| 1. |
- Almén, Niclas, 1971-
(författare)
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A Cognitive Behavioral Model Proposing That Clinical Burnout May Maintain Itself
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 16:7
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Forskningsöversikt (refereegranskat)abstract
- Burnout is common in many countries and is associated with several other problems such as depression, anxiety, insomnia, and memory deficits, and prospectively it predicts long-term sick-leave, cardiovascular disease, and death. Clinical burnout or its residual symptoms often last several years and a common assumption is that recovery takes a long time by nature, despite full time sick-leave and the absence of work stress. The literature suggests models that hypothetically explain the development, but not maintenance, of the syndrome. Based on cognitive and behavioral principles, stress research, and stress theories, this paper describes a theoretical model explaining how clinical burnout can develop and be maintained. While the development of clinical burnout is mainly explained by prolonged stress reactions and disturbed recovery processes due to work related stressors, maintenance of the syndrome is particularly explained by prolonged stress reactions and disturbed recovery processes due to the new context of experiencing burnout and being on sick-leave. Worry about acquired memory deficits, passivity and excessive sleep, shame, fear of stress reactions, and the perception of not being safe are examples of responses that can contribute to the maintenance. The model has important implications for research and how to intervene in clinical burnout. For example, it can offer support to professional care providers and patients in terms of focusing on, identifying, and changing current contextual factors and behaviors that maintain the individual’s clinical burnout symptoms and by that facilitate burnout recovery. Regarding research, the model provides a highly important reason for researchers to study contextual factors and behaviors that contribute to the maintenance of clinical burnout, which has been neglected in research.
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| 2. |
- Almén, Niclas, 1971-
(författare)
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A Functionalistic Stress Recovery Intervention Improves Perceived Recovery Opportunities and Relaxational Behaviors : A Secondary Analysis of a Randomized Controlled Trial
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:21
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Tidskriftsartikel (refereegranskat)abstract
- The recovery perspective on stress management is new and few recovery intervention studies have been conducted. The aim of the study was to evaluate behavioral effects of a functionalistic stress recovery intervention, in which individuals perceiving high levels of stress were encouraged to pay attention to possibilities to perform potential recovery behaviors in everyday life and to choose behaviors that were predicted to lead to resource restoration. Seventy-three individuals were randomly allocated to either a 10-week intervention or a waiting-list control group. Three types of recovery behavior factors during leisure time were studied: perceived recovery opportunities (i.e., control), relaxational behaviors (i.e., relaxation), and positively challenging behaviors (i.e., mastery). In comparison with the control group, the intervention group significantly improved, showing high between-group effect sizes, regarding perceived recovery opportunities (p < 0.001; d = 0.75) and relaxational behaviors (p < 0.001; d = 0.80). Both groups normalized their levels of positively challenging behaviors between pre- and postassessment, and no statistically significant group difference was demonstrated. Analyses of reliable and clinically significant changes demonstrated results in favor of the intervention group regarding perceived recovery opportunities and relaxational behaviors but not positively challenging behaviors. The tested intervention warrants further research, for example, if a modified version of the intervention including components aiming at increasing postwork positively challenging behaviors would be beneficial for the improvement of the behavior and for health.
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| 3. |
- Almén, Niclas, 1971-, et al.
(författare)
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Behavioral Stress Recovery Management Intervention for People With High Levels of Perceived Stress : A Randomized Controlled Trial
- 2020
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Ingår i: International Journal of Stress Management. - : American Psychological Association (APA). - 1072-5245 .- 1573-3424. ; 27:2, s. 183-194
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Tidskriftsartikel (refereegranskat)abstract
- Continuous and prolonged exposure to stressors or unsuccessfully dealing with such exposure has been suggested as precursors for burnout. Current research indicates that such stress problems could be conceptualized as deficiencies in recovery between periods of stress. The purpose of this study was to evaluate the efficacy of a behaviorally oriented stress recovery management intervention for people experiencing high levels of stress. A total of 73 individuals with experiences of stress symptoms and high levels of perceived stress (>= 25 on the Perceived Stress Scale) were randomly allocated to either a 10-week intervention group or a waiting-list control group. Participants were assessed at preintervention, postintervention, and 3-month follow-up. The Perceived Stress Scale, questions about tension, and the Shirom-Melamed Burnout Questionnaire were used as primary outcome measures. and the Hospital Anxiety and Depression Scale was used as a secondary outcome measure. Data were analyzed following the intention-to-treat principle. The analysis demonstrated statistically significant improvements for all measures at posttreatment and at follow-up. The between-groups effect sizes were high at posttreatment and moderate-to-high at follow-up. Intervention focused on stress recovery behavior seems to be an effective way of reducing perceived stress, tension, burnout symptoms, anxiety, and depression in people with stress symptoms and high levels of perceived stress in everyday life. The tested intervention warrants further research. Other stress recovery behavior interventions need to be tested to draw conclusions on the efficacy of stress recovery behavior interventions in general regarding stress and burnout.
