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Cognitively Oriented Behavioral Rehabilitation in Combination with Qigong for Patients on Long-Term Sick Leave Because of Burnout: REST—A Randomized Clinical Trial

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Abstract

Background

Despite an increase in the occurrence of burnout, there is no agreement on what kind of rehabilitation these patients should be offered.

Purpose

Primary aim of this study was to evaluate effects on psychological variables and sick leave rates by two different group rehabilitation programs for patients on long-term sick leave because of burnout. Rehabilitation program A (Cognitively oriented Behavioral Rehabilitation (CBR) and Qigong) was compared with rehabilitation program B (Qigong only).

Method

In a randomized clinical trial, 96 women and 40 men with a mean age of 41.6 ± 7.4 years were allocated to one of the two rehabilitation programs.

Results

A per-protocol analysis showed no significant difference in treatment efficacy between the groups. Both groups improved significantly over time with reduced levels of burnout, self-rated stress behavior, fatigue, depression, anxiety, obsessive–compulsive symptoms, and sick leave rates. In an intention-to-treat analysis, patients in program A had fewer obsessive–compulsive symptoms and larger effect sizes in self-rated stress behavior and obsessive–compulsive symptoms compared to patients in program B.

Conclusion

This study showed no differences in effect between CBR and Qigong compared with Qigong only in a per-protocol analysis. Both rehabilitation programs showed positive effect for patients with burnout.

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References

  1. Maslach C, Jackson S, Leiter M. Maslach Burnout Inventory manual. Third ed. Palo Alto, California: Consulting Psychologists; 1996.

    Google Scholar 

  2. Shirom A. Burnout in work organizations. International Review of Industrial and Organizational Psychology. New York: Wiley; 1989. p. 25–48.

    Google Scholar 

  3. Schaufeli W, Enzmann D. The burnout companion to study & practice: a critical analysis.London: Taylor & Francis; 1998.

    Google Scholar 

  4. Ekstedt M, Fagerberg I. Lived experiences of the time preceding burnout. J Adv Nurs. 2005;49(1):59–67.

    Article  PubMed  Google Scholar 

  5. Kushnir T, Melamed S. The Gulf War and its impact on burnout and well-being of working civilians. Psychol Med. 1992;22:987–95.

    Article  PubMed  CAS  Google Scholar 

  6. Pines A. Marriage burnout: a new conceptual framework for working with couples. Psychother Priv Pract. 1987;5:31–44.

    Article  Google Scholar 

  7. Stenlund T, Ahlgren C, Lindahl B, Burell G, Knutsson A, Stegmayr B, Slunga Birgander L. Patients with burnout in relation to gender and a general population. Scand J Public Health. 2007;35:516–23.

    Article  PubMed  Google Scholar 

  8. Hallsten L, Bellaagh K, Gustafsson K. Utbränning i Sverige-en populationsstudie. (Burnout in Sweden—a population study). Arbete & Hälsa, 6. Stockholm: National Institute for Working Life; 2002. (in Swedish).

    Google Scholar 

  9. Lindblom KM, Linton SJ, Fedeli C, Bryngelsson IL. Burnout in the working population: relations to psychosocial work factors. Int J Behav Med. 2006;13(1):51–9.

    Article  PubMed  Google Scholar 

  10. Soares J, Grossi G, Sundin Ö. Burnout among women: associations with demographic/socio-economic, work, life-style and health factors. Arch Womens Ment Health. 2007;10:61–71.

    Article  PubMed  CAS  Google Scholar 

  11. Cohen-Katz J, Wiley S, Capuano T, Baker D, Shapiro S. The effects of mindfulness-based stress reduction on nurse stress and burnout, part II. Holist Nurs Pract. 2005;19(1):26–35.

    PubMed  Google Scholar 

  12. Granath J, Ingvarsson S, Von Thiele U, Lundberg U. Stress management: a randomized study of cognitive behavioural therapy and yoga. Cogn Behav Ther. 2006;35(1):3–10.

    Article  PubMed  Google Scholar 

  13. Hasson D, Anderberg UM, Theorell T, Arnetz B. Psychophysiological effects of a web-based stress management system: a prospective, randomized controlled intervention study of IT and media workers. BMC Public Health. 2005;5(78):1–14.

