Exploring experiences with stressors and coping resources among Dutch socioeconomic groups during the COVID-19 pandemic.

The COVID-19 crisis impacts populations globally. This impact seems to differ for groups with low- and high-socioeconomic status (SES). We conducted a qualitative study in the Netherlands using a salutogenic perspective to examine experiences with stressors and coping resources during the pandemic among both SES groups to gain insight on how to promote the health and well-being of these groups. We conducted 10 focus group discussions and 20 interviews to explore the experiences, including resources and stressors, of respondents from low- (N = 37) and high-SES (N = 38) groups (25-55 years, Dutch speaking). We analyzed the findings at individual, community, and national levels. The results show that coping depends on government-imposed measures and the way individuals handle these measures; restriction to the home context with positive and negative consequences for work and leisure; psychological negative consequences and resourcefulness; and social effects related to unity (e.g. social cohesion or support) and division (including polarization). Respondents with lower SES expressed more problems with COVID-19 measures and experienced more social impact in their neighborhood than those with higher SES. Where low-SES groups especially mentioned the effects of staying at home on family life, high-SES groups mentioned effects on work life. At last, psychological consequences seem to differ somewhat across SES groups. Recommendations include consistent government-imposed measures and government communication, support for home schooling children, and strengthening the social fabric of neighborhoods.

Developing an Intervention and Evaluation Model of Outdoor Therapy for Employee Burnout: Unraveling the Interplay Between Context, Processes, and Outcomes.

Background: Burnout is a major societal issue adversely affecting employees' health and performance, which over time results in high sick leave costs for organizations. Traditional rehabilitation therapies show suboptimal effects on reducing burnout and the return-to-work process. Based on the health-promoting effects of nature, taking clients outdoors into nature is increasingly being used as a complementary approach to traditional therapies, and evidence of their effectiveness is growing. Theories explaining how the combination of general psychological support and outdoor-specific elements can trigger the rehabilitation process in outdoor therapy are often lacking, however, impeding its systematic research. Aim: The study aims to develop an intervention and evaluation model for outdoor therapy to understand and empirically evaluate whether and how such an outdoor intervention may work for rehabilitation after burnout. Methodological Approach: We build on the exemplary case of an outdoor intervention for rehabilitation after burnout, developed by outdoor clinical psychologists in Netherlands. We combined the generic context, process, and outcome evaluation model and the burnout recovery model as an overarching deductive frame. We then inductively specified the intervention and evaluation model of outdoor therapy, building on the following qualitative data: semi-structured interviews with outdoor clinical psychologists and former clients; a content analysis of the intervention protocol; and reflective meetings with the intervention developers and health promotion experts. Results: We identified six key outdoor intervention elements: (1) physical activity; (2) reconnecting body and mind; (3) nature metaphors; (4) creating relationships; (5) observing natural interactions; and (6) experiential learning. The results further showed that the implementation of these elements may facilitate the rehabilitation process after burnout in which proximal, intermediate, and distal outcomes emerge. Finally, the results suggested that this implementation process depends on the context of the therapist (e.g., number of clients per day), therapy (e.g., privacy issues), and of the clients (e.g., affinity to nature). Conclusion: The intervention and evaluation model for outdoor therapy shows how key outdoor intervention elements may contribute to the rehabilitation process after burnout. However, our model needs to be further tested among a larger group of clients to empirically evaluate whether and how outdoor therapy can support rehabilitation.

The Role of Off-Job Crafting in Burnout Prevention during COVID-19 Crisis: A Longitudinal Study.

The COVID-19 pandemic and remote working challenge employees' possibilities to recover from work during their off-job time. We examined the relationship between off-job crafting and burnout across the COVID-19 crisis. We used a longitudinal research design, comprising one wave collected before the onset of the pandemic, in March 2019 (T1), and one wave collected during the first lockdown of the crisis in April 2020 (T2). We measured the six off-job crafting dimensions (Crafting for Detachment, Relaxation, Autonomy, Mastery, Meaning, and Affiliation) and burnout (fatigue/exhaustion) via a questionnaire among German and Swiss employees (N = 658; Age M = 47; 55% male). We found that both burnout levels and crafting for affiliation significantly decreased at T2 compared to T1. All off-job crafting dimensions and burnout correlated negatively cross-sectionally and longitudinally. Regression analyses showed that employees who crafted in their off-job time before and during the crisis experienced fewer burnout complaints during the crisis. Looking more closely at the subdimensions of off-job crafting, employees who crafted for detachment before and during, and for affiliation before the crisis, reported less burnout during the crisis. We conclude that off-job crafting may act as a buffer mechanism against burnout during the COVID-19 crisis.

Socioeconomic status and mental health during the COVID-19 crisis: Are sense of coherence, sense of community coherence and sense of national coherence predictors for mental health?

