| 1. |
- Almén, Niclas, 1971-
(författare)
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Intervening Stress Recovery Behaviors in Everyday Life
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background. High levels of perceived stress and stress-related ill health, such as burnout, are common in many countries. Several theories postulate that stress behaviors promote adaption to environmental changes and if sustained they are potentially harmful for the body. In accordance, impaired stress recovery behaviors, i.e., psychophysiological deactivation after periods of stress behaviors, have been suggested to be a critical factor in explaining stress-related ill health. Whereas research shows that interventions targeting stress reactivity can have beneficial effects on stress-related variables, studies on interventions targeting stress recovery are surprisingly few. Also, the number of validated instruments for measuring behaviors important for stress recovery are few, in particular easily used self-rating scales. Aims. The primary aim of the thesis was to evaluate stress and health-related effects of an intervention targeting stress recovery behaviors in everyday life among people perceiving high levels of stress in life. A secondary aim was to validate a self-report scale measuring behaviors important for stress recovery in everyday life. Method. Three empirical studies were conducted to evaluate effects of the behavioral stress recovery intervention “balance in everyday life”, which solely aims at strengthening stress recovery behaviors in everyday life. First, a brief version of the intervention was investigated through a small pilot study in which a single-subject experimental design was used (study 1). After that, the intervention was exploratively tested in a group format in which a quasi-experimental design was used (study 2). Due to the positive results of these two studies, a larger scale study using a randomized controlled design was conducted in order to further investigate the effects of the intervention when delivered in a group format (study 3). To fulfill the secondary aim of the thesis, the Recovery Experience Questionnaire was translated into Swedish and analyzed using exploratory factor analysis and confirmatory factor analysis (study 4). Results. In study 1, data demonstrated immediate reduction of stress symptoms as a function of the intervention. The improvements were maintained at 1-year and 5-year follow-up assessments. In study 2, in comparison with a waiting-list-control group, the intervention yielded statistically significant improvements between pre- and postintervention assessment on eleven out of twelve stress and health-related variables. Medium to large between-groups effect sizes were demonstrated for the primary outcome measures covering (potential) recovery behaviors, perceived stress and rest and experiences of being recovered. In the third study, statistically significant improvements for all outcome measures at postintervention assessment and at the 3-month follow-up were demonstrated. The between-groups effect sizes for the primary measures - perceived stress, tension, and burnout - were medium-to-high at postintervention assessment and at follow-up. In addition, in all studies the intervention was associated with beneficial changes in levels of anxiety and depression. In the last study, support was found for the proposed four-factor structure of the Swedish version of the Recovery Experience Questionnaire. Conclusions. The results clearly indicate that the intervention “balance in everyday life” improves stress and health-related factors in a relatively satisfactory way among people perceiving high levels of stress in life. The empirical support is strongest for the reduction in tension, perceived stress, burnout, anxiety and depression, and to deliver the intervention in a group format. The studies demonstrated results that warrant further investigation of the effects of “balance in everyday life”, for example in different contexts, and to study other behavioral recovery interventions. To test (potential) recovery facilitating behaviors as mediators of intervention effects, such as reduction in burnout, the Swedish version of the Recovery Experience Questionnaire could be used.
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| 2. |
- Akerstedt, Torbjörn, et al.
(författare)
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Predicting road crashes from a mathematical model of alertness regulation--The Sleep/Wake Predictor.
- 2008
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Ingår i: Accid Anal Prev. - : Elsevier BV. - 0001-4575. ; 40:4, s. 1480-5
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Predicting road crashes from a mathematical model of alertness regulation--The Sleep/Wake Predictor.Akerstedt T, Connor J, Gray A, Kecklund G.Stress Research Institute, Stockholm University and Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. torbjorn.akerstedt@ki.seSleepiness is related to factors such as the time of day, the time since awakening and the duration of prior sleep. The present study investigated whether actual road crashes could be predicted from a mathematical model based on these three factors (the Sleep/Wake Predictor-SWP). Data were derived from a population-based case-control study of serious injury crashes. Data on accident time (or control sampling time) and start and end of prior sleep were entered into the model (blind). The predicted sleepiness values were used in logistic regressions. The results showed a highly significant odds ratio (OR)=1.72 (confidence interval=1.41-2.09) for each incremental step of sleepiness on the output sleepiness scale (nine steps). There was also a significant interaction with blood alcohol level, showing high OR values for high sleepiness levels and alcohol levels above 50 mg% (0.05 g/dl). It was concluded that the model is a good predictor of road crashes beyond that of alcohol level, and that interaction between the two carries a very high risk.
