Talma Kushnir

Burnout and Risk Factors for Cardiovascular Diseases

The burnout syndrome denotes a constellation of physical fatigue, emotional exhaustion, and cognitive weariness resulting from chronic stress. Although it overlaps considerably with chronic fatigue as defined in internal medicine, its links with physical illness have not been systematically investigated. This exploratory study, conducted among 104 male workers free from cardiovascular disease (CVD), tested the association between burnout and two of its common concomitants--tension and listlessness--and cardiovascular risk factors. After ruling out five possible confounders (age, relative weight, smoking, alcohol use, and sports activity), the authors found that scores on burnout plus tension (tense-burnout) were associated with somatic complaints, cholesterol, glucose, triglycerides, uric acid, and, marginally, with ECG abnormalities. Workers scoring high on tense-burnout also had a significantly higher low density lipoprotein (LDL) level. Conversely, scores on burnout plus listlessness were significantly associated with glucose and negatively with diastolic blood pressure. The findings warrant further study of burnout as a predictor of cardiovascular morbidity and mortality.

Attenuating the impact of job demands: Additive and interactive effects of perceived control and social support☆

Abstract The study investigated the combined additive and interactive effects of psychosocial resources, perceived control (PC) and social support (SS), on psychological outcomes of job demands. Previous studies looked at their effects separately. The study adopted the expanded Job Demands-Control-Support (JD-CS) model. It addressed existing criticisms of many studies based on the original JD-C model, by using a broad spectrum measure of job demands, a more valid PC index, and modeling statistical interactions. The results among 267 female social workers indicate that PC and SS exert an additive effect in attenuating the impact of job demands. The lowest burnout level and the highest job satisfaction were found under conditions of low stress, i.e. low demands, high PC, and high SS. The opposite occurred under high stress, i.e., high demands, low PC, and low SS. As in most other studies of the JD-C or the JD-C-S models, no evidence of an interactive effect was found.

Continuing medical education and primary physicians' job stress, burnout and dissatisfaction

The association between opportunities for continuing medical education (CME) and primary physicians’ job stress, burnout and job dissatisfaction has not been investigated. It was hypothesized that participation in CME activities and perceived opportunities at work for keeping up‐to‐date with medical and professional developments would be correlated negatively with job stress and burnout, and positively with job satisfaction.

The Gulf War and its impact on burnout and well-being of working civilians

Burnout signifies the chronic depletion of coping resources following prolonged exposure to emotionally charged demands. It is manifested by symptoms of emotional, physical and cognitive exhaustion, and is usually studied in relation to occupational stressors. We hypothesized that the major life crisis engendered by missile attacks would give rise to burnout or exacerbate preexisting burnout symptoms. We also hypothesized that individuals suffering from prewar burnout would appraise the war as being more threatening and would be more vulnerable to upper respiratory infections (URI). Wartime and pre-war (baseline) levels of burnout and related symptomatology (cognitive weariness, listlessness, tension and somatic complaints) were compared among 162 Israeli civilians who carried on with their employment duties throughout the Gulf War. We found that the war impacted primarily on younger individuals (age < 45). All the pre-war levels of the above measures increased significantly (except for a marginal increase in tension). The impact of the war was mediated by threat appraisal, as indicated by worry and apprehension. Worry was positively associated with pre-war burnout, and negatively with age and education. Pre-war burnout was associated positively with wartime URIs. It was concluded that the war accelerated the depletion of coping resources and that burnout may be affected by factors other than occupational stress.

Association between burnout at work and leukocyte adhesiveness/aggregation.

OBJECTIVE This study examined whether burnout at work is associated with leukocyte adhesiveness/aggregation (LAA), a phenomenon known to be affected by stress. METHODS The LAA levels of 179 employees (68 men and 111 women) of Tel Aviv University were determined when the employees underwent their annual routine medical checkup. Blood pressure and toxic chemical exposure were also measured, and background data were retrieved from medical records. Information on burnout and somatic complaints (known to be a general marker of stress) was collected through a self-report questionnaire. RESULTS Total burnout and each of its subcomponents, emotional exhaustion, chronic fatigue, and cognitive weariness, was significantly associated with LAA levels, even after controlling for age, sex, and educational level. Burnout and somatic complaints intercorrelated positively, but somatic complaints were not significantly associated with LAA levels before or after controlling for the above possible confounders. CONCLUSIONS Burnout was positively associated with LAA levels. This finding is consistent with the growing evidence of the negative impact of burnout on physical health. The lack of an association between somatic complaints and LAA levels reinforces the claim that burnout and stress are two different concepts.

