Ellen Melbye Langballe

Positive and negative work–family interaction and burnout: A longitudinal study of reciprocal relations

Abstract This study examined the longitudinal relationship between work–family interaction (WFI) in terms of the direction of influence (work-to-family vs. family-to-work) and type of effect (conflict vs. facilitation) and burnout. A sample of 2235 respondents from eight different occupational groups (lawyers, bus drivers, employees within information technology, physicians, teachers, church ministers, employees within advertisement, and nurses) supplied data at two points in time with a 2-year time interval. Building upon Hobfolls (1989) Conservations of Resources (COR) theory, three causal models were proposed. The results of SEM-analyses revealed evidence for both a normal (WFI → burnout), a reverse (WFI ← burnout), and a reciprocal (WFI ↔ burnout) relationship. In general, there were lagged positive effects between the conflict dimensions of WFI and burnout and lagged negative effects between the facilitation dimension of WFI and burnout. One exception was a significant lagged negative effect between disengagement at Time 1 and work-to-family conflict at Time 2, suggesting that distancing oneself from job might act as a coping strategy causing lower levels of work-to-family conflict.

The Factorial Validity of the Maslach Burnout Inventory–General Survey in Representative Samples of Eight Different Occupational Groups

The Maslach Burnout Inventory-General Survey (MBI-GS) is designed to measure the three subdimensions (exhaustion, cynicism, and professional efficacy) of burnout in a wide range of occupations. This article examines the factorial validity of the MBI-GS across eight different occupational groups in Norway: lawyers, physicians, nurses, teachers, church ministers, bus drivers, and people working within advertising and information technology (N = 5,024). Separate confirmatory factor analyses using LISREL showed that the hypothesized three-factor model had sufficient fit in all occupational groups except for the group of people working in advertising. In a multigroup analysis including all occupations but the latter one and in an analysis of all individuals combined into one sample, the three-factor model had a clearly better fit than the alternative one-factor and two-factor models. The results support that MBI-GS provides a suitable measurement to assess burnout across a diversity of professions.

Short- and Long-term Mortality Risk Associated with the Use of Antipsychotics Among 26,940 Dementia Outpatients: A Population-Based Study

OBJECTIVE To investigate short- and long-term mortality risk associated with the use of antipsychotics in dementia outpatients, assessing the risk over specific time frames and quantifying the risk by the individual antipsychotics. METHODS This population-based study used data from the Norwegian Prescription Database. The study sample included 26,940 dementia outpatients aged 65 years or older prescribed antidementia drugs and psychotropics from Norwegian pharmacies between 2004 and 2010. RESULTS Cox survival analyses, adjusted for age, gender, mean daily defined dose, and severe medical conditions, showed that antipsychotic use compared with other psychotropics involved approximately twice the mortality risk in outpatients with dementia. Furthermore, these results are consistent for all investigated time points after first dispensing the drugs (hazard ratio [HR]30 days = 2.1 [95% confidence interval {CI}: 1.6-2.9] to HR 730-2,400 days = 1.7 [95% CI: 1.6-1.9]). Haloperidol was associated with higher mortality risk (HR 30 days = 1.7 [95% CI: 1.0-3.0] to HR 730-2,400 days = 1.4 [95% CI: 1.0-1.9]) than risperidone. CONCLUSION This first study to observe antipsychotic use and mortality in dementia outpatients over more than 6 years clearly shows that antipsychotics involve increased short- and long-term mortality risk. Physicians may justly consider antipsychotics to be the best option for some dementia patients among available nonpharmacologic and pharmacologic treatments. However, although causal conclusions are precluded due to limited adjustments in the analyses, the findings support the current treatment recommendations that antipsychotics should be avoided or used with great caution.

Midlife vascular risk factors and their association with dementia deaths: results from a Norwegian prospective study followed up for 35 years.

