Work-Related Exhaustion in East and West Germany

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This entry is adapted from the peer-reviewed paper 10.3390/ijerph191811533

Chronic exhaustion is a consequence of detrimental working conditions and demands, as well as inadequate coping techniques, potentially resulting in burnout. Previous research has studied occupational environment and individual factors as predictors of exhaustion. These differ between former East and West German states, the regional distinction regarding exhaustion has been neglected.

exhaustion technostress burnout information and communication technologies East/West Germany

1. Introduction

Information and communication technologies (ICTs) have reached a pervasive level in the labor domain. Conventional workday frames have become blurred as many organizational tasks are now independent of time and distance ^[1]. The growing intrusion of occupational aspects into leisure time might worsen the balance between the two domains. With less time to recover from everyday work-related stress, one might burn out ^[2] due to “excessive demands on energy, strength, or resources” ^[3]. Aside from work-related aspects such as ICT demands, individual factors play an important role for exhaustion or subsequent burnout ^[4]. The effort–reward imbalance model constitutes an example, in which work-related and individual factors both foster exhaustion through high demands and little gratification ^[5].

As a major public health concern, exhaustion increases behavioral health risk factors ^[6]^[7] and in turn the morbidity risk ^[8]. Malakh-Pines ^[9] defined three types of exhaustion: emotional, mental, and physical exhaustion. Emotional exhaustion can be described as feeling emotionally overextended and a perceived absence of emotional resources ^[10]. Mental exhaustion goes along with negative attitudes towards one’s self, one’s own life, or other people ^[9]. Physical exhaustion is associated with low energy, weakness, and weariness ^[9]. Overall, exhaustion is one of the symptoms of burnout ^[11] which is correlated with low mental and general health ^[12]. By the first definition of burnout, Freudenberger ^[3] listed frequent headaches, gastrointestinal problems, sleep trouble, and shortness of breath as its physical signs. In recent research, assessing burnout and differentiating it from exhaustion turned out to be problematic ^[8]. Van Dam ^[8] stated that clinical burnout could not be measured using the common questionnaires, as they overestimated the burnout prevalence due to the participants′ short-term stress, neglecting the duration of the symptoms.

Previous research has shown the occupational environment in East Germany differs from West Germany, even after the reunification: compared to West Germany, East Germans′ jobs are more often shaped by Tayloristic work practices of monotonous production procedures ^[13]. This may be a remnant of the strong primary and secondary sectors of the economy of the German Democratic Republic (GDR), as opposed to the industrialized West as well as the Federal Republic of Germany (FRG) ^[14]. Therefore, the occupational environment may be associated with the general psychological health differences that were found between the two regions over the past 30 years ^[15]. However, despite their different work environments, exhaustion has not been compared between the former eastern and western states of Germany.

2. The Definition and Identification of Exhaustion and Burnout

Originally, the concept of burnout was related to people working in human service jobs who became “unable to cope with this continual emotional stress” ^[16] (p. 16). Kristensen et al. ^[12] have extended exhaustion as a key component of burnout to anyone. This stems from the definition of Schaufeli and Greenglass ^[17], who see emotionally demanding jobs as sources of physical, emotional, and mental exhaustion. Kristensen et al. ^[12] thus developed and validated the Copenhagen Burnout Inventory (CBI) and its subgroup on personal burnout, which asks for the intensity of one’s physical and psychological exhaustion unrelated to a certain domain. Still, they found its correlation with the other subgroup of work-related burnout (r = 0.72, p < 0.001) to be very high.

For a long time, the International Classification of Diseases (ICD), ICD-10, merely mentioned burnout to be a “state of vital exhaustion” ^[18]. Only in the upcoming ICD-11 is burnout treated as an illness (QD85) under “Factors influencing health status or contact with health services” ^[11]. It is defined as a consequence of chronic work stress and characterized by three dimensions: (1) exhaustion; (2) mental distance from the job, negativism or cynicism towards it; and (3) feeling ineffective or lacking accomplishment ^[11]. Thus, as chronic work stress increases the risk for burnout ^[8]^[11], many questionnaires that try to assess burnout, such as the CBI ^[12] or the more commonly used Maslach Burnout Inventory ^[19], are not sufficient due to their lack of assessment of the symptoms’ time span. However, the duration of the feelings of exhaustion is crucial for the emergence of clinical burnout ^[8]. People suffering from clinical burnout oftentimes even become accustomed to their stressful lives until they collapse; while they were trying to maintain high standards of task performance, they were not able to recover from stressful times anymore ^[8]. Because of this circumstance, the term exhaustion was used instead. The majority of previous research used the term burnout, although their scale did not ask for the duration of the symptoms. Moreover, exhaustion can indicate more phenomena than only burnout, as multiple physical or mental health issues are related to it ^[20]. Since Kristensen’s et al. ^[12] burnout concept does not assess the duration of the symptoms, the term exhaustion is more appropriate.

