Open Access Research article

A three-year cohort study of the relationships between coping, job stress and burnout after a counselling intervention for help-seeking physicians

Karin E Isaksson Ro12*, Reidar Tyssen2, Asle Hoffart13, Harold Sexton1, Olaf G Aasland45 and Tore Gude12

Author Affiliations

1 The Research Institute, Modum Bad, NO-3370 Vikersund, Norway

2 Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Boks 1111 Blindern, NO-0317 Oslo, Norway

3 Department of Psychology, University of Oslo, Norway

4 Research Institute of the Norwegian Medical Association, Postbox 1152 Sentrum, NO-0107 Oslo, Norway

5 Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Norway

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BMC Public Health 2010, 10:213  doi:10.1186/1471-2458-10-213

Published: 27 April 2010



Knowledge about important factors in reduction of burnout is needed, but there is a dearth of burnout intervention program studies and their effects among physicians. The present three-year follow-up study aimed to investigate the roles of coping strategies, job stress and personality traits in burnout reduction after a counselling intervention for distressed physicians.


227 physicians who attended a counselling intervention for burnout at the Resource Centre Villa Sana, Norway in 2003-2005, were followed with self-report assessments at baseline, one-year, and three-year follow-up. Main outcome measures were emotional exhaustion (one dimension of burnout), job stress, coping strategies and neuroticism. Changes in these measures were analyzed with repeated measures ANOVA. Temporal relationships between changes were examined using structural modelling with cross-lagged and synchronous panel models.


184 physicians (81%, 83 men, 101 women) completed the three-year follow-up assessment. Significantly reduced levels of emotional exhaustion, job stress, and emotion-focused coping strategies from baseline to one year after the intervention, were maintained at three-year follow-up.

Panel modelling indicated that changes in emotion-focused coping (z = 4.05, p < 0.001) and job stress (z = 3.16, p < 0.01) preceded changes in emotional exhaustion from baseline to three-year follow-up. A similar pattern was found from baseline to one-year follow-up.


A sequential relationship indicated that reduction in emotion-focused coping and in job stress preceded reduction in emotional exhaustion. As a consequence, coping strategies and job stress could be important foci in intervention programs that aim to reduce or prevent burnout in help-seeking physicians.