There is growing evidence that midlife risk factors for vascular disease also are risk factors for dementia, but there is still need for long-term observational studies to address this. Our objective was to investigate the association of midlife vascular disease risk factors with dementia death. Participants were included in The Norwegian Counties Study (NCS) in the period 1974-78, aged 35-50 years at baseline. Information from NCS was linked with the Cause of Death Registry through the year 2009 using the unique personal identification number. The study included 48,793 participants, 1.5 million person years and 486 dementia deaths (187 Alzheimers; 299 non-Alzheimers dementia). Cox regression for cause-specific hazards was used. Dementia death was associated with increased total cholesterol levels (>7.80 vs. <5.20 mmol/l: HR=2.01, 95% confidence interval 1.37-2.93); diabetes (HR=2.43, 95% CI 1.40-4.32) and low body mass index (<20 kg/m(2) vs. 20-25 kg/m(2): HR=1.76, 95% CI 1.15-2.68) in midlife. The associations remained after adjustment for other vascular risk factors and educational level. Smoking status or blood pressure in midlife was not significantly associated with risk of dementia death, although the results indicate a possible increased risk in heavy smokers. People suffering from high cholesterol levels, diabetes or underweight in midlife are at increased risk of dying from or with dementia later in life. Our findings add to previous results suggesting that intervention in midlife may be important. To better understand the mechanisms involved in the associations between midlife underweight, diabetes, and elevated cholesterol level and late-life dementia death, these links need to be further investigated.

Gender-Specific Perceptions of Four Dimensions of the Work/Family Interaction

The aim of this study was twofold. The first intention was to examine the factorial validity of a work/family interaction in terms of the direction of influence (work-to-family vs. family-to-work) and type of effect (conflict vs. facilitation). Second, gender differences along these four dimensions of work/family interaction were explored. Data were obtained from eight different occupational groups in Norway: lawyers, physicians, nurses, teachers, church ministers, bus drivers, and people working in advertising and information technology (IT; N = 3,313). Multigroup analysis indicated that the hypothesized four-factor model clearly has a better fit than the alternative one-factor and two-factor models. Latent mean comparisons revealed significant gender differences along all the dimensions. Women reported more conflict and facilitation in both directions compared to men. Although there were some occupational differences, this was indicative of a more fluid boundary between work and family among women. The findings are discussed in an identity perspective.

A Longitudinal Study of the Relationship between Work Engagement and Symptoms of Anxiety and Depression

This longitudinal study examined the dynamic relationship between work engagement (vigour and dedication) and symptoms of anxiety and depression. A sample of 3475 respondents from eight different occupational groups (lawyers, physicians, nurses, teachers, church ministers, bus drivers, people working in advertising and people working in information technology) in Norway supplied data at two points in time with a 2-year time interval. The advantages of longitudinal design were utilized, including testing of reversed causation and controlling for unmeasured third variables. In general, the results showed that the hypothesized normal causal relationship was superior to a reversed causation model. In other words, this study supported the assumption that work engagement is more likely to be the antecedent for symptoms of depression and anxiety than the outcome. In particular, the vigour facet of work engagement provides lower levels of depression and anxiety 2 years later. However, additional analyses modelling unmeasured third variables indicate that unknown third variables may have created some spurious effects on the pattern of the observed relationship. Implications of the findings are discussed in the paper.

The relationship between burnout and musculoskeletal pain in seven Norwegian occupational groups.

Occupational and gender differences were investigated in the relationship between burnout and musculoskeletal pain in the head, neck, shoulders, and back. Representative samples of lawyers, physicians, nurses, teachers, church ministers, bus drivers, and information technology workers in Norway (N=4507) were analyzed using structural equation modeling. The exhaustion dimension of burnout was positively associated with musculoskeletal pain in all groups, and the strength of the relationship ranged from moderate to strong. The disengagement dimension of burnout was negatively associated with musculoskeletal pain in five groups and only ranged from -0.15 to -0.42. Professional efficacy was slightly weaker, and inconsistently (i.e., both positively and negatively) associated with musculoskeletal pain in four of the groups. There were larger differences in the strength of the relationships between the seven occupational groups than between males and females within the same profession. Results suggest that burnout and musculoskeletal pain are related, but the strength of the associations varies according to gender and occupation. Overall, occupational factors appear to be stronger predictors of the co-occurrence of burnout and musculoskeletal pain than gender.

