CoChat
Sign Up
Cited by 44Healthcare professionals’ stress and burnoutStress and Burnout ResearchOccupational Health and Burnout

Associations between healthcare worker participation in workplace wellness activities and job satisfaction, occupational stress and burnout: a cross-sectional study in Botswana

Open access
Ledikwe, Jenny H, Kleinman, Nora Joelle, Mpho, Maureen, Mothibedi, Heather, Mawandia, Shreshth, Semo, Bazghina-werq, O’Malley, Gabrielle·2018·BMJ Open
DOI 10.1136/bmjopen-2017-018492PMC PMC5857656
Open this paper in CoChat — free account

Abstract

Objectives: Healthcare workers (HWs) are prone to high levels of stress and burnout, particularly when caring for people with HIV/AIDS. This study assessed whether participation in Botswana’s Workplace Wellness Programme (WWP) for HWs was associated with job satisfaction, occupational stress, well-being and burnout. Methods: Using multistage sampling, a paper-based questionnaire was distributed to 1856 randomly selected HWs at 135 public facilities across Botswana. Well-validated scales assessed key outcomes. Analysis of covariance models were built for psychosocial factors associated with WWP participation, controlling for associated demographics. Results: Response rate was 73% (n=1348). The majority of respondents were female (62%), not married (65%) and had children (84%). Mean age was 40.0 years (SD±9.9). Respondents were roughly split between participation in no WWP activities (29.4%), 1–6 WWP activities (38.9%) and seven or more WWP activities (31.7%) in the past year. High participation was associated with older age, being a doctor or other professional, working at hospitals or District Health Management Teams, working longer in health services or working longer at a facility. In unadjusted analyses, high participation was significantly associated (P<0.05) with higher satisfaction with overall job, work, supervision, promotion, pay and professional efficacy and lower stress, exhaustion and cynicism. All associations remained significant in controlled analyses except cynicism. Conclusions: Results from this study suggest that participation in workplace wellness activities is associated with higher satisfaction with multiple job facets and lower stress, exhaustion and cynicism. Introduction of these activities may help ameliorate high occupational stress levels among HWs.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1136/bmjopen-2017-018492

Cites

2 of 2 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Burnout has negative impacts on job satisfaction, the health of the residents, and the delivery of clinical services to patients.

    “Burnout contributes to poor job satisfaction [14] and a negative impact on their mental and physical health [15,16].”

    From Prevalence of Burnout in Medical and Surgical Residents: A Meta-Analysis (2019) · cites this paper as [14]

    The Results report that greater participation in workplace wellness activities was associated with both higher job satisfaction and lower exhaustion, a measure of burnout. They do not show that burnout causes poor job satisfaction; the Discussion says the interplay among stress, burnout and job satisfaction is not well understood. Citation [14] is attached to the job-satisfaction clause, not the separately cited health clause. (LLM, conf=0.80)

    Experimental — accuracy not yet measured

  • In Botswana and Mozambique, organizational structures such as supportive supervision, clear communication, and participation in wellness activities were associated with improved motivation, teamwork and job satisfaction.

    “In Botswana and Mozambique, organizational structures, such as supportive supervision, clear communication, and participation in wellness activities, were associated with improved motivation, teamwork and job satisfaction (13, 14).”

    From Management strategies for healthcare worker burnout in Sub-Saharan Africa: an integrative review (2026) · cites this paper as [13]

    The Discussion reports that participation in workplace wellness activities was associated with higher job satisfaction among health workers in Botswana. It does not report findings from Mozambique or establish associations involving clear communication, supportive supervision, motivation, or teamwork. The study is cross-sectional, so it also cannot establish that wellness activities caused improvement. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Burnout management in Sub-Saharan Africa is multifaceted, shaped by the interplay between organizational support, interpersonal relationships, individual burnout management strategies, and culturally grounded practices.

    “Collectively, the findings demonstrate that burnout management in the region is multifaceted, shaped by the interplay between organizational support, interpersonal relationships, individual burnout management strategies, and culturally grounded practices (12–14, 19).”

    From Management strategies for healthcare worker burnout in Sub-Saharan Africa: an integrative review (2026) · cites this paper as [13]

    The Discussion presents workplace wellness programmes and organisational policy as potential ways to support healthcare workers, and the Results report participation in psychosocial and spiritual care activities. The paper does not establish the claimed interplay among organisational support, interpersonal relationships, individual burnout-management strategies and culturally grounded practices across sub-Saharan Africa. The indexed passages provide section labels but no page numbers. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Wellness programs in Botswana were associated with lower emotional exhaustion and higher job satisfaction.