    Google Scholar 

  14. Rowe M. Skills training in the long-term management of stress and occupational burnout. Curr Psychol. 2000;19(3):215–28.

    Article  Google Scholar 

  15. Van Rhenen W, Blonk R, Van Der Klink J, Van Dijk F, Schaufeli W. The effect of a cognitive and physical stress-reducing programme on psychological complaints. Int Arch Occup Environ Health. 2005;78:139–48.

    Article  PubMed  Google Scholar 

  16. Blonk R, Brenninkmeijer V, Lagerveld S, Houtman I. Return to work: a comparison of two cognitive behavioural interventions in cases of work-related psychological complaints among the self-employed. Work Stress. 2006;20(2):129–44.

    Article  Google Scholar 

  17. Brattberg G. Internet-based rehabilitation for individuals with chronic pain and burnout: a randomized trial. Int J Rehabil Res. 2006a;29:221–7.

    Article  PubMed  Google Scholar 

  18. Heiden M, Lyskov E, Nakata M, Sahlin K, Sahlin T, Barnekow-Bergkvist M. Evaluation of cognitive behavioural training and physical activity for patients with stress-related illness: a randomized controlled study. J Rehabil Med. 2007;39:366–73.

    Article  PubMed  Google Scholar 

  19. Brattberg G. Internet-based rehabilitation for individuals with chronic pain and burnout II: a long-term follow-up. Int J Rehabil Res. 2007;30:231–4.

    Article  PubMed  Google Scholar 

  20. Michie S, Williams S. Reducing work related psychological ill health and sickness absence: a systematic literature review. Occup Environ Med. 2003;60:3–9.

    Article  PubMed  CAS  Google Scholar 

  21. Mimura C, Griffiths P. The effectiveness of current approaches to workplace stress management in the nursing profession: an evidence based literature review. Occup Environ Med. 2003;60:10–5.

    Article  PubMed  CAS  Google Scholar 

  22. Van Der Klink J, Blonk R, Schene A, Van Dijk F. The benefits of interventions for work-related stress. Am J Public Health. 2001;91(2):270–6.

    Article  PubMed  Google Scholar 

  23. Sancier K. Medical applications of Qigong. Altern Ther Health Med. 1996;2(1):40–6.

    PubMed  CAS  Google Scholar 

  24. Lee M, Ryu H, Chung H. Stress management by psychosomatic training: effects of ChunDoSunBup Qi-training on symptoms of stress: a cross-sectional study. Stress Med. 2000;16:161–6.

    Article  Google Scholar 

  25. Skoglund L, Jansson E. Qigong reduces stress in computer operators. Complement Ther Clin Pract. 2007;13:78–84.

    Article  PubMed  CAS  Google Scholar 

  26. Lee M, Kang C, Lim H, Lee M. Effects of Qi-training on anxiety and plasma concentrations of cortisol, ACTH, and aldosterone: a randomized placebo-controlled pilot study. Stress Health. 2004;20:243–8.

    Article  Google Scholar 

  27. Tsang H, Fung K, Chan A, Lee G, Chan F. Effect of a Qigong exercise programme on elderly with depression. Int J Geriatr Psychiatry. 2006;21:890–7.

    Article  PubMed  Google Scholar 

  28. Stenlund T, Lindström B, Granlund M, Burell G. Cardiac rehabilitation for the elderly: Qi Gong and group discussions. Eur J Cardiovasc Prev Rehabil. 2005;12:5–11.

    Article  PubMed  Google Scholar 

  29. Melamed S, Kushnir T, Shirom A. Burnout and risk factors for cardiovascular diseases. Behav Med. 1992;18:53–60.

    PubMed  CAS  Google Scholar 

  30. Melamed S, Ugarten U, Shirom A, Kahana L, Lerman Y, Froom P. Chronic burnout, somatic arousal and elevated salivary cortisol levels. J Psychosom Res. 1999;46:591–8.

