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BMJ Open. 2013 May 2;3(5). pii: e002297. doi: 10.1136/bmjopen-2012-002297.

Job strain and supervisor support in primary care health centres and glycaemic control among patients with type 2 diabetes: a cross-sectional study.

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1
Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland.

Abstract

OBJECTIVES:

This study investigates associations between healthcare personnel's perceived job strain, supervisor support and the outcome of care in terms of glycaemic control among patients with type 2 diabetes.

DESIGN:

A cross-sectional study from 2006.

SETTING:

18 primary care health centres (HCs) from five municipalities in Finland.

PARTICIPANTS:

Aggregated survey data on perceived job strain and supervisor support from healthcare personnel (doctors, n=122, mean age 45.5 years, nurses, n=300, mean age 47.1 years) were combined with registered data (Electronic Medical Records) from 8975 patients (51% men, mean age 67 years) with type 2 diabetes.

OUTCOME MEASURE:

Poor glycaemic control (glycated haemoglobin (HbA1c) ≥7%).

RESULTS:

The mean HbA1c level among patients with type 2 diabetes was 7.1 (SD 1.2, range 4.5-19.1), and 43% had poor glycaemic control (HbA1c ≥7%). Multilevel logistic regression analyses, adjusted for patient's age and sex, and HC and HC service area-level characteristics, showed that patients' HbA1c-levels were less optimal in high-strain HCs than in low-strain HCs (OR 1.44, 95% CI 1.12 to 1.86). Supervisor support in HCs was not associated with the outcome of care.

CONCLUSIONS:

The level of job strain among healthcare personnel may play a role in achieving good glycaemic control among patients with type 2 diabetes.

KEYWORDS:

Primary Care

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