A meta-analysis by Shoman et al. ^[4] showed that situational and work-related (e.g., job demands, interpersonal relationships) as well as individual factors (e.g., personality traits, job attitudes), work–individual (conflicts, enrichment), and finally perceived intermediate work consequences (stress, satisfaction) predicted exhaustion in employees. Further, the work–family balance or work–life balance have an important mediating role when it comes to the association between ICT demands (e.g., pressure to be constantly available, interruptions during work time, work overload) and exhaustion as a higher balance reduces the risks of exhaustion ^[2]. Comparing several analyses, the Cohen’s f2 effect sizes of the work–family conflict range from small (<0.02) to medium (<0.15) ^[4]. Using prospective data, the correlations between job insecurity as well as emotional demands regarding the job and later burnout symptoms are positive ^[21].

3. Constant Availability and Technostress as Modern Side Effects

ICT use can simplify many aspects of everyday life and work, as it is able to structure work in a different, more independent way ^[22]. However, an overload of ICT use can be problematic. Ragu-Nathan et al. ^[1] developed the conceptual framework of technostress creators. First, constant connectivity, technoinvasion, enables people to be contacted anywhere and at any time; many of them feel forced to respond. Second, techno-overload explains how it becomes more difficult for workers to handle several mobile communication tools simultaneously as internal and external information increases. Previous research has shown adverse health effects related to technostress creators. Information overload and communication demands related to ICT use in the private sphere predict perceived stress for the group within the ages of 50 and 85 ^[23]. Moreover, Misra and Stokols ^[24] proposed that information overload as a consequence of the increasing use of ICTs were deleterious to attentional capacities and well-being. Technoinvasion was found to have a mediating role regarding the effect of techno-overload on burnout ^[25], using the scale developed by Malakh-Pines ^[26]. ICT demands have a higher impact on exhaustion, work–family balance and job satisfaction, which outweighs its supporting aspects ^[2]. A meta-analysis by Berg-Beckhoff et al. ^[22] revealed associations between ICT use within occupational settings and stress, whereas intervention studies did not find this. ICT use and burnout are positively associated, especially within the groups of middle-aged workers between the age of 35 and 45. Therefore, ICT demands were considered work-related predictors of exhaustion.

4. Different Occupational Environments in East and West Germany

Becker et al. ^[13] focused on past and present working conditions and aspects in East and West Germany. They reported that East Germans more often reported mental strains related to work than West Germans, especially due to financial loss or interruptions during work hours. In their argumentation, due to lower levels of wages before reunification and the rather slow convergence to West German standards, the ratio of income and working hours was lower in East Germany, providing West Germans with a higher financial gratification for their labor. Furthermore, they reported that East Germans worked more often in on-call duty as well as shift duty, and thus, needed to be available during leisure time more frequently than West Germans. In general, working conditions were partially less favorable in the former eastern states of Germany, posing a potential health risk for its employed inhabitants.

However, in the GDR, compared to the FRG, a different and regulatorily broader approach to worker protection and occupational health existed, though its realization varied ^[13]. East German employees partly suffered from the adaptation to less protective West German occupational health after reunification, as they were accustomed to this form of working socialization.

Nevertheless, more West Germans call in sick because of mental health issues which is why Becker et al. ^[13] assume that East Germans tend to continue working while being sick, exhibiting so-called presenteeism. This stems from having suffered from pervasive layoffs after the reunification and an insufficient protection of advocacies ^[27]. Moreover, East Germans tend to deny being ill ^[27].

5. Exhaustion Rates in East and West Germany

Overall, work-related exhaustion was higher in West Germany. Living in East Germany was significantly negatively associated with exhaustion and might thus buffer it. This might be related to the finding that the relation between exhaustion and technostress (in the form of the number of e-mails received during leisure time as well as the social pressure within the occupational realm to be constantly available) signficantly differs between East and West Germany, with the association being stronger in the latter region. In the East, individual factors as sex, working hours, age, or the partnership status indicated higher relations with exhaustion.

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