    “Wellness programs in Botswana were associated with lower emotional exhaustion and higher job satisfaction (13).”

    From Management strategies for healthcare worker burnout in Sub-Saharan Africa: an integrative review (2026) · cites this paper as [13]

  • In Botswana, emotional exhaustion was found to co-occur with low participation in wellness programs.

    “In Botswana, emotional exhaustion was found to co-occur with low participation in wellness programs, suggesting that when support structures are limited or difficult to access, healthcare workers may resort to less helpful coping patterns (13).”

    From Management strategies for healthcare worker burnout in Sub-Saharan Africa: an integrative review (2026) · cites this paper as [13]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 29

  1. [1]Maslach C, Schaufeli WB, Leiter MP Job burnout. Annu Rev Psychol 2001; 52: 397– 422. 10.1146/annurev.psych.52.1.397 11148311 · DOI · Paper page
  2. [2]Felton JS Burnout as a clinical entity-its importance in health care workers. Occup Med 1998; 48: 237– 50. 10.1093/occmed/48.4.237 9800422 · DOI
  3. [3]Silverman DC Psychosocial impact of HIV-related caregiving on health providers: a review and recommendations for the role of psychiatry. Am J Psychiatry 1993; 150: 705– 12. 10.1176/ajp.150.5.705 8480814 · DOI
  4. [4]Demmer C Burnout: the health care worker as survivor. AIDS Read 2004; 14: 522-523, 528-530, 535-527. 15510388
  5. [5]Kerr ZY, Miller KR, Galos D, et al Challenges, coping strategies, and recommendations related to the HIV services field in the HAART era: a systematic literature review of qualitative studies from the United States and Canada. AIDS Patient Care STDS 2013; 27: 85– 95. 10.1089/apc.2012.0356 23336722 · DOI
  6. [11]Baicker K, Cutler D, Song Z Workplace wellness programs can generate savings. Health Aff 2010; 29: 304– 11. 10.1377/hlthaff.2009.0626 20075081 · DOI
  7. [12]Goetzel RZ, Henke RM, Tabrizi M, et al Do workplace health promotion (wellness) programs work? J Occup Environ Med 2014; 56: 927– 34. 10.1097/JOM.0000000000000276 25153303 · DOI · Paper page
  8. [13]Kolbe-Alexander TL, Proper KI, Lambert EV, et al Working on wellness (WOW): a worksite health promotion intervention programme. BMC Public Health 2012; 12: 372 10.1186/1471-2458-12-372 22625844 PMC3433314 · DOI
  9. [14]Astrella JA Return on investment: evaluating the evidence regarding financial outcomes of workplace wellness programs. J Nurs Adm 2017; 47(7-8): 379– 83. 10.1097/NNA.0000000000000499 28727623 · DOI
  10. [15]Kaspin LC, Gorman KM, Miller RM Systematic review of employer-sponsored wellness strategies and their economic and health-related outcomes. Popul Health Manag 2013; 16: 14– 21. 10.1089/pop.2012.0006 23113636 · DOI
  11. [16]Howarth A, Quesada J, Mills PR A global, cross cultural study examining the relationship between employee health risk status and work performance metrics. Ann Occup Environ Med 2017; 29: 17 10.1186/s40557-017-0172-1 28616243 PMC5469053 · DOI
  12. [17]Milner K, da Silva R, Patel D, et al How do we measure up? A comparison of lifestyle-related health risk factors among sampled employees in South African and UK companies. Glob Health Promot 2016: 175797591665634 10.1177/1757975916656346 27406821 · DOI
  13. [18]Kolbe-Alexander T, Greyling M, da Silva R, et al The relationship between workplace environment and employee health behaviors in a South African workforce. J Occup Environ Med 2014; 56: 1094– 9. 10.1097/JOM.0000000000000236 25285833 · DOI
  14. [19]Milner K, Greyling M, Goetzel R, et al The relationship between leadership support, workplace health promotion and employee wellbeing in South Africa. Health Promot Int 2015; 30: 514– 22. 10.1093/heapro/dat064 24143003 · DOI
  15. [20]Patel D, Goetzel RZ, Beckowski M, et al The Healthiest Company Index: a campaign to promote worksite wellness in South Africa. J Occup Environ Med 2013; 55: 172– 8. 10.1097/JOM.0b013e3182728d61 23287724 · DOI
  16. [21]Conradie CS, van der Merwe Smit E, Malan DP Corporate health and wellness and the financial bottom line: evidence from South Africa. J Occup Environ Med 2016; 58: e45– 53. 10.1097/JOM.0000000000000653 26849271 PMC4730788 · DOI
