Overindebtedness, unemployment, and poor mental health - and the role of sense of control: a population-based Swiss study.

Background: Both overindebtedness and unemployment are critical life events that can result in or lead to poor mental health. What is less known is that the two partly interrelated events frequently go along with a feeling of loss or lack of control in life, which could be the main reason why they are associated with poor mental health. This has not been examined in previous research, particularly not in this combination. Methods: This study used and merged two cross-sectional data sets. Data collected in 2019 on 219 overindebted clients of the four official debt advisory centers in the Canton of Zurich were linked with a comparable subsample of 1,997 respondents from the Swiss Health Survey of 2017. The entire study population covered 2,216 adult individuals living in the Canton of Zurich. Results: The prevalence of no or low sense of control, medium to high psychological distress, and moderate to major depression was much higher among the 44 solely unemployed (36/30/12%), the 189 solely overindebted (73/83/53%), and particularly among the 30 unemployed and overindebted (93/97/60%) than among all 1,953 other survey participants (21/13/7%). Unemployment, overindebtedness, and a (resulting) lack or loss of control were all found to be strong risk factors for the two mental health outcomes under study. Associations, or rather negative health effects, were partly but not fully mediated by the sense of control. Overindebtedness much more strongly predicted psychological distress (ß = -0.37) and depression (ß = 0.17) than unemployment (ß = -0.05/0.01). The sense of control turned out to be an independent explanatory factor for poor mental health and even the strongest of all (ß = 0.49/-0.59). Conclusion: Improving a person's control beliefs could be a promising measure for preventing mental health disorders in general and in people who are unemployed and/or overindebted in particular.

Burnout and Disengagement at Work Among Health Professionals-Interrelations and Associations With Stress Indicators and Job Resources.

OBJECTIVE: The aim of the study is to explore common risk and protective factors of burnout and disengagement at work among healthcare workers. METHODS: Cross-sectional survey data of 1232 health professionals and employees of five public hospitals and rehabilitation clinics collected in 2015/16 in German-speaking Switzerland were used and analyzed. Different stress measures and job resources were studied as predictors of burnout and work engagement. RESULTS: Burnout was found to be largely explained by work stress (ß = 0.22) and particularly by general stress (ß = 0.54) whereas work engagement was only marginally determined by these stress indicators. Job autonomy or supervisor support on the other hand had no protective effect on burnout at all but a fairly strong predictive effect on work engagement (ß = 0.27/0.23). CONCLUSION: Burnout turned out to be mainly stress-induced whereas work engagement emerged largely as a result of job autonomy and supervisor support.

Quitting one's job or leaving one's profession: unexplored consequences of workplace violence and discrimination against health professionals.

BACKGROUND: Although workplace violence and discrimination against healthcare workers are global and universal phenomena, and violence at work is recognized as a serious and growing problem, in Switzerland, hardly anything is known about the related consequences on job changes and career endings, which are two major staffing challenges present in the notoriously understaffed healthcare sector. METHOD: Data collected from a written survey conducted among 1,840 hospital employees, of which 1,441 were health professionals, were used to evaluate and estimate the prevalence and impact of specific and cumulated forms of workplace violence and discrimination on the work climate and particularly on subsequent turnover intentions and career endings. Established multi- and single-item measures were used as predicting, intervening and outcome variables. Relative frequencies stratified for nurses, physicians and therapists were calculated to estimate and differentiate the size of the phenomena under study. Furthermore, crosstabulations, as well as multivariate regression analyses, were performed to explore the associations of interest. RESULTS: Every fifth to sixth nurse and every seventh to eighth physician reported having had intentions to change jobs or leave the profession within the past year. These intentions become much more prevalent across all health professions when one or even two or more different forms of violence and/or discrimination at work are experienced and reported. Accordingly, the relative risks for intending to quit one's job or leave one's profession increase significantly and steadily with a growing number (1, 2 +) of different experienced forms of violence and/or discrimination at work compared to the reference group of those who are nonaffected (aOR from 2.5 up to 5.4). This fairly strong association was only slightly reduced (aOR from 2.1 to 4.0) when work climate was additionally taken into account as a potential intervening variable. Although work climate only partly accounted for the association under study, a poor work climate was an additional strong predictor and independent risk factor for intentions to turnover (aOR = 6.4) or leave the profession (aOR = 4.2). CONCLUSIONS: Experiences of workplace violence and discrimination and the resulting poor work climate both together and independent of each other seem to be important causes of job changes and career endings among healthcare workers in Switzerland.

