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Steffey MA, Griffon DJ, Risselada M, Buote NJ, Scharf VF, Zamprogno H, Winter AL. A narrative review of the physiology and health effects of burnout associated with veterinarian-pertinent occupational stressors. Front Vet Sci 2023; 10:1184525. [PMID: 37465277 PMCID: PMC10351608 DOI: 10.3389/fvets.2023.1184525] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/19/2023] [Indexed: 07/20/2023] Open
Abstract
Chronic workplace stress and burnout are serious problems in veterinary medicine. Although not classified as a medical condition, burnout can affect sleep patterns and contributes to chronic low grade systemic inflammation, autonomic imbalance, hormonal imbalances and immunodeficiencies, thereby increasing the risks of physical and psychological ill health in affected individuals. Cultural misconceptions in the profession often lead to perceptions of burnout as a personal failure, ideas that healthcare professionals are somehow at lower risk for suffering, and beliefs that affected individuals can or should somehow heal themselves. However, these concepts are antiquated, harmful and incorrect, preventing the design of appropriate solutions for this serious and growing challenge to the veterinary profession. Veterinarians must first correctly identify the nature of the problem and understand its causes and impacts before rational solutions can be implemented. In this first part of two companion reviews, burnout will be defined, pathophysiology discussed, and healthcare and veterinary-relevant occupational stressors that lead to burnout identified.
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Affiliation(s)
- Michele A. Steffey
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Dominique J. Griffon
- Western University of Health Sciences, College of Veterinary Medicine, Pomona, CA, United States
| | - Marije Risselada
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West-Lafayette, IN, United States
| | - Nicole J. Buote
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
| | - Valery F. Scharf
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, United States
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Alsén S, Ali L, Ekman I, Fors A. Having allies—Experiences of support in people with stress-related exhaustion: A qualitative study. PLoS One 2022; 17:e0277264. [DOI: 10.1371/journal.pone.0277264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
Background
The number of people seeking care for symptoms of exhaustion and stress is a major concern in several countries. The condition is a challenging and life-changing experience, and a deeper understanding of support to help people on sick leave due to stress-related exhaustion in their early stages is needed to facilitate recovery.
Objective
The aim was to explore experiences of support in people with stress-related exhaustion being on sick-leave less than six months.
Method
A qualitative interview study was conducted with 12 participants (7 women and 5 men; aged 25–46 years) who were on sick leave that had not exceeded six months due to stress-related exhaustion. The participants were recruited from public healthcare centres in the western part of Sweden, and the intention was to reach them early in their ongoing sick leave period. The interviews were performed face-to-face and analysed using a phenomenological hermeneutical approach.
Results
The findings show that people affected by stress-related exhaustion struggle to maintain their dignity and define support in terms of allies who acknowledge their personhood and provide them helpful guidance. Participants expressed their needs to be taken seriously by professionals, family, and friends willing to engage in their situation. Lack of empathy and professional knowledge in the clinical encounter induced additional stress.
Conclusions
This study indicates that people affected by stress-related exhaustion need allies from their surrounding networks in their struggle to maintain their dignity. Our findings highlight that it is essential to acknowledge them as persons and establish an alliance to provide appropriate support based on each person’s specific situation, needs and resources. This approach can be facilitated in a partnership, as emphasized in person-centred care (PCC). PCC emphasizes the co-creation of care in partnership between the patient (often with relatives) and health care professionals which may imply a more collaborative view of health care in which patients are engaged as active partners in planning their care.
