Healthy social services - Health risks and prevention potential in the social services of hospitals and rehabilitation facilities in Germany

Status:

completed 04/2025

Aims:

Social workers are confronted with specific professional demands. Recent studies show that members of this occupational group report higher emotional and cognitive demands than other occupational groups. Work-related psychological stress can promote the development of emotional exhaustion and burnout. Health reports from health insurance companies show that social and healthcare professionals have a disproportionately high number of incapacity to work due to mental and behavioral disorders. Neither the working conditions of employees in social services in the inpatient healthcare sector nor their health situation has been sufficiently researched.

Therefore, the study aims to record work-related psychological stress and strain outcomes for employees in hospital social services and social services in preventive care and rehabilitation facilities in Germany and to compare them with reference groups. The central question of this study is: What psychological stress and stress consequences do employees in social services in inpatient healthcare settings experience, and how do they differ from social work employees in other fields of work and other occupational groups?

Activities/Methods:

An explanatory study was conducted using quantitative empirical methods in a cross-sectional design. The database of hospitals and preventive or rehabilitation facilities was the "Directory of Hospitals and Preventive or Rehabilitation Facilities" of 2020. The directory contains an overview of all hospitals and almost all preventive or rehabilitation facilities in Germany that were available for inpatient medical care of the federal population on 31.12.2020 and agreed to publication in the directory. A partially standardized questionnaire was developed to record mental stress and the consequences of stress, as well as other relevant variables. The measurements of psychological stress and the consequences of stress were carried out using the German version of the COPSOQ (Copenhagen Psychosocial Questionnaire). In 2023 and 2024,

1. the social services of hospitals and
2. the social services of preventive care or rehabilitation facilities were invited to participate in a voluntary online survey via LimeSurvey.

The e-mail addresses of the social services were researched beforehand via the respective homepages of the social services. The survey was designed as a full survey and thus offered decisive advantages over a random sample survey (e.g., no risk of over- or under-representation).

Results:

It was found that hospital social services in Germany reported significantly higher quantitative and emotional demands compared to the reference groups ("social work/social education" and "all professions"). They also reported burnout symptoms and presenteeism significantly more frequently than the reference groups. Compared to the reference groups, the social services of prevention and rehabilitation facilities were significantly less likely to report the removal of work-related boundaries, work-privacy conflicts, and role conflicts. However, they reported higher emotional demands and hiding emotions significantly more frequently compared to all professions. Both the hospital social services and the social services of rehabilitation facilities also reported high presenteeism values. Overall, the results indicate higher levels of work-related psychological stress and strain outcomes in hospital social services in direct comparison with social services in rehabilitation facilities and the reference groups. There is a need for stress reduction and burnout prevention as part of workplace health promotion in social services in the inpatient healthcare sector.

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