Determinants and changes in adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer-prevention recommendations over the past 25†years in Switzerland.

OBJECTIVES: The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) established 10 lifestyle recommendations for cancer prevention. The current study examines the proportion and changes over 25 years of adherence to these recommendations and their determinants in Switzerland. METHODS: On the basis of six Swiss Health Surveys (1992-2017, N = 110 478), an index reflecting adherence to the 2018 WCRF/AICR cancer-prevention recommendations was created. Multinomial logistic regression models were fitted to investigate changes over time and determinants of a cancer-protective lifestyle. RESULTS: Adherence to cancer-prevention recommendations was moderate and higher in the years 1997-2017 compared to 1992. Higher adherence was observed among women (odds ratio [OR]high vs. low adherence ranging from 3.31 to 3.74) and participants with a tertiary education level (ORhigh vs. low adherence ranging from 1.71 to 2.18), and lower adherence among participants of the oldest age group (ORhigh vs. low adherence ranging from 0.28 to 0.44) and participants of the Switzerland (lat.: Confoederatio helvetica)-French language regions (ORhigh vs. low adherence ranging from 0.53 to 0.73). CONCLUSION: Our results showed that cancer-prevention recommendations are not well followed by the general Swiss population, as the adherence to a cancer-protective lifestyle was generally moderate; however, adherence to cancer-prevention recommendations improved over the past 25 years. Sex, age group, education level, and language regions were significant determinants of adherence to a cancer-protective lifestyle. Further actions at the governmental and individual levels promoting the adoption of a cancer-protective lifestyle are needed.

Work Related Demands and Resources as Predictors of Well-being at Work Among Healthcare Workers in Switzerland.

OBJECTIVE: The aim was to examine the effects of work-related demands and resources on well-being at work among employees in Swiss hospitals. METHODS: Self-reported survey data from 1840 employees of six hospitals/clinics were analyzed using multivariate linear regression analyses (all professions included). RESULTS: Of all demands, work-life imbalance had the strongest negative effect on well-being at work. The most relevant resource varied depending on the dimension of well-being: for job satisfaction it was good leadership, for work engagement job decision latitude and for satisfaction with relationships at work social support at work. The resources were more relevant for well-being at work than the demands. They also buffered against the negative effects of the demands. CONCLUSIONS: To enhance well-being at work in hospitals, it is necessary to enable a good work-life balance and to strengthen work-related resources.

Over-indebtedness and health in Switzerland: A cross-sectional study comparing over-indebted individuals and the general population.

BACKGROUND: Previous international studies have shown that over-indebtedness is associated with poor health. However, in Switzerland research addressing over-indebtedness is widely lacking, strongly needed and particularly important because it is evidently a rising but still commonly tabooed, socially "undesired" and highly stigmatized phenomenon that is rarely discussed and largely ignored and unexplored. METHODS: A cross-sectional survey was conducted among over-indebted adults seeking advice from one of the four official debt advisory centers in the Canton of Zurich. The survey finally included 219 respondents participating voluntarily and anonymously. This sample was then linked with a comparable subsample of the nationally representative Swiss Health Survey of 2017, namely 1,997 respondents of the same age from the Canton of Zurich. For reasons of comparability identical health questions and measures were taken from the Swiss Health Survey and used in the over-indebtedness survey. The pooled or combined dataset covered a total of 2,216 adult individuals. RESULTS: Remarkably high prevalence rates and relative risks of poor self-rated health, severe musculoskeletal and sleep disorders and moderate to severe depression were observed among over-indebted individuals compared to the general population. More than 50% of the over-indebted individuals had poor general health or moderate to severe depression compared to the general population with 14% and 7%, respectively. And far above one third of the over-indebted but 'only' between 6% and 8% of the general population showed severe musculoskeletal disorders and sleep disorders. Even after adjustment for various control variables and covariates, over-indebtedness increased the odds ratios for poor health outcomes consistently and dramatically, i.e. by a factor of 8 and more (aOR = 8.5-11.6). CONCLUSIONS: Over-indebtedness in Switzerland has particularly negative effects on various aspects of the health of the persons concerned, irrespective of their demographic characteristics and their social and employment status.

