Effect of Vacation on Health: Moderating Factors

of Vacation Outcome
Gerhard Strauss-Blasche, Barbara Reithofer,Wolfgang Schobersberger,
Cem Ekmekcioglu, and Wolfgang Marktl

Background: Vacation has recently become a topic of interest in health research as both beneficial and adverse health
effects have been documented. The present study was aimed at identifying vacation characteristics predicting health-
related vacation outcome.
Methods: One hundred ninety-one predominantly white-collar employees (109 female, 82 males; mean age 37.8 yr, range
16–62 yr) received a questionnaire in the week after vacation assessing subject characteristics, physical vacation char-

Downloaded from https://academic.oup.com/jtm/article/12/2/94/1863838 by guest on 25 June 2021

acteristics, the individual structuring of the day, health and social behavior, and stress during vacation as well as the
perceived change of recuperation and exhaustion from before to after a vacation. Regression analysis was used to iden-
tify variables predicting vacation outcome.
Results:Twenty-seven percent of the variance of the change of recuperation and 15% of the change of exhaustion could
be explained. Recuperation was facilitated by free time for one’s self, warmer (and sunnier) vacation locations, exercise
during vacation, good sleep, and making new acquaintances, especially among vacationers reporting higher levels of
prevacation work strain. Exhaustion was increased by vacation-related health problems and a greater time-zone differ-
ence to home, and was reduced by warmer vacation locations.
Conclusion: Health-related vacation outcome is significantly affected by the way an individual organizes his or her vacation.

Vacation, defined by Lounsbury and Hoops as a
temporary respite from work lasting several days to sev-
eral weeks, has presently become a topic of interest in
health research.1 A recent study suggests that the frequency
of annual vacations for men at risk for coronary heart dis-
ease (CHD) is associated with a reduced risk of mortal-
ity, which is predominantly attributed to the CHD.2
Also, leisure vacation has been reported to be negatively
associated with depression,3 a potential risk factor for
CHD,4 in a sample of Japanese male white-collar work-
ers. In longitudinal research with healthy employees, we
and others found vacation to be associated with at least
short-term improvements of health-related variables
such as burnout, mood, and physical complaints.5,6 To date,
the mechanisms leading to these results, except for a
Gerhard Strauss-Blasche, PhD, Cem Ekmekcioglu, MD, and
Wolfgang Marktl, MD: Department of Physiology, Medical
University of Vienna, Vienna, and Ludwig Boltzmann Institute
for Biological Rhythm Research, Bad Tatzmannsdorf, Austria;
Barbara Reithofer, MA: Department of Physiology, Medical
University of Vienna, Vienna, Austria; Wolfgang
Schobersberger MD: Institute for Leisure, Travel and Alpine
Medicine, University for Health Sciences, Medical
Informatics and Technology Tyrol, Innsbruck, Austria.
Reprint requests: Gerhard Strauss-Blasche, PhD,
Department of Physiology, Medical University of Vienna,
Schwarzspanierstrasse 17, 1090 Vienna, Austria.
J Travel Med 2005; 12:94–101.
removal of work stress and an increase of personally
available time,5,6 are as yet unclear. On the other hand,
vacation may also be associated with adverse health
effects for some individuals, potentially leading to leisure
sickness or cardiac incidence.7,8
Therefore, the aim of the present study was to iden-
tify variables relevant to the individual’s vacation that affect
both positive and negative health-related vacation out-
come.The study is exploratory as little information on
the effects of specific vacation attributes on health-
related vacation outcomes is provided in literature. Our
approach was to study physiologic and psychological
factors that have a known potential effect on well-being
and health in addition to vacation-specific variables
potentially moderating vacation outcome. Four aspects
of vacation were studied: (1) physical aspects of vacation,
including vacation duration assuming vacation benefits
to increase with longer vacation,9 the average tempera-
ture at the vacation site as a climatic variable,10 the time-
zone difference to account for jet lag,11 and the travel time
to account for travel stress12; (2) the organization of daily
routine, including the number of provided meals and the
planning of the day, both potential exogenous pace-
makers affecting health,13 self-determination of daily
actions, and time for one’s self and needs as leisure fac-
tors contributing to psychological well-being 14,15 ;
(3) health and social behavior including the amount of
physical activity,16 the duration and quality of sleep,17 and
making new acquaintances as known factors improving
health and mood18; and (4) potential stressors during

