| 1. |
- Asberg, Marie, et al.
(författare)
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Novel biochemical markers of psychosocial stress in women.
- 2009
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 4:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Prolonged psychosocial stress is a condition assessed through self-reports. Here we aimed to identify biochemical markers for screening and early intervention in women. METHODS: Plasma concentrations of interleukin (IL) 1-alpha, IL1-beta, IL-2, IL-4, IL-6, IL-8, IL-10, interferon-gamma (INF-gamma), tumor necrosis factor-alpha (TNF-alpha), monocyte chemotactic protein-1 (MCP-1), epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), thyroid stimulating hormone (TSH), total tri-iodothyronine (TT3), total thyroxine (TT4), prolactin, and testosterone were measured in: 195 women on long-term sick-leave for a stress-related affective disorder, 45 women at risk for professional burnout, and 84 healthy women. RESULTS: We found significantly increased levels of MCP-1, VEGF and EGF in women exposed to prolonged psychosocial stress. Statistical analysis indicates that they independently associate with a significant risk for being classified as ill. CONCLUSIONS: MCP-1, EGF, and VEGF are potential markers for screening and early intervention in women under prolonged psychosocial stress.
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| 2. |
- Asp, Margareta, et al.
(författare)
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Trötthet, vila och sömn
- 2009. - 1:a
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Ingår i: Omvårdnadens grunder.. - Lund. - 9789144048765 ; , s. 417-487
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 3. |
- Ekstedt, Mirjam
(författare)
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Burnout and sleep
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to describe the physiological characteristics of sleep in persons with burnout and the relation between sleep and a number of physiological stress markers. The aim was also to evaluate the diurnal pattern of subjective sleepiness and fatigue across workday and weekend, and to describe the experiences of time preceding burnout from a life world perspective. This thesis focuses on burnout in white-collar workers; one group on sick-leave (I, II) and one with high burnout scores (pre-burnout) but still at work (III, IV). The Shirom- Melamed Burnout Questionnaire (SMBQ) was used for selection of participants with a mean of >4,75 on the total score (range 1-7) as upper limit and <2,5 as cut off for the two control groups. A combination of methods was used – interviews, sleep and wake diaries, questionnaires, blood and saliva samples, and polysomnograpic (EEG, EOG, EMG) measures of sleep. The analyses included; t tests, χ2, analysis of variance, ANOVA, and covariance, ANCOVA, correlations, Pearson’s r, stepwise regression analyses (study II-IV), and phenomenological analysis (study I). Study I describes the complex interaction between the person and his/her life world during the process of burning out. Study II evaluated whether subjective sleep complaints in burnout individuals on sick leave was related to disturbed sleep architecture and impaired homeostatic processes. Physiological and subjective aspects of sleep before a workday and a day off were investigated in study III. The diurnal pattern of sleepiness on workday and weekend was evaluated in study II and III, and the diurnal pattern of mental fatigue was evaluated in study II as well as occupational fatigue. Additionally, the burnout groups (II III) were described with respect to work stress, mood, recovery and burnout related variables. Study IV was a correlation study where the relation between sleep fragmentation and a number of physiological stress parameters, as well as possible predictors in daily life was evaluated. The most important finding is that sleep was impaired on all essential sleep variables in the burnout group on sick-leave (II). In the pre-burnout group (III) the main findings was an increased frequency of arousals, and the relatively moderate sleep fragmentation was related to a number of risk factors for CVD and the metabolic syndrome (IV). Also unclear boundaries between work and leisure time and tension/irritability were associated with the sleep fragmentation. The burnout group on sick leave was sleepier than the controls for most point in time, with levels comparable to night or early morning shifts, and mental fatigue was equally elevated (except for weekday evenings). The pattern of sleepiness and mental fatigue was consistent across days. The high and low burnout groups were equally sleepy during workdays but differed during days off, indicating impaired recovery in the high burnout group. The time preceding burnout (I) was experienced as being trapped between never-ending demands on the one hand and stimulating challenges on the other. “Cutting off” important areas of life enhanced the strong focus on responsibilities, protected their ‘self-images’ and impeded sleep and recovery. Acceptance of the situation was the turning point from where a new reconstruction of life could emerge. These findings suggest that sleep disruptions and impaired recovery seem to be characteristics of burnout, resulting in fatigue, and that inability to unwind the stress system may be a mediating factor. With this knowledge interventions for sleep improvement on company or population level seems important, and effective treatment of sleep disorders in order to prevent or relieve burnout is needed, as is a deeper understanding of how fatigue is experienced in health and illness.
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| 4. |
- Ekstedt, Mirjam, et al.