    Article  PubMed  CAS  Google Scholar 

  31. Burell G, Granlund B. Women’s hearts need special treatment. Int J Behav Med. 2002;9:228–42.

    Article  PubMed  Google Scholar 

  32. Bergdahl J, Larsson A, Nilsson LG, Riklund Åhlström K, Nyberg L. Treatment of chronic stress in employees: subjective, cognitive and neural correlates. Scand J Psychol. 2005;46:395–402.

    Article  PubMed  Google Scholar 

  33. Grossi G, Perski A, Evengård B, Blomkvist V, Orth-Gomér K. Physiological correlates of burnout among women. J Psychosom Res. 2003;55:309–16.

    Article  PubMed  Google Scholar 

  34. Claesson M, Slunga Birgander L, Lindahl B, Nasic S, Åström M, Asplund K, Burell G. Women’s hearts–stress management for women with ischemic heart disease. J Cardiopulm Rehabil. 2005;25:93–102.

    Article  PubMed  Google Scholar 

  35. Beurskens A, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, Swaen G. Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000;57:353–7.

    Article  PubMed  CAS  Google Scholar 

  36. Mattila-Evenden M, Svanborg P, Gustavsson P, Åsberg M. Determinants of self-rating and expert rating concordance in psychiatric out-patients, using the affective subscales of the CPRS. Acta Psychiatr Scand. 1996;94:386–96.

    Article  PubMed  CAS  Google Scholar 

  37. Svanborg P, Åsberg M. A new self-rating scale for depression and anxiety states based on the Comprehensive Psychopathological Rating Scale. Acta Psychiatr Scand. 1994;89:21–8.

    Article  PubMed  CAS  Google Scholar 

  38. Dawson-Saunders B, Trapp RG. Basic & clinical biostatistics. East Norwalk, Connecticut: Appleton & Lange; 1994.

    Google Scholar 

  39. Jensen IB, Bergström G, Ljungquist T, Bodin L, Nygren ÅL. A randomized controlled component analysis of a behavioral medicine rehabilitation program for chronic spinal pain: are the effects dependent on gender? Pain. 2001;91:65–78.

    Article  PubMed  CAS  Google Scholar 

  40. Engström LG, Janson S. Stress-related sickness absence and return to labour market in Sweden. Disabil Rehabil. 2007;29(5):411–6.

    Article  PubMed  Google Scholar 

  41. Lund T, Kivimäki M, Labriola M, Villadsen E, Christensen KB. Using administrative sickness absence data as a marker of future disability pension: the prospective DREAM study of Danish private sector employees. Occup Environ Med. 2008;65:28–31.

    Article  PubMed  Google Scholar 

  42. Brattberg G. PTSD and ADHD: underlying factors in many cases of burnout. Stress Health. 2006b;22:305–13.

    Article  Google Scholar 

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Acknowledgements

This study was funded by the Swedish Council for Working Life and Social Research (dnr 2003-0761), the Västerbotten County Council, and the Swedish Social Insurance Agency.

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Authors and Affiliations

  1. Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, 901 87, Umeå, Sweden

    Therese Stenlund, Katarina Steinholtz, Leif Nilsson & Lisbeth Slunga Birgander

  2. Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden

    Christina Ahlgren

  3. Department of Public Health and Clinical Medicine, Behavioral Medicine, Umeå University, Umeå, Sweden

    Bernt Lindahl

  4. Department of Public Health and Caring Sciences, University of Uppsala, Uppsala, Sweden

    Gunilla Burell

  5. Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences, Umeå University, Umeå, Sweden

    Curt Edlund

  6. Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden

    Curt Edlund & Anders Knutsson

Authors
  1. Therese Stenlund
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  2. Christina Ahlgren
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  3. Bernt Lindahl
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  4. Gunilla Burell
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  6. Curt Edlund
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  9. Lisbeth Slunga Birgander
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Corresponding author

Correspondence to Therese Stenlund.

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Stenlund, T., Ahlgren, C., Lindahl, B. et al. Cognitively Oriented Behavioral Rehabilitation in Combination with Qigong for Patients on Long-Term Sick Leave Because of Burnout: REST—A Randomized Clinical Trial. Int.J. Behav. Med. 16, 294–303 (2009). https://doi.org/10.1007/s12529-008-9011-7

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  • DOI: https://doi.org/10.1007/s12529-008-9011-7

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