BACKGROUND: Evidence about the impact of the COVID-19 pandemic on existing health inequalities is emerging. This study explored differences in mental health, sense of coherence (SOC), sense of community coherence (SOCC), sense of national coherence (SONC), and social support between low and high socioeconomic (SES) groups, and the predictive value of these predictors for mental health. PARTICIPANTS AND PROCEDURE: A cross-sectional study was conducted using an online survey in the Netherlands in October 2021, comprising a total of 91 respondents (n = 41, low SES; n = 50, high SES). RESULTS: There were no differences in mental health, SOC, SOCC, SONC, and social support between the groups. SOC was a predictor for mental health in both groups and SOCC for the low SES group. CONCLUSIONS: We found that both SOC and SOCC predict mental health during the pandemic. In the article we reflect on possible pathways for strengthening these resources for mental health.

Seizing and realizing the opportunity: A salutogenic perspective on rehabilitation after burnout.

BACKGROUND: Most research on burnout has focused on its antecedents, correlates, and consequences. However, little empirical attention has been paid to what constitutes successful rehabilitation after burnout, especially among young employees. OBJECTIVE: The present study empirically examined resources supporting successful rehabilitation after burnout among young employees (between 18 and 35 years of age) from a salutogenic perspective. METHODS: Interpretative phenomenological analysis was used as a methodological framework to explain the experiences of young employees underlying their rehabilitation after burnout. RESULTS: The analysis showed that the rehabilitation process comprises four phases: 1) facing the crisis; 2) addressing the root causes; 3) seizing and achieving the opportunity; and 4) staying at work. Essential overarching resources facilitating successful recovery after burnout included receiving social support from family, friends, and colleagues, as well as having a feeling of control over the rehabilitation process. Participants learned to be aware of potential pitfalls that could trigger burnout symptoms, while having confidence in their ability to prevent burnout from reoccurring. These continuous learning processes were experienced as a prerequisite to remain at work. CONCLUSIONS: Receiving social support and experiencing a feeling of control over the rehabilitation process appear to be key resources in facilitating a stable, meaningful return to work after burnout.

The Relationship Between Individual, Social And National Coping Resources And Mental Health During The Covid-19 Pandemic In The Netherlands.

BACKGROUND: The COVID-19 pandemic has a potential negative impact on mental health. Adopting the salutogenic model of health, this study examined the predictive value of personal (sense of coherence), social (social support, trust in institutions), and national (sense of national coherence) resources for mental health in the Netherlands during the COVID-19 pandemic. PARTICIPANTS AND PROCEDURE: An online survey was administered in the Netherlands (N = 622) in April 2020. A multiple regression analysis was performed to test the predictive value of the resources for mental health. RESULTS: Mental health was significantly predicted by the sense of coherence, social support and sense of national coherence, but not by trust in institutions. The results showed that personal and social resources were most strongly related to mental health. CONCLUSIONS: The results suggest that mental health is predicted by various resources. Hence, strengthening resources seems vital in promoting mental health in times of crisis.

Combined Interventions to Reduce Burnout Complaints and Promote Return to Work: A Systematic Review of Effectiveness and Mediators of Change.

Burnout has adverse effects on the health and work-related outcomes of employees. Nevertheless, little is known about effective ways of reducing burnout complaints and facilitating full return to work, which defines rehabilitation. This study consists of a systematic review of the effects of combined interventions (i.e., both person-directed and organization-directed). It also includes the identification and description of mediators of change, thereby explaining how combined interventions do or do not work. Seven electronic databases were searched for English peer-reviewed publications: the Psychology and Behavioral Sciences Collection; PsycARTICLES; Web of Science; Scopus; SocINDEX; PubMed; and PsycINFO, using various combinations of search terms (e.g., burnout AND intervention). Out of 4110 abstracts published before 29 September, 2019, 10 studies (reporting the effects of nine combined interventions) fulfilled the inclusion criteria, which were defined using PICOS criteria (participants, interventions, comparators, outcomes and study design). Although the risk of bias of the included studies is high, all combined interventions were effective in facilitating rehabilitation. Results suggest that involving employees in decision-making and enhance their job control and social support, while eliminating stressors, explain the effectiveness of the intentions. With caution, workplace health promotion practitioners are encouraged to use these findings to tackle burnout among employees.

A Salutogenic Approach to Understanding the Potential of Green Programs for the Rehabilitation of Young Employees With Burnout: Protocol for a Mixed Method Study on Effectiveness and Effective Elements.

