Is combining human service work with family caregiving associated with additional odds of emotional exhaustion and sickness absence? A cross-sectional study based on a Swedish cohort

Emma Drake,Constanze Leineweber,Anna Nyberg,Susanna Toivanen

doi:10.1007/s00420-019-01461-0

Abstract

PurposeThe aim of the study is to examine to what extent human service work and family caregiving is associated with emotional exhaustion and sickness absence, and to what extent combining human service work and family caregiving is associated with additional odds.MethodsData were derived from participants in paid work from the Swedish Longitudinal Occupational Survey of Health, year 2016 (n = 11 951). Logistic regression analyses were performed and odds ratios and 95% confidence intervals estimated for the association between human service work and family caregiving, respectively, as well as combinations of the two on one hand, and emotional exhaustion and self-reported sickness absence on the other hand. Interaction between human service work and family caregiving was assessed as departure from additivity with Rothman’s synergy index.ResultsHuman service work was not associated with higher odds of emotional exhaustion, but with higher odds of sickness absence. Providing childcare was associated with higher odds of emotional exhaustion, but lower odds of sickness absence, and caring for a relative was associated with higher odds of both emotional exhaustion and sickness absence. There was no indication of an additive interaction between human service work and family caregiving in relation to neither emotional exhaustion nor sickness absence.ConclusionsWe did not find support for the common assumption that long hours providing service and care for others by combining human service work with family caregiving can explain the higher risk of sickness absence or emotional exhaustion among employees in human service occupations.

Highlights

In Sweden, human service occupations employ over 800,000 individuals in healthcare, elderly care and education and employees in them constitute a large part of the working population (Swedish Social Insurance Agency 2014).Employees working with human service have been found to have higher risk of stress-related disorders (Wieclaw et al 2006), more sickness absence due to mental disorders (Swedish Social Insurance Agency 2014), more doctor-certified sickness absence (Aagestad et al 2016) and higher risk of antidepressent use (Buscariolli et al 2018) than other employees
The aim of the study is to examine to what extent human service work and family caregiving are associated with emotional exhaustion and sickness absence, and to what extent combining human service work and family caregiving is associated with additional odds of these outcomes
Human service workers were more likely to be older, have a university education, work less than 35 h per week, and spend less time caring for children and more time caring for a relative

Summary

Introduction

In Sweden, human service occupations employ over 800,000 individuals in healthcare, elderly care and education and employees in them constitute a large part of the working population (Swedish Social Insurance Agency 2014).Employees working with human service have been found to have higher risk of stress-related disorders (Wieclaw et al 2006), more sickness absence due to mental disorders (Swedish Social Insurance Agency 2014), more doctor-certified sickness absence (Aagestad et al 2016) and higher risk of antidepressent use (Buscariolli et al 2018) than other employees. The emotional and interpersonal stressors from providing service and care to other people have been suggested and reported to be one of the most influential factors (Aronsson et al 2019; Bria et al 2012; Maslach et al 2001). Another factor that could explain the high risks of sickness absence among employees working in human service occupations may be found in the high total number of working hours in provision of service and caregiving arising from combining paid and unpaid work (AFA Försäkring 2015). In accordance with the role strain hypothesis (Goode 1960), suggesting that multiple roles in life create increased stress and demands on time, energy, and psychological resources, combining emotionally demanding work with those in need at home and at work may have negative health consequences

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