title: The Effectiveness of a Stress Reduction and Burnout Prevention Program.
abstract: Chronic psychological distress appears to have increased in recent years, mainly among the working population. The data available indicate that mental and behavioral disorders, including burnout syndrome, represent not only a personal problem for those afflicted, but also a serious public health issue. This study aimed at evaluating the effects of an outpatient burnout prevention program in a mono-center health resort setting.
  
  
  
  Adults experiencing an above-average level of stress and thus being at an increased risk of burnout were randomized either to the intervention group (IG) or the waiting control group (WG). The 3-week program included stress management intervention, relaxation, physical exercise and moor applications. The primary outcome was change in perceived stress (PSQ) at 6 months post-intervention. Secondary outcomes included burnout symptoms, well-being, health status, psychological symptoms, back pain, and number of sick days. Participants were examined at baseline, post-intervention (3 weeks) and after 1, 3 and 6 months.
  
  
  
  Data from 88 adults (IG=43; WG=45) were available for (per protocol) analysis (mean age: 50.85; 76.1% female). Participants in the IG experienced significant immediate improvement in all outcome measures, which declined somewhat during the first three months post-intervention and then remained stable for at least another three months. Those in the WG did not experience substantial change across time. For the 109 randomized persons, results for PSQ were confirmed in an intention-to-treat analysis with missing values replaced by last observation carried forward (between-group ANCOVA for PSQScore at 6 months, parameter estimator for the group: -20.57; 95% CI: [-26.09; -15.04]). Large effect sizes (Cohen's d for PSQ: 1.09-1.72) indicate the superiority of the intervention.
  
  
  
  The program proved to be effective in reducing perceived stress, emotional exhaustion and other targets. Future research should examine the long-term impact of the program and the effect of occasional refresher training.
authors.affiliation: Chair of Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology - IBE, Ludwig-Maximilians-Universität (LMU); Psychocomatic Clinic Windach.
authors.forename: Marita
authors.initials: M
authors.lastname: Stier-Jarmer
authors.forename: Dieter
authors.initials: D
authors.lastname: Frisch
authors.forename: Cornelia
authors.initials: C
authors.lastname: Oberhauser
authors.forename: Götz
authors.initials: G
authors.lastname: Berberich
authors.forename: Angela
authors.initials: A
authors.lastname: Schuh
mesh_terms: D001521:Behavior Therapy; D002055:Burnout, Professional / Q000628:therapy*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011613:Psychotherapy; D012064:Relaxation Therapy