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International Archives of Occupational and Environmental Health

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01-07-2019 | Burnout Syndrome | Original Article

Emotional demands and exhaustion: cross-sectional and longitudinal associations in a cohort of Danish public sector employees

Authors: Marianne Agergaard Vammen, Sigurd Mikkelsen, Julie Lyng Forman, Åse Marie Hansen, Jens Peter Bonde, Matias Brødsgaard Grynderup, Henrik Kolstad, Linda Kaerlev, Reiner Rugulies, Jane Frølund Thomsen

Published in: International Archives of Occupational and Environmental Health | Issue 5/2019

Abstract

Purpose

To examine cross-sectional and longitudinal associations between content-related emotional demands at work and exhaustion, and to investigate if these associations were modified by other psychosocial work characteristics.

Methods

In 2007, 4489 Danish public service employees participated in the PRISME study by completing postal questionnaires, and 3224 participated in the follow-up in 2009. Content-related emotional demands were measured by a scale (scored 1 to 5) based on five work-content-related items, and exhaustion was measured with the general exhaustion scale from the Copenhagen Burnout Inventory (CBI) (scored 1 to 5). The cross-sectional and longitudinal associations with exhaustion were analysed in the same model and adjusted for effects of potential confounders. Effect modifications were examined separately for self-reported emotional enrichment, meaningful work, job control, social support at work and quantitative demands.

Results

Exhaustion increased with increasing emotional demands, both cross-sectionally and longitudinally. However, although statistically significant, the effect was small. In the longitudinal analysis, a one unit increase in emotional demands was associated with a 0.03 unit (95% CI: 0.01–0.06) increase in exhaustion. We found statistically significant effect modification for three of six potentially modifying work characteristics. The effect of emotional demands on exhaustion was lower for participants with high levels of emotional enrichment (cross-sectionally and longitudinally), high levels of meaningful work (longitudinally), and higher for high levels of quantitative demands (cross-sectionally).

Conclusions

Increasing content-related emotional demands were associated with increasing levels of exhaustion, cross-sectionally and longitudinally. This effect was reduced if the work was experienced as emotionally enriching and meaningful.

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Agius RM, Blenkin H, Deary IJ, Zealley H, Wood RA (1996) Survey of perceived stress and work demands of consultant doctors. OEM 53:217–224

Arnold BB, Demerouti E (2007) The job demands-resources model: state of the art. J Manag Psycho 22(3):309–328CrossRef

Aronsson G, Theorell T, Grape T, Hammarström A, Hogstedt C, Skoog I, Träskman-Bendz L, Hall C (2017) A systematic review including meta-analysis of work environment and burnout symptoms. BMC Public Health 17:264. https://doi.org/10.1186/s12889-017-4153-7 CrossRef

Bakker AB, Demerouti E (2016) Job demands-resources theory: Taking stock and looking forward. J Occup Health Psychol 22(3):273–285CrossRef

Bakker AB, Demerouti E, Euwema MC (2005) Job Resources Buffer the Impact of Job Demands on Burnout. J Occup Health Psychol 10(2):170–180CrossRef

Bianchi R, Schonfeld IS, Laurent E (2015) Burnout-depression overlap: a review. Clin Psychol Rev 36:28–41. https://doi.org/10.1016/j.cpr.2015.01.004 CrossRef

Borritz M. Burnout in human service work—causes and consequences (2006c) Ph.D. thesis. National Institute of Occupational Health, Denmark

Borritz M, Bultmann U, Rugulies R, Christensen KB, Villadsen E, Kristensen TS (2005) Psychosocial work characteristics as predictors for burnout: findings from 3-year follow up of the PUMA Study. J Occup Environ Med 47(10):1015–1025CrossRef

Borritz M, Rugulies R, Bjorner JB, Villadsen E, Mikkelsen OA, Kristensen TS (2006a) Burnout among employees in human service work: design and baseline findings of the PUMA study. Scand J Public Health 34(1):49–58CrossRef

Borritz M, Rugulies R, Christensen KB, Villadsen E, Kristensen TS (2006b) Burnout as a predictor of self-reported sickness absence among human service workers: prospective findings from three year follow up of the PUMA study. Occup Environ Med 63(2):98–106CrossRef

Brand S, Beck J, Hatzinger M, Harbaugh A, Ruch W, Holsboer-Trachsler E (2010) Associations between satisfaction with life, burnout-related emotional and physical exhaustion, and sleep complaints. World J Biol Psychiatry 11(5):744–754CrossRef

Brugha T, Bebbington P, Tennant C, Hurry J (1985) The List of Threatening Experiences: a subset of 12 life event categories with considerable long-term contextual threat. Psychol Med 15(1):189–194CrossRef

Cho SH, Park M, Jeon SH, Chang HE, Hong HJ (2014) Average Hospital Length of Stay, Nurses’ Work Demands, and Their Health and Job Outcomes. J Nurs Scholarsh 46(3):199–206CrossRef