94
S t r a u s s - B l a s ch e e t a l , M o d e r a t i n g F a c t o r s o f Va c a t i o n
vacation including health problems and interpersonal con-
flicts.19,20
Methods
Subjects and Procedure
Subjects were employees of a large travel agency and
their relatives.A questionnaire, including a cover letter
asking for participation in a study of the effect of vaca-
tion type and vacation activities on recuperation and
well-being, was e-mailed or handed to approximately
500 recipients. Subjects were asked to fill out the ques-
tionnaire within the 2 weeks following their vacation.
Of the 295 returned questionnaires (response rate 59%),
only the 239 filled out by occupationally active indi-
viduals were included in the study. Of these, 38 had to
be rejected owing to incomplete answers or delayed
responses, and 10 were rejected owing to a vacation dura-
tion > 4 weeks.The latter criterion was established as
vacations > 4 weeks are unusual and the frequency of
these vacations was small in the current sample. Of 191
remaining study participants, 109 were females and 82
were males with a mean age of 37.8 years (SD = 11.3;
range 16–62 yr). Most study participants had partners
(72.8%); 24% had children younger than 14 years.The
study reflected a variety of locations, most commonly
in Austria (27%), followed by Italy (17%), Greece (13%),
northern Europe (11%), and Croatia (8%).About 5% of
the subjects traveled to other continents.Approximately
80% of the subjects filled out their questionnaire within
the first week of return; 30% completed it during the
first 3 days after vacation.
Measures
Selected items of a standardized German quality-of-
life questionnaire were used as outcome measure.21 This
quality-of-life measure, although initially constructed
for hypertensive patients, encompasses a broad variety of
items related to positive and negative well-being and self-
perceived fitness and is quite sensitive to change. From
these three scales, 11 items were chosen, and subjects were
asked to rate their current state of well-being in com-
parison to the state 2 weeks before their vacation.This
approach is a modification of the postintervention “then
rating” devised to minimize errors in the measurement
of change.22 Two scales were derived from the 11 items
by factor analysis, together explaining 60.3% of the vari-
ance. One item was discarded owing to a low factor load-
ing.Scale 1 (“recuperation”) was composed of seven items
(“In comparison to the 2 weeks before vacation, I now
feel mentally fitter, feel more balanced and relaxed, can
concentrate better during work, feel physically fitter, do
my work more easily, am in a better mood, and feel more
recuperated”) with a scale reliability of Cronbach’s
=
95
.91. Scale 2 (“exhaustion”) was composed of three items
(“In comparison to the 2 weeks before vacation, I now
feel more indifferent and apathetic, more depressed, and
more exhausted”) with a scale reliability of Cronbach’s

= .73.To describe subject characteristics, age, sex, and
an estimate of physical as well as mental strain of daily
work were assessed, the latter two because we assumed
that more strained individuals would show a greater
improvement during vacation.23
The independent variables described four different
aspects of vacation: (1) physical vacation characteristics
(duration, average temperature, time-zone difference,
time to reach destination), (2) organization of the day
(number of provided meals, self-determination of one’s
Downloaded from https://academic.oup.com/jtm/article/12/2/94/1863838 by guest on 25 June 2021
daily actions, planning of day ahead, time for one’s self
and needs), (3) health and social behavior (physical activ-
ity during vacation, average sleep duration during vaca-
tion, sleep quality, making new acquaintances), and
(4) stress during vacation (health problems, interper-
sonal conflicts).A complete list of items and their response
frequencies is presented in Table 1.
Statistics
The intercorrelation between the subject charac-
teristics and the independent variables as well as their cor-
relation with the two outcome measures was calculated.
The predictive effect of these variables on the two out-
come measures was analyzed using two separate linear
regression analyses. Vacationer characteristics and the
four groups of items representing the different aspects
of vacation were entered in five separate blocks.Total R2,
R2 change for each block, and  values for every vari-
able were listed.None of the variables had a variance infla-
tion factor of greater than 1.5.24
Results
The variables of subject and vacation description and
their frequency distribution are illustrated in Table 1.The
intercorrelation of these variables is illustrated in Table 2.
To predict vacation outcome, we conducted two regres-
sion analyses for both outcome measures—recupera-
tion and exhaustion (Table 3). Five groups of variables
were entered consecutively as separate blocks.The first
block encompassed variables describing the vacationers,
the second block variables described physical vacation
characteristics, the third block described the way vaca-
tioners organized their day, the fourth block related to
health and social behavior, and the fifth block related to
stressful events during vacation.
Twenty-seven percent of the change of recupera-
tion could be explained by the descriptive variables.
The vacationer characteristics (block 1) explained 7% of
the variance, with the mental strain of prevacation daily
96 J o u r n a l o f Tr a v e l M e d i c i n e , Vo l u m e 1 2 , N u m b e r 2