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| 4. |
- Almén, Niclas, 1971-, et al.
(författare)
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Burn Out: Effects Of A Brief Behavioral Recovery Program
- 2019
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Ingår i: Libro de Actas. - Granada. ; , s. 269-
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Konferensbidrag (refereegranskat)abstract
- Background: Continuous and prolonged exposure to stressors or unsuccessfully dealing with such exposure has been suggested as precursors for burnout. Current research indicates that such stress problems could be conceptualized as deficiencies in recovery between periods of stress. The purpose of this study was to evaluate the efficacy of a brief stress-recovery behavior intervention for people experiencing high levels of stress. Method: Seventy-three individuals with experiences of stress symptoms and high levels of perceived stress (≥ 25 on the Perceived Stress Scale) were randomly allocated to either a 12-week intervention group (INT) or a waiting list control group (WLC). Participants were assessed at pre-intervention, post-intervention and at 3-month follow-up. Data, including indices of Heart Rate Variability (HRV), Perceived stress scale (PSS), questions about tension, Shirom-Melamed Burnout Questionnaire (SMBQ), and the Hospital Anxiety and Depression Scale (HADS) as a secondary outcome measure, will be analyzed and presented following the intention-to-treat principle.
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| 5. |
- Almén, Niclas, 1971-, et al.
(författare)
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Bättre arbetsmiljö ger fler psykologer
- 2018
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Ingår i: Dagens medicin. - Stockholm. - 1402-1943. ; :27 augusti
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- I vårt debattinlägg betonade vi att psykisk ohälsa är ett vida utbrett problem och att patienter inte får effektiv hjälp eftersom det finns ett omfattande underskott på psykologer inom primärvården. Vi var kritiska till Centerpartiets vårdreform som riskerar medföra att problemet förvärras eftersom det inte skulle öka antalet psykologer vilka kan genomföra de behandlingar som Socialstyrelsen rekommenderar.
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| 6. |
- Almén, Niclas, 1971-, et al.
(författare)
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Effects of a Recovery-Focused Intervention for Stress Management : A Randomized Controlled Trial
- 2015
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Konferensbidrag (refereegranskat)abstract
- AbstractINTRODUCTIONStress symptoms, burnout, poor mental health and long-term sick leave related to these are major problems in Sweden and elsewhere. Evidence-based prevention and treatment efforts are lacking. Research indicates that stress related health problems primarily could be conceptualized as deficiencies in recovery responses between stress periods rather than high level of stress responses per se. Therefore it is relevant to examine whether it is effective to intervene the recovery behavior – instead of the stress behavior - of people with stress symptoms.OBJECTIVESThe primary purpose of this study was to investigate if a behavioral oriented recovery management intervention could enhance “recovery behaviors” and experiences of recovery and reduce stress related ill health.METHODS A group based intervention program focusing exclusively on “recovery behavior” in everyday life (earlier developed and tested in two pilot studies) was evaluated in an experimental group study. The intervention consisted of seven group sessions of 2.5 hours over a period of approximately 10 weeks supplemented by an internet based treatment support system. Self- referred subjects with scores above 24.4 on the Perceived stress scale were randomized to the intervention (n=26) or a waiting-list (n=33).RESUL TStatistically significant and clinically relevant effects were achieved for the intervention group compare to the waiting-list group: recovery behaviors and experiences of recovery were increased, and levels of perceived stress, worry, anxiety, depression and exhaustion were decreased.DISCUSSION These results are in line with two previous pilot studies that we have done. A behavioral and recovery oriented intervention seems to be effective to increase the recovery of the individual and decrease stress related ill health. There are reasons to continue to explore the potential of recovery-oriented interventions for example for different populations (such as people with more extensive clinical health problems) and in different contexts.
