We studied the clinical course and long-term effects of inpatient treatment in 723 patients with job burnout referred with an ICD-10 F diagnosis and Z73.0 code («overwhelming exhaustion») to a Swiss ...hospital specialized in the treatment of job stress-related disorders. Patients were characterized in terms of age, gender, socioeconomic status. Self-rated psychological measures related to general and burnout-specific symptoms (i. e., emotional exhaustion, depersonalization, and diminished personal accomplishments) were applied before and after a six-week treatment program, as well as at 15 months after hospital discharge in 232 patients. The results show that the multimodal inpatient psychiatric-psychotherapeutic treatment was successful with a sustainable effect on psychological well-being (>90 %), including improvements regarding emotional exhaustion, depersonalization and personal accomplishments as well as professional reintegration in 71 % of cases.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Abstract
Background:
In bibliotherapy, the therapeutic gains of reading fiction are ascribed to the literature. Viewing reading fiction as an occupation may give other explanations of its therapeutic ...function.
Aim:
The aim of this qualitative study was to explore the experiences of reading fiction among women during a period of sick leave.
Material and methods:
A qualitative approach was applied. Eight women who had been reading fiction during sick leave were interviewed.
Results:
An overarching theme: Supporting one's active self, comprised five categories of experiences: a prospect of ordinary life, a place of refuge, a life together with others, a source of power, and as supporting an active life.
Conclusion and significance:
Based on the categories, reading fiction is seen to comprise intentional, functional, mental, relational, and personal dimensions. A tentative model of supporting one's active self is proposed, which may be helpful in clarifying the mechanisms of the process of change. The health-related dimensions of reading fiction suggest that reading fiction should be regarded as a significant occupation comparable with other, more highlighted ones. Understood in this way, it is argued that the results add to the knowledge base in occupational therapy focusing on how meaningful occupations connect to occupational life trajectories.
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DOBA, IJS, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
The purpose of this paper was to develop a pro forma which classifies the components of service delivery and organization which may impact on the outcomes of elderly peoples’ community and ...intermediate care services. The resulting analytic template provides a basis for comparison between services and may help guide service commissioning and development. A qualitative approach was used in which key evaluations and reports were selected on the basis that they described elderly peoples’ community and intermediate care services. These were analysed systematically using a qualitative (template) approach to draw out the key themes used to describe services. Themes were then structured hierarchically into an analytic template. Seventeen key documents were analysed. The initial coding framework classified 334 themes describing intermediate care services. These items were then clustered into 78 categories, which were reduced to 17 subcategories, then six overall groupings to describe the services, namely; (1) context; (2) reason for the service; (3) service‐users; (4) access to the service; (5) service structure; and (6) the organization of care. The resulting analytic template has been developed into a ‘service pro forma’ which can be used as a basis to describe and compare a range of services. We propose that all service evaluations should describe, in detail, their context in a comparable way, so that other services can learn from and/or apply the findings from these studies.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Resumo Este estudo tem como objetivo investigar os motivos da não inclusão de trabalhadores contribuintes junto ao Programa de Reabilitação Profissional (PRP) do Instituto Nacional do Seguro Social, ...INSS. Lançando-se mão de um estudo de caso, transversal e documental, foram coletados dados dos prontuários dos sujeitos encaminhados ao PRP de uma Agência do INSS, da região Sudeste do Brasil, entre 2007 e 2012. Elaborou-se um instrumento para a referida coleta, para padronizar o registro dos dados, verificando-se nos pareceres finais acerca da Avaliação do Potencial Laborativo, redigidos pela equipe responsável pelo atendimento inicial, se o trabalhador encaminhado foi elegível ou não para integrar o PRP. Os motivos descritos pela equipe para a não inclusão dos trabalhadores foram agrupados segundo a proximidade quanto ao significado, formando categorias centrais, discriminando-se as justificativas de cada uma.
