Teachers are at high risk of stress-related disorders. This longitudinal study aimed to (a) identify which occupational, sociodemographic and life-style factors and self-efficacy at baseline that ...were of importance for burnout, (b) explore associations between changes in the studied factors versus changes in burnout, and (c) by interviews increase the understanding of perceived job demands among teachers.
A cohort of 310 Swedish teachers in school-years 4-9 responded to a questionnaire of occupational, sociodemographic and life-style factors, self-efficacy and burnout, at baseline and at follow-up (mean 30 months later). A combined measure with four levels of burnout was crafted, based on exhaustion, cynicism and professional efficacy (Maslach Burnout Inventory-General Survey). Quantitative data were analysed with multiple ordinal regression, and qualitative data were analysed with content analysis of interview responses from a subgroup of the teachers (n = 81).
The occurrence of high burnout (level 2 and 3 combined) were similar at baseline and follow-up (14% vs. 15%). However, many teachers fluctuated between the levels of burnout (28% increased and 24% decreased). Burnout at baseline was of importance for change of work or being off duty at follow up. In the multi-exposure model, low self-efficacy OR 0.42; CI 0.26-0.68 and high job demands OR 1.97; CI 1.02-3.8 were the strongest explanatory variables. Low self-efficacy remained as the strongest explanatory factor after adjustment for burnout at baseline. Increased job demands during follow-up was associated with an increased level of burnout OR 3.41; CI 1.73-6.69, whereas increased decision latitude was associated with a decreased level of burnout OR 0.51; CI 0.30-0.87. Two major categories of demands emerged in the qualitative analysis; i.e. too high workload and a sense of inadequacy.
A substantial proportion of teachers showed signs of burnout at both occasions. Low self-efficacy and high job demands was of importance for burnout, and changes in burnout was further associated with changes in decision latitude. The results points to the need of actions on individual, organizational and a societal levels.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
While poor mental health and psychiatric disorders attributed to stressful work conditions are a public health concern in many countries, the health consequences of the occupational stress ...experienced by school principals is an understudied issue. Although current data is lacking, some research suggests that principals have a stressful work situation that eventually may lead to burnout and exhaustion disorder, thus negatively affecting the ability of principals to function as leaders. To gauge the situation in Sweden, and as a basis for future preventive actions, we examined to what extent principals displayed signs of exhaustion and whether the prevalence rates of exhaustion differed across school levels, length of work experience as a principal, and gender.
Principals (N = 2219; mean age 49 years SD 7 years; 78% women) working at least 50% in pre-schools, compulsory schools, upper secondary schools or adult education completed a cross-sectional web survey entailing two validated inventories: The Karolinska Exhaustion Disorder Scale (KEDS) and the Lund University Checklist for Incipient Exhaustion (LUCIE). Data was analysed using traditional non-parametric methods. Gender stratification achieved covariate balance when analysing school level and length of work experience.
Altogether, 29.0% of the principals met the exhaustion criteria in KEDS. The prevalence rates for the four LUCIE-steps of increasing signs of exhaustion were: no signs of stress, 48.8%; weak signs of stress, 25.6%; clear signs of stress but no exhaustion, 15.4%; possible exhaustion disorder, 10.2%. Compared with male principals, female principals reported more signs of possible exhaustion disorder in both LUCIE and KEDS. School level was not associated with reports of exhaustion symptoms in neither LUCIE nor KEDS. Among male principals, length of work experience was associated with exhaustion symptoms in KEDS.
A large group of Swedish principals working in pre-schools, compulsory schools, upper secondary schools or adult education displayed a symptomatology of signs of exhaustion that if sustained might lead to poor health. This observation suggests that education authorities, or other relevant stakeholders, ought to take some form of preventive action. However, effective combinations of individual, group, organisational, and/or societal preventive activities remain to be identified and tested.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
As part of our research on Swedish school principals, we examined the concurrent validity between the Karolinska Exhaustion Disorder Scale (KEDS) and the Lund University Checklist for Incipient ...Exhaustion (LUCIE) in a cross-sectional study sample (N = 2670). Specifically, we examined: (a) to what extent LUCIE and KEDS identified the same individuals and their level of agreement, and (b) to what extent the present observations among school-principals agreed with previous observations made in a highly educated and healthy study sample drawn from the general population. Depending on established cut-points on LUCIE, the Kappa agreement (K) between LUCIE and KEDS varied between fair (K = 0.34 95% Confidence Interval = 0.30-0.38) and moderate (K = 0.54 95% Confidence Interval = 0.51-0.58). While the instruments did not always identify the same individuals, the most reasonable comparison between KEDS and LUCIE was achieved when the cut-off on LUCIE was made between step two and step three. The results essentially replicated our previous results observed in a highly educated and healthy study sample drawn from the general population. The level of agreement suggests that KEDS and LUCIE scores are supplementary rather than interchangeable. Thus, individual result from KEDS and LUCIE are probably best understood in dialogue with the person screened.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Teachers are at high risk of stress-related disorders. This study aimed to examine the occurrence of burnout in a sample of Swedish school-teachers, to test a combined measure of three burnout ...dimensions on the individual level, to characterize associations between burnout and factors encountered during work and leisure time, and to explore any differences between the genders.
