Work characteristics and sickness absence in burnout and nonburnout groups: A study of Swedish health care workers.

The aim of this study was to search for constellations of work characteristics that discriminate people who experience burnout from those who do not, and also from those who score high in exhaustion but not in disengagement, and vice versa. The study is based on data from 3,719 employees in a County Council in Sweden. Discriminant analysis revealed that four burnout categories (nonburnout, disengaged, exhausted, and burnout) related in different ways to self-reported work characteristics. The proportions of respondents with overtime, sickness absence, and sickness presence were higher in the burnout and the exhausted groups compared with the nonburnout group. The most common professions in the burnout group were, unexpectedly, dental nurses, secretaries, and service staff. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The job demands-resources model of burnout.

The job demands-resources (JD-R) model proposes that working conditions can be categorized into 2 broad categories, job demands and job resources, that are differentially related to specific outcomes. A series of LISREL analyses using self-reports as well as observer ratings of the working conditions provided strong evidence for the JD-R model: Job demands are primarily related to the exhaustion component of burnout, whereas (lack of) job resources are primarily related to disengagement. Highly similar patterns were observed in each of 3 occupational groups: human services, industry, and transport (total N?=?374). In addition, results confirmed the 2-factor structure (exhaustion and disengagement) of a new burnout instrument—the Oldenburg Burnout Inventory—and suggested that this structure is essentially invariant across occupational groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multigroup analysis of the job demands-resources model in four home care organizations.

The job demands-resources (JD-R) model was tested in a study among 3,092 employees working in 1 of 4 different home care organizations. The central assumption in the model is that burnout develops when certain job demands are high and when job resources are limited because such negative working conditions lead to energy depletion and undermine worker motivation and learning opportunities, respectively. A series of multigroup structural equation modeling analyses provide strong evidence for the JD-R model. Specifically, results showed that job demands are primarily and positively related to the exhaustion component of burnout, whereas job resources are primarily related to cynicism (negatively) and professional efficacy (positively). The theoretical and practical implications of the JD-R model are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The need for continuing education in ethics as reported by rural and urban mental health care providers.

Continuing professional education (CPE) sponsors planning events for mental health care licensees can assure better attendance if they can successfully address the needs of their target audience. Offering topics of interest is particularly crucial when CPE events need to draw large numbers of attendees to be financially viable. A survey of nearly 400 health licensees regarding CPE needs, especially as related to ethics, revealed that the greatest interest in such CPE was reported by master's-level mental health care providers. Topic areas with the greatest draw were the management of clients who present with special issues (e.g., substance abuse, medical illness, or cultural diversity) and competent management of colleague misconduct and impairment, rather than more traditional ethics issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Overload, autonomy, and burnout as predictors of physicians' quality of care.

A model in which perceived overload and burnout mediated the relations of workload and autonomy with physicians' quality of care to their patients was examined. The study was based on data from 890 specialists representing six medical specialties. Including global burnout as well as its three first-order facets of physical fatigue, cognitive weariness, and emotional exhaustion improved the fit between the structural model and the data relative to an alternative model that included only global burnout. Workload (number of work hours) indirectly predicted quality of care through perceived overload. Additionally, the authors found that the paths from the first order factors of emotional exhaustion, physical fatigue, and cognitive weariness predicted quality of care negatively, positively, and nonsignificantly, respectively. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized trial of a brief mental health intervention for primary care patients.

This randomized trial is a first evaluation of a brief psychotherapeutic intervention for primary care patients. Sixty-two participants were randomly assigned to the intervention or to treatment as usual. As compared with treatment as usual, the intervention led to significant reductions in symptoms of anxiety and depression. The reduction was maintained for 3 months after the end of treatment, but some return of symptoms occurred by 6 months after treatment. The treatment was well accepted by patients. This study provides good preliminary evidence for the effectiveness of this intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

From inequity to burnout: The role of job stress.

This research examined burnout (i.e., emotional exhaustion, depersonalization, and lack of personal accomplishment) among 2 samples of Dutch teachers as a function of inequity and experienced job stress in 3 different exchange relationships (with students, colleagues, and the school). It was hypothesized that inequity would he linked to burnout through the stress resulting from this inequity. Analysis of a cross-sectional sample (N?=?271) revealed that this was indeed the case. Findings were replicated longitudinally using an independent sample of 940 teachers. It is concluded that the often-reported effect of inequity on burnout can partly be interpreted in terms of elevated levels of job stress. Implications of the findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The evaluation of an individual burnout intervention program: The role of inequity and social support.

This study evaluated a 5-week, group-based burnout intervention program among direct-care professionals working with mentally disabled individuals. Equity theory was used as the theoretical framework. The main objective of the program was to reduce perceptions of inequity in the relationship with the organization and with the recipients of care by increasing the fit between the professional's goals and expectations and the actual work situation. One experimental group and 2 control groups participated. All 3 groups filled out 3 questionnaires: before the program started, 6 months later, and 1 year later. Individual absenteeism rates were assessed for 1 year before and after the program. Results showed that in the experimental group burnout, absence, and deprived feelings diminished compared with the control groups. The most profound effects were among participants who could draw on social resources to benefit from the intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of full-day and half-day workshops for health care providers in techniques for increasing resistant clients' motivation.