Christensen KS, Fink P, Toft T, Frostholm L, Ornbøl E, Olesen F (2005) A brief case-finding questionnaire for common mental disorders: the CMDQ. Fam Pract 22:448–457CrossRef

De Jonge J, Mulder MJ, Nijhuis FJ (1999) The incorporation of different demand concepts in the job demand-control model: effects on health care professionals. Soc Sci Med 48(9):1149–1160. https://doi.org/10.1016/j.ijnurstu.2007.11.002 CrossRef

De Jonge J, Le Blanc PM, Peeters MC, Noordam H (2008) Emotional job demands and the role of matching job resources: a cross-sectional survey study among health care workers. Int J Nurs Stud 45(10):1460–1469CrossRef

Demerouti E, Bakker AB, Nachreiner F, Schaufeli WB (2001) The job demands-resources model of burn-out. J Appl Psychol 86:499–512CrossRef

Eysenck HJ, Eysenck SBG (1975) Manual of the eysenck personality Questionnaire. Hodder & Stoughton, London

Fitzmaurice GM, Laird NM, Ware JH (2012) Fixed effects versus random effects models. In: Fitzmaurice GM, Laird NM, Ware JH Applied Longitudinal Analysis. John Wiley & Sons, Hoboken

Freimann T, Merisalu E (2015) Work-related psychosocial risk factors and mental health problems amongst nurses at a university hospital in Estonia: A cross-sectional study. Scand J Public Health 43(5):447–452. https://doi.org/10.1177/1403494815579477 CrossRef

Frese M, Zapf D (1988) Methodological issues in the study of work stress: objective vs. subjective measurement of work stress and the question of longitudinal studies. In: Cooper CL, Payne R (eds) Causes, coping and consequences of stress at work. Wiley, Chichester, pp 375–411

Grandey A (2000) Emotion regulation in the workplace: a new way to conceptualize emotional labor. J Occup Health Psychol 5:95–110. https://doi.org/10.1037//1076-8998.5.1.95 CrossRef

Grynderup MB, Mors O, Hansen ÅM, Andersen JH, Bonde JP, Kærgaard A et al (2013) Work-unit measures of organisational justice and risk of depression—a 2-year cohort study. Occup Environ Med 70(6):380–385. https://doi.org/10.1136/oemed-2012-101000 CrossRef

Huynh JY, Xanthopoulou D, Winefield AH (2013) Social support moderates the impact of demands on burnout and organizational connectedness: a two-wave study of volunteer firefighters. J Occup Health Psychol 18:9–15. https://doi.org/10.1037/a0030804 CrossRef

Idris MA, Dollard MF, Yulita (2014) Psychosocial safety climate, emotional demands, burnout, and depression: a longitudinal multilevel study in the Malaysian private sector. J Occup Health Psychol 19(3):291–302. https://doi.org/10.1037/a0036599 CrossRef

Kaerlev L, Kolstad HA, Hansen AM, Thomsen JF, Kaergaard A, Rugulies R et al (2011) Are risk estimates biased in follow-up studies of psychosocial factors with low base-line participation? BMC Public Health 11:539. https://doi.org/10.1186/1471-2458-11-539 CrossRef

Kim IH, Noh S, Muntaner C (2013) Emotional demands and the risks of depression among homecare workers in the USA. Int Arch Occup Environ Health 86(6):635–644. https://doi.org/10.1007/s00420-012-0789-x CrossRef

Kolstad HA, Hansen AM, Kærgaard A, Thomsen JF, Kaerlev L, Mikkelsen S et al (2011) Job Strain and the Risk of Depression: Is Reporting Biased? Am J Epidemiol 173(1):94–102. https://doi.org/10.1093/aje/kwq318 CrossRef

Kozak A, Kersten M, Schillmoller Z, Nienhaus A (2013) Psychosocial work-related predictors and consequences of personal burnout among staff working with people with intellectual disabilities. Res Dev Disabil 34(1):102–115CrossRef

Kristensen TS, Borritz M, Villadsen E, Christensen KB (2005a) The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. Work Stress 19(3):192–207. https://doi.org/10.1080/02678370500297720 CrossRef

Kristensen TS, Hannerz H, H›gh A, Borg V (2005b) The Copenhagen Psychosocial Questionnaire—a tool for the assessment and improvement of the psychosocial work environment. Scand J Work Environ Health 31(6):438–449CrossRef

Lorente Prieto L, Salanova Soria M, Martínez Martínez IM, Shaufeli W (2008) Extension of the Job Demands- Resources model in the prediction of burnout and engagement among teachers over time. Psicothema 20(3):354–360

Madsen IE, Diderichsen F, Rugulies R (2010) Person-related work and incident use of antidepressants: relations and mediating factors from the Danish work environment cohort study. Scand J Work Environ Health 36(6):435–444. https://doi.org/10.5271/sjweh.3049 CrossRef

