibliographically approved

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Norlund, SofiaReuterwall, ChristinaHöög, JonasNordin, MariaEdlund, CurtSlunga Birgander, Lisbeth
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