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| 3. |
- Akerstedt, Torbjörn, et al.
(författare)
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Sleep and sleepiness in relation to stress and displaced work hours.
- 2007
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Ingår i: Physiol Behav. - : Elsevier BV. - 0031-9384. ; 92:1-2, s. 250-5
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Sleep and sleepiness in relation to stress and displaced work hours.Akerstedt T, Kecklund G, Gillberg M.Karolinska Institutet, Institute for Psychosocial Medicine Box 230, S-171 77 Stockholm, Sweden. torbjorn.akerstedt@ipm.ki.seSleep is an important factor in relation to accidents, long-term health and mortality. Our group has had a long-term commitment to research on sleep regulation and its consequences. Over the years we have demonstrated pronounced effects of night work on sleep and alertness, including electroencephalographically determined sleep during work. We have also demonstrated that experimental displacement of sleep will result in short sleep at daytime and increased physiological sleepiness at night and developed mathematical models for prediction of sleep duration, as well as of sleepiness and risk of sleep-related accidents. We have also looked at the concept of sleep quality and found it dependent on sleep duration, sleep continuity and content of sleep stages 3 and 4. Sleep is also clearly disturbed in patients on long-term sick leave for burnout or in non-patients with high burnout scores, in particular sleep fragmentation is increased and sleep efficiency and sleep stages 3 and 4 (SWS--deep sleep) decreased. The fragmentation in turn seems related to endocrine changes. Present work is focused on bringing this work together, connecting the links from stress to sleep to metabolic changes to disease and long-term sickness absence.PMID: 17585960 [PubMed - indexed for MEDLINE]
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| 4. |
- Albrecht, Sophie Charlotte, 1988-
(författare)
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The Highs and Lows of Work-Time Control : Exploring the role of control over working hours for health
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Flexible work-time arrangements are thought to create ways of aligning work and private life and facilitate recovery. While temporal flexibility is found to generally bolster work–life balance, its effects on health outcomes are less well known. The present thesis seeks to examine if and how perceived control over working hours benefits workers’ health. Utilising a large Swedish cohort study, four empirical studies explored the association of work-time control (WTC) with subsequent mental and physical health as well as the underlying mechanisms and moderating influences.Study I assessed the factorial structure of an instrument to measure WTC and found two sub-dimensions: control over daily hours (the length, starting and ending times of a workday) and control over time off (the taking of breaks/time/days off, paid and unpaid). Levels of control per sub-dimension were described by demographic and work-related factors for a large sample of Swedish workers. In particular, shift, public sector and female workers reported low levels of WTC.Study II examined effects of control over daily hours and time off on depressive symptoms. Increasing control over time off was related to decreasing depressive symptoms over time, whereas only initial level of control over daily hours was associated with lower levels of depressive symptoms. For both sub-dimensions of WTC, the direction of this effect was predominantly from perceived control to subsequent depressive symptoms; reversed processes were of less importance.Study III focused on work–life interference as one step on the causal chain between WTC and depressive symptoms and musculoskeletal complaints, respectively. For both sub-dimensions of WTC, part of the effect on depressive symptoms went through work–life interference. Reversed processes played a role between depressive symptoms and work–life interference only. Control over time off was found to mitigate work–life interference and subsequent depressive symptoms more than control over daily hours, albeit with generally small effects. Regarding musculoskeletal complaints, effects were even smaller and work–life interference appeared to be less important.Study IV assessed gender differences in the impact of WTC on work–life interference and exhaustion regarding the mediating role of overtime hours. In a sample of knowledge workers, higher control over time off was associated with lower subsequent work–life interference and exhaustion, while control over daily hours was unrelated to both outcomes. Although men worked more overtime hours than women on average, no evidence was found for men with high control over time off/daily hours to perceive more work–life interference/exhaustion due to increased overtime compared to women.This thesis found that higher levels of WTC were beneficial for a range of health outcomes, which was partly explained by fewer work–life conflicts. While these effects were generally small, control over time off in particular was consistently associated with favourable outcomes in health, work-life balance and working hours. Given that the level of workers’ discretion over working hours varies starkly by work and demographic factors, enhancing the availability of flexible work-time arrangements is in the interest of public health. WTC, with a particular focus on employees’ ability to take time off from work, may improve the daily work–life interface and support a sustainable working life.