Over-indebtedness, mastery and mental health: a cross-sectional study among over-indebted adults in Switzerland.

OBJECTIVES: The aim is to investigate whether and why over-indebted individuals in German-speaking Switzerland have poorer mental health than the general population. METHODS: A cross-sectional study among over-indebted people in the canton of Zurich was conducted in 2019. The study population (n = 219) was compared to the cantonal subsample of the general adult population selected from the nationally representative sample of the Swiss Health Survey 2017 (n = 1,997). Bivariate and multivariate statistical analyses were used to examine associations between over-indebtedness, mastery and health outcomes like mental stress and depression. RESULTS: Over-indebted people have poorer mental health and weaker mastery than the general population. Low mastery is the strongest predictor of poor mental health (beta coefficient = 0.58/-0.62 for mental stress/depression respectively) among the over-indebted, followed by the perception of one's health being affected by over-indebtedness (beta coefficient = -0.19/0.15). The amount of debt, anticipated time until repayment of debt and duration of indebtedness had no predictive effects. CONCLUSION: Surprisingly, traditional debt parameters cannot explain the poor mental health of the over-indebted, in contrast to a strong sense of mastery, which was identified as a highly protective factor.

Prevalence and health correlates of workplace violence and discrimination against hospital employees - a cross-sectional study in German-speaking Switzerland.

BACKGROUND: Violence and discrimination are common events at work, especially in health care. Moreover, such workplace experiences are considered to have negative impacts and particularly adverse health consequences on health care workers. Nevertheless, the problem is still highly underreported and thus largely ignored and unexplored in Switzerland as comprehensive data and studies on their prevalence and health correlates among hospital staffs and health professionals are widely missing. METHODS: This cross-sectional study was based on secondary data from a company survey among several public hospitals and rehabilitation clinics in German-speaking Switzerland conducted in 2015/16. The study population was limited to a subsample of 1567 health professionals among the surveyed staffs of five participating hospitals and clinics. Relative frequencies of different forms of violence and discrimination at work and the total number of such experiences were calculated for the entire study population and for occupational subgroups. These data were compared with a nationally representative subsample of the Swiss Health Survey 2017 as a reference population. Multiple logistic regression analyses were further computed to investigate the association between the number of different experienced forms of violence and/or discrimination at work and several poor general and mental health outcomes. RESULTS: 23% of the inverviewed hospital employees experienced at least one form of discrimination or violence at work in the past year, compared to 18% of the general working population. Nurses were by far the most affected occupational group regarding all forms of violence. More and particularly the most exposed and affected hospital employees with regard to experiences of violence and/or discrimination at work showed almost consistently increased frequencies and relative risks for the studied poor mental and general health outcomes. Prevalence rates and odds ratios for strong sleep disorders, strong stress feelings and increased burnout symptoms were between 3 and 4 times higher among the most exposed compared to the non-exposed group of hospital employees. CONCLUSIONS: Study findings underline the importance of an active combat against violent and discriminatory behaviors in health care. Prevention strategies should particularly focus on nurses and midwives, which turned out to be the most affected and exposed group of all health professions.

Stress-Buffering and Health-Protective Effect of Job Autonomy, Good Working Climate, and Social Support at Work Among Health Care Workers in Switzerland.

OBJECTIVE: The relationship between work stress, job resources, and health has not yet been investigated among health professionals in Switzerland. METHODS: Cross-sectional survey data, collected among hospital employees in German-speaking Switzerland, have been used for this study. Established measures were used to assess work stress as the main predictor and self-rated health and work-related burnout as the outcome variables. Validated measures for job autonomy, work climate, and social support at work were used as intervening variables. RESULTS: The studied job resources were all found to be quite strongly and negatively associated with the two health outcomes but only partly explained and reduced the extraordinary strong positive association and clear dose-response relationship between work stress and poor self-rated health or burnout. CONCLUSION: Job resources like these cannot completely prevent health professionals from negative health-related consequences of work stress.