Table 1 Subject Characteristics, Variables Describing Vacation, and Outcome Measures

Characteristic/Variable Range Response Frequency (%)
Age (yr) 16–24 12
25–30 15.7
30–39 28.3
40–49 26.2
50–62 17.8
Physical strain of daily work (scale*) Low 37.6
2 40.7
3 11.2
4 7.8
High 2.7
Mental strain of daily work (scale*) Low 3.5
2 17.4
3 5.4

Downloaded from https://academic.oup.com/jtm/article/12/2/94/1863838 by guest on 25 June 2021

4 33.3
High 40.3
Duration of vacation (d) 3–7 34.9
8–14 43.8
15–21 12.8
22–28 8.5
Time zone difference to home (h) 0 64.3
1–2 33
5–8 2.7
Average temperature at vacation site (C) 15–20 14.3
21–25 27.9
26–30 40
30–45 17.8
Time to travel to vacation site (h) 1–3 36.4
4–7 37.6
8–12 16.3
13–48 9.7
Provided meals (number) None 34
1 (breakfast) 27.2
2 22.5
3 16.2
Self-determination of daily actions (scale*) Not at all 2.1
2 11.0
3 2.1
4 16.1
Very much so 68.6
Planning the day ahead (scale*) Not at all 25.7
2 40.3
3 9.4
4 20.4
Very much so 4.2
Time for one’s self and needs (scale*) None 2.6
2 16.2
3 2.6
4 31.9
Adequate 46.6
Physical activity during vacation (scale*) None 20.4
2 26.2
3 24.1
4 22.0
Very often 7.3
Average duration of sleep (h) 5–7 8.9
8 24.1
9 39.3
10–11 27.7
Sleep quality (scale*) Bad 1.6
Continued
S t r a u s s - B l a s ch e e t a l , M o d e r a t i n g F a c t o r s o f Va c a t i o n 97

Table 1 (Continued)
Characteristic/Variable Range Response Frequency (%)
2 15.7
3 3.7
4 25.1
Good 53.9
Making new acquaintances (scale*) Not at all 27.2
2 32.5
3 6.3
4 19.4
Very much so 14.7
Health problems during vacation (scale*) None 78.0
2 13.6
3 5.2
4 3.1

Downloaded from https://academic.oup.com/jtm/article/12/2/94/1863838 by guest on 25 June 2021

Very often 0
Interpersonal conflicts (scale*) Not at all 69.6
2 20.9
3 3.7
4 3.1
Very much so 2.6
Recuperation (scale 0–100) 0–19 5.2
20–39 12.6
40–59 24.6
60–79 41.9
80–100 15.7
Exhaustion (scale 0–100) 0–19 71.2
20–39 17.3
40–59 9.4
60–79 2.1
80–100 0
*Five-point Likert scale.

