Advanced

A systematic review including meta-analysis of work environment and burnout symptoms

Aronsson, Gunnar; Theorell, Töres; Grape, Tom; Hammarström, Anne; Hogstedt, Christer; Marteinsdottir, Ina; Skoog, Ingmar; Träskman-Bendz, Lil LU and Hall, Charlotte (2017) In BMC Public Health 17(1).
Abstract

Background: Practitioners and decision makers in the medical and insurance systems need knowledge on the relationship between work exposures and burnout. Many burnout studies - original as well as reviews - restricted their analyses to emotional exhaustion or did not report results on cynicism, personal accomplishment or global burnout. To meet this need we carried out this review and meta-analyses with the aim to provide systematically graded evidence for associations between working conditions and near-future development of burnout symptoms. Methods: A wide range of work exposure factors was screened. Inclusion criteria were: 1) Study performed in Europe, North America, Australia and New Zealand 1990-2013. 2) Prospective or comparable... (More)

Background: Practitioners and decision makers in the medical and insurance systems need knowledge on the relationship between work exposures and burnout. Many burnout studies - original as well as reviews - restricted their analyses to emotional exhaustion or did not report results on cynicism, personal accomplishment or global burnout. To meet this need we carried out this review and meta-analyses with the aim to provide systematically graded evidence for associations between working conditions and near-future development of burnout symptoms. Methods: A wide range of work exposure factors was screened. Inclusion criteria were: 1) Study performed in Europe, North America, Australia and New Zealand 1990-2013. 2) Prospective or comparable case control design. 3) Assessments of exposure (work) and outcome at baseline and at least once again during follow up 1-5 years later. Twenty-five articles met the predefined relevance and quality criteria. The GRADE-system with its 4-grade evidence scale was used. Results: Most of the 25 studies focused emotional exhaustion, fewer cynicism and still fewer personal accomplishment. Moderately strong evidence (grade 3) was concluded for the association between job control and reduced emotional exhaustion and between low workplace support and increased emotional exhaustion. Limited evidence (grade 2) was found for the associations between workplace justice, demands, high work load, low reward, low supervisor support, low co-worker support, job insecurity and change in emotional exhaustion. Cynicism was associated with most of these work factors. Reduced personal accomplishment was only associated with low reward. There were few prospective studies with sufficient quality on adverse chemical, biological and physical factors and burnout. Conclusion: While high levels of job support and workplace justice were protective for emotional exhaustion, high demands, low job control, high work load, low reward and job insecurity increased the risk for developing exhaustion. Our approach with a wide range of work exposure factors analysed in relation to the separate dimensions of burnout expanded the knowledge of associations, evidence as well as research needs. The potential of organizational interventions is illustrated by the findings that burnout symptoms are strongly influenced by structural factors such as job demands, support and the possibility to exert control.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Burnout, Cynicism, Emotional exhaustion, GRADE system, Job control, Job demands, Meta-analyses, Personal accomplishment, Review, Social support
in
BMC Public Health
volume
17
issue
1
publisher
BioMed Central
external identifiers
  • scopus:85015153856
  • wos:000396680500005
ISSN
1471-2458
DOI
10.1186/s12889-017-4153-7
language
English
LU publication?
yes
id
e28a68ab-0f0b-4333-9c6e-df01c5462e3a
date added to LUP
2017-04-03 10:31:41
date last changed
2018-01-14 04:31:22
@article{e28a68ab-0f0b-4333-9c6e-df01c5462e3a,
  abstract     = {<p>Background: Practitioners and decision makers in the medical and insurance systems need knowledge on the relationship between work exposures and burnout. Many burnout studies - original as well as reviews - restricted their analyses to emotional exhaustion or did not report results on cynicism, personal accomplishment or global burnout. To meet this need we carried out this review and meta-analyses with the aim to provide systematically graded evidence for associations between working conditions and near-future development of burnout symptoms. Methods: A wide range of work exposure factors was screened. Inclusion criteria were: 1) Study performed in Europe, North America, Australia and New Zealand 1990-2013. 2) Prospective or comparable case control design. 3) Assessments of exposure (work) and outcome at baseline and at least once again during follow up 1-5 years later. Twenty-five articles met the predefined relevance and quality criteria. The GRADE-system with its 4-grade evidence scale was used. Results: Most of the 25 studies focused emotional exhaustion, fewer cynicism and still fewer personal accomplishment. Moderately strong evidence (grade 3) was concluded for the association between job control and reduced emotional exhaustion and between low workplace support and increased emotional exhaustion. Limited evidence (grade 2) was found for the associations between workplace justice, demands, high work load, low reward, low supervisor support, low co-worker support, job insecurity and change in emotional exhaustion. Cynicism was associated with most of these work factors. Reduced personal accomplishment was only associated with low reward. There were few prospective studies with sufficient quality on adverse chemical, biological and physical factors and burnout. Conclusion: While high levels of job support and workplace justice were protective for emotional exhaustion, high demands, low job control, high work load, low reward and job insecurity increased the risk for developing exhaustion. Our approach with a wide range of work exposure factors analysed in relation to the separate dimensions of burnout expanded the knowledge of associations, evidence as well as research needs. The potential of organizational interventions is illustrated by the findings that burnout symptoms are strongly influenced by structural factors such as job demands, support and the possibility to exert control.</p>},
  articleno    = {264},
  author       = {Aronsson, Gunnar and Theorell, Töres and Grape, Tom and Hammarström, Anne and Hogstedt, Christer and Marteinsdottir, Ina and Skoog, Ingmar and Träskman-Bendz, Lil and Hall, Charlotte},
  issn         = {1471-2458},
  keyword      = {Burnout,Cynicism,Emotional exhaustion,GRADE system,Job control,Job demands,Meta-analyses,Personal accomplishment,Review,Social support},
  language     = {eng},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {BMC Public Health},
  title        = {A systematic review including meta-analysis of work environment and burnout symptoms},
  url          = {http://dx.doi.org/10.1186/s12889-017-4153-7},
  volume       = {17},
  year         = {2017},
}