A questionnaire of occupational, sociodemographic and life-style factors was answered by 490 teachers in school years 4-9. Outcome measures were (a) the single burnout dimensions of exhaustion, cynicism and professional efficacy (Maslach Burnout Inventory-General Survey), and (b) a combined measure based on high or low values in the three dimensions. The combined measure was used to stratify the study population into four levels (0-3) of burnout. Multivariable Poisson regression was applied on level 2 + 3 vs. level 0 + 1, for variables that we considered as relevant risk factors for burn out.
Half of the teachers reported low values in all three dimensions (level 0), whereas 15 were classified as having high burnout in at least two out of the three dimensions (level 2 + 3), and 4 % in all three dimensions (level 3). Almost all psychosocial factors were incrementally more unfavourably reported through the rising levels of burnout, and so were dissatisfaction with the computer workstation, pain, sleep problems and lack of personal recovery. There was no association between gender and rising levels of overall burnout (p > 0.30). Low self-efficacy, poor leadership, high job demands and teaching in higher grades were the variables most clearly associated with burnout in multivariable Poisson regression.
Even if circa 50 % of the teachers appear do well with respect to burnout, the results points to the need of implementing multifaceted countermeasures that may serve to reduce burnout.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Home care is beset with work environment issues and high staff turnover, while research concerned with interventions to improve the work environment is sparse. Few of the existing interventions apply ...a participative approach, despite this being associated with more positive outcomes and sustainable change. This paper presents a framework, rooted in action research and action learning, for participatory work environment interventions in home care, and demonstrates how this framework has been implemented in four Swedish home care organizations.
The framework has three phases (pre-intervention, intervention planning and intervention implementation) and consists of cycles of action and reflection in three constellations: a group of researchers, a reference group with labour market organization representatives and home care managers, and intervention work groups in the home care organizations. The work was documented and analysed with focus on the realization of the framework and challenges that were met on the way. The interventions were evaluated using a pre-/post-test questionnaire design.
Parts of the framework were successfully implemented. The pre-intervention phase and the intervention planning phase, with intervention work groups, worked well. All four groups identified one intervention relevant to their own context. However, only two of the proposed interventions were fully implemented and evaluated. The high staff and management turnover, and the high rate of organizational changes made it impossible to evaluate the interventions statistically. Yet, data from open-ended questions in the post questionnaire showed that the two implemented interventions were perceived as successful.
The participatory framework, presented in this paper, seems promising for work environment interventions in home care. The framework was designed to reduce the risk of known disturbances affecting the process in unstable organizations. Despite this, it proved challenging to execute the framework, and especially the interventions, due to changes happening at high speed. In the two cases where organizational changes were not dominating, the interventions were implemented successfully. While the prerequisites for participation and successful implementation could be improved somewhat, the main issue, the instability of the organizational context, is hard for researchers or the individual home care units to tackle alone.
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CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Mitochondria are essential eukaryotic organelles often forming intricate networks. The overall network morphology is determined by mitochondrial fusion and fission. Among the multiple mechanisms that ...appear to regulate mitochondrial fission, the ER and actin have recently been shown to play an important role by mediating mitochondrial constriction and promoting the action of a key fission factor, the dynamin‐like protein Drp1. Here, we report that the cytoskeletal component septin 2 is involved in Drp1‐dependent mitochondrial fission in mammalian cells. Septin 2 localizes to a subset of mitochondrial constrictions and directly binds Drp1, as shown by immunoprecipitation of the endogenous proteins and by pulldown assays with recombinant proteins. Depletion of septin 2 reduces Drp1 recruitment to mitochondria and results in hyperfused mitochondria and delayed FCCP‐induced fission. Strikingly, septin depletion also affects mitochondrial morphology in Caenorhabditis elegans, strongly suggesting that the role of septins in mitochondrial dynamics is evolutionarily conserved.
Synopsis
This study provides evidence that septins, conserved components of the cytoskeleton, are involved in Drp1‐mediated mitochondrial fission.
Septin depletion causes mitochondrial elongation in mammalian cells and in the nematode C. elegans.
Septin 2 directly interacts with the mitochondrial fission factor Drp1 and regulates its mitochondrial association.
This study provides evidence that septins, conserved components of the cytoskeleton, are involved in Drp1‐mediated mitochondrial fission.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Few studies have assessed the mental health of principals, or studied associations with both organizational and social work environment factors and occupational balance. The purpose of the present ...study was therefore to investigate associations between supporting and demanding organizational and social work environment factors, occupational balance and stress symptoms in principals.
A total of 4309 surveys (2316 from the first round, 1992 from the second round), representing 2781 Swedish principals who had responded to at least one of two surveys, were included in the present study. The surveys include questions about socio-demographic factors, occupational balance, overtime work, and supporting and demanding organizational and social work environment factors, as well as questions about personal stress and exhaustion. Generalized Estimating Equations (GEE) models were used to specify a repeated measures model with a dichotomous outcome (binary logistic regression) and multiple independent factors. Data from two surveys were combined, taking into account dependent observations due to the fact that many study subjects had participated in both surveys.
