Reiner Rugulies

Burnout as a predictor of self‐reported sickness absence among human service workers: prospective findings from three year follow up of the PUMA study

Aim: To investigate whether burnout predicts sickness absence days and sickness absence spells in human service workers. Method: A total of 824 participants from an ongoing prospective study in different human service sector organisations were eligible for the three year follow up analysis. Burnout was measured with the work related burnout scale of the Copenhagen Burnout Inventory. Sickness absence was measured with self-reported number of days and spells during the last 12 months before the baseline and the follow up survey. A Poisson regression model with a scale parameter was used to account for over dispersion. A linear regression model was used for analysing changes in burnout and absence between baseline and follow up. Results: Burnout was prospectively associated with both sickness absence days and sickness absence spells per year. Differences in sickness absence days varied from a mean of 5.4 days per year in the lowest quartile of the work related burnout scale to a mean of 13.6 in the highest quartile. An increase of one standard deviation on the work related burnout scale predicted an increase of 21% in sickness absence days per year (rate ratio 1.21, 95% CI 1.11 to 1.32) after adjusting for gender, age, organisation, socioeconomic status, lifestyle factors, family status, having children under 7 years of age, and prevalence of diseases. Regarding sickness absence spells, an increase of one standard deviation on the work related burnout scale predicted an increase of 9% per year (rate ratio 1.09, 95% CI 1.02 to 1.17). Changes in burnout level from baseline to follow up were positively associated with changes in sickness absence days (estimate 1.94 days/year, SE 0.63) and sickness absence spell (estimate 0.34 spells/year, SE 0.08). Conclusion: The findings indicate that burnout predicts sickness absence. Reducing burnout is likely to reduce sickness absence.

Impact of the psychosocial work environment on registered absence from work: A two-year longitudinal study using the IPAW cohort

During the Intervention Project on Absence and Well-being (IPAW), a 5-year project conducted in Denmark, we investigated psychosocial work environment factors as independent predictors of the number of absence days per year. The present two-year longitudinal study used the IPAW cohort, but was not intended to study intervention effects, which will be reported later. Data were derived from baseline questionnaires and employers’ registers of absence for 1919 participants (1305 women, 614 men, mainly in low-skilled jobs) in different occupations from 52 workplaces. These workplaces included municipal care, municipal technical services and a large pharmaceutical company. Analyses were performed by Poisson regression accounting for over-dispersion. After controlling for age, family type, health behaviours and physical work environment variables, we found that high levels of decision authority predicted low absence rates in both women and men. We tested two new psychosocial constructs developed for this study: Predictability (relating to being informed on future events at work) and Meaning of Work (relating to how meaningful and useful the work is perceived to be). Higher Predictability was a significant predictor of lower absence rates in men. This study adds to the body of evidence that the psychosocial working environment influences absence and should therefore be considered to be an important target for intervention.

Misclassification and the use of register‐based indicators for depression

Objective:  To study the degree to which depression indicators based on register data on hospital and antidepressant treatment suffer from differential misclassification with respect to gender, age and social group.

Functional recovery following musculoskeletal injury in hospital workers

BACKGROUND Hospital workers are at high risk of work-related musculoskeletal disorders (WRMSDs), but outcomes following such injuries have not been well studied longitudinally. AIMS To ascertain functional recovery in hospital workers following incident WRMSDs and identify predictors of functional status. METHODS Cases (incident WRMSD) and matched referents from two hospitals were studied at baseline and at 2 year follow-up for health status [SF-12 physical component summary (PCS)], lost workdays, self-rated work effectiveness and work status change (job change or work cessation). Predictors included WRMSD and baseline demographics, socio-economic status (SES), job-related strain and effort-reward imbalance. Logistic regression analysis tested longitudinal predictors of adverse functional status. RESULTS The WRMSD-associated risk of poor (lowest quartile) PCS was attenuated from a baseline odds ratio (OR) of 5.2 [95% confidence interval (CI) 3.5-7.5] to a follow-up OR of 1.5 (95% CI 1.0-2.3) and was reduced further in multivariate modelling (OR = 1.4; 95% CI 0.9-2.2). At follow-up, WRMSD status did not predict significantly increased likelihood of lost workdays, decreased effectiveness or work status change. In multivariate modelling, lowest quintile SES predicted poor PCS (OR = 2.0; 95% CI 1.0-4.0) and work status change (OR = 2.5; 95% CI 1.1-5.8). High combined baseline job strain/effort-reward imbalance predicted poor PCS (OR = 1.7; 95% CI 1.1-2.7) and reduced work effectiveness (OR = 2.6; 95% CI 1.6-4.2) at follow-up. CONCLUSIONS Baseline functional deficits associated with incident WRMSDs were largely resolved by 2 year follow-up. Nonetheless, lower SES and higher combined job strain/effort-reward imbalance predicted adverse outcomes, controlling for WRMSDs.