Personal and organizational determinants of well-being at work: the case of Swedish physicians.

PURPOSE: The traditional perspective in the occupational and organizational psychology literature aimed at understanding well-being, has focused almost exclusively on the "disease" pole. Recently, however, new concepts focusing on health are emerging in the so-called "positive psychology" literature. The purpose of this paper is to test multiple possible linkages (or profiles) between certain personal, organizational, and cultural variables that affect both burnout and vigor. Burnout (disease) and vigor (health) are assumed to represent two extreme poles of the well-being phenomenon. DESIGN/METHODOLOGY/APPROACH: An innovative statistical treatment borrowed from data mining methodology was used to explore the conceptual model that was utilized. A self-administered questionnaire from a sample of 1,022 physicians working in Swedish public hospitals was used. Standardized job/work demands with multiple items were employed in conjunction with the Uppsala Burnout scale, which was dichotomized into high (burnout) and low (vigor) score. A combination of ANOVAs and "classification and regression tree analyses" was utilized to test the relationships and identify profiles. FINDINGS: Results show an architecture that predicts 59 percent of the explained variance and also reveals four "tree branches" with distinct profiles. Two configurations indicate the determinants of high-burnout risk, while two others indicate the configurations for enhanced health or vigor. ORIGINALITY/VALUE: In addition to their innovative-added value, the results can also be most instrumental for individual doctors and hospitals in gaining a better understanding of the aetiology of burnout/vigor and in designing effective preventative measures for reducing risk factors for burnout, and enhancing well-being (vigor).

Research on psychotherapy efficacy and effectiveness: between Scylla and Charybdis?

Clinical researchers have recently begun to explore differences between psychotherapy outcome studies that focus on efficacy and those that focus on effectiveness. The authors provide concise descriptions of these research models, followed by more extended consideration of the most important conceptual and empirical distinctions between the two. Research on the efficacy/effectiveness distinction is then put into context: The common treatment variables that also influence treatment outcomes are reviewed. Fifty years of research on psychotherapy outcomes are next considered; contemporary research on the efficacy and effectiveness research models is emphasized. A description and evaluation of current efforts to heighten the value of technique-focused research to clinicians follow. The authors conclude by anticipating some promising future directions in this research domain.

Factor VIII and DDAVP reverse the effect of recombinant desulphatohirudin (CGP 39393) on bleeding in the rat.

The infusion of a high dose of recombinant desulphatohirudin HVI (CGP 39393) for 40 min at 30 micrograms/kg/min, resulted in a prolongation of bleeding time in the rat when evaluated using transection of the tail. The prolonged bleeding was evident both immediately, and 30 min after cessation of the infusion of hirudin (CGP 39393). Bleeding time returned to normal after 60 min. The effect of several agents, reported to be successful in reducing bleeding tendencies in man, were evaluated in this rat model. The agents were administered immediately following cessation of the CGP 39393 infusion and their ability to normalize the prolonged bleeding-time, observed at 30 min after cessation of the CGP 39393 infusion, determined. Desmopressin (DDAVP), recombinant factor VIII and Vueffe reduced the bleeding time to the control range but did not exert any significant effects on the bleeding time in rats which did not receive CGP 39393. Epsilon-aminocaproic acid (EACA) and recombinant factor VII were ineffective, at the doses used. In conclusion, DDAVP, factor VIII and Vueffe are effective in reversing the effect of direct thrombin inhibition on bleeding in the rat.

Lack of professional latitude and role problems as correlates of propensity to quit amongst nursing staff.

Which job stressors are the best predictors of propensity to quit among the nursing staff in emergency wards and intensive care units are explored in this paper. Employees of 30 Quebec hospitals (i.e. 60 wards in total) participated in the study (n = 1237). Stepwise multiple regression revealed that lack of professional latitude and role problems are the best predictors of the intention to quit the organization among all nursing staff. These two job stressors are briefly addressed in the context of intervention and possible remedies aiming at improving quality of life, mental health and decreasing the rate of turnover. It is argued that such intervention would benefit the nurses, the quality of patient care, as well as the respective hospitals.

Intrinsic job stress and diastolic blood pressure among female hospital workers.

The present study of 375 female hospital workers assesses the impact of two specific dimensions of vocational stress on standing diastolic blood pressure. Both intrinsic (pertaining to job content) and extrinsic (associated with job context) stressors were examined in this study. Diastolic blood pressure was found to be significantly related to scores on an intrinsic stress measure, but not with the extrinsic one, even after the contribution of obesity and age levels were controlled. However, the effect of intrinsic stress was only found to be significant among women younger than 35. We believe this to be preliminary evidence that perceived dimensions of chronic intrinsic role stressors can be significant psychosocial correlates of diastolic blood pressure.