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| 7. |
- 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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| 8. |
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| 9. |
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| 10. |
- Almén, Niclas, 1971-, et al.
(författare)
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Recovery experiences effects of a recovery behaviour intervention for people with high levels of perceived stress : A randomized control trial
- 2018
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Konferensbidrag (refereegranskat)abstract
- Background: Stress problems could be conceptualized as deficiencies in recovery between periods of stress and research indicates that recovery from work stress and effort might be crucial for health and well-being. The purpose of this study was to evaluate the efficacy of a behaviorally oriented stress-recovery management intervention for people with high levels of perceived stress on different recovery experiences. Method: 73 individuals with high levels of perceived stress (>24.4 on Perceived Stress Scale) were randomly allocated to either a 10-week intervention group or a waiting list control group. Participants were assessed at pre-intervention, immediately after the intervention, and 3-month after the end of the intervention. The outcome measures were the four dimensions of the Recovery Experiences Questionnaire (REQ): relaxation, mastery, control and psychological detachment. For analysis the intention-to-treat principle was used.Results: Preliminary analysis indicated positive results on measurements of different recovery dimensions of this brief intervention.
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| 11. |
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| 12. |
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| 13. |
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| 14. |
- Almén, Niclas, 1971-, et al.
(författare)
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Stress-Recovery Management : A Pilot Study Using a Single-Subject Experimental Design
- 2020
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Ingår i: Behavior modification. - : SAGE Publications. - 0145-4455 .- 1552-4167. ; 44:3, s. 449-466
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Tidskriftsartikel (refereegranskat)abstract
- Work-related stress is considered one of the biggest health and safety challenges among the member states of the European Union. A critical factor is recovery between periods of stress. The primary purpose of this study was to investigate whether a brief behaviorally oriented stress-recovery management intervention delivered in an individual setting could reduce stress symptoms among individuals with high levels of perceived stress. A single-subject experimental design with multiple baselines across three individuals was used. The results indicate, with at least moderate experimental control, a temporal relation between the start of the intervention and beneficial changes from baseline in continuous self-recordings of stress symptoms. The changes were maintained at 1-year and 5-year follow-up assessments. Also, self-reporting inventories measuring perceived stress, worry, anxiety, depression, burnout, type A behavior, unwinding and recuperation from work stress, and insomnia showed overall changes in beneficial directions at post-assessment, as well as the two follow-up assessments. The results indicate that a behaviorally oriented stress-recovery management intervention delivered in an individual setting can reduce stress symptoms in individuals with high levels of perceived stress. However, for firm conclusions to be drawn, further research is needed.
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| 15. |
- Almén, Niclas, 1971-, et al.
(författare)
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The reliability and factorial validity of different versions of the Shirom-Melamed Burnout Measure/Questionnaire and normative data for a general Swedish sample
- 2021
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Ingår i: International Journal of Stress Management. - : American Psychological Association (APA). - 1072-5245 .- 1573-3424. ; 28:4, s. 314-325
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Tidskriftsartikel (refereegranskat)abstract
- Burnout is a common problem in many countries and is associated with psychological ill health, somatic diseases, mortality and long-term sick leave. Different versions of the Shirom-Melamed Burnout Questionnaire/Measure (SMBQ/SMBM) are widely used to measure burnout. Using confirmatory factor analysis, the main purpose of the present study was to empirically evaluate different Swedish versions of the SMBQ/SMBM. A questionnaire containing 23 SMBQ/SMBM-items was sent to 4,000 randomly selected individuals of which 765 with no missing data were included in the analyses. The well-used 4-factor SMBQ/SMBM-22 including the factors emotional and physiological exhaustion (EPE), cognitive weariness (CWE), listlessness (LIS), and tension (TES) and the 3-factor SMBQ/SMBM-18 (including the EPE, the CWE, and the LIS) reached good model fit after minor modifications. Two 2-factor models (based on 12 and 11 items, respectively), including the EPE and the CWE reached good model fit without any modifications. Even though there were some concerns regarding all models with respect to discriminant validity, the factors in all models showed evidence of good composite reliability (CR) and convergent validity. Lastly, a brief six-item version of the scale based on the 12-item version of the scale indicated an excellent model fit, and the composite score of the six-item scale correlated strongly with the composite scores from the others models, suggesting that the brief version could be used with advantage. In addition, based on the LIS, a new three-item scale that measures vitality is proposed. For all measures, normative data are reported.
