Long work hours increase the need for recovery after work (Sluiter, Van der Beek, & Frings-Dresen, 1999). The majority of GPs in this study perceived they worked long hours with an ongoing heavy workload. Although research has identified that high workload inhibits psychological detachment (Sonnentag & Bayer, 2005), most
participants had found respite activities that could counteract the negative influence of high workload on their ability to detach. The respite activities they found conducive to recovery were sometimes simply rest or a change of activity. For example, physical activity such as running, yoga, swimming, meditation, and holidays (vacations); household activities, especially caring for children were helpful for recovery from the daily demands of work (Rook & Ziljstra, 2006). The most salient factor facilitating participants’ psychological detachment was their engagement in activities that were conceptually different from their daily GP work tasks.
8.7.1 Type of Respite Activities and Recovery
Time spent engaged in physical activities, has been shown to increase recovery levels (Rook & Ziljstra, 2006). The majority of participants in the current study engaged in physical activity because they considered this assisted recovery from work demands. All participants recognised the importance of physical activity for their physical and mental health, and many used this form of respite activity to facilitate psychological detachment. However, the type, duration and intensity varied considerably, depending upon the individual GPs attitude toward exercise and the amount of time they chose to allocate to
physical activity (e.g., walking, swimming, yoga, running, tennis, cycling), or, other leisure activities (e.g., music), and individual preferences and characteristics.
Participants did not always find it necessary to engage in leisure type of activities in order to take respite from work demands. For example, Robert worked in an emergency department of a hospital one day per month and found this provided respite from his GP role. In the emergency department, Robert was able to utilise the medical skills he had learned during medical training that he no longer used as a GP. He perceived this work as a positive experience that strengthened his feelings of competence, and gave him the opportunity to ‘get away’ from the daily demands of general practice. Although the emergency department may be considered a stressful environment, there was opportunity for Robert to experience a change of work context that provided ‘time out’ from his usual work duties. It is possible Robert’s change of work context is comparable to the Etzion et al. (1994) study regarding recovery of resources through military service. Although clearly not leisure activities, active military service and the emergency department provided opportunities to be geographically removed from the usual workplace and engage in activities outside their ‘usual’ work activities. This change of work context may assist psychological detachment and respite effect, that is, recovery of resources.
8.7.2 Type of Respite Activity and Psychological Detachment
Participants used a variety of respite activities with differing duration and frequency. The type, duration, and frequency of respites also changed dependent on the level of demands at the time. Short respites comprised regular physical activity, meditation, massage, and hobbies were combined with longer respites in the form of holidays (vacations), usually in two week periods three times a year. Participants considered that the type of respite was important because the respite activity had to facilitate
psychological detachment. For some participants in particular, simply being physically away from the practice did not necessarily mean they were leaving their ‘work at work’, they required activities that distracted them thinking about work. The majority of
participants worked for at least part of the day on Saturday and or Sunday; this precluded their use of the traditional two-day weekend respite whereby a significant amount of recovery occurs. The positive effects of a two-day period of time off from work without the pressures of work being present allow people to recover from work demands (Strauss- Blasche, Reithofer, Schobersberger, Ekmekcioglu, & Marktl 2005). This level of recovery does not seem possible during the working week. However, several participants in this study took a day off during the week, and reported finding this extremely beneficial in terms of psychological detachment and recovery from their daily GP work demands. This was consistent with the findings ofStrauss-Blasche, Reithofer, Schobersberger,
Ekmekcioglu, and Marktl (2005) who found that short breaks could facilitate recovery. There may not be an ‘optimal’ respite length, because it may be that people require individually tailored respites or combination of respites to derive maximum relief and recovery. Although all participants acknowledged the importance of taking holidays, short breaks more regularly may be an additional benefit for GPs. As Westman and Eden (1997) identified, the relief from job stress and burnout provided by a holiday respite gradually faded. It may, therefore, be important for GPs to engage in brief respites on a regular basis in order to reduce the fade-out that occurs following return to work after taking a holiday (vacation).
Most participants’ perceived constraints associated with time pressure and workload that prevented them from engaging in informal activity, in the form of brief respites, during the day for lunch or a coffee break (or even taking the time to go to the bathroom). These constraints appeared, to a large extent, to be self-imposed. Rather than insisting
that office staff allowed time in their schedule for a lunch break or short breaks during the work day, they allowed these opportunities for brief respites to be filled with extra
patients, phone calls, and paperwork. All participants, whether employers or employees, had the decision latitude to control and regulate their work pace; but despite their high level of professional autonomy, some participants did not perceive they had control over their workload and work flow, and, were not taking the opportunity to engage in brief respites during the day.
The sections above have identified that degree of work centrality, preference for integrating or segmenting work, and non-work/family domains, and general practice situational factors influence individual GP participants choice of respite activity and ability to psychologically detach. The link between these factors and whether or not participants obtained sufficient recovery to facilitate adaptation and perceived work-life balance was also identified.