Social mixing and risk exposures for SARS-CoV-2 infections in elderly persons.

AIMS OF THE STUDY: During the transitional phase between the two pandemic waves of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), infection rates were temporarily rising among younger persons only. However, following a temporal delay infections started to expand to older age groups. A comprehensive understanding of such transmission dynamics will be key for managing the pandemic in the time to come and to anticipate future developments. The present study thus extends the scope of previous SARS-CoV-2-related research in Switzerland by contributing to deeper insight into the potential impact of “social mixing” of different age groups on the spread of SARS-CoV-2 infections. METHODS: The present study examined persons aged 65 years and older with respect to possible SARS-CoV-2 exposure risks using longitudinal panel data from the Swiss COVID-19 Social Monitor. The study used data from two assessments (survey “May” and survey “August”). Survey “May” took place shortly after the release of the lockdown in Switzerland. Survey “August” was conducted in mid-August. To identify at-risk elderly persons, we conducted a combined factor/k-means clustering analysis of the survey data assessed in August in order to examine different patterns of adherence to recommended preventive measures. RESULTS: In summary, 270 (survey “May”) and 256 (survey “August”) persons aged 65 years and older were analysed for the present study. Adherence to established preventive measures was similar across the two surveys, whereas adherence pertaining to social contacts decreased substantially from survey “May” to survey “August”. The combined factor/k-means clustering analysis to identify at-risk elderly individuals yielded four distinct groups with regard to different patterns of adherence to recommended preventive measures: a larger group of individuals with many social contacts but high self-reported adherence to preventive measures (n = 86); a small group with many social contacts and overall lower adherence (n = 26); a group with comparatively few contacts and few social activities (n = 66); and a group which differed from the latter through fewer contacts but more social activities (n = 78). Sociodemographic characteristics and risk perception with regard to SARS-CoV-2 infections among the four groups did not differ in a relevant way across the four groups. CONCLUSIONS: Although many elderly persons continued to follow the recommended preventive measures during the transitional phase between the two pandemic waves, social mixing with younger persons constitutes a way for transmission of infections across age groups. Pandemic containment among all age groups thus remains essential to protect vulnerable populations, including the elderly.

The COVID-19 Social Monitor longitudinal online panel: Real-time monitoring of social and public health consequences of the COVID-19 emergency in Switzerland.

BACKGROUND: The COVID-19 pandemic challenges societies in unknown ways, and individuals experience a substantial change in their daily lives and activities. Our study aims to describe these changes using population-based self-reported data about social and health behavior in a random sample of the Swiss population during the COVID-19 pandemic. The aim of the present article is two-fold: First, we want to describe the study methodology. Second, we want to report participant characteristics and study findings of the first survey wave to provide some baseline results for our study. METHODS: Our study design is a longitudinal online panel of a random sample of the Swiss population. We measure outcome indicators covering general well-being, physical and mental health, social support, healthcare use and working state over multiple survey waves. RESULTS: From 8,174 contacted individuals, 2,026 individuals participated in the first survey wave which corresponds to a response rate of 24.8%. Most survey participants reported a good to very good general life satisfaction (93.3%). 41.4% of the participants reported a worsened quality of life compared to before the COVID-19 emergency and 9.8% feelings of loneliness. DISCUSSION: The COVID-19 Social Monitor is a population-based online survey which informs the public, health authorities, and the scientific community about relevant aspects and potential changes in social and health behavior during the COVID-19 emergency and beyond. Future research will follow up on the described study population focusing on COVID-19 relevant topics such as subgroup differences in the impact of the pandemic on well-being and quality of life or different dynamics of perceived psychological distress.

Work- and stress-related musculoskeletal and sleep disorders among health professionals: a cross-sectional study in a hospital setting in Switzerland.