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| 5. |
- Albrecht, Sophie, 1988-, et al.
(författare)
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Prospective effects of work-time control on overtime, work-life interference and exhaustion in female and male knowledge workers
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Aims: Employee-based flexible working hours are increasing, particularly among knowledge workers. Research indicates that women and men use work–time control (WTC; control over time off and daily hours) differently: while men work longer paid hours, women use WTC to counteract work–life interference. In a knowledge-worker sample, we examined associations between WTC and overtime, work–life interference and exhaustion and tested if gender moderates the mediating role of overtime.Methods: The sample contained 2248 Swedish knowledge workers. Employing hierarchical regression modelling, we examined effects of control over time off/daily hours on subsequent overtime hours, work–life interference and exhaustion in general and in gender-stratified samples. Using conditional process analysis, we tested moderated mediation models.Results: Control over time off was related to less work–life interference (βmen=-0.117; CI95%: -0.237 to 0.003; βwomen=-0.253; CI95%: -0.386 to -0.120) and lower exhaustion (βmen=-0.199; CI95%: -0.347 to -0.051; βwomen=-0.271; CI95%: -0.443 to -0.100). For control over daily hours, estimates were close to zero. While men worked more overtime (42 minutes/week), we could not confirm gender moderating the indirect effect of control over time off/daily hours on work–life interference/exhaustion via overtime. Independent of gender, effects of control over time off on work–life interference were partly explained by working fewer overtime hours.Conclusion: Control over time off was related to lower exhaustion and better work–life balance (in particular for women). We found no evidence for men’s work–life interference increasing with higher WTC due to working more overtime. Knowledge workers’ control over time off may aid to prevent work–life interference and burnout.
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| 6. |
- Amid Hägg, Shadi, 1982-
(författare)
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Sleep disturbances : Consequences and comorbidities
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Sleep disorders are common in the general population, with insomnia and sleep-related breathing disorders being the most common disorders. Since sleep has many important functions, such as a role in consolidation of memories and learning, energy conservation, cardiovascular and immune system regulation, it is not surprising that the disruption of normal sleep may lead to negative health effects and various comorbidities. Aim: The overall aim of this thesis was to investigate the impact of disturbed sleep on various consequences and comorbidities. Methods and results: Papers I and II were based on the Sleep and Health in Women (SHE), a population-based prospective study of women, where a questionnaire was sent to women in 2000 and 2010. In paper I, the study cohort comprised 4,320 women <67 years of age who answered both questionnaires and had worked during the follow-up period. In women, having a long history of insomnia symptoms was associated with an increased risk of self-reported occupational accidents.In paper II, the 4,882 participants who answered the questions regarding nocturnal gastroesophageal reflux and snoring in both questionnaires were included in the study cohort. Women with nocturnal gastroesophageal reflux and snoring were at an increased risk of developing daytime sleepiness and to involuntarily fall asleep during the day. Paper III was based on the RHINE-cohort with participants from seven Northern European centers. The study cohort in paper III comprised the 2,568 smokers in the baseline study that also reported being smokers or former smokers in the follow-up study. It was found that having insomnia symptoms or excessive daytime sleepiness decreases the chance of long-term smoking cessation, and that smoking increases the risk of incident difficulties inducing sleep. Paper IV was the population-based, cross-sectional GA2LEN-survey which was conducted in four major Swedish cities. Paper IV included the 25,901 participants who answered questions regarding both snoring and insomnia symptoms. The combination of snoring and insomnia symptoms was associated with an increased risk of hypertension, asthma, chronic obstructive pulmonary disease, and daytime sleepiness. Conclusions: Disturbed sleep, due to varying causes, influences the risk of occupational accidents, on the chance of successful smoking cessation, on the risk of daytime sleepiness, hypertension, and obstructive lung disease. In clinical consultation, it is important to always inquire about disturbed sleep as it can have an impact on many aspects of health.