Are psychotherapy training workshops worth the time and money? The current study examined the effectiveness of 3-hr and 6-hr versions of a workshop for health care providers in techniques for increasing motivation in resistant clients. Role plays were used to examine pretraining and posttraining behavior of graduate student and clinician participants from various health care fields. Both workshops were associated with higher levels of workshop-consistent behavior and lower levels of workshop-inconsistent behavior. Degree status (student or clinician) and openness to the material were not related to these changes. Results suggest potential guidelines for clinicians to determine whether a training opportunity would be useful. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experiences of parents of children with congenital limb differences with health care providers: A qualitative study.

This article describes a qualitative, participatory action research study based in grounded theory, in which an online survey was developed and utilized to explore and generate suggestions for further research about the needs and health care experiences of parents of children with congenital limb differences (CLD) during the first year of the child’s life. Participants: Fifty parents completed an online survey that was developed through review of themes in the literature and input from people with CLD and their families. Primarily with open-ended questions, the survey targeted the respondents’ perceptions of the attitudes and approaches of health care providers. Results and Discussion: Results indicate that parents consistently commented on three main areas of interaction with health care providers: attitudes, information, and emotional or psychological support. Research hypotheses generated from the data are presented. Implications and suggestions for future directions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pilot trial of a disclosure intervention for HIV+ mothers: The TRACK program.

Objective: The Teaching, Raising, And Communicating with Kids (TRACK) program was a longitudinal pilot-trial intervention designed to assist mothers living with HIV (MLHs) to disclose their serostatus to their young children (age 6–12 years). Method: MLH and child dyads (N = 80 dyads) were recruited and randomized to intervention or control; the intervention group had 3 individual sessions and 1 follow-up phone call. The sessions focused on preparing MLHs for disclosure through behavioral exercises using Derlega's model (V. J. Derlega, B. A. Winstead, K. Greene, J. Serovich, & W. N. Elwood, 2004) of HIV disclosure. Both MLHs and their child were assessed across multiple time points (baseline, 3, 6, and 9 months) regarding disclosure of HIV status, and specific outcome variables (i.e., relationship context, mother's health, child's mental health, and family outcomes). Results: MLHs in the intervention group were 6 times more likely to disclose their HIV status than those in the control group (OR = 6.33, 95% CI [1.64, 24.45]), with 33% disclosing in the intervention group compared with 7.3% in the control group. MLHs in the intervention group showed increases in disclosure self-efficacy across time, increased communication with their child, and improvement in emotional functioning. Children of MLHs in the intervention group exhibited reductions in depression and anxiety, and increases in happiness. Conclusions: TRACK was found to be successful in helping MLHs disclose their HIV status to their children, with positive outcomes noted for both MLHs and their children. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The influence of emotional dissonance and resources at work on job burnout among Chinese human service employees.

The authors extended Hobfoll's Conservation of Resources (COR) model to examine the influence of emotional dissonance and work resources on burnout among 392 Chinese human service employees. Bivariate correlation results showed that emotional dissonance correlated positively with display rules and burnout, but negatively with work resources, specifically, satisfactory work relations and job rewards. Results of structural equation modeling analyses supported the extension of the COR model to study the dissonance-resources-burnout association. In the revised model, display rules had a direct impact on emotional dissonance, which in turn influenced burnout indirectly through the mediation of work resources. Limitations of the study and implications for work stress management are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Making telehealth a viable component of our national health care system.

Technological advances and the development of a national information infrastructure give telehealth the potential to overcome barriers to health care services that rural Americans confront. This technology can range from simple use of the telephone to high-tech equipment that enables a psychologist at an urban medical center to counsel a patient in a small town hundreds of miles away. This technology includes interactive video equipment, fax machines, and computers, along with satellites and fiber optics. Although there is a temptation to get caught up in the wizardry of high-tech telecommunications, telehealth will not solve all the access and distribution problems that now plague our health care system. It can, however, be an important part of the solution. Throughout the country, health care providers in fields such as mental health, dermatology, and pediatric cardiology—just to name a few—are taking advantage of this technology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A theory-based dual-focus alcohol intervention for preadolescents: The Strong African american Families program.

This study examined mediators of the Strong African American Families Program, a randomized, dual-focus prevention trial intended to delay the onset of alcohol use and reduce alcohol consumption among rural African American youths. More specifically, it demonstrated that changes in consumption 2 yrs after the intervention were mediated through 2 different paths, a social reaction path and a reasoned/intention path. The social reaction path provided evidence that relative to the control condition, the intervention decreased children's willingness to drink by making their images of drinkers less favorable. The reasoned/intention path provided evidence that the intervention influenced the children's intentions to drink by increasing targeted parenting behaviors related to alcohol. Furthermore, the data demonstrate that these changes in willingness and intentions were independently associated with alcohol consumption at the follow-up, and they suggest that a dual-process model approach that targets both intentions and willingness can be more successful than either approach alone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of a multicomponent appearance-based sun-protective intervention for young women: Uncovering the mechanisms of program efficacy.

