Nature-Based Rehabilitation for Patients with Long-Standing Stress-Related Mental Disorders: A Qualitative Evidence Synthesis of Patients' Experiences.

Stress-related mental disorders contribute to work disabilities globally and are a common cause for sick leave. Nature-based rehabilitation (NBR) is a multi-disciplinary approach offered to this patient group on a limited scale. Qualitative studies provide insight into patients' experiences of NBR, and there is a need to synthesize and assess the certainty of evidence for patient-experienced benefits.

Concurrent and lagged effects of psychosocial job stressors on symptoms of burnout.

Purpose: Burnout is a mental condition described as being a result of long-term stressors commonly related to psychosocial factors at work. The aim of the present study was to investigate longitudinal relationships between job demands, decision authority, effort and reward, and symptoms of burnout, as well as the joint effects of job demands and decision authority, and of effort and reward.

Methods: The data came from a four-wave longitudinal cohort study of Swedish health care workers.

The capacity to work puzzle: a qualitative study of physicians' assessments for patients with common mental disorders.

Background: Entitlement to sickness benefits is a legal process requiring health-related reduced work capacity confirmed by a physician via a sickness certificate. However, there is a knowledge gap concerning physicians' clinical practice of work capacity assessments for patients with common mental disorders (CMD). Physicians claim more knowledge and skills in how to actually do the assessments.

Occupational imbalance and the role of perceived stress in predicting stress-related disorders.

Background: Stress-related disorders are the main reason for sick leave in many European countries. The aim of the present study was to explore whether perceived occupational imbalance predicts stress-related disorders, potential gender differences, and to explore the mediating role of perceived stress.

Method: Longitudinal data on 2223 employees in a public organization in Sweden were collected by surveys, and analyzed by logistic regression.

Uncovering paradoxes from physicians' experiences of patient-centered ward-round.

Purpose The purpose of this paper is to uncover paradoxes emerging from physicians' experiences of a patient-centered and team-based ward round, in an internal medicine department. Design/methodology/approach Abductive reasoning relates empirical material to complex responsive processes theory in a dialectical process to further understandings. Findings This paper found the response from physicians, to a patient-centered and team-based ward round, related to whether the new demands challenged or confirmed individual physician's professional identity.

Occupations, perceived stress, and stress-related disorders among women and men in the public sector in Sweden.

Background: Stress-related disorders are a public health problem and represent a significant burden to individuals and society. It is, therefore, of importance to regard stress in a wider context and identify risk factors not only at work but in all occupations in everyday life, to prevent ill health.

Aim/objective: The aim of this study was to examine potential associations between everyday occupations, perceived stress, and stress-related disorders as well as potential gender differences.

Affective stress responses during leisure time: Validity evaluation of a modified version of the Stress-Energy Questionnaire.

Background: Psychosocial stress at work is one of the most important factors behind increasing sick-leave rates. In addition to work stressors, it is important to account for non-work-related stressors when assessing stress responses. In this study, a modified version of the Stress-Energy Questionnaire (SEQ), the SEQ during leisure time (SEQ-LT) was introduced for assessing the affective stress response during leisure time.

Internal construct validity of the stress-energy questionnaire in a working population, a cohort study.

Background: Psychosocial stress at work has been recognised as one of the most important factors behind the increase in sick leave due to stress-related mental disorders. It is therefore important to be able to measure perceived work stress in a way that is both valid and reliable. It has been suggested that the Stress-Energy Questionnaire (SEQ) could be a useful tool for measuring mood (stress and energy) at work and it has been used in many Scandinavian studies.

Prevalence of perceived stress and associations to symptoms of exhaustion, depression and anxiety in a working age population seeking primary care--an observational study.

Background: Prolonged stress may lead to mental illness, but the prevalence of stress in a working age population seeking primary health care for whatever reason, is unknown. This paper seeks to examine to what extent this group perceives stress, as well as symptoms of burnout/exhaustion, depression and anxiety.

Methods: In 2009, 587 primary health care patients aged 18-65 years (377 women, 210 men), with an appointment with a primary health care physician, participated in the study.

Using nature-based rehabilitation to restart a stalled process of rehabilitation in individuals with stress-related mental illness.

After a period of decrease, sick leave in Sweden due to psychiatric diagnoses is on the increase. The lack of established rehabilitation programmes for patients with stress-related mental disorders (SRMD) has opened up for the use of garden/nature in a multimodal rehabilitation context (Nature-Based Rehabilitation, NBR). Region Västra Götaland (VGR) started an NBR to offer additional rehabilitation for its employees on long-term sick leave due to SRMD, where initial care had not been sufficient.

Health care professionals' experience-based understanding of individuals' capacity to work while depressed and anxious.

Aim: The meaning of capacity to work while depressed and anxious is not well comprehended. The aim of this study was to explore and describe health care professionals' experience-based understanding of capacity to work in individuals with depression and/or anxiety disorders.

Method: An exploratory qualitative design was used.

Nature-based stress management course for individuals at risk of adverse health effects from work-related stress-effects on stress related symptoms, workability and sick leave.

Sick leave due to stress-related disorders is increasing in Sweden after a period of decrease. To avoid that individuals living under heavy stress develop more severe stress-related disorders, different stress management interventions are offered. Self-assessed health, burnout-scores and well-being are commonly used as outcome measures.