Work–home conflict and facilitation across four different family structures in Norway

The purpose of this study was to examine how work–home conflict and facilitation vary among people living in different family structures in Norway, here conceptualized as: two-parent families; single parents; childless couples; and singles. The study used data from a Norwegian study on occupational health (N=2414). We hypothesized that respondents living in two-parent families experience more work–home conflict and facilitation than others due to more complex role expectations. Similarly, we hypothesized that the effect of workload and autonomy on work–home conflict and facilitation would be stronger among this group. The results indicate that conflict between work and home life are more profound among those living in two-parent families and among single parents than among childless couples and singles. Work-to-home facilitation did not vary by family structure, whereas the childless couples reported more home-to-work facilitation. Furthermore, with a few exceptions the effects of workload and autonomy on work–home conflict and facilitation did not differ by family structure.

Mental health and wellbeing in spouses of persons with dementia: the Nord-Trøndelag health study

BackgroundCaring for a spouse diagnosed with dementia can be a stressful situation and can put the caregiving partner at risk of loss of mental health and wellbeing. The main aim of this study was to investigate the relationship between dementia and spousal mental health in a population-based sample of married couples older than 55 years of age. The association was investigated for individuals living together with their demented partner, as well as for individuals whose demented partner was living in an institution.MethodsData on dementia were collected from hospitals and nursing homes in the county of Nord-Trøndelag, Norway. These data were combined with data on spousal mental health, which were collected in a population-based health screening: the Nord-Trøndelag Health Study (HUNT). Of 6,951 participating couples (>55 years), 131 included one partner that had been diagnosed with dementia.ResultsOur results indicate that after adjustment for covariates, having a partner with dementia is associated with lower levels of life satisfaction and more symptoms of anxiety and depression than reported by spouses of elderly individuals without dementia. Spouses living together with a partner diagnosed with dementia experienced moderately lower levels of life satisfaction (0.35 standard deviation [SD]) and more symptoms of depression (0.38 SD) and anxiety (0.23 SD) than did their non-caregiving counterparts. Having a partner with dementia that resided in a nursing home was associated with clearly lower life satisfaction. Compared with non-caregivers, these spouses reported lower levels of life satisfaction (1.16 SD), and also more symptoms of depression (0.38 SD), and more symptoms of anxiety (0.42 SD).ConclusionsHaving a partner with dementia is associated with loss of mental health and reduced life satisfaction. The risk of adverse mental health outcomes is greatest after the partner’s nursing home admission.

Personal vulnerability and work‐home interaction: The effect of job performance‐based self‐esteem on work/home conflict and facilitation

The aim of the present study was to examine the longitudinal relationship between job performance-based self-esteem (JPB-SE) and work-home interaction (WHI) in terms of the direction of the interaction (work-to-home vs. home-to-work) and the effect (conflict vs. facilitation). A sample of 3,475 respondents from eight different occupational groups (lawyers, physicians, nurses, teachers, church ministers, bus drivers, and people working in advertising and information technology) supplied data at two points of time with a two-year time interval. The two-wave, cross-lagged structural equations modeling (SEM) analysis demonstrated reciprocal relationships between these variables, i.e., job performance-based self-esteem may act as a precursor as well as an outcome of work-home interaction. The strongest association was between job performance-based self-esteem and work-to-home conflict. Previous research on work-home interaction has mainly focused on situational factors. This longitudinal study expands the work-home literature by demonstrating how individual vulnerability (job performance-based self-esteem) contributes to the explanation of work-home interactions.