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Pijpker R, Veen EJ, Vaandrager L, Koelen M, Bauer GF. Developing an Intervention and Evaluation Model of Outdoor Therapy for Employee Burnout: Unraveling the Interplay Between Context, Processes, and Outcomes. Front Psychol 2022; 13:785697. [PMID: 35310237 PMCID: PMC8929413 DOI: 10.3389/fpsyg.2022.785697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Burnout is a major societal issue adversely affecting employees’ health and performance, which over time results in high sick leave costs for organizations. Traditional rehabilitation therapies show suboptimal effects on reducing burnout and the return-to-work process. Based on the health-promoting effects of nature, taking clients outdoors into nature is increasingly being used as a complementary approach to traditional therapies, and evidence of their effectiveness is growing. Theories explaining how the combination of general psychological support and outdoor-specific elements can trigger the rehabilitation process in outdoor therapy are often lacking, however, impeding its systematic research. Aim The study aims to develop an intervention and evaluation model for outdoor therapy to understand and empirically evaluate whether and how such an outdoor intervention may work for rehabilitation after burnout. Methodological Approach We build on the exemplary case of an outdoor intervention for rehabilitation after burnout, developed by outdoor clinical psychologists in Netherlands. We combined the generic context, process, and outcome evaluation model and the burnout recovery model as an overarching deductive frame. We then inductively specified the intervention and evaluation model of outdoor therapy, building on the following qualitative data: semi-structured interviews with outdoor clinical psychologists and former clients; a content analysis of the intervention protocol; and reflective meetings with the intervention developers and health promotion experts. Results We identified six key outdoor intervention elements: (1) physical activity; (2) reconnecting body and mind; (3) nature metaphors; (4) creating relationships; (5) observing natural interactions; and (6) experiential learning. The results further showed that the implementation of these elements may facilitate the rehabilitation process after burnout in which proximal, intermediate, and distal outcomes emerge. Finally, the results suggested that this implementation process depends on the context of the therapist (e.g., number of clients per day), therapy (e.g., privacy issues), and of the clients (e.g., affinity to nature). Conclusion The intervention and evaluation model for outdoor therapy shows how key outdoor intervention elements may contribute to the rehabilitation process after burnout. However, our model needs to be further tested among a larger group of clients to empirically evaluate whether and how outdoor therapy can support rehabilitation.
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Affiliation(s)
- Roald Pijpker
- Health and Society, Social Sciences Group, Wageningen University, Wageningen, Netherlands
| | - Esther J Veen
- Urban Food Issues, Aeres University of Applied Sciences, Almere, Netherlands
| | - Lenneke Vaandrager
- Health and Society, Social Sciences Group, Wageningen University, Wageningen, Netherlands
| | - Maria Koelen
- Health and Society, Social Sciences Group, Wageningen University, Wageningen, Netherlands
| | - Georg F Bauer
- Center of Salutogenesis, Division of Public and Organizational Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Ellbin S, Jonsdottir IH, Bååthe F. "Who I Am Now, Is More Me." An Interview Study of Patients' Reflections 10 Years After Exhaustion Disorder. Front Psychol 2021; 12:752707. [PMID: 34955973 PMCID: PMC8699002 DOI: 10.3389/fpsyg.2021.752707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/19/2021] [Indexed: 11/13/2022] Open
Abstract
Aim: To achieve a deeper understanding of the patient's perception regarding individual aspects related to the development of exhaustion, hindering and supporting factors in the recovery process, and potential remaining consequences, 7-12 years after receiving an exhaustion disorder diagnosis. Participants and Methods: Twenty patients previously diagnosed with and treated for exhaustion disorder were interviewed 7-12 years after onset of the disease. The semi-structured interviews were transcribed verbatim and analyzed with inductive content analysis. Results: Three main themes with patterns of shared meaning resulted from the analysis: "it's about who I am," "becoming a more authentic me," and "the struggle never ends." The interviewees described rehabilitation from exhaustion disorder as the start of an important personal development toward a truer and more authentic self-image. They perceived this as an ongoing long-lasting process where learned behavior and thought patterns related to overcommitment and overcompliance needed to be re-evaluated. The results also convey long-term consequences such as cognitive difficulties and reduces energy, uncertainty about one's own health, and the need to prioritize among one's relationships. Conclusion: Patients with exhaustion disorder are still struggling with dysfunctional strategies and functional impairments such as cognitive problems which limit their lives, 10 years after receiving their exhaustion disorder diagnosis. While informants describe some positive consequences of ED, the results also emphasize the importance of acknowledging that the patients are embedded in systems of relationships, in working life as well as in family life. This needs to be considered, together with other aspects, when working toward prevention of stress-related mental health problems.