Negative association between reported life events and cardiovascular disease risk factors in employed men: The CORDIS study

There is evidence of a link between stressful life events and risk of cardiovascular disease, but the pathway has not been fully explored. The present study of 1859 employed men tested the association between reported intensity of life events and blood pressure and serum lipid levels, risk behaviors, and psychological distress symptoms. The findings revealed a striking disparity in the outcomes. Life events were negatively associated with systolic (p = 0.001) and diastolic (p = 0.038) blood pressure, triglycerides (p = 0.011), and uric acid (p = 0.05), even after controlling for job strain and other possible confounders. In contrast, life events were positively associated with somatic complaints (p < 0.0001), anxiety (p < 0.0001), irritability (p < 0.0001), and depression (p < 0.0001). In addition there was a linear trend between intensity level of life events and low exercise (p = 0.006), smoking (p = 0.007), and alcoholic intake (p = 0.035). The possibility that the above disparity is a product of powerful biases, such as repressive coping and negative affectivity disposition, is discussed.

Preventing burnout: increasing professional self efficacy in primary care nurses in a Balint Group.

Nursing is reported to be a stressful occupation, and chronic stress is often associated with burnout. Many ways of reducing stress have been proposed. Of these, the Balint group method provides a forum in which health professionals can present and attempt to resolve stressful situations with clients, coworkers, or other professionals. Balint groups help health professionals improve coping with psychosocial stressors in a supporting and accepting group atmosphere. This article reports changes in professional self efficacy associated with reduced burnout in a group of 13 nurses working in community based primary care clinics. Results showed significant increases in awareness and ability cognitions after the Balint group and reduced emotional exhaustion and cognitive weariness. The ramifications of these findings are discussed.

Meaning in Life: Does It Play a Role in Smoking?

The aim of this study was to investigate whether a relationship exists between a decreased level of meaning in life and smoking. In 2006, 341 Hungarian respondents (48.1% males, 51.9% females) completed a questionnaire that included the Purpose in Life test, a shortened version of the Aspiration Index and the Beck Depression Inventory, as well as questions about sociodemographic characteristics, past year alcohol and illicit drug consumption, and smoking behavior. The mean age of the participants was 33.0 years (SD = 14.6), while the average years of education of the respondents was 14.5 (SD = 2.7). According to the results of the regression analysis, meaning in life proved to be significant in differentiating between nonsmokers and daily smokers. With regard to the nonsmoker vs. occasional smoker and the daily vs. occasional smoker relationship, level of life meaning was not a significant predictor. The gender-meaning in life interaction was insignificant in all three relations. Limitations of this explorative investigation are noted.

Coping with preoperative anxiety in cesarean section: physiological, cognitive, and emotional effects of listening to favorite music.

BACKGROUND Listening to music has a stress-reducing effect in surgical procedures. The effects of listening to music immediately before a cesarean section have not been studied. The objective of this study was to assess the effects of listening to selected music while waiting for a cesarean section on emotional reactions, on cognitive appraisal of the threat of surgery, and on stress-related physiological reactions. METHODS A total of 60 healthy women waiting alone to undergo an elective cesarean section for medical reasons only were randomly assigned either to an experimental or a control group. An hour before surgery they reported mood, and threat perception. Vital signs were assessed by a nurse. The experimental group listened to preselected favorite music for 40 minutes, and the control group waited for the operation without music. At the end of this period, all participants responded to a questionnaire assessing mood and threat perception, and the nurse measured vital signs. RESULTS Women who listened to music before a cesarean section had a significant increase in positive emotions and a significant decline in negative emotions and perceived threat of the situation when compared with women in the control group, who exhibited a decline in positive emotions, an increase in the perceived threat of the situation, and had no change in negative emotions. Women who listened to music also exhibited a significant reduction in systolic blood pressure compared with a significant increase in diastolic blood pressure and respiratory rate in the control group. CONCLUSION Listening to favorite music immediately before a cesarean section may be a cost-effective, emotion-focused coping strategy. (BIRTH 39:2 June 2012).

Stress management and burnout prevention in female blue-collar workers: Theoretical and practical implications

Occupational stress is a pervasive problem among blue-collar workers, and women employees are especially vulnerable, yet this population is rarely addressed. The study concerns a stress management training program developed for female production workers with little formal education, based on the cognitive approach of Rational-Emotive-Behavioral Training (REBT). Several strategies and teaching aids suitable for such a population are suggested. Twenty-seven women participated in the program. Fourteen of them comprised the waiting-list control group. Burnout, tension, listlessness, cognitive weariness, and work/home conflict were assessed before, at the end, and at 12 months follow-up. At the end of the six-session program, four of the five measures in the experimental group were significantly reduced compared to the control group. At the 12 months follow-up, tension and burnout were still reduced compared to baseline suggesting that REBT can be successfully taught to such participants but booster sessions are required.