BACKGROUND: Musculoskeletal and sleep disorders have been reported to be very common among health care and hospital workers and particularly nurses. They are assumed or found to be a result of psychological stress and/or physical strain or pain. However, no other study so far - at least in a hospital setting and for Switzerland - has considered and investigated musculoskeletal as well as sleep disorders in consequence of or rather in association with both physical workload and psychological stress. METHODS: Cross-sectional survey data of 1232 health professionals were used and analysed. Data were collected in 2015/16 among the health care workforces of three public hospitals and two rehabilitation clinics in the German-speaking part of Switzerland. Musculoskeletal and sleep disorders were assessed by three items taken from the Swiss Health Survey, a 2-item measure of accumulated low back, back, neck and shoulder pain and a single-item measure of problems in getting to sleep or sleeping through. Stratified and adjusted bivariate logistic and multivariate linear regression analyses were performed to calculate measures of association (adjusted odds ratios, z-standardized beta coefficients), to control for potential confounders, and to compare different health professions (nurses, physicians, therapists, other). RESULTS: Almost every fourth of the studied health professionals reported severe or even very severe musculoskeletal disorders (MSDs) and nearly every seventh severe sleep disorders (SDs). These prevalence rates were significantly or at least slightly higher among nurses than among physicians and other health care workers. General stress, work stress, physical effort at work, and particularly a painful or tiring posture at work were found to be clear and strong risk factors for MSDs, whereas only general and work-related stress were found to be significantly associated with SDs. There was no or only weak association between MSDs and SDs. CONCLUSIONS: This study found MSDs to be largely a result of physical workload or rather poor posture at work and only secondarily a consequence of (general) stress, whereas SDs were revealed to be primarily a consequence of stress on and particularly off the job. Preventive strategies therefore have to differentiate and combine measures for the reduction of both psychological stress and physical strain.

Temporal work stressors and satisfaction with work, life and health among health professionals in Switzerland.

BACKGROUND: Working in a hospital can be both rewarding and stressful. Whether one or the other is dominant depends on a number of factors ranging from shift work, physical demands, responsibilities and time pressure to job autonomy, work climate and leisure time. AIM: This study aimed to examine associations between temporal work stressors and satisfaction with work, life and health among health professionals in general, and nurses and physicians in particular. Associations were further investigated for possible mediating and intervening factors. METHODS: Cross-sectional survey data on 1232 health professionals at three public hospitals and two rehabilitation clinics were collected in 2015/2016. Stepwise multiple linear regression analyses were used to estimate the standardised effects (beta coefficients) of temporal work stressors (overtime and time pressure), and organisational and personal resources (job autonomy, work climate, internal control belief) on general stress as the assumed mediator and finally on satisfaction with work, life and health. RESULTS: Temporal work stressors were found to strongly predict general stress symptoms among health professionals (ß = 0.25) and particularly physicians (ß = 0.30), independently of the observed stress-buffering effects of organisational resources such as job autonomy (ß = −0.09) or work climate (ß = −0.22). Associations between temporal work stressors (as predictors) and satisfaction with work, life and health (as outcomes) turned out to be mostly indirect, mediated by general stress. General stress in turn was observed to be the strongest predictor of domain-specific satisfaction (ß = −0.17 to −0.34), sometimes only surpassed by resources such as work climate or internal control belief. Explained variance of the three satisfaction outcomes in the fully specified regression or explanatory models ranged between 14% and 45% depending on the (sub-)sample (nurses, physicians, all health professionals) or the outcome. Control belief was revealed to be a strong and independent personal resource, particularly regarding satisfaction with life and health in general (ß = 0.25/0.21). CONCLUSION: Satisfaction and well-being of health professionals are strongly affected by job stressors such as frequent or excessive overtime work or permanent time pressure at work. Negative consequences of temporal work stressors are attenuated by organisational and personal resources such as a high level of job autonomy, a good work climate or a strong internal control belief.

Predictors of Presenteeism Among Hospital Employees-A Cross-Sectional Questionnaire-Based Study in Switzerland.