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Affiliation(s)
| | - Ingibjörg H. Jonsdottir
- Institute of Stress Medicine, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Göteborg, Sweden
| | - Fredrik Bååthe
- Institute of Stress Medicine, Gothenburg, Sweden
- Institute of Health and Caring Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute for Studies of the Medical Profession, Oslo, Norway
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Salminen S, Mäkikangas A, Kykyri VL, Saari EL, Pekkonen M. Spouses’ Experiences of Rehabilitees’ Burnout and Recovery. Scandinavian Journal of Work and Organizational Psychology 2021. [DOI: 10.16993/sjwop.139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Abstract
BACKGROUND: Most research on burnout has focused on its antecedents, correlates, and consequences. However, little empirical attention has been paid to what constitutes successful rehabilitation after burnout, especially among young employees. OBJECTIVE: The present study empirically examined resources supporting successful rehabilitation after burnout among young employees (between 18 and 35 years of age) from a salutogenic perspective. METHODS: Interpretative phenomenological analysis was used as a methodological framework to explain the experiences of young employees underlying their rehabilitation after burnout. RESULTS: The analysis showed that the rehabilitation process comprises four phases: 1) facing the crisis; 2) addressing the root causes; 3) seizing and achieving the opportunity; and 4) staying at work. Essential overarching resources facilitating successful recovery after burnout included receiving social support from family, friends, and colleagues, as well as having a feeling of control over the rehabilitation process. Participants learned to be aware of potential pitfalls that could trigger burnout symptoms, while having confidence in their ability to prevent burnout from reoccurring. These continuous learning processes were experienced as a prerequisite to remain at work. CONCLUSIONS: Receiving social support and experiencing a feeling of control over the rehabilitation process appear to be key resources in facilitating a stable, meaningful return to work after burnout.
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Affiliation(s)
- Roald Pijpker
- Health and Society, Department of Social Sciences, Wageningen University & Research, The Netherlands
| | - Lenneke Vaandrager
- Health and Society, Department of Social Sciences, Wageningen University & Research, The Netherlands
| | - Esther J Veen
- Rural Sociology, Department of Social Sciences, Wageningen University & Research, The Netherlands
| | - Maria A Koelen
- Health and Society, Department of Social Sciences, Wageningen University & Research, The Netherlands
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Köpsén S, Sjöström R. Patients' Experiences of a Stress-Management Programme in Primary Care. J Multidiscip Healthc 2020; 13:207-216. [PMID: 32110035 PMCID: PMC7041602 DOI: 10.2147/jmdh.s235930] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/13/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction Stress and stress-related ill health have a multifactorial impact; both on physical and mental health. To better meet this category of patients a primary care unit started a stress-management programme using cognitive behavioural therapy and basic body awareness therapy. Purpose To describe participant´s experiences of a primary care stress-management programme using cognitive behavioural therapy and basic body awareness therapy. Methods In a qualitative study, a semi-structured interview guide was used in individual interviews with 9 people, all women aged 41–57, working or on sick leave, who had enrolled in the stress-management programme. The material was analysed through qualitative content analysis. Results The analysis resulted in the theme “Process of change for a sustainable everyday living”. The participants described having gained awareness of the symptoms of their stress, knowledge and tools to manage their stress, ways to relax, awareness of their body, and the means to develop better habits and to change their behaviour. Fundamental in the material was the importance of participants’ identification with the others in the group. Conclusion The participants started a process of change with new knowledge and growth, but they encountered difficulties and obstacles. Behavioural change is a time-consuming process.
