title: Understanding long-term sick leave in female white-collar workers with burnout and stress-related diagnoses: a qualitative study.
abstract: BACKGROUND
  Sick leave rates in Sweden have been significant since the end of the 1990s. In this paper we focus on individual female white-collar workers and explore various factors and setting-based sources of ill health in working life and in private life, in order to understand impaired work ability, leading ultimately to long-term sick leave.
  
  
  METHODS
  A qualitative methodology was chosen, and thematic, open-ended interviews were carried out with 16 women. The interviewees were strategically selected from a cohort of 300 women in full-time white-collar jobs in high-level positions, living in three urban areas in Sweden, and on long-term sick leave > or =90 days. A qualitative content analysis was carried out.
  
  
  RESULTS
  The informants in the study were generally well educated, but a few had surprisingly little formal education considering their salary level and position on the labour market. The women were in professional positions more commonly held by men, either as specialists with some degree of managerial role or as executives with managerial responsibilities. Both external and internal stressors were identified. The analysis indicated that being in these gender-typed jobs could have induced sex discrimination and role conflicts. The women expressed strong agreement regarding success in working life, but emphasised the lack of competence matching in their present jobs. They also lacked the sense of having a rewarding job, saw leadership as weak, and disliked their present workplace and colleagues. Impaired health may have hindered them from changing jobs; conversely, their locked-in positions could have resulted in deterioration in their health status. The women displayed personal overcommitment, both at work and in private life, and had difficulties in setting limits.
  
  
  CONCLUSIONS
  Factors in working life, as well as in private life, played an important role in the informants' deteriorated health and long-term sick leave. Job and workplace mismatching, problems in connection with company profitability, and poor leadership contributed to stress-related symptoms, resulting in reduced working capacity. On the basis of these findings, attention should be paid to identification of early indicators of exhaustion, and measures should be taken in work settings and in working life as a whole to promote retained work ability.
authors.affiliation: School of Health and Medical Sciences, Public Health Science, Orebro University, Sweden. helene.sandmark@oru.se
authors.forename: Hélène
authors.initials: H
authors.lastname: Sandmark
authors.forename: Monica
authors.initials: M
authors.lastname: Renstig
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000150:complications / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D007407:Interviews as Topic; D007857:Leadership; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology; D009790:Occupations; D011361:Professional Competence; D036301:Qualitative Research; D018582:Sick Leave; D012923:Social Class; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology*; D013548:Sweden; D014931:Women, Working / Q000193:education / Q000523:psychology* / Q000706:statistics & numerical data; D016526:Workload / Q000523:psychology*