ABSTRACT
INTRODUCTION: The aim of this study was to investigate the impact of psychosocial working conditions and coping strategies at work on change in sick leave level for patients on long-term sick leave due to burnout. METHODS: A cohort sample of patients (n = 117) on long-term sick leave due to burnout was analyzed. The patients answered a questionnaire at baseline and sick leave information was collected from the Swedish Social Insurance Agency at baseline and at follow-up 2 years later. Two groups were formed depending on whether the patients had "improved" and reduced their sick leave level (56%) or if the sick leave level was "unchanged" (44%) at follow-up. The association between change in sick leave and predictors measuring psychosocial working conditions and coping strategies at work were analyzed using logistic regression. RESULTS: The predictor, low control at work, was associated with unchanged sick leave at follow-up. When background characteristics were taken into account, usage of covert coping towards supervisors and covert coping towards workmates, respectively, also predicted unchanged sick leave level. High overcommitment was of borderline significance and associated with a reduced sick leave level at follow-up. CONCLUSIONS: Patients with burnout who have experienced low control at work and used covert coping towards supervisors and/or workmates have a higher risk of not reducing their sick leave after rehabilitation. The workplace may contribute to a reduction of sick leave lengths with a more flexible work environment and improvement in communication strategies for employees and supervisors.
Subject(s)
Adaptation, Psychological , Burnout, Professional/psychology , Employment/psychology , Sick Leave/statistics & numerical data , Workplace/psychology , Adult , Burnout, Professional/rehabilitation , Female , Follow-Up Studies , Humans , Job Satisfaction , Logistic Models , Longitudinal Studies , Male , Middle Aged , Risk Factors , Sick Leave/trends , Stress, Psychological , Surveys and Questionnaires , Sweden , Workplace/organization & administrationABSTRACT
OBJECTIVES: The number of employees on sick leave due to stress-related syndromes has increased drastically in many industrialized countries. Cognitive dysfunction is a common complaint among patients suffering from chronic stress. Previous research on chronic stress has mainly focused on its interpersonal, attitudinal, psychological, organizational, and physical effects. Less attention has been allocated to effects of chronic stress on cognitive functioning. Hence the aim of the present study was to investigate the relationship between chronic stress and cognition. METHODS: The cognitive performance of 19 chronic stress outpatients and 19 matched controls was studied. A battery of standard and experimental cognitive tests assessing processing speed, attention, working memory, and episodic and semantic memory were administered. RESULTS: Performance deficits of the chronic stress patients relative to the performance of the controls were found for some but not all cognitive tasks, indicating a selective deficit. Deficits were found for episodic memory, particularly for learning across repeated trials and for tasks requiring divided attention during either the encoding or retrieval of words. Performance differences were also found for aspects of working memory, mental tempo, semantic access, and prospective memory, but not for basic perceptual speed measures. CONCLUSIONS: These findings may suggest suboptimal executive functioning (eg, strategic or attentional control) among chronic stress patients. Particularly, poor performance in letter fluency and prospective memory were significantly associated with chronic stress, the finding suggesting the usefulness of these tests as clinical tools in evaluations of chronic stress states.
Subject(s)
Burnout, Professional/complications , Cognition Disorders/etiology , Outpatients/psychology , Stress, Psychological/etiology , Adult , Burnout, Professional/psychology , Case-Control Studies , Chronic Disease , Cognition Disorders/diagnosis , Cognition Disorders/psychology , Female , Humans , Logistic Models , Male , Memory , Mental Recall , Psychological Tests , Psychomotor Performance , Stress, Psychological/psychology , Surveys and Questionnaires , SwedenABSTRACT
BACKGROUND AND PURPOSE: Leptin, an important hormone for body weight regulation, may be involved in the pathogenesis of cardiovascular manifestations of obesity. We tested whether leptin may be an independent risk marker for stroke in a case-referent study. METHODS: Definitive acute stroke events, defined by MONICA criteria, were identified from October 1, 1995 to April 30, 1999. Referents without known cardiovascular disease were randomly selected from a population census. Patient characteristics were taken from hospital files and leptin was analyzed in stored samples. Logistic regression analysis was used to determine possible differences in leptin levels between groups. RESULTS: One hundred and thirty-seven cases with ischemic stroke and 69 cases with hemorrhagic stroke were identified. In comparison with referents, male patients with stroke had significantly higher leptin levels. Both male and female stroke patients had increased blood pressure compared with the referents. In multivariate analyses, high leptin levels were associated with both ischemic (OR = 4.89; 95% CI: 1.89-12.62) and hemorrhagic (OR = 3.86; 95% CI: 1.13-13.16) stroke in men, and with ischemic stroke in women (OR = 4.10; 95% CI: 1.45-11.62). The combination of high leptin levels and increased blood pressure (systolic or diastolic) was associated with a strong positive interaction in males with hemorrhagic stroke. CONCLUSION: Leptin may be an important link for the development of cerebrovascular disease in the insulin resistance syndrome in men.