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| 7. |
- Annell, Stefan, 1970-, et al.
(författare)
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Means of Sustainable Recruitment : The Importance of Selection Factors and Psychosocial Working Conditions in Predicting Work and Health Outcomes
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Research on selection factors often focuses on how to identify suitable candidates, while fewer studies have investigated the long-term effects of such selection factors once the suitable candidates have started working and faced the work situation. The overall aim of the present study was to examine the relative importance of selection factors (general intelligence, personality, and physical fitness), measured during recruitment, and psychosocial working conditions (e.g., workload, job control, and job challenge)for four different outcomes (job satisfaction, organizational citizenship behavior, occupational retention, and health). Data came from a longitudinal study of newly hired police officers in Sweden (N = 508), including information from both the recruitment process and a three-and-a-half year follow-up. Results of hierarchical multiple regression analyses show that psychosocial working conditions were far more important than the selection factors in predicting the four outcomes. The strong effects of psychosocial working conditions for new officers’ work-related attitudes and health suggest that employers, to ensure sustainability, need to focus on activities facilitating the organizational and professional entrance of newcomers by providing a sound work climate.
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| 8. |
- Anund, Anna, 1964-, et al.
(författare)
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Bussförares arbetstider kopplat till trötthet
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Bussförare i kollektivtrafiken har ofta oregelbundna arbetstider och en arbetssituation som kan innebära hög stress. Dessa faktorer kan leda till allvarlig trötthet. Syftet med denna studie är att belysa hur arbetstiden påverkar sömn, stress, trötthet och körförmåga. Projektet omfattar fyra delstudier: enkätstudie, sömndagböcker och aktigrafi, analys av schemaläggning och ett experiment på riktig väg med bussförare. Hypoteserna var att tidiga morgonturer, delade skift, långa arbetsdagar och få timmars vila mellan arbetspassen bidrar till trötthet, stress och nedsatt körförmåga, som tillsammans kan leda till en sämre säkerhet. De övergripande resultaten stödjer dessa hypoteser. Generellt sett upplevs sömnighet och trötthet under körning som ett problem eftersom förarna anser att detta innebär nedsatt körförmåga, vilket ökar risken för incidenter och olyckor. Totalt 45 procent av förarna hade minst två gånger i månaden svårt att hålla sig vakna när de kör buss och 19 procent hade under det senaste decenniet varit inblandade i en incident där trötthet varit en bidragande orsak. Experimentet med delade skift med tidig start på morgonen stöder dessa rön. Rapporten avslutas med en lista med förslag.
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| 9. |
- Anund, Anna, 1964-, et al.
(författare)
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Countermeasures for fatigue in transportation : a review of existing methods for drivers on road, rail, sea and in aviation
- 2015
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim with this study was to gather knowledge about countermeasures for driver fatigue (including sleepiness) in road, rail, sea and air transportation. The knowledge has been used as an input for evaluating advantages and disadvantages with different countermeasures and to estimate their potential to be used regardless mode of transportation. The method used was a literature review and a workshop with experts from all transportation modes. At the workshop the effectiveness of countermeasures for a single mode, but also regardless mode were discussed and a ranking was done. The report discuss the potential of fighting fatigue among drivers for specific mode of transport but also from a more generic point of view, considering scheduling, model prediction of fatigue risk, legislation, a just culture, technical solutions, infrastructure, education, self-administered alertness interventions and fatigue risk management (FRM). The overall judgement was that a just culture, education, possibility to nap and schedules taking the humans limitations into consideration as the most effective countermeasures to fight fatigue, regardless mode of transportation.
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| 10. |
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