Proefschrift Willem van Rhenen. From stress to engagement.
Text of Proefschrift Willem Van Rhenen
1. Willem van RhenenFrom stressto engagement
2. From stress to engagement Willem van Rhenen ArboNed B.V. Coronel Institute, AMC, University of Amsterdam
3. Opgedragen aan mijn gezin en mijn ouders.Funding: The studies in this thesis are supported by ArboNed B.V. and by a grant of ZonMWCoverillustration: Lydia van RhenenLay-out and design: Pre Press Buro Booij, Huis ter HeidePublished by: ArboNed B.V.Printed by: Ponsen & Looijen bv, WageningenISBN/EAN: 978-90-813145-1-0 ArboNed B.V.All rights reserved. No parts of this book may be reproduced in any waywhatsoever without the written permission from the Publisher.2
4. From stress to engagement Academisch Proefschrift ter verkrijging van de graad van doctor aan de Universiteit van Amsterdam op gezag van de Rector Magnicus prof. dr. D.C. van den Boom ten overstaan van een door het college voor promoties ingestelde commissie, in het openbaar te verdedigen in de Aula der Universiteit op woensdag 25 juni 2008, te 14:00 uur door Willem van Rhenen geboren te Driebergen 3
5. PromotiecommissiePromotores: Prof. dr. F.J.H. van Dijk Prof. dr. W.B. SchaufeliCo-promotores: Prof. dr. R.W.B. Blonk Prof. dr. J. J. L. van der KlinkOverige leden: Prof. dr. A.H. Schene Prof. dr. E. Schad Prof. dr. J.C.J.M. de Haes Prof. dr. P.M.G. Emmelkamp Prof. dr. C.A.L. HoogduinFaculteit der Geneeskunde4
6. ContentsChapter 1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Chapter 2 The Four-Dimensional Symptom Questionnaire (4DSQ): Measuring distress and other mental health problems in a working population Work and Stress 2004;18(3):187-207 Terluin B, Van Rhenen W, Schaufeli WB, De Haan M. . . . . . . . . . . . . . . . . . . 23Chapter 3 Distress or no distress, thats the question: A cutoff point for distress in a working population J Occup Med Toxicol 2008;3:3 Van Rhenen W, Van Dijk FJH, Schaufeli WB, Blonk RWB. . . . . . . . . . . . . . . 53Chapter 4 The effect of a cognitive and a physical stress-reducing programme on psychological complaints Int Arch Occup Environ Health 2005;78(2):139-48 Van Rhenen W, Blonk RWB, van der Klink JJL, van Dijk FJH, Schaufeli WB. . . 71Chapter 5 Can sickness absence be reduced by stress reduction programs: on the effectiveness of two approaches Int Arch Occup Environ Health 2007;80(6):505-15 Van Rhenen W, Blonk RWB, Schaufeli WB, van Dijk FJH. . . . . . . . . . . . . . . . 91Chapter 6 Coping and sickness absence Int Arch Occup Environ Health 2008;81(4):461-72 Van Rhenen W, Schaufeli WB, van Dijk FJH, Blonk RWB . . . . . . . . . . . . . . 115Chapter 7 Do job demands, job resources and personality predict burnout and work engagement? A two-sample study Submitted Van Rhenen W, van Dijk FJH, Schaufeli WB . . . . . . . . . . . . . . . . . . . . . . . . 139Chapter 8 Discussion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163Chapter 9 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183Chapter 10 Samenvatting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195Curriculum vitae . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207Naschrift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209 5
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8. Chapter 1IntroductionThe main objectives of this thesis are to evaluate the assessment of stresscomplaints in occupational health surveillance; to evaluate the extent towhich two stress-reducing programs are able to reduce psychologicalcomplaints and sickness absence; to study the role of coping in thesickness absence process; and to identify predictors of burnout and workengagement. As these objectives make clear, stress and the managementof stress are central themes of the thesis.Job stress: A short introductionThe roots of modern occupational health services can be traced backto doctors in the late-19th century who not only treated patients withwork-related injuries or illnesses, but also recommended preventivemeasures (Gochfeld 2005a). Thackrah (1831), for example, recognizedthat dust affected the lungs of miners and metal workers, and drew aconnection between trades involving high levels of exposure to dust andtuberculosis. He wrote a treatise on the removal of workplace hazards andcampaigned to promote longevity. Thackrah is an exponent of an era inwhich particular attention was paid to social and physical occupationalhealth issues, such as setting limits on the number of hours that womenand children could work, workers compensation, and compensability ofvarious diseases (Josephson, 1934). In addition, it was an era in whichoccupational health services were developed in a number of industries inthe United States (Gochfeld 2005b).The practice of the occupational physician has evolved since that time,keeping pace with the needs of society, organizations, employers, andthe modern workforce (Hooker 2004). The focus of occupational healthhas changed as a result. Occupational health services are now drivenby one of the hallmarks of modern society: the fact that organizationsand self-employed workers have to adapt to rapidly-changing markets, 7
9. FROM STRESS TO ENGAGEMENTincreased competition and growing demand. This transition has hadnegative consequences for managers and employees, however. Changingconditions have generated high levels of job stress for many managersand employees, impacting on their health and well-being, and resulting inparticular attention being paid to what had been a relatively new area inoccupational health practice.To counter the negative aspects of modern labor conditions, occupationalhealth services are increasingly focused on issues such as mental workload,job stress, and the resulting strain and consequences for workers health.And not without reason; the Fourth European Working Conditions Survey(Parent-Thirion et al. 2007), which was commissioned by the EuropeanFoundation for the Improvement of Living and Working Conditions,reveals that job stress affects more than two out of every ten (22.3%)European workers. In the Netherlands, the gures are even more alarming:in 2006, circa 29% of employees reported working under stress (Van denBossche et al. 2007). Moreover, the societal costs of related absenteeismand disability are enormous. The percentage of sickness absence due towork- and stress-related Repetitive Strain Injuries, and work- and stress-related mental disorders in the Netherlands is estimated to be 3.8-6.2%and 3.6-6.3% respectively (Blatter et al. 2005).In order to limit the economic costs of treatment, more prevention andhealth promotion is needed. Treatment of stress in the workplace hasbeen predominantly studied from the perspective of the individual, withthe aim of reducing the effects of stress, instead of dealing with actualstressors in the workplace (Jordan et al. 2003). One reason for this may bethat in general, managers only act when forced to do so and when clearintervention strategies are available. Nevertheless, several authors (Jordanet al. 2003; Elo et al. 1998) promote the merits of preventive interventionsat earlier stages in the process, maintaining that it is better to prevent thanto cure. Little research exists, however, on the effectiveness of preventiveinterventions, and those ndings that are available are inconclusive(Houtman 2005).Very recently, the focus of job-related stress practice and research shifted inthe opposite direction, towards work engagement, a state characterized byhigh levels of energy, dedication, and immersion in work activities (Schaufeliand Salanova 2007).This new focus is in line with health-promotion programs8