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| 16. |
- Almén, Niclas, 1971-, et al.
(författare)
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The reliability and factorial validity of the Swedish version of the Recovery Experience Questionnaire
- 2018
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Ingår i: Nordic Psychology. - : Informa UK Limited. - 1901-2276 .- 1904-0016. ; 70:4, s. 324-333
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Tidskriftsartikel (refereegranskat)abstract
- Recent research has indicated that recovery from work stress and effort might be crucial for health and well-being. Thus, a valid measurement of recovery becomes important. The main purpose of the present study was to empirically evaluate and seeking support for the hypothesized four-factor model of the Swedish version of Recovery Experience Questionnaire (REQ). The total sample (N = 680) was randomly split into two subsamples. The first subsample was used for finding the best-fitting model using an exploratory factor analysis and the second subsample was used to test the a priori model using confirmatory factor analysis. The results support the proposed four-factor structure of the scale for both males and females. Additionally, apart from high reliability estimates, this instrument proved to have good convergent and discriminant validity for all four factors. Implications for the use of the REQ in conjunction with recovery-focused interventions were discussed, as were limitations such as low response rate.
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| 20. |
- Almén, Niclas, 1971-
(författare)
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Återhämtningsguiden : Må bra trots stress och press
- 2021. - 1
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Bok (populärvet., debatt m.m.)abstract
- Förmodligen ser återhämtningsbehovet ut ungefär som kostbehovet. Vi mår bäst av att äta då och då – några gånger per dag – snarare än att äta jättemycket en gång om dagen, eller bara på helgen … eller semestern.Stresshantering har tidigare mest handlat om att minska faktorer som leder till stress. Men många forskare är idag överens om att det inte är stressen i sig som orsakar ohälsa – utan bristen på återhämtning.Psykologen och forskaren Niclas Almén ger in sin bok många infallsvinklar på återhämtning. Han beskriver också ett program som stegvis och strukturerat vägleder dig i att förbättra din återhämtning i vardagen.Programmet leder till ökad både mental och fysisk pigghet, samtidigt som det minskar upplevd stress, irritabilitet, jäkt, oro, ångest, nedstämdhet och utmattning. Ditt välbefinnande har med andra ord goda chanser att öka om du följer råden! Boken riktar sig till dig som vill må bra, leva ett aktivt liv och prestera så bra som möjligt utan att behöva göra det omöjliga: ta bort all stress – vare sig om det är i förebyggande syfte eller om du har utvecklat utmattningsproblem.
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| 21. |
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| 22. |
- Nordenmark, Mikael, 1964-, et al.
(författare)
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Work/Family Conflict of More Importance than Psychosocial Working Conditions and Family Conditions for Mental Wellbeing
- 2020
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Ingår i: Societies. - : MDPI. - 2075-4698. ; 10:67, s. 1-15
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Tidskriftsartikel (refereegranskat)abstract
- Studies have indicated the importance of family life and psychosocial working conditions for mental wellbeing. More recently, studies have highlighted that a good balance between work and family is crucial for good mental wellbeing. However, few studies compare the relative importance of these factors for mental wellbeing. The main aim of this study was to analyse the relative importance of psychosocial working conditions, family conditions and work/family conflict for mental wellbeing. The analyses are based on a Swedish data set, including questions regarding working life, family life and mental wellbeing. A total of 12,461 married/cohabiting individuals employed in Swedish organisations were included in the study. Results show that psychosocial working conditions, family conditions and work/family conflict all were related to mental wellbeing. In the final regression model, the strongest correlation was found between mental wellbeing and the variables work/family conflict, satisfaction with private life and partner relationship, with work/family conflict appearing to be of greatest importance. These findings highlight the necessity of including measurements of work/family conflict when studying the importance of work and family conditions for individual mental wellbeing. For workplace health promotion and improvement, it may be beneficial to consider not only psychosocial working conditions, but also family conditions, and particularly work/life conflict
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