Associations were found between occupational balance (Q1: OR 2.52, 95% CI 2.03-3.15; Q2: OR 4.95, 95% CI 3.86-6.35; Q3: OR 9.29, 95% CI 6.99-12.34), overtime work (Once a week: OR 1.51, 95% CI 1.10-2.08; Sometimes a week: OR 1.31, 95% CI 1.03-1.66), supportive private life (OR 1.50, 95% CI 1.36-1.66), supportive colleagues at the leadership level (OR 1.24, 95% CI 1.14-1.36), supportive management (OR 1.17, 95% CI 1.07-1.28) and no or negligible stress symptoms. In addition, role demands (OR 0.72, 95% CI 0.63-0.83), having a container function (OR 0.72, 95% CI 0.64-0.82), collaboration with employees (OR 0.77, 95% CI 0.66-0.89), role conflicts (OR 0.75, 95% CI 0.66-0.89) and having a buffer function (OR 0.86, 95% CI 0.77-0.97) were associated with lower likelihood to rate no or negligible stress symptoms.
The occupational balance of principals is strongly associated with no or negligible stress symptoms, and thus is a promising venue for promoting well-being. Improvements should be made to several factors in the organizational and social work environments to improve principals' chances of having occupational balance, and therefore better mental health.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Screening inventories are important tools in clinical settings and research but may be sensitive to temporary fluctuations. Therefore, we revisited data from a longitudinal study with the Lund ...University Checklist for Incipient Exhaustion (LUCIE) that comprised occupationally active individuals (n = 1355; 27-52 years; 57% women) and one initial paper and pencil survey and 10 subsequent equally spaced online surveys. In the present study we examine to what extent the LUCIE scores changed across 3 years (11 assessments) and whether episodes of temporary elevated LUCIE scores (LTE) coincided with reports of negative or positive changes at work or in private life.
In the total sample, the prevalence rates for the four LUCIE classifications of signs of increasing exhaustion (from no exhaustion to possible exhaustion disorder) ranged from 65.4-73.0%, 16.6-20.9%, 6.2-9.6%, and 3.4-5.0%. Of 732 individuals screened for LTE episodes, 16% had an LTE episode. The LTE episodes typically coincided with reports of adverse changes at work or, to a lesser extent, in private life. Thus, LUCIE classifications appear reliable and lend themselves to repeated use on the same individuals, or group of individuals. Even single episodes of elevated LUCIE scores seem appropriately to indicate adverse reactions to the work situation.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Purpose
The aims of the present study were to investigate whether being subjected to bullying and witnessing bullying at the workplace was associated with concurrent sleep difficulties, whether ...frequently bullied/witnesses have more sleep difficulties than occasionally bullied/witnesses, and whether there were associations between being subjected to bullying or witnessing bullying at the workplace and subsequent sleep difficulties.
Methods
A total of 3,382 respondents (67 % women and 33 % men) completed a baseline questionnaire about their psychosocial work environment and health. The overall response rate was 46 %. At follow-up 2 years later, 1671 of those responded to a second questionnaire (49 % of the 3,382 respondents at baseline). Sleep difficulties were measured in terms of disturbed sleep, awakening problems, and poor quality of sleep.
Results
Bullied persons and witnesses reported more sleep difficulties than those who were neither bullied nor witnesses to bullying at baseline. Frequently bullied/witnesses reported more sleep difficulties than respondents who were occasionally bullied or witnessing bullying at baseline. Further, odds ratios for subsequent sleep difficulties were increased among the occasionally bullied, but not among witnesses. However, the associations weakened when adjusting for sleep difficulties at baseline.
Conclusion
Being subjected to occasional bullying at baseline was predictive of subsequent sleep difficulties. Witnessing bullying at baseline did not predict sleep difficulties at follow-up.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
The relationships among bullying or witnessing bullying at work, self-reported health symptoms, and physiological stress reactivity were analysed in a sample of 437 employees (294 women and 143 men). ...Physiological stress reactivity was measured as cortisol in the saliva. Of the respondents, 5% of the women (
n=15) and 5% of the men (
n=7) reported bullying, whereas 9% of the women (
n=25) and 11% of the men (
n=15) had witnessed bullying at work. The results indicated that the bullied respondents had lower social support from coworkers and supervisors, and they reported more symptoms of somatisation, depression, anxiety, and negative affectivity (NA) than did the nonbullied respondents. Witnesses reported more symptoms of anxiety and lower support from supervisor than did the nonbullied employees. Concentrations of cortisol in the saliva were lower at awakening in bullied respondents compared with nonbullied respondents. Previous studies have reported lower diurnal concentration of cortisol for people with posttraumatic stress disorder (PTSD) and chronic fatigue. To our knowledge, this is the first full study on the associations among being subjected to bullying, health outcomes, and physiological stress response.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
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