Mohren DCL, Swaen GMH, Kant I, van Amelsvoort LGPM, Borm PJA, Galama JMD (2003) Common infections and the role of burnout in a Dutch working population. J Psychosom Res 55(3):201–208CrossRef

Pejtersen J, Kristensen TS, Bjorner JB, Borg V, Christensen KB (2010) The second version of the Copenhagen Psychosocial Questionnaire. Scand J Public Health 2010;38(suppl 3):8–24. https://doi.org/10.1177/1403494809349858 CrossRef

Peng K, Peng KZ, Wong C, Che H, Peng C, Wong H (2010) The missing link between emotional demands and exhaustion. J Manag Psychol 25(7):777–798CrossRef

Poghosyan L, Aiken LH, Sloane DM (2014) Corrigendum to “Factor structure of the Maslach burnout inventory: an analysis of data from large scale cross-sectional surveys of nurses from eight countries”. Int J Nurs Stud 51(10):1416–1417CrossRef

Schaufeli WB (1998) The burnout companion to study and practice, a critical analysis. Taylor & Francis, London

Seidler A, Thinschmidt M, Deckert S, Then F, Hegewald J, Nieuwenhuijsen K, Riedel-Heller SG (2014) The role of psychosocial working conditions on burnout and its core component emotional exhaustion – a systematic review. J Occup Med Toxicol 9:10. https://doi.org/10.1186/1745-6673-9-10 CrossRef

Söderfeldt M (1997) Burnout? School of Social Work, Lund University

Sundin L, Hochwalder J, Bildt C, Lisspers J (2007) The relationship between different work-related sources of social support and burnout among registered and assistant nurses in Sweden: a questionnaire survey. Int J Nurs Stud 44(5):758–769. https://doi.org/10.1016/j.ijnurstu.2006.01.004 CrossRef

Sundin L, Hochwalder J, Lisspers J (2011) A longitudinal examination of generic and occupational specific job demands, and work-related social support associated with burnout among nurses in Sweden. Work 38(4):389–400. https://doi.org/10.3233/WOR-2011-1142 CrossRef

Taris TW, Schreurs PJ (2009) Explaining worker strain and learning: how important are emotional job demands? Anxiety Stress Coping 22(3):245–262. https://doi.org/10.1080/10615800802460401 CrossRef

Tuxford LM, Bradley GL (2015) Emotional job demands and emotional exhaustion in teachers. Educational Psychology 35(8):1006–1024. https://doi.org/10.1080/01443410.2014.912260 CrossRef

Vammen MA, Mikkelsen S, Hansen AM, Bonde JP, Grynderup MB, Kolstad H et al (2016) Emotional demands at work and the risk of clinical depression: a longitudinal study in the danish public sector. J Occup Environ Med 58(10):994–1001. https://doi.org/10.1097/JOM.0000000000000849 CrossRef

Van Vegchel N, de Jonge J, Söderfeldt M, Dormann C, Schaufeli W (2004) Quantitative Versus Emotional Demands Among Swedish Human Service Employees: Moderating Effects of Job Control and Social Support. Int J Stress Manag 11(1):21–40. https://doi.org/10.1037/1072-5245.11.1.21 CrossRef

Van de Ven B, van den Tooren M, Vlerick P (2013) Emotional job resources and emotional support seeking as moderators of the relation between emotional job demands and emotional exhaustion: a two-wave panel study. J Occup Health Psychol 18(1):1–8. https://doi.org/10.1037/a0030656 CrossRef

Van Der Ploeg E, Kleber R (2003) Acute and chronic job stressors among ambulance personnel: predictors of health symptoms. Occup Environ Med 60:40–46CrossRef

Ware JH, Dockery DW, Louis TA, Xu XP, Ferris BG Jr, Speizer FE (1990) Longitudinal and cross-sectional estimates of pulmonary function decline in never-smoking adults. Am J Epidemiol 132(4):685–700CrossRef

Wolfgang AP (1988) Job stress in the health professions: a study of physicians, nurses, and pharmacists. Behav Med 14(1):43–47CrossRef

Title: Emotional demands and exhaustion: cross-sectional and longitudinal associations in a cohort of Danish public sector employees
Authors: Marianne Agergaard Vammen
Sigurd Mikkelsen
Julie Lyng Forman
Åse Marie Hansen
Jens Peter Bonde
Matias Brødsgaard Grynderup
Henrik Kolstad
Linda Kaerlev
Reiner Rugulies
Jane Frølund Thomsen
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Keyword: Burnout Syndrome
Published in: International Archives of Occupational and Environmental Health / Issue 5/2019
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-018-01398-w

At a glance: The STEP trials

Springer Medicine

Emotional demands and exhaustion: cross-sectional and longitudinal associations in a cohort of Danish public sector employees

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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