(författare)
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Disturbed sleep and fatigue in occupational burnout
- 2006
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 32:2, s. 121-31
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The purpose of this study was to investigate sleep with polysomnography and self-ratings and the diurnal pattern of sleepiness and fatigue in a group suffering from severe occupational burnout.METHOD: Twelve white-collar workers on long-term sick leave (>3 months) and 12 healthy controls with high and low scores on the Shirom Melamed Burnout Questionnaire (SMBQ) were included. A 1-night polysomnographic recording (after habituation) was carried out at home, and sleepiness and mental fatigue were rated at different times of the day for weekdays and the weekend. Precipitating factors at the time of the illness at work and real life were considered, and different dimensions of occupational fatigue were described. A repeated-measures analysis of variance using two or three within group factors was used to analyze the data.RESULTS: The main polysomnographic findings were more arousals and sleep fragmentation, more wake time and stage-1 sleep, lower sleep efficiency, less slow wave sleep and rapid eye movement sleep, and a lower delta power density in non-rapid eye movement sleep in the burnout group. The burnout patients showed pronounced sleepiness and mental fatigue at most times of the day for weekdays without reduction during weekends. The precipitating factor was occupational stress (psychiatric interview), and work stress indicators were increased.CONCLUSIONS: Occupational burnout is characterized by impaired sleep. It is suggested that impaired sleep may play a role in the development of fatigue or exhaustion in burnout.
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| 5. |
- Ekstedt, Mirjam, et al.
(författare)
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Lived experiences of the time preceding burnout
- 2005
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 49:1, s. 59-67
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This paper reports a study to illuminate the complex interaction between person and their life world during the burnout development period.BACKGROUND: Burnout is a construct describing the psychological state resulting from ineffective strategies for coping with enduring stress in both client and non-client work. Role conflict and role ambiguity, or long-term stress and frustration caused by strain in daily life, promote or exacerbate burnout, indicating that the person's entire life world is involved. There is still a lack of description of lived experiences of the time preceding manifest burnout.METHOD: Data were collected from interviews with eight people suffering from burnout and analysed using a phenomenological method.FINDINGS: The essential meaning of the phenomenon of burnout is understood as being trapped with stimulating challenges as a self-nourishing drive on one side and with responsibilities and demands on the other. This essence can be illuminated by its eight constituents: inner incentive, feeling responsible, threatened self-image, cutting off, bodily manifestations, psychological manifestations, fatigue and reaching the bottom line.CONCLUSIONS: The lived experiences of the time preceding manifest burnout are an ambiguous struggle. Cutting off is understood as a mean to shelter the threatened self-image in a state of vulnerability and weakened strength. Accordingly, a better understanding of how to reach behind the defence of 'cutting off' and thus help to open up for consolation and self-acceptance is an essential skill for nurses, health care professionals and others encountering the burnout sufferers. Furthermore this study illuminates early signs of burnout and an important issue is how to strengthen the individuals' ability to shelter their need for recovery and restitution.
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| 6. |
- Ekstedt, Mirjam, et al.
(författare)
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Sleep physiology in recovery from burnout
- 2009
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Ingår i: Biological Psychology. - : Elsevier BV. - 0301-0511 .- 1873-6246. ; 82:3, s. 267-73
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to investigate the role of sleep physiology in recovery from burnout, in particular the relation between sleep and changes in fatigue and whether those changes would be related to return to work. 23 white-collar workers on long-term sick leave (>3 months) due to a burnout related diagnosis and 16 healthy controls were subjected to polysomnographic recordings at baseline and after 6-12 months' rehabilitation. Occupational status, subjective sleep quality, fatigue, anxiety and depression were assessed. Recovery from burnout was accompanied by improved sleep continuity. Significant interaction effects were seen for number of arousals, sleep fragmentation, sleep latency, sleep efficiency and time of rising. The burnout group improved significantly on all symptom variables although the post-treatment levels did not reach the levels of the controls. Recovery from fatigue was related to a reduction of the arousal from sleep and was the best predictor of return to work.
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| 7. |
- Grossi, Giorgio, et al.
(författare)
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The morning salivary cortisol response in burnout.
- 2005
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Ingår i: Journal of Psychosomatic Research. - : Elsevier. - 0022-3999 .- 1879-1360. ; 59:2, s. 103-111
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Tidskriftsartikel (refereegranskat)abstract
- The results of the present study indicate a dysregulation in hypothalamic-pituitary-adrenocortical axis (HPA axis) activity, characterised by elevated morning salivary cortisol levels, among female burnout patients. Among males, increased cortisol levels were observed among participants with moderate levels of burnout, but not among patients or healthy controls.
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| 8. |
- Söderström, Marie, et al.
(författare)
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Weekday and weekend patterns of diurnal cortisol, activation and fatigue among people scoring high for burnout
- 2006
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Ingår i: SJWEH Supplements. - 1795-9926 .- 1795-9918. ; :2, s. 35-40:2, s. 35-40
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The present pilot study attempted to investigate the diurnal pattern of cortisol, subjective activation, and mental fatigue among workers scoring high for burnout. The purpose was also to relate the cortisol data to objective sleep data.Methods One group with high (N=9) burnout scores and one with low (N=11) such scores were compared during a workday and a day off.Results The high-burnout group showed higher awakening cortisol during the workday than during the weekend. They also showed higher ratings for activation and mental fatigue during the weekend than the low-burnout group. A higher frequency of arousals during the prior sleep was associated with a higher diurnal amplitude and an earlier diurnal peak of cortisol during the workday.Conclusions The present results, which, due to the small sample size, should be interpreted with caution, may indicate that stress-induced frequency of arousal during sleep could contribute to the diurnal amplitude of cortisol. Furthermore, increased activation and mental fatigue during the weekend may reflect impaired recovery, which is of possible importance in the burnout process.
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