OBJECTIVE: The aim of this cross-sectional study was to examine work- and person-related predictors of the largely "invisible" behavior and phenomenon of presenteeism among employees in a health-care setting in German-speaking Switzerland. METHODS: Self-reported survey data from 1840 employees of four hospitals and two rehabilitation clinics collected in 2015 and 2016 were utilized and analyzed. RESULTS: All studied work-related factors such as patient contact, job satisfaction, high work load, forced overtime, fear of job-loss, and particularly mental strain turned out to be significant and relevant predictors of presenteeism. Younger employees, female workers, and employees with a chronic disease also were more likely to show presenteeism. CONCLUSION: Work stress, work without patients, job dissatisfaction, a chronic disease, and/or a younger age or rather less work experience seem to increase the chances of presenteeism among health-care workers.

Correction: Health risks associated with social isolation in general and in young, middle and old age.

[This corrects the article DOI: 10.1371/journal.pone.0219663.].

Health risks associated with social isolation in general and in young, middle and old age.

INTRODUCTION: Health effects of social isolation are well-studied at older age, in English-speaking countries, for individual health conditions, and based on unidimensional measures of isolation. Hardly any evidence exists for younger ages, for continental European and particularly German-speaking countries and based on multidimensional measures of isolation. This study therefore aimed to examine prevalence rates and associations of social isolation with various health conditions and behaviors in the entire Swiss population and across different age groups. METHODS: Nationally representative cross-sectional data from the Swiss Health Survey collected in 2012 were used and analyzed. The study sample covered 21,597 randomly selected adolescents and adults living in Switzerland and aged 15 and older. A multifactorial five-item social integration index was used to assess social disconnectedness and perceived isolation. RESULTS: Social isolation has been found to steadily increase with age and almost consistently to be strongly associated with poor health conditions and unfavorable behaviors across all ages. Nearly a quarter of the general population could be categorized as either only partly integrated or even poorly integrated and largely isolated. The socially isolated people independent of their age showed strongly elevated relative risks of poor self-rated health (aOR = 4.0), musculoskeletal disorders (aOR = 2.8), moderate to severe depression (aOR = 11.5), and multiple health problems (aOR = 5.0). They were also found to be at comparably high risk of behaving unhealthy with regard to physical inactivity (aOR = 2.2), poor diet (aOR = 1.9) and use of psychotropic medications (aOR = 3.6). Although prevalence rates of poor health conditions and behaviors differed greatly between the studied age groups, strong associations and clear dose-response relationships have been found separately for all age groups and particularly for the youngest. A fairly weak or no association at all (depending on the age group) with the degree of social integration was observed only for daily smoking. CONCLUSIONS: Social isolation may be less prevalent at younger ages, but is then even more strongly associated with poor health conditions and behaviors than at older ages.

Explaining burnout and the intention to leave the profession among health professionals - a cross-sectional study in a hospital setting in Switzerland.

BACKGROUND: Burnout and the intention to leave the profession are frequently studied outcomes in healthcare settings that have not been investigated together and across different health professions before. This study aimed to examine work-related explanatory factors or predictors of burnout and the intention to leave the profession among health professionals in general, and nurses and physicians in particular. METHODS: Cross-sectional survey data of 1840 employees of six public hospitals and rehabilitation clinics recorded in 2015/16 in German-speaking Switzerland were used. Multiple logistic and stepwise linear regression analyses were performed to estimate the relative risks (odds ratios) and standardized effects (beta coefficients) of different workloads and work-related stressors on these outcomes and to study any possible mediation between them. RESULTS: On average, one in twelve health professionals showed increased burnout symptoms and every sixth one thought frequently of leaving the profession. Temporal, physical, emotional and mental workloads and job stresses were strongly and positively associated with burnout symptoms and thoughts of leaving the profession. However, the relative risks of increased burnout symptoms and frequent thoughts of leaving the profession were highest in the case of effort-reward and work-life imbalances. In fact, these two work-related stress measures partly or even largely mediated the relationships between exposures (workloads, job stresses) and outcomes and were found to be the strongest predictors of all. Whereas a work-life imbalance most strongly predicted burnout symptoms among health professionals (ß = .35), and particularly physicians (ß = .48), an effort-reward imbalance most strongly predicted thoughts of leaving the profession (ß = .31-36). A substantial part of the variance was explained in the fully specified regression models across both major health professions and both outcomes. However, explained variance was most pronounced for burnout symptoms of physicians (43.3%) and for frequent thoughts of leaving the profession among nurses and midwives (28.7%). CONCLUSIONS: Reducing workload and job stress, and particularly reward frustration at work, as well as the difficulties in combining work and private lives among health professionals, may help to prevent them from developing burnout and/or leaving the profession and consequently also to reduce turnover, early retirement, career endings and understaffing in healthcare settings.