An appearance-based sun-protection intervention program was developed, implemented, and evaluated in a sample of 211 Caucasian women (ages 18-25) randomly assigned to the sun-protection program or to a stress management (control) program. The sun-protection program incorporated a novel construct of image norms of aspirational peers (i.e., female media figures, fashion models) approving paleness. The authors targeted these image norms as well as the advantages of tanning, health beliefs about photoaging and skin cancer, and self-efficacy for sun protection. The intervention produced significant differences across conditions favoring sun protection on all constructs but severity of skin cancer and barriers to sun protection. At follow-up, treatment participants exceeded controls both in intention to sun protect and sun-protective behavior and reported lower intention to sunbathe and fewer hours of sunbathing. A mediational model of intervention outcomes revealed distinct mediators for sun protection versus sunbathing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Standard care quality determines treatment outcomes in control groups of HAART-adherence intervention studies: Implications for the interpretation and comparison of intervention effects.

Objective: Clinical trials of behavioral interventions seek to enhance evidence-based health care. However, in case the quality of standard care provided to control conditions varies between studies and affects outcomes, intervention effects cannot be directly interpreted or compared. The objective of the present study was to examine whether standard care quality (SCQ) could be reliably assessed, varies between studies of highly active antiretroviral HIV-adherence interventions, and is related to the proportion of patients achieving an undetectable viral load (“success rate”). Design: Databases were searched for relevant articles. Authors of selected studies retrospectively completed a checklist with standard care activities, which were coded to compute SCQ scores. The relationship between SCQ and the success rates was examined using meta-regression. Main Outcome Measures: Cronbach’s alpha, variability in SCQ, and relation between SCQ and success rate. Results: Reliability of the SCQ instrument was high (Cronbach’s alpha = .91). SCQ scores ranged from 3.7 to 27.8 (total range = 0–30) and were highly predictive of success rate (p = .002). Conclusions: Variation in SCQ provided to control groups may substantially influence effect sizes of behavior change interventions. Future trials should therefore assess and report SCQ, and meta-analyses should control for variability in SCQ, thereby producing more accurate estimates of the effectiveness of behavior change interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy of the RECAP intervention program for children with concurrent internalizing and externalizing problems.

The authors evaluated the efficacy of RECAP, a psychosocial intervention developed to treat concurrent internalizing and externalizing problem in children. Participants included 93 4th-grade children assigned to the treatment group or a no-treatment control group. The school-based program, which lasts the 9-month academic year, provides individual, group, classroom, teacher, and parent training in the RECAP skills-development curriculum, which was derived from empirically supported treatment programs for nonconcurrent internalizing and externalizing problems. Outcome assessments included parent-, teacher-, self-, and peer reports. A mixed hierarchical linear models analysis indicated that, overall, treatment children's rate of improvement in both internalizing and externalizing problems was significantly greater than that for control participants. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Job control mediates change in a work reorganization intervention for stress reduction.

This longitudinal, quasi-experiment tested whether a work reorganization intervention can improve stress-related outcomes by increasing people's job control. To this end, the authors used a participative action research (PAR) intervention that had the goal of reorganizing work to increase the extent to which people had discretion and choice in their work. Results indicated that the PAR intervention significantly improved people's mental health, sickness absence rates, and self-rated performance at a 1-year follow-up. Consistent with occupational health psychology theories, increase in job control served as the mechanism, or mediator, by which these improvements occurred. Discussion focuses on the need to understand the mechanism by which work reorganization interventions affect change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Workplace Triple P: A controlled evaluation of a parenting intervention for working parents.

This paper examined the effects of a parenting intervention targeting working parents called Workplace Triple P. The intervention targeted both parenting and work factors, focusing on key transition times (e.g., from home to work) and trained parents to more effectively manage these transitions. One-hundred-and-twenty-one working parents with children ranging in age from 1–16 years were randomly assigned to either a Workplace Triple P condition (WPTP) or to a waitlist control condition (WLC). Results showed that parents who had received the intervention reported significantly lower levels on measures of personal distress and dysfunctional parenting; and higher levels of work commitment, work satisfaction, and self-efficacy. Implications for the delivery of parenting interventions as employee assistance programs are discussed along with how such interventions can enhance work and family life. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Collaborative versus directive interventions in the treatment of eating disorders: Implications for care providers.

Given that individuals with eating disorders, are typically ambivalent about changing their eating patterns, what approach is most helpful in working with this challenging group? This research compared the responses of clients with eating disorders and those of care providers to written clinical vignettes. All participants rated collaborative interventions as more acceptable and more likely to produce positive clinical outcomes than directive interventions. In addition, clients who were least ready for change rated directive interventions as less acceptable and less likely to produce adherence than did clients who were more ready. Despite participants' clear preference for collaborative interventions, directive interventions were rated as equally likely to occur. The implications of participant preferences and reasons that these preferences may not be reflected in actual clinical practice are addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)