Recording Recovery Opportunities at Work and Functional Fatigue after Work: Two Instruments Adapted to the Swedish Context

Objectives: The importance of considering need for recovery after work and recovery opportunities at the workplace is relevant for occupational groups supporting clients in the workplace. Therefore, it is important that these concepts may be estimated with valid and reliable instruments within also a Swedish context. Thus, the aim of the study was to adapt the Need for Recovery (NFR) scale and the Recovery Opportunities (RO) scale to Swedish conditions and to assess the psychometric properties of the scales. Material and Methods: The translation process followed the guidelines for cultural adaptation of questionnaires. Both the RO scale and the NFR scale were assessed for stability, internal consistency and validity (n=146) in accordance with the validation of the original Dutch scales. An exploratory factor analysis with oblique rotation was performed regarding both scales. An Eigenvalue greater than one was used to determine number of factors. Results: The validity of the control scale RO in terms of the NFR value correlatively linked detachment from work to recovery from work demands. Regarding NFR, RO was more important than the other control scales. Work demands were negatively correlated with RO and an Influence control scale. Sufficient psychometric properties were found for both the NFR and the RO scales with stability measures (ICC) exceeding 0.90 and with a Cronbach’s alpha of 0.80 for RO and 0.90 for NFR. Principal component analysis showed meaningful results and regarding NFR confirmed earlier Dutch findings. Conclusion: Both scales proved to be reliable instruments to evaluate recovery opportunities related to work shifts and work-related fatigue after the shifts. The instruments confirmed findings from other countries regarding meaningful correlations with well-established instruments. The two instruments together confirm the importance of detachment from work for health benefit. ISSN: 2577-2007 COJ Nurse Healthcare Copyright © Kerstin Wentz 28 How to cite this article: Wentz K, Gyllensten K, Archer T. Recording Recovery Opportunities at Work and Functional Fatigue after Work: Two Instruments Adapted to the Swedish Context. COJ Nurse Healthcare. 1(2). COJNH.000507. 2018. DOI: 10.31031/COJNH.2017. 01.000507 Volume 1 Issue 2 employees. Conversely, substantial actions taken to increase and improve recovery among coach drivers showed a good effect on need for recovery after work fatigue, emotional exhaustion, and physical problems [15]. The need for recovery depends not only on the working conditions but also on age [7]. Recovery from work demands can be divided into two different types. These types concern either job design, for example, allowing workers to control longer or shorter breaks during work shifts, or time off from work [16]. Regarding leisure time recovery, Sonnentag [17] documented that social activity, low effort (passive) activity, and physical activity were beneficial. In addition, Sonnentag [17] points out that the negative effects from time pressure at work mainly unfold during leisure time, thereby affecting the recovery process as measured by wellbeing at bedtime. Also, the finding by Fransson & Heikkilä [18] suggests that unfavorable work characteristics affect the feasibility of leisure time recovery by increasing the risk of physical inactivity. With regard to after-effects from high workload impinging the recovery process, researchers such as Frankenhaeuser [19], Meijman [20], have documented how a high workload correlates with pronouncedly elevated adrenaline excretion rates during leisure time. Patterns of high workload accompanied by an increased risk for both physical [21] and mental health problems [22,23] have been documented. Simultaneously, these kinds of processes may prove themselves at early stages. This important phenomenon provides a rationale for using the signaling effect from an increased need for recovery as a preventive measure for antecedents of physical and mental health problems [6]. Put differently, the work shift may be used as a litmus paper on health. Critical care nurses constitute one of several professions at risk for burnout and secondary trauma-components of compassion fatigue, as a consequence of the high-pressure work environment. Compassion satisfaction and compassion fatigue influence nurses’ intention to continue within their chosen professions. It was observed among critical care nurses’ profiles that, whilst not in crisis, did not attain optimal levels of high compassion satisfaction and moderate/low fatigue although these individuals were not at crisis Jakimowicz [24] nevertheless, they remain at higher risk for compassion fatigue with necessity for improved postgraduate education. The relevance of meaningful recognition tools and other predictors of compassion fatigue have been assessed [25]. They obtained an equivalent extent of burnout, secondary traumatic stress, compassion satisfaction, overall satisfaction, and intent to leave from nurses serving in hospitals with and without meaningful recognition programs. However, meaningful recognition predicted decreased burnout and increased compassion satisfaction whereas job satisfaction and job enjoyment assessments predicted decreased burnout, decreased secondary traumatic stress, and increased compassion satisfaction. There are several questionnaires that may be used to measure need for recovery. For example, Aronsson & Astvik [14] used eight items to measure unwinding and recovery in a study with employees within pre-school, home care and social work in Sweden. The items reflected daily recovery and recovery during vacations. The need for recovery scale (NFR) is one of the main scales used to assess work-induced fatigue and quality of recovery time. It was developed in the Netherlands and has been used in occupational health practice and academic research in many studies [3,26]. Moreover, it has been translated into several languages and used in academic research in countries, such as Brazil and Italy [27,28]. One of the most relevant factors influencing recovery from work is the level of control over recovery opportunities during work shifts including the interface between the shifts and the personal sphere [16]. The recovery opportunities scale (RO) assesses workers’ opportunities to take breaks, pauses and days from work. It aims at situational characteristics that enable individuals to recuperate from work effort. Both the NFR and the RO scales have been used with different occupations and have been found to have good reliability and validity [3,5,29]. Despite the large number of studies using these scales an examination of the literature indicated that, to date, no studies have adapted the scales to the Swedish occupational context. Therefore, the objectives of this study were to translate and adapt the NFR and RO to the Swedish language. The translation was conducted in accordance with the guidelines for crosscultural adaptation of self-report measures on health proposed by Beaton [30]. The validity of the scales was explored by testing the correlations between the Swedish versions of the RO and NFR and the Demand Control Questionnaire [31], Influence at Work scale and the Possibilities for Development scale both from the Copenhagen Psycho Social Questionnaire [32], the single-item version of the Work Ability Index [33] and the Vitality scale from SF-36 [34]. The reliability of both scales was tested through Cronbach’s alpha, the intra-class correlation coefficient (ICC), the split half reliability, items-total correlation, and alpha-if-item-deleted. Additionally, exploratory factor analyses were performed.