Prevalence and course of somatic symptoms in patients with stress-related exhaustion: does sex or age matter.

Background: Both mental and somatic symptoms are commonly reported in patients with stress-related problems. We have explored the prevalence of somatic symptoms in patients seeking medical care for stress-related mental health problems and followed the course of illness alongside with that the patients receive multimodal treatment.

Method: This study comprises data from 228 patients (69% women, mean age 43 years) who fulfilled the criteria for Exhaustion Disorder (ED).

Healthcare managers in negative media focus: a qualitative study of personification processes and their personal consequences.

Background: Over the last decade healthcare management and managers have increasingly been in focus in public debate. The purpose of the present study was to gain a deeper understanding of how prolonged, unfavorable media focus can influence both the individual as a person and his or her managerial practice in the healthcare organization.

Methods: In-depth interviews (n = 49) with 24 managers and their superiors, or subordinate human resources/information professionals, and partners were analyzed using a grounded theory approach.

The relationships of change in physical activity with change in depression, anxiety, and burnout: a longitudinal study of Swedish healthcare workers.

Objective: The purpose of the present study was to examine whether intraindividual changes in physical activity were correlated with intraindividual changes in mental health (depression, anxiety, and burnout) across four measurement time-points over 6 years, both from between-person and within-person perspectives.

Methods: Health care workers (N = 3717; mean age = 46.9; SD = 10.

Self-assessed mental health problems and work capacity as determinants of return to work: a prospective general population-based study of individuals with all-cause sickness absence.

Background: Mental health problems are common in the work force and influence work capacity and sickness absence. The aim was to examine self-assessed mental health problems and work capacity as determinants of time until return to work (RTW).

Methods: Employed women and men (n=6140), aged 19-64 years, registered as sick with all-cause sickness absence between February 18 and April 15, 2008 received a self-administered questionnaire covering health and work situation (response rate 54%).

The level of leisure time physical activity is associated with work ability-a cross sectional and prospective study of health care workers.

Background: With increasing age, physical capacity decreases, while the need and time for recovery increases. At the same time, the demands of work usually do not change with age. In the near future, an aging and physically changing workforce risks reduced work ability.

Construct validity of the Psychological General Well Being Index (PGWBI) in a sample of patients undergoing treatment for stress-related exhaustion: a Rasch analysis.

Purpose: The Psychological General Well Being Index (PGWBI) is a widely used scale across many conditions. Over time issues have been raised about the dimensional structure of the scale, and it has not yet been subjected to scrutiny by modern Psychometric approaches. The current study thus evaluates the PGWBI with Rasch- and factor analysis.

A prospective study of managers' turnover and health in a healthcare organization.

Aims: To assess turnover and health of Swedish healthcare managers, and identify important supporting factors relating to work and individual resources.

Background: Individual managers' own sustainability in terms of turnover and health may be influenced by managerial working conditions and individual resources.

Methods: A 4-year prospective questionnaire study of 216 healthcare managers.

Course of mental symptoms in patients with stress-related exhaustion: does sex or age make a difference?

Background: Long-term sick leave due to mental health problems, especially among women, is a substantial problem in many countries, and a major reason for this is thought to be psychosocial stress. The recovery period of different patient groups with stress-related mental health problems can differ considerably. We have studied the course of mental health symptoms during 18 months of multimodal treatment in relation to sex and age in a group of patients with stress-related exhaustion.

Internal construct validity of the Shirom-Melamed Burnout Questionnaire (SMBQ).

Background: Burnout is a mental condition defined as a result of continuous and long-term stress exposure, particularly related to psychosocial factors at work. This paper seeks to examine the psychometric properties of the Shirom-Melamed Burnout Questionnaire (SMBQ) for validation of use in a clinical setting.

Methods: Data from both a clinical (319) and general population (319) samples of health care and social insurance workers were included in the study.

Healthcare workers' participation in a healthy-lifestyle-promotion project in western Sweden.

Background: Healthcare professionals play a central role in health promotion and lifestyle information towards patients as well as towards the general population, and it has been shown that own lifestyle habits can influence attitudes and counselling practice towards patients. The purpose of this study was to explore the participation of healthcare workers (HCWs) in a worksite health promotion (WHP) programme. We also aimed to find out whether HCWs with poorer lifestyle-related health engage in health-promotion activities to a larger extent than employees reporting healthier lifestyles.

Work attendance among healthcare workers: prevalence, incentives, and long-term consequences for health and performance.

Aim: This paper is a report of a cohort study of healthcare workers' work attendance, and its long-term consequences' on health, burnout, work ability and performance.

Background: Concepts and measures of work attendance have varied in the scientific literature. Attending work in spite of being sick can have serious consequences on health.

Cancer morbidity in Swedish dry-cleaners and laundry workers: historically prospective cohort study.

Purpose: Despite decades of experimental and observational studies, the carcinogenic risks to humans associated with occupational exposure to perchloroethylene (PER) remain uncertain. The aims of the present study were to further examine the possible associations.

Methods: A national cohort of dry-cleaning and laundry workers (n = 10,389) assembled in 1984 was followed up for new cases of cancer by matching with the Swedish cancer register from 1985 to 2006 (inclusive), and the results were compared with expected frequencies derived from national reference data.