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Affiliation(s)
- Sofia Köpsén
- Krokom Health Care Center, Region Jämtland Härjedalen, Krokom, Sweden.,Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Rita Sjöström
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.,Unit of Research, Education and Development, Region Jämtland Härjedalen, Östersund, Sweden
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Eskilsson T, Fjellman-Wiklund A, Ek Malmer E, Stigsdotter Neely A, Malmberg Gavelin H, Slunga Järvholm L, Boraxbekk CJ, Nordin M. Hopeful struggling for health: Experiences of participating in computerized cognitive training and aerobic training for persons with stress-related exhaustion disorder. Scand J Psychol 2020; 61:361-368. [PMID: 31995652 DOI: 10.1111/sjop.12623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 12/16/2019] [Indexed: 11/28/2022]
Abstract
It is important to understand how people with exhaustion disorder (ED) perceive interventions aiming to facilitate cognitive functioning. Therefore, the overall aim of this study was to explore experiences from persons with ED after participating in a 12-week intervention of either computerized cognitive training or aerobic training. Both interventions were performed in addition to a multimodal rehabilitation programme. Thirteen participants, 11 women and 2 men, were interviewed about pros and cons with participating in the training. The interviews were analysed with Qualitative Content Analysis. The analyses resulted in the theme hopeful struggling for health and the categories support, motivation and sensations. It was hard work recovering from ED. Support from others who are in the same situation, family members, and technology and routines for the training were strongly emphasized as beneficial for recovery. Timing, i.e., matching activities to the rehabilitation programme, getting feedback and perceiving joy in the training were important for motivation. Participants in both interventions experienced positive sensations with improved memory performance, everyday life functioning and increased faith in the prospect of recovery. However, it is important to consider various aspects of support and motivation in both computerized cognitive training and aerobic training to enable participants to pursue their participation.
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Affiliation(s)
- Therese Eskilsson
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Sustainable Health and Medicine, Umeå University, Umeå, Sweden
| | | | - Elin Ek Malmer
- Department of Rehabilitation Medicine, Danderyd Hospital, Stockholm, Sweden
| | - Anna Stigsdotter Neely
- Department of Psychology, Umeå University, Umeå, Sweden.,Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Hanna Malmberg Gavelin
- Department of Psychology, Umeå University, Umeå, Sweden.,Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne, Australia
| | - Lisbeth Slunga Järvholm
- Department of Public Health and Clinical Medicine, Sustainable Health and Medicine, Umeå University, Umeå, Sweden
| | - Carl-Johan Boraxbekk
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark.,Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Maria Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
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Wisenthal A, Krupa T, Kirsh B, Lysaght R. Insights into cognitive work hardening for return-to-work following depression: Qualitative findings from an intervention study. Work 2019; 62:599-613. [DOI: 10.3233/wor-192893] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - Terry Krupa
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - Bonnie Kirsh
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Rosemary Lysaght
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
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Salminen S, Andreou E, Holma J, Pekkonen M, Mäkikangas A. Narratives of burnout and recovery from an agency perspective: A two-year longitudinal study. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.burn.2017.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lehti A, Fjellman-Wiklund A, Stålnacke BM, Hammarström A, Wiklund M. Walking down ‘Via Dolorosa’ from primary health care to the specialty pain clinic - patient and professional perceptions of inequity in rehabilitation of chronic pain. Scand J Caring Sci 2016; 31:45-53. [DOI: 10.1111/scs.12312] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 10/27/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Arja Lehti
- Division for Professional Development; Department of Clinical Sciences; Umeå University; Umeå Sweden
| | | | - Britt-Marie Stålnacke
- Department of Community Medicine and Rehabilitation, Rehabilitation Medicine; Umeå University; Umeå Sweden
| | - Anne Hammarström
- Department of Public Health and Clinical Medicine; Umeå University; Umeå Sweden
| | - Maria Wiklund
- Department of Community Medicine and Rehabilitation, Physiotherapy; Umeå University; Umeå Sweden
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Salminen S, Mäkikangas A, Hätinen M, Kinnunen U, Pekkonen M. My Well-Being in My Own Hands: Experiences of Beneficial Recovery During Burnout Rehabilitation. J Occup Rehabil 2015; 25:733-741. [PMID: 25963325 DOI: 10.1007/s10926-015-9581-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE To explore how burnout rehabilitation clients experienced their recovery from burnout and what they found beneficial in rehabilitation. SUBJECTS Twelve clients whose burnout levels had declined during rehabilitation were interviewed at the end of the second period of the rehabilitation course. METHODS Semi-structured interviews comprised the main material of the study and were analysed by content analysis. In addition, the Bergen Burnout Indicator (BBI-15) was used to measure the reduction in burnout levels. RESULTS The analysis yielded a single overarching theme, My well-being in my own hands, and four categories. The overarching theme describes the overall process of recovery and the revelation experienced by clients that they are in charge of their own well-being. The process starts with Support from rehabilitation professionals, the client group and family or friends. The categories Awareness and Approval refer to specific changes in the attitude towards and recognition of one's needs and limits. The category Regained joy describes the culmination of the recovery process manifested in different spheres of life. CONCLUSIONS The rehabilitation course proved particularly beneficial for individuals suffering from burnout. The accumulation of support, awareness and approval led to a revival of joy in life and greater perceived control over one's well-being.