Abstract Objective Burnout among nurses is an issue of concern, and preventive interventions are important to implement and evaluate. This study investigated levels and predictors of change in ...burnout dimensions after an intervention for help-seeking nurses. Methods Nurses participating in a self-referral, counseling intervention, from 2004 to 2006 in Norway, were followed with self-reporting assessments. One-year follow-up was completed by 160/172 (93%, 155 women and 5 men). Results Mean level of emotional exhaustion (one dimension of burnout, scale 1–5) was significantly reduced from 2.87 (SD 0.79) to 2.52 (SD 0.8), t = 5.3, p < 0.001, to the level found in a representative sample of Norwegian nurses. The proportion of nurses seeking psychotherapy increased after the intervention, from 17.0% (25/147) to 34% (50/147), p < 0.001. Less reduction in emotional exhaustion was independently predicted by reporting a work-related conflict ( β −0.53 (SE 0.13), p < 0.001) or by getting a period of sick leave ( β −0.28 (SE 0.12), p < 0.05) after the intervention. Conclusions A short-term preventive intervention could contribute to reduction of emotional exhaustion in nurses. Work-related conflict and sick leave after the intervention were negatively associated with this reduction. Practice implications Preventive interventions to reduce burnout for nurses should be considered, as well as programs for preventing or handling conflicts at work.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
To evaluate the effects of a stress management intervention among 24 female patients on sick leave due to work-related psychological complaints.
The study design was quasi-experimental. All ...participants received a standard individual treatment for stress at a company healthcare unit. Half of the sample was also enrolled in a group intervention aimed at coping with psychological/somatic symptoms of stress. Data were collected before and after treatment and at 6- and 12-month follow-ups, through questionnaires and blood sampling. Rates of return to work were assessed for up to 5 years.
Levels of depression decreased in both conditions and these improvements were maintained at follow-up. The experimental condition was superior in alleviating burnout, as measured with the Karolinska Exhaustion Scale. Paradoxically, these improvements were accompanied by significant increases in levels of glycated haemoglobin in both groups. At 5-year follow-up 40% of participants in both conditions had returned to work.
The stress management intervention seems to have beneficial effects on self-rated symptoms, but is comparable to treatment as usual with respect to rates of return to work. More studies are needed to investigate the impact of this intervention on physiological parameters.
A randomised controlled trial was conducted in a metal working plant. The primary endpoint was perceived stress reactivity (Stress Reactivity Scale, SRS). 174 participants were randomly assigned to a ...stress-management intervention (SMI) (IG) or a waiting control group (CG). N=174 participants (171 male) were recruited at t0, 154 (89%) were still taking part after one year (t1), 131 (76%) after 2 years. The SRS score decreased in both groups. The conducted SMI proved to be effective over both a 1- and a 2-year period.
Strategies to assess work abilities and skills are crucial in designing a program for professional and work rehabilitation of individuals with intellectual disability. The most important component of ...functional assessment is not determining the existence of disability or explaining the deficit underlying the disability, but the level at which intellectual disability limits professional and other activities related to an individual's independent life. Strengths and weaknesses of individuals with ID are considered through developing and defining appropriate professional goals, and identifying services needed to achieve immediate and long-term goals of professional rehabilitation. Assessment of work abilities, aptitude and skills is a part of a process which should start in childhood, with the aim to multidimensinally consider all the factors which influence professional rehabilitation, employment and potential to live independently of people with intellectual disability. A comprehensive approach, which includes individuals with intellectual disability and their families, is crucial in the process of appropriate academic orientation, work training and the level of social support.
Introduction: Burnout and mental distress in working doctors increase the risk for both suboptimal treatment of patients and negative health consequences for the doctors. Doctors have low rates of ...sickness absence and are reluctant to seek help, especially for mental distress. We examined whether a spell of sickness absence after a counselling intervention could predict reduction in emotional exhaustion among doctors at work 3 years later. Methods: A 3-year follow up after a counselling intervention for burnout at the Resource Centre Villa Sana in Norway in 2003-05 was completed by 184/227 doctors. Selfreport assessments were administered at baseline, 1-, and 3-years. The effect of number of weeks of sickness absence on reduction in emotional exhaustion among doctors working 3 years after the intervention was assessed by linear regression. Results: Of the 184 doctors completing assessment, 149 were working at 3-year follow up. Emotional exhaustion (scale 1-5) was significantly reduced at follow up (from 3.00±0.96 to 2.37±0.79, p<0.001). The number of weeks of sickness absence after the intervention was a significant positive predictor of this reduction (β=0.31, p<0.001), also after including sex, age, neuroticism, reduction of work hours, and other forms for treatment in the model. Conclusions: The number of weeks of sickness absence after a counselling intervention for burnout had a positive predictive effect on reduction in emotional exhaustion among doctors at work 3 years later. Sick leave thus seems to "prevent" later burnout, which can be of importance both for their patients and for the doctors themselves.
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BFBNIB, NMLJ, NUK, OILJ, PNG, SAZU, UKNU, UL, UM, UPUK
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