Effort-Reward Imbalance, Work-Privacy Conflict, and Burnout Among Hospital Employees.

OBJECTIVE: Studies investigating the relative importance of effort-reward imbalance and work-privacy conflict for burnout risk between professional groups in the health care sector are rare and analyses by educational attainment within professional groups are lacking. METHODS: The study population consists of 1422 hospital employees in Switzerland. Multivariate linear regression analyses with standardized coefficients were performed for the overall study population and stratified for professional groups refined for educational attainment. RESULTS: Work-privacy conflict is a strong predictor for burnout and more strongly associated with burnout than effort-reward imbalance in the overall study population and across all professional groups. Effort-reward imbalance only had a minor effect on burnout in tertiary-educated medical professionals. CONCLUSION: Interventions aiming at increasing the compatibility of work and private life may substantially help to decrease burnout risk of professionals working in a health care setting.

Informal caregiving, work-privacy conflict and burnout among health professionals in Switzerland - a cross-sectional study.

INTRODUCTION: Health professionals were found to have an elevated burnout risk compared to the general population. Some studies also reported more emotional exhaustion - a component of burnout - for health professionals with informal caregiving responsibilities for children (double-duty child caregivers) or adults (double-duty adult caregivers) or a combination of both (triple-duty caregivers) compared to health professionals without informal caregiving roles (formal caregivers). However, the potential mediating effect of the work-privacy conflict in this relationship as well as differences between occupational groups have not yet been studied in healthcare settings. AIM: To assess the impact of informal caregiving on burnout risk among health professionals and whether this relationship is mediated by work-privacy conflict or differs between occupational groups. METHODS: Data were collected through an employee survey in six hospitals from German-speaking Switzerland in 2015/2016. Mediation analyses were performed using linear mixed models with fixed effects for caregiving situation and work-privacy conflict as well as random effects for hospitals. RESULTS: Triple-duty caregivers were found to have a significantly higher burnout risk compared to formal caregivers only. Work-privacy conflict did not mediate this relationship, except among the "other health professionals" group. CONCLUSION: Additional and large-scale studies focusing on the combination of formal and informal caregiving roles are needed to better understand its effect on burnout among healthcare professionals and to evaluate the role of work-privacy conflict.

Health and well-being at work: The key role of supervisor support.

This study aims to explore whether and in what way social support from different sources and domains makes an additional or different and independent contribution to various health and work-related outcomes. Cross-sectional data were used from an employee survey among the workforces of four service companies from different industries in Switzerland. The study sample covered 5,877 employees of working age. The lack of social support from a spouse, relatives, friends, direct supervisors, closest colleagues at work and other co-workers in case of problems at work and at home were assessed and studied individually and jointly as risk factors with respect to a total number of eight outcomes. Health-related outcomes covered poor self-rated health, musculoskeletal disorders, stress feelings and burnout symptoms. Work-related outcomes included feeling overwhelmed at work, difficulty with switching off after work, job dissatisfaction and intention to turnover. Social support from multiple sources in contrast to only individual sources in both life domains was found to be more frequent in women than in men and proved to be most protective and beneficial with regard to health and well-being at work. However, after mutual adjustment of all single sources of social support from both domains, a lack of supervisor support turned out to be the only or the strongest of the few remaining support measures and statistically significant risk factors for the studied outcomes throughout and by far. Being unable to count on the support of a direct supervisor in case of problems at work and even at home was shown to involve a substantially increased risk of poor health and work-related outcomes (aOR = up to 3.8). Multiple sources of social support, and particularly supervisor support, seem to be important resources of health and well-being at work and need to be considered as key factors in workplace health promotion.