1. Vårdcentralen Staffanstorp 3.1

2. Vårdcentralen Staffanstorp Stress management courses at a Swedish health care center – a co-operation between several professions with a bio-psychosocial point of view Marie Johnsson, Social studies graduate, Psychotherapist Christina Nordström, Occupational Therapist Welcome! Vårdcentralen Staffanstorp

3. Course programme Introduction of Mindfulness Society past and present Stress physiology Listening to your signals Balance of occupations Sleep Physical activity Closure Follow up after 6 months

4. Vårdcentralen Staffanstorp Selection for group treatment Ability to concentrate Being in the recovery phase Main diagnosis burnout syndrome Being listed at the health care centre

5. Vårdcentralen Staffanstorp The effects of stress management courses 120 patients since the start in 2007 34 patients in the project since 2010-2011 30 women and 4 men Average age 44 years

6. Vårdcentralen Staffanstorp Evaluation instruments SMBQ – Shirom-Melamed Burnout Questionnaire - an internationally validated screening instrument concerning burnout syndrome High/pathological burnout ≥ 4,47 Low burnout, healthy ≤ 2, 75 » Emotional/physical fatigue » Listlessness » Tension » Cognitive difficulties

7. Vårdcentralen Staffanstorp Evaluation instruments EQ5D – a measure of health-related quality of life Health profileHealth index 0-100 (1= full health, Swedish normal population = 0.85) » Mobility » Hygiene » Main activities » Pain » Anxiousness/depression

8. Vårdcentralen Staffanstorp The results… 71% of the participants scored high burnout levels at the start of the course. 6 months later only 11% of them scored high burnout levels.

9. Vårdcentralen Staffanstorp SMBQ Group level

10. Vårdcentralen Staffanstorp EQ5D Health profile - Group

11. Vårdcentralen Staffanstorp EQ5D Health index - Group

12. Vårdcentralen Staffanstorp Sick leave

13. Vårdcentralen Staffanstorp Comments from the participants ”Coming here has been without demands. You have learned to come to terms with yourself and to figure out what you need to change.” ”The course gives an opportunity for discussions. An open and relaxed climate. 1.5 hours is about all that you can manage.” ”I feel that I need time to reflect. Time for recovery. I think it will take some time for the stress to diminish.”

14. Vårdcentralen Staffanstorp What have we learned? SMBQ as a screening instrument Preventive sick leave in relation to burnout scores Increase the knowledge about stress disorders – a more accurate diagnosis A wide scale of different treatment options Two therapists at the same time is advisable 6 months follow up Information to relatives A difficult group to reach preventively Educate managers and politicians?

15. Vårdcentralen Staffanstorp 3.1