A three-year cohort study of the relationships between coping, job stress and burnout after a counselling intervention for help-seeking physicians

<p>Abstract</p> <p>Background</p> <p>Knowledge about important factors in reduction of burnout is needed, but there is a dearth of burnout intervention program studies and their effects among physicians. The present three-year follow-up study aimed to investigate the roles of coping strategies, job stress and personality traits in burnout reduction after a counselling intervention for distressed physicians.</p> <p>Methods</p> <p>227 physicians who attended a counselling intervention for burnout at the Resource Centre Villa Sana, Norway in 2003-2005, were followed with self-report assessments at baseline, one-year, and three-year follow-up. Main outcome measures were emotional exhaustion (one dimension of burnout), job stress, coping strategies and neuroticism. Changes in these measures were analyzed with repeated measures ANOVA. Temporal relationships between changes were examined using structural modelling with cross-lagged and synchronous panel models.</p> <p>Results</p> <p>184 physicians (81%, 83 men, 101 women) completed the three-year follow-up assessment. Significantly reduced levels of emotional exhaustion, job stress, and emotion-focused coping strategies from baseline to one year after the intervention, were maintained at three-year follow-up.</p> <p>Panel modelling indicated that changes in emotion-focused coping (z = 4.05, p < 0.001) and job stress (z = 3.16, p < 0.01) preceded changes in emotional exhaustion from baseline to three-year follow-up. A similar pattern was found from baseline to one-year follow-up.</p> <p>Conclusion</p> <p>A sequential relationship indicated that reduction in emotion-focused coping and in job stress preceded reduction in emotional exhaustion. As a consequence, coping strategies and job stress could be important foci in intervention programs that aim to reduce or prevent burnout in help-seeking physicians.</p

The Mental Vitality @ Work study: design of a randomized controlled trial on the effect of a workers' health surveillance mental module for nurses and allied health professionals

Employees in health care service are at high risk for developing mental health complaints. The effects of mental health complaints on work can have serious consequences for the quality of care provided by these workers. To help health service workers remain healthy and productive, preventive actions are necessary. A Workers' Health Surveillance (WHS) mental module may be an effective strategy to monitor and promote good (mental) health and work performance. The objective of this paper is to describe the design of a three arm cluster randomized controlled trial on the effectiveness of a WHS mental module for nurses and allied health professionals. Two strategies for this WHS mental module will be compared along with data from a control group. Additionally, the cost effectiveness of the approaches will be evaluated from a societal perspective. The study is designed as a cluster randomized controlled trial consisting of three arms (two intervention groups, 1 control group) with randomization at ward level. The study population consists of 86 departments in one Dutch academic medical center with a total of 1731 nurses and allied health professionals. At baseline, after three months and after six months of follow-up, outcomes will be assessed by online questionnaires. In both intervention arms, participants will complete a screening to detect problems in mental health and work functioning and receive feedback on their screening results. In cases of impairments in mental health or work functioning in the first intervention arm, a consultation with an occupational physician will be offered. The second intervention arm offers a choice of self-help e-mental health interventions, which will be tailored based on each individual's mental health state and work functioning. The primary outcomes will be help-seeking behavior and work functioning. Secondary outcomes will be mental health and wellbeing. Furthermore, cost-effectiveness in both intervention arms will be assessed, and a process evaluation will be performed. When it is proven effective compared to a control group, a WHS mental module for nurses and allied health professionals could be implemented and used on a regular basis by occupational health services in hospitals to improve employees' mental health and work functioning. NTR278

Association of work-related stress with depression and anxiety in radiologists

Background: L\u2019attivit\ue0 professionale del radiologo o del radioterapista pu\uf2 esporre a rilevanti fattori di rischio psicosociale, cos\uec che taluni lavoratori possono trovarsi in condizioni di distress. Scopo di questo lavoro \ue8 studiare la relazione tra lo stress lavorativo e la presenza di sintomi di ansia, depressione e malessere psicologico e valutare quale sia il rischio di disturbi psichici nei radiologi che si trovano in condizioni di distress lavorativo. Metodo: 654 radiologi hanno risposto all\u2019invito di compilare un questionario per la valutazione dello stress da lavoro e delle patologie correlate: il General Health Questionnaire e le scale di Ansia e Depressione di Goldberg. Risultati: I punteggi delle scale di ansia, depressione e malessere psicologico nei radiologi aumentano al crescere dello sforzo lavorativo estrinseco (effort) e di quello intrinseco (overcommitment), mentre il controllo sul lavoro (control) ed il sostegno sociale (support) hanno un effetto protettivo. I radiologi che avvertono una discrepanza tra lo sforzo lavorativo e le ricompense ricevute hanno un marcato aumento del rischio di ansia (OR 14,14 IC95% 9,15-21,86), di depressione (OR 7,00 IC95% 4,76-10,30) e di disturbi psichici (OR 3,95 IC95% 2,62-9,57). Anche i radiologi che avvertono richieste eccessive in rapporto alla loro capacit\ue0 di controllo hanno un aumentato rischio di essere ansiosi (OR 2,98, IC95% 2,05-4,31), depressi (OR 1,73; IC95% 1,21-2,48) e di soffrire di disturbi psichici (OR 2,26 IC95% 1,48-3,45) rispetto ai radiologi che non si trovano in condizione di \u201cdistress\u201d. Conclusioni: La radiologia ha compiuto progressi tecnici eccezionali ed ha un ruolo insostituibile nella sanit\ue0 pubblica; deve ora realizzare un sostanziale miglioramento delle condizioni di benessere mentale dei medici radiologi, nell\u2019interesse non solo dei lavoratori, ma anche dei pazienti e della qualit\ue0 delle cure cui questi hanno diritto.Purpose Since radiologists and radiotherapists can be occupationally exposed to significant psychosocial risk factors, some may find themselves in a state of distress. The aim of this study was to investigate the association of work-related stress with the presence of symptoms of anxiety, depression and psychological malaise and to evaluate the risk of psychic disorder in radiologists suffering from work-related stress. Methods A total of 654 radiologists responded to our invitation to complete a questionnaire designed to evaluate work-related stress and associated medical conditions: the General Health Questionnaire and Goldberg\u2019s Anxiety and Depression scales. Results Scores on the anxiety, depression and psychological malaise scales rise with an increase in effort and over-commitment, while control and support exert a protective effect. In radiologists who are aware of an effort/ reward imbalance, there is a marked increase in the risk of anxiety [odds ratio (OR) 14.14, 95 % CI 9.15\u201321.86], depression (OR 7.00, 95 % CI 4.76\u201310.30) and psychic disorders (OR 3.95, 95 % CI 2.62\u20139.57). Radiologists who perceive demand as excessive in relation to their power of control also have an increased risk of being anxious (OR 2.98, 95 % CI 2.05\u20134.31), depressed (OR 1.73, 95 % CI 1.21\u20132.48) and affected by psychic disorders (OR 2.26, 95 % CI 1.48\u20133.45) compared to fellow workers who are not in a state of distress. Conclusions Outstanding technical progress has been made in the field of radiology which today plays an invaluable role in public health. Now a major effort must also be made to improve the mental wellbeing of radiologists, both in the interests of the workers themselves, and also in those of their patients and the quality of the treatment they have the right to receive