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Affiliation(s)
- Stela Salminen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland.
| | - Anne Mäkikangas
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | | | - Ulla Kinnunen
- School of Social Sciences and Humanities (Psychology), University of Tampere, Tampere, Finland
| | - Mika Pekkonen
- Peurunka Medical Rehabilitation Centre, Laukaa, Finland
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Lindström C, Åman J, Anderzén-Carlsson A, Lindahl Norberg A. Group intervention for burnout in parents of chronically ill children - a small-scale study. Scand J Caring Sci 2015; 30:678-686. [PMID: 26395446 DOI: 10.1111/scs.12287] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 08/05/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Long-term stress leading to burnout symptoms is prevalent in parents of chronically ill children. The aim of the study was to evaluate the effect of a group intervention by measuring changes in self-rated clinical burnout and performance-based self-esteem. In addition, the parental perceptions of the acceptability of the intervention were explored. METHODS Previously, we have explored the prevalence of clinical burnout in parents of patients 1-18 years with type 1 diabetes mellitus (T1DM) and inflammatory bowel disease (IBD) in the county of Örebro. All parents who exhibited clinical burnout symptoms in accordance with the Shirom-Melamed Burnout Questionnaire (SMBQ) were then invited to participate in a group intervention, which was evaluated in the present small-scale study. The group intervention consisted of eight sessions over a 12-week period, including education about behaviour, cognition and symptoms associated with burnout, intending to help the parents to develop adequate strategies for coping with and reducing stress. We evaluated the effect of the intervention in terms of self-rated clinical burnout and performance-based self-esteem (PBSE). In addition, the acceptability of the intervention was evaluated by analyses of recruitment and retention and self-reports from parents. RESULTS Sixteen parents (13 of children with TIDM and three of children with IBD) out of 104 reporting clinical burnout participated in the intervention. All participants completed the intervention, and the mean attendance rate at all sessions was 90%. Parents' subjective evaluations were mainly positive, and SMBQ (p = 0.01) and PBSE scale (p = 0.04) measurements were significantly reduced, which effects remained 6 months after completion of the intervention. CONCLUSIONS Despite the small-scale study, we consider that this intervention for parents with clinical burnout was appreciated and well accepted. The significant reduction in clinical burnout symptoms requires further evaluation in randomised controlled studies based on larger groups of parents.
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Affiliation(s)
- Caisa Lindström
- Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Jan Åman
- Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Agneta Anderzén-Carlsson
- Centre for Health Care Science, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Strömbäck M, Wiklund M, Renberg ES, Malmgren-Olsson EB. Complex symptomatology among young women who present with stress-related problems. Scand J Caring Sci 2014; 29:234-47. [PMID: 24953100 DOI: 10.1111/scs.12154] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 05/18/2014] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In Scandinavia and globally, mental health and stress-related problems among adolescent girls and young women are public health concerns that need attention. The aim of this study was to investigate mental health and somatic symptoms with a special focus on internalised problems, self-image and body-mind aspects of body perception in a group of adolescent girls and young women presenting with stress-related problems at a youth-friendly Swedish health centre, and to compare them with normative and clinical reference groups. METHODS The participants were 47 adolescent girls and young women, aged 17-25 years. The adult self-report (ASR), social analysis of social behaviour (SASB) and body perception questionnaire (BPQ) were used to measure multiple symptom areas. RESULTS Compared to reference groups, adolescent girls and young women report complex symptomatology with high levels of internalised problems such as anxiousness, depression and somatic complaints. This manifested in attention problems, negative self-image and perceived bodily discomfort and distrust. CONCLUSION Adolescent girls and young women emerging into adulthood present complex symptomatology of stress-related problems. This study gathered valuable information about their symptoms when they were seeking help. These young women showed higher symptom frequency than normative groups, and similar or higher symptom frequency than other clinical groups. Our findings of internalised and cognitive problems, including impaired self-image and body perceptions, point to the need for preventive strategies and tailored multidisciplinary interventions involving body-based methods to meet this complexity. Using tenets of stress theory, the complex symptomatology may be understood as logical responses to overwhelming stimuli and demands that exceed their ability to cope and disturb their 'equilibrium'. However, the complex gendered interplays between various external/internal stressors and a broad range of stress responses and health outcomes need further study in a long-term perspective.
