Original articleSelf-rated recovery from work stress and allostatic load in women
Introduction
It has been suggested that insufficient or poor recovery is pertinent to stress-related ill health [1], [2], [3], [4]. Previous research on the biologic pathways of recovery from work stress have mainly focused on stress hormones such as catecholamines (adrenaline and noradrenaline) and cortisol. Several studies [1], [5], [6] have shown that insufficient recovery from work is associated with higher catecholamine output in women and men. For cortisol, previous findings have shown that high cortisol reactivity at work and low cortisol reactivity off work are associated with a higher need for recovery in men [7]. Furthermore, recent findings have shown that high morning cortisol is associated with insufficient recovery from work in female and male white collar workers [4].
The concept of allostatic load (AL), in extending the focus on separate biomarkers, has been proposed as a multisystems approach describing how daily stress relates to health and disease [8], [9], [10], [11], [12]. This model focuses on an individual's experience of challenging events and associated biologic responses of the body. It also takes into account the ability of bodily systems to reach stability through change and distinguishes between the effects of acute and chronic stress responses, respectively. Acute stress responses necessary for adapting to current demands posed by the environment have a potentially protective effect if followed by periods of rest and recovery. However, repeated and/or prolonged stress-related activation increases wear and tear of bodily systems, which increases AL. Examples of conditions contributing to AL and increased health risks are hypothesized to include frequent exposure to stressful conditions without enough time for rest and recovery and inability to shut off the stress response after the end of the stress exposure (e.g., being unable to unwind in the evening after work). AL has been operationalized as a summary indicator of biologic challenges of multiple bodily systems to reflect this multisystems view. To date, the operationalization of AL differs between studies, depending on the type and number of biomarkers available [13], [14], [15], [16]. However, across studies, findings have shown that a high AL increases the risk for future ill health [17], [18].
With the use of a multisystems approach, we set out to investigate the relationships between self-rated recovery from work stress and biologic dysregulation load in terms of AL in employed women.
Section snippets
Participants
Participants were female employees of two public health care organizations in Stockholm, Sweden, who took part in a larger project aimed at investigating the impact of changes in the scheduling of work on employee health and well-being. Participation was voluntary but encouraged by the employer. In all, 390 persons were invited to participate in the study; 367 of these individuals volunteered. For the purposes of this study, only data from female employees (n=312) were included. Of these
Recovery profiles
The initial cluster analysis produced three clusters. Fig. 1 describes the patterns of the three cluster profiles in terms of their mean values on the items of the recovery measure. Based on these cluster profiles, the three profiles were denoted recovered, nonrecovered, and fatigued. The recovered cluster consisted of 108 women and was characterized by sufficient recuperation from work stress. This included feeling recuperated after a night's sleep, at the beginning of a workday, and after
Discussion
This study distinguished between three types of self-rated recovery from work stress—recovered, nonrecovered, and fatigued profiles—and showed that these had specific relationships with AL. More specifically, fatigue was associated with an increased risk for a high AL, whereas nonrecovery was not. This difference may be explained by examining the characteristics of these two recovery profiles: whereas the fatigued profile involved sleeping problems coupled with mental and physical exhaustion,
Acknowledgments
This research was supported by grants to Ulf Lundberg from the Bank of Sweden Tercentenary Foundation, the Swedish Research Council, and the Swedish Council for Working Life and Social Research and to Petra Lindfors from the Anna Ahlström and Ellen Terserus Foundation.
We thank the employees that volunteered to participate in the study and the occupational health company, AB Previa.
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