  17. [23]Stanton JM, Sinar EF, Balzer WK, et al Development of a compact measure of job satisfaction: the abridged job descriptive index. Educ Psychol Meas 2002; 62: 173– 91. 10.1177/001316440206200112 · DOI
  18. [24]Kinicki AJ, Mckee-Ryan FM, Schriesheim CA, et al Assessing the construct validity of the job descriptive index: a review and meta-analysis. J Appl Psychol 2002; 87: 14– 32. 10.1037/0021-9010.87.1.14 11916208 · DOI
  19. [25]Stanton JM, Balzer WK, Smith PC, et al A general measure of work stress: the stress in general scale. Educ Psychol Meas 2001; 61: 866– 88. 10.1177/00131640121971455 · DOI
  20. [27]Ali GC, Ryan G, De Silva MJ Validated screening tools for common mental disorders in low and middle income countries: a systematic review. PLoS One 2016; 11: e0156939 10.1371/journal.pone.0156939 27310297 PMC4911088 · DOI · Paper page
  21. [28]Schaufeli WB, Greenglass ER Introduction to special issue on burnout and health. Psychol Health 2001; 16: 501– 10. 10.1080/08870440108405523 22804495 · DOI
  22. [29]Poghosyan L, Aiken LH, Sloane DM Factor structure of the Maslach burnout inventory: an analysis of data from large scale cross-sectional surveys of nurses from eight countries. Int J Nurs Stud 2009; 46: 894– 902. 10.1016/j.ijnurstu.2009.03.004 19362309 PMC2700194 · DOI
  23. [30]Worley J, Vassar M, Wheeler D, et al Factor structure of scores from the Maslach Burnout Inventory: a review and meta-analysis of 45 exploratory and confirmatory factor-analytic studies. Educ Psychol Meas 2008; 68: 797– 823.
  24. [31]Langballe EM, Falkum E, Innstrand ST, et al The factorial validity of the Maslach Burnout Inventory–general survey in representative samples of eight different occupational groups. J Career Assess 2006; 14: 370– 84.
  25. [32]Harris PA, Taylor R, Thielke R, et al Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42: 377– 81. 10.1016/j.jbi.2008.08.010 18929686 PMC2700030 · DOI · Paper page
  26. [33]Yassi A, O’Hara LM, Lockhart K, et al Workplace programmes for HIV and tuberculosis: a systematic review to support development of international guidelines for the health workforce. AIDS Care 2013; 25: 525– 43. 10.1080/09540121.2012.712668 22880845 · DOI
  27. [34]Basson HA, Roets L Workplace wellness for HIV/AIDS-affected nurses in South Africa. Br J Nurs 2013; 22: 38– 44. 10.12968/bjon.2013.22.1.38 23299210 · DOI · Paper page
  28. [36]Cropanzano R, Mitchell MS Social exchange theory: an interdisciplinary review. J Manage 2005; 31: 874– 900. 10.1177/0149206305279602 · DOI · Paper page
  29. [38]Khamisa N, Oldenburg B, Peltzer K, et al Work related stress, burnout, job satisfaction and general health of nurses. Int J Environ Res Public Health 2015; 12: 652– 66. 10.3390/ijerph120100652 25588157 PMC4306884 · DOI

Cited by

Sorted by citations

Authors
Ledikwe, J. H., Kleinman, N. J., Mpho, M., Mothibedi, H., Mawandia, S., Semo, B.-W., & O’Malley, G.
Affiliations
  • University of Washington (US)
  • Ministry of Health (BW)
Corresponding author
Ledikwe, Jenny H
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2018-03
Volume
8
Issue
3
Pages
e018492
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2017-018492
PMC
PMC5857656
OpenAlex
W2791590677
Cited by
44
References
2
Citations by year
2026: 2 · 2025: 7 · 2024: 7 · 2023: 5 · 2022: 10 · 2021: 3 · 2020: 4 · 2019: 4 · 2018: 1
FWCI
4.58
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
U.S. President’s Emergency Plan for AIDS Relief
Topics
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
  • Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
Keywords
workplace wellness programmes, healthcare workers, job satisfaction, occupational stress, burnout, cynicism, exhaustion, well-being, HIV care, Botswana
MeSH terms
Occupational Stress, Work Engagement, Adult, Botswana, Burnout, Professional, Cross-Sectional Studies, Female, Health Personnel, Health Promotion, Humans, Job Satisfaction, Male, Middle Aged, Workplace

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review