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Affiliation(s)
- Maria Strömbäck
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.,Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden.,National Research School for Gender Studies, Umeå Centre for Gender Studies, Umeå University, Umeå, Sweden
| | - Maria Wiklund
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
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Abstract
This study used a descriptive phenomenological approach to describe the experience of finding and receiving health services for neck pain. Nineteen participants (18 females, 1 male) with neck pain (>3 months) were interviewed using a semi-structured questionnaire guide. Interviews were recorded, transcribed and coded. Two overarching themes described the experience: complexity in finding effective health care; and the need for informative, personalized, respectful communication. Complexity in finding effective health care was attributed to the variable approach and effectiveness of different health professionals, the need to experiment with care to find what works, the need to differentiate temporary versus permanent treatment effects, concerns about treatment side effects and the sense that financial factors influence personal treatment choices and provider behaviours. The need for informative, personalized, respectful communications was broken down into the following subthemes: the importance of being listened to, seen and believed; the need for useful information; and a desire to have outcomes formally tracked as a means of individualizing treatment. Overall, patients struggled to navigate the variable health services and providers that were available and that provided variable outcomes. They often did so through a trial and error approach. As such, patients remain open to unproven, even controversial treatment options. Research evidence was not a key ingredient in patient decision-making about accessing health services. The environmental, personal, health behavior factors interacted to contribute to health service utilization and would increase the burden of these for both the individual and society at large. The effectiveness of neck pain interventions is dependent on complex interactions between the context, individual, and health care provider, therefore, physiological responses cannot be considered as being distinct from these determinants.
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Affiliation(s)
- Joy C Macdermid
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario and Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph's Health Centre, London, Ontario, Canada
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Hellman T, Jonsson H, Johansson U, Tham K. Connecting rehabilitation and everyday life – the lived experiences among women with stress-related ill health. Disabil Rehabil 2013; 35:1790-7. [DOI: 10.3109/09638288.2012.754951] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
OBJECTIVE We have limited knowledge about the specific elements in an occupational rehabilitation programme that facilitate the process leading to return to work (RTW) as perceived by the patients. The aim of the study was to explore individual experiences regarding contributing factors to a successful RTW, 3 years after a resident occupational rehabilitation programme. METHODS The study is based on interviews of 20 individuals who attended an occupational rehabilitation programme 3 years earlier. Ten informants had returned to work (RTW) and ten were receiving disability pension (DP). Data were analysed by systematic text condensation inspired by Giorgi's phenomenological analysis. RESULTS The core categories describing a successful RTW process included positive encounters, increased self-understanding and support from the surroundings. While the informants on DP emphasized being seen, heard and taken seriously by the professionals, the RTW group highlighted being challenged to increase self-understanding that promoted new acting in every-day life. Being challenged on self-understanding implied increased awareness of own identity, values and resources. Support from the surroundings included support from peer participants, employer and social welfare system. CONCLUSION Successful RTW processes seem to comprise positive encounters, opportunities for increased self-understanding and support from significant others. An explicit focus on topics like identity, own values and resources might improve the outcome of the rehabilitation process.
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Affiliation(s)
- Liv Haugli
- Air-National Center in Occupational Rehabilitation, Rauland, Norway.
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Haugstvedt KTS, Hallberg U, Graff-Iversen S, Sørensen M, Haugli L. Increased self-awareness in the process of returning to work. Scand J Caring Sci 2011; 25:762-70. [DOI: 10.1111/j.1471-6712.2011.00891.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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