BACKGROUND: Burnout is the leading cause of absenteeism in the Netherlands, with associated sick leave costs amounting to around €1.8 billion. Studies have indicated that burnout complaints increased from almost 14.4% in 2014 to 17.3% in 2018, especially among employees between the ages of 18 and 35 years, and further increases are expected. Although there are many published articles on burnout, not much is known about what constitutes effective rehabilitation (ie, the reduction of burnout complaints and the facilitation of returning to work). At the same time, multiple pilot studies have indicated that green programs are effective in both reducing burnout complaints and facilitating return to work. Green programs have been developed by professionals experienced in using the natural environment to facilitate rehabilitation (eg, through green exercise and healing gardens). The literature nevertheless lacks comprehensive and contextual insight into what works and why. OBJECTIVE: The overarching aim of this study is to explore the potential of green programs for young employees with burnout. We present the study protocol from an ongoing research project consisting of 2 phases, each composed of 2 research objectives that sequentially build upon each other. METHODS: The study is based on a sequential design with 4 research objectives, using both qualitative and quantitative research methods. In the first phase, a systematic literature review (research objective 1) and in-depth interviews (research objective 2) will be used to explore mechanisms underlying the rehabilitation of young employees with burnout. In the second phase, a multicase study will be conducted to examine the extent to which green programs are built on mechanisms identified in the first phase (research objective 3). By employing a pretest and posttest design, a specific green program that captures most of those mechanisms will then be evaluated on its effect and process with regard to the rehabilitation of young employees with burnout (research objective 4). The project started in June 2018 and will continue through June 2022. RESULTS: The first phase (research objectives 1 and 2) is intended to generate information on the mechanisms underlying the rehabilitation of young employees with burnout. The second phase (research objectives 3 and 4) is designed to demonstrate the extent to which and how the selected green program facilitates the rehabilitation of young employees with burnout. CONCLUSIONS: Understanding how green programs can facilitate the rehabilitation of young employees with burnout complaints can help to address this societal issue. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/15303.

Unravelling salutogenic mechanisms in the workplace: the role of learning / Descifrando los mecanismos salutogénicos en el lugar de trabajo: el papel del aprendizaje

Objective: To explore the moderating and mediating role(s) of learning within the relationship between sense of coherence (SOC) and generalized resistance resources. Method: Cross-sectional study (N=481), using a self-administered questionnaire, of employees working in the healthcare sector in the Netherlands in 2017. Four residential healthcare settings and one healthcare-related Facebook group were involved. Multiple linear regression models were used to test for moderating and mediating effects of learning. Results: Social relations, task significance, and job control significantly explained variance in SOC. Conceptual, social, and instrumental learning, combined, moderated the relationship between SOC and task significance. Instrumental learning moderated the relationship between job control and SOC. Social learning also mediated this relationship. Conceptual learning did not show any moderating or mediating effect. Conclusions: The relationship between SOC and the three GRRs seems to be strengthened or explained−to a certain extent−by instrumental and social learning. Healthcare organizations are recommended to promote learning through formal activities as well as through cooperation, feedback, sharing experiences, and job challenges. This requires employee participation and a multilevel interdisciplinary approach

Objetivo: Explorar el rol del aprendizaje conceptual, instrumental y social en la relación entre el sentido de la coherencia (SC) y los recursos generales de resistencia (RGR) clave. Métodos: Se realizó un estudio transversal en 2017 (N=481) a profesionales del sector sanitario en Holanda mediante un cuestionario autoadministrado. Participaron cuatro centros de residencia geriátrica, así como un grupo de profesionales de salud de la red social de Facebook. Se utilizaron modelos de regresión lineal múltiple para evaluar los efectos de los roles de moderación y mediación del aprendizaje. Resultados: Las relaciones sociales, el significado de las tareas y el control del trabajo explicaron de manera significativa la varianza en el SC. La combinación del aprendizaje conceptual, instrumental y social moderó la relación entre el SC y el significado de las tareas. El aprendizaje instrumental moderó la relación entre el control del trabajo y el SC. El aprendizaje social también medió en esta relación. Sin embargo, el aprendizaje conceptual no mostró ningún efecto moderador ni mediador. Conclusiones: La relación entre el SC y estos tres RGR parece verse fortalecida o explicada, en cierta medida, por el aprendizaje instrumental y social. Se recomienda a las organizaciones sanitarias promover el aprendizaje a través de actividades formales, así como mediante la cooperación, comentarios, intercambio de experiencias y desafíos laborales. Esto requiere la participación del profesional, así como una cooperación multidisciplinaria y a distintos niveles

Unravelling salutogenic mechanisms in the workplace: the role of learning.

OBJECTIVE: To explore the moderating and mediating role(s) of learning within the relationship between sense of coherence (SOC) and generalized resistance resources. METHOD: Cross-sectional study (N=481), using a self-administered questionnaire, of employees working in the healthcare sector in the Netherlands in 2017. Four residential healthcare settings and one healthcare-related Facebook group were involved. Multiple linear regression models were used to test for moderating and mediating effects of learning. RESULTS: Social relations, task significance, and job control significantly explained variance in SOC. Conceptual, social, and instrumental learning, combined, moderated the relationship between SOC and task significance. Instrumental learning moderated the relationship between job control and SOC. Social learning also mediated this relationship. Conceptual learning did not show any moderating or mediating effect. CONCLUSIONS: The relationship between SOC and the three GRRs seems to be strengthened or explained-to a certain extent-by instrumental and social learning. Healthcare organizations are recommended to promote learning through formal activities as well as through cooperation, feedback, sharing experiences, and job challenges. This requires employee participation and a multilevel interdisciplinary approach.