work positively predicting outcome; that is, individuals
with high job strain experienced greater recuperation
during vacation. Age, sex, and physical strain were not
significantly associated with recuperation. Physical vaca-
tion characteristics (block 2) explained 6% of the vari-
ance, with warm temperature at the vacation site
predicting recuperation. Despite a single-order correla-
tion, the duration of vacation did not predict recuper-
ation in the regression analysis nor did time-zone
difference or travel time.
The way vacationers organized their day (block 3)
explained 8% of the variance.Whereas the number of pro-
vided meals,the extent of self-determination of one’s daily
activities, and the extent vacationers tended to plan their
day ahead did not predict recuperation, the amount of
time vacationers perceived to have for themselves and their
needs was positively and strongly associated with recu-
peration. Health and social behaviors (block 4) explained
7% of the perceived change of recuperation.Vacationers
engaging in more physical activity, having a better qual-
ity of sleep, and making new acquaintances perceived
greater recuperation after vacation. Sleep duration dur-
ing vacation did not significantly predict recuperation.
Potential vacation stressors (block 5) predicted 2% of the
variance. Interpersonal conflicts were negatively related;
health problems were unrelated to recuperation.
Overall, 15% of the second outcome measure, the
perceived change of exhaustion, could be explained by
the descriptive variables.The vacationer characteristics
(block 1) did not predict exhaustion. Physical vacation
characteristics (block 2) predicted 7% of the change of
exhaustion,with a greater time-zone difference being pos-
itively related to exhaustion and the average tempera-
ture at the vacation site negatively related to exhaustion.
The duration of vacation and the time to travel to the
vacation destination were unrelated. The individual
organization of daily vacation activities (block 3) did not
predict exhaustion. Also, health and social behaviors
(block 4) were unrelated to exhaustion.Stress during vaca-
tion (block 5) explained 3% of the variance, with health
problems, but not interpersonal conflicts, predicting
exhaustion.
Discussion
Even though studies in tourism and leisure research
have assessed the effect of vacation-related factors on
vacation satisfaction,25 the present study is, to our knowl-
98 J o u r n a l o f Tr a v e l M e d i c i n e , Vo l u m e 1 2 , N u m b e r 2

Table 2 Intercorrelation of Subject and Vacation Characteristics*

Characteristic 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
1 Age — .21 .24 .29 .19 .16 .19
2 Sex (1= m, 2 = f) .21 — .17
3 Physical strain of
daily work —
4 Mental strain of
daily work — .14 .15
5 Duration of
vacation (d) .24 — .26 .27 .21 .25
6 Time-zone
difference to
home (h) .26 — .22 .32 .30 .17
7 Average temperature
at vacation site .29 .22 — .18 .27 .19

Downloaded from https://academic.oup.com/jtm/article/12/2/94/1863838 by guest on 25 June 2021

8 Time to travel to
vacation site (h) .19 .27 .32 — .18
9 Number of provided
meals .30 .18 — .18
10 Self-determining one’s
daily actions .16 .27 — .37
11 Planning the day ahead .17 — .17
12 Time for one’s self
and needs .14 .21 .37 — .21
13 Physical activity
duringvacation —
14 Average duration
of sleep (h) .19 .25 —
15 Sleep quality .15 .17 .21 — .22
16 Make new
acquaintances .17 .18 —
17 Health problems
during vacation .19 .18 .22 —
18 Interpersonal conflicts
*Only significant correlations (p < .05) are listed.

edge, the first one investigating the effect of vacation
descriptors on health-related vacation outcome. Relevant
vacationer characteristics were thereby considered simul-
taneously.Health-related vacation outcome was measured
using two variables derived by factor analysis of rephrased
items from a standardized German quality-of-life ques-
tionnaire21: recuperation, reflecting positive mood, well-
being and perceived mental and physical fitness; and
exhaustion, reflecting depressive mood and fatigue.The
distinction between these two measures can be seen as
similar to the established distinction between positive and
negative well-being.26
Overall, a qualified proportion of the perceived
change of recuperation during vacation could be pre-
dicted, indicating that the vacation descriptors did actu-
ally tap relevant aspects of vacation. In contrast, only a
relatively small amount of the change of exhaustion
could be explained, presumably owing to the small
increase of exhaustion reported.
Of the variables describing the vacationers, sex did
not affect vacation outcome in this study, although a
greater improvement of burnout in females has been
reported elsewhere.5 Age was associated with a number
of differences in vacation organization, such as vacation
duration and travel time, but did not affect outcome on
its own. Higher mental prevacation work strain was
associated with greater vacation-related recuperation, a
result that is in accordance with the removal of work strain
hypothesis of vacation,27 and has been found for biologic
and nonbiologic markers.8,23 Individuals experiencing
high levels of work strain show greater improvements of
well-being when relieved from this strain (eg,during vaca-
tion) than do those who do not experience high work
strain. A similar result was not found for physical work
strain, presumably because of its small prevalence in the
predominantly white-collar-employee study sample.
Of the physical vacation characteristics, vacation
duration did not predict vacation outcome despite a
positive single-order correlation. This is a surprising
result, as one would assume that a longer vacation would
be more recuperating. It has been found that quality of
sleep increases throughout vacation, but mood essentially
S t r a u s s - B l a s ch e e t a l , M o d e r a t i n g F a c t o r s o f Va c a t i o n 99

Table 3. Regression Analysis Predicting Vacation Outcome†

 Values Single-Order Correlations
Block Characteristics/Variables Recuperated Exhausted Recuperated Exhausted
Total R2 .30*** .15*
1. Subject characteristics
(R2  change recuperation: .08**; R2  change
exhaustion: .00)
Age .12 .09 .11 .03
Sex .10 .05 .04 .05
Physical strain of daily work .12 .00 .09 .00
Mental strain of daily work .17** .02 .20** .02
2. Physical vacation characteristics
(R2  change recuperation: .06*; R2  change
exhaustion: .07**)
Duration of vacation (d) .09 .06 .18* .03

Downloaded from https://academic.oup.com/jtm/article/12/2/94/1863838 by guest on 25 June 2021

Average temperature at vacation site .20** .22** .16* .13
Time-zone difference to home (h) .16* .20** .01 .17*
Time to travel to vacation destination (h) .01 .06 .07 .09
3. Individual organization of day
(R2  change recuperation: .08**; R2  change
exhaustion: .03)
Number of provided meals .08 .00 .08 .05
Self-determination of one’s daily activities .08 .13 .03 .18*
Planning the day ahead .09 .07 .17* .03
Time for one’s self and needs .21** .05 .29*** .13
4. Health and social behavior
(R2  change recuperation: .07**; R2  change
exhaustion: .01)
Physical activity during vacation .14* .08 .17* .08
Average sleep duration during vacation (h) .08 .01 .16* .03
Sleep quality .14* .04 .24* .05
Making new acquaintances .16* .02 .12 .09
5. Stress during vacation
(R2  change recuperation: .02; R2  change
exhaustion: .03*)
Health problems during vacation .07 .17* .06 .17*
Interpersonal conflicts .11 .08 .11 .08
†
Variables were entered in five blocks; R2  change of each block (the amount of variance explained by those variables) both for recuperation and
exhaustion as well as  values and single-order correlations are displayed (*p < .05; **p < .01; ***p < .001).

finds its peak after 7 days.9,28 As both variables show the
greatest improvement in the first 3 days, several-day
vacations may also have a relevant impact on well-being
and health, although vacation-related factors such as
travel strain and altitude have to be taken into account.28
Another surprising result is the strong positive effect of
the average temperature at the vacation site on both out-
come measures. As most vacations in warmer climates
took place in the summer in the Mediterranean area, the
effect presumably is primarily due to sun exposure, a vari-
able known to affect mood positively.10,29 In addition,
lifestyle factors also may contribute to this result, illus-
trated by the association of average temperature with some
variables of vacation organization.
An expected result is that a greater time-zone dif-
ference was related to greater exhaustion, pointing to the
well-known phenomenon of jet lag,11 even though the
number of time zones crossed was moderate.On the other
hand, the travel time, which ranged from 1 to 48 hours,
did not affect vacation outcome.Although related to the
strain of travel (r = .31), the type of transportation may
be more relevant than the duration, as has been found
in a recent study investigating vacation-related factors on
myocardial infarction.7
The individual organization of the day, for exam-
ple, how vacationers planned their time, was the strongest
predictor of recuperation among the four studied aspects
of vacation.This was owing to the large positive impact
of having enough free available time for one’s self and
one’s needs, which is in accordance with the notion that
relaxation and freedom of obligations are important
aspects of leisure leading to well-being.15,30 The result
replicates a previous result obtained by our group,6 and
it can be seen as related to the finding that low-effort,
that is, relaxing, undemanding activities, enhance after-
work recovery.31 A greater self-determination of one’s
100
daily activities, however, was not related to recuperation,
as has been suggested in leisure research.14 Possibly, self-
determination or self-control is only important in the
presence of stress, as underlined by Karasek’s demand-
control model and illustrated in the negative single-
order correlation with postvacation exhaustion in the
present study.32 Also contrary to our expectations,the vari-
ables associated with how individuals structured their day
(number of provided meals, planning of day ahead) did
not affect vacation outcome. Based on our knowledge
of residential spa therapy and on the presumed positive
effect of exogenous pacemakers,13,33 we had imagined that
a moderate amount of daily structure would positively
affect well-being and health, but this hypothesis was not
supported.
Health and social behaviors also predicted recu-
peration strongly. The amount of physical activity, the
quality of sleep, and the extent of making new acquain-
tances were all positively associated with recuperation.
Physical activity is a known factor improving well-being
and health.16 In a recent study we found a vacation
incorporating regular walking tours to improve per-
ceived health in individuals with metabolic syndrome.28
Quality of sleep not only affects well-being but is also
affected by well-being.17 Therefore, the positive effect of
good sleep should be interpreted cautiously as good
sleep may also be a result of greater recuperation. Sleep
quantity, on the other hand, did not predict vacation out-
come, a result also in line with other research finding sleep
duration less relevant for health and mood,34 although
a positive single-order correlation was present. Making
new acquaintances was associated with greater recuper-
ation, presumably reflecting the well-known mood-
enhancing effect of social interaction.18
Stress in the form of health problems—but not in
the form of interpersonal conflicts—negatively affected
vacation outcome, with health problems leading to
increased postvacation exhaustion. Health problems are
a known phenomenon during vacation and travel and
are attributable to both environmental and psycholog-
ical factors.8,19 Although interpersonal conflicts are an
obvious stressor affecting well-being,their impact on vaca-
tion outcome could not be detected in the present
study.20
There are some limitations to this study that have
to be addressed. Asking the vacationers to estimate the
degree of change from 2 weeks before to after vacation,
may be subject to two forms of measurement error:
(1) individuals may not be rating change but may be rat-
ing their current state, and (2) individuals who are
appraising change may be subject to reporting or mem-
ory error.35 If the first error applied, the results would
reflect an association between a general mood state and
J o u r n a l o f Tr a v e l M e d i c i n e , Vo l u m e 1 2 , N u m b e r 2
a style of vacation organization, rather than an effect of
vacation organization on perceived health, thereby revers-
ing the expected direction of causation.This explanation
cannot be completely ruled out but seems unlikely
owing to the positive association of perceived workload
and positive vacation outcome. If individuals were rat-
ing their current state, then a negative association should
be present, if any, with high workload potentially being
associated with poorer mood and health.36,37 A report-
ing or memory error cannot be ruled out, but as only
effects in relation to vacation organization were assessed,
a systematic memory or reporting error should not have
affected the results.
Downloaded from https://academic.oup.com/jtm/article/12/2/94/1863838 by guest on 25 June 2021
Conclusions
The study implies that the effect of vacation can-
not merely be explained by the removal of work stress,
as has been indicated in previous studies.5,27 Rather, the
way an individual organizes his or her vacation makes a
difference in regard to health-related vacation outcome.
Having enough time for one’s self and one’s needs, exer-
cising, getting good sleep, and socializing in a warm
vacation climate facilitate recuperation, especially in
vacationers reporting higher levels of prevacation men-
tal strain. On the other hand, larger time-zone differences
to home and health problems affect vacation outcome
negatively.As has been stressed by Eden in a recent arti-
cle,30 further studies are necessary to establish more con-
sistent criteria regarding vacation description and
individual vacation organization and their effects on
well-being and health.
Declaration of Interests
The authors have no financial or other conflicts of
interest to disclose.
Acknowledgment
We would like to express our gratitude to Mrs.
Barbara Hadek for proofreading the final version of the
manuscript.
References
1. Lounsbury JW, Hoops LL.A vacation from work: changes in
work and non-work outcomes. J Appl Psychol 1986;
71:392–401.
2. Gump BB, Matthews KA. Are vacations good for your
health? The 9-year mortality experience after the multiple
risk factor intervention trial. Psychosom Med 2000;
62:608–612.
S t r a u s s - B l a s ch e e t a l , M o d e r a t i n g F a c t o r s o f Va c a t i o n
3. Tarumi K, Hagihara A. An inquiry into the causal relation-
ship among leisure vacation, depression, and absence from
work. Sangyo Ika Daigaku Zasshi 1999; 21:289–307.
4. Kubzansky LD, Kawachi I. Going to the heart of the mat-
ter: do negative emotions cause coronary heart disease? J Psy-
chosom Res 2000; 48:323–337.
5. Westman M, Eden D. Effects of a respite from work on
burnout: vacation relief and fade-out. J Appl Psychol 1997;
82:516–527.
6. Strauss-Blasche G, Ekmekcioglu C, Marktl W. Does vacation
enable recuperation? Changes in well-being associated with
time away from work. Occup Med (Lond) 2000; 50:167–172.
7. Kop WJ,Vingerhoets A, Kruithof GJ, Gottdiener JS. Risk fac-
tors for myocardial infarction during vacation travel. Psy-
chosom Med 2003; 65:396–401.
8. Vingerhoets AJ,Van Huijgevoort M,Van Heck GL. Leisure
sickness: a pilot study on its prevalence, phenomenology, and
background. Psychother Psychosom 2002; 71:311–317.
9. Roth S, Silberer G. Urlaubsstimung und Tourismusmarket-
ing. [Holiday mood and tourist marketing.] Planung und
Analyse 2000; 2000(2):77–83.
10. Molin J, Mellerup E, Bolwig T, et al.The influence of climate
on development of winter depression. J Affect Disord 1996;
37:151–155.
11. Loat CE, Rhodes EC. Jet-lag and human performance.
Sports Med 1989; 8:226–238.
12. Raggatt PT, Morrissey SA.A field study of stress and fatigue
in long-distance bus drivers. Behav Med 1997; 23:122–129.
13. Piggins HD.Human clock genes.Ann Med 2002;34:394–400.
14. Coleman D,Iso-Ahola SE.Leisure and health:the role of social
support and self-determination.J Leisure Res 1993;25:111–128.
15. Caldwell LL, Smith EA. Leisure: an overlooked component
of health promotion.Can J Public Health 1988;79(2):S44–S48.
16. Scully D, Kremer J, Meade MM, et al. Physical exercise and
psychological well being: a critical review. Br J Sports Med
1998; 32:111–120.
17. Pilcher JJ, Ott ES.The relationships between sleep and meas-
ures of health and well-being in college students: a repeated
measures approach. Behav Med 1998; 23:170–178.
18. Argyle M, Martin M.The psychological causes of happiness.
In: Starck F, Argyle M, Schwarz N, eds. Subjective well-
being. Oxford: Pergamon Press, 1991:74–100.
19. Rogers HL, Reilly SM. A survey of the health experiences
of international business travelers. Part one—physiological
aspects.AAOHN J 2002; 50:449–459.
20. Kiecolt-Glaser JK, Glaser R, Cacioppo JT, Malarkey WB. Mar-
ital stress: immunologic, neuroendocrine, and autonomic
correlates.Ann N Y Acad Sci 1998; 840:656–663.
21. Siegrist J, Broer M, Junge A. Profil der Lebensqualitaet chro-
nisch Kranker (PLC). Goettingen: Beltz, 1996.
101
22. Howard GS, Ralph KM, Gulanick NA, et al. Internal inva-
lidity in pretest-posttest self-reporting evaluations and a
reevaluation of retrospective pretests. Appl Psychol Meas
1979; 3:1–23.
23. Strauss-Blasche G, Ekmekcioglu C, Marktl W. Serum lipid
responses to a respite from occupational and domestic
demands in subjects with varying levels of stress. J Psycho-
som Res 2003; 55:521–524.
24. Miles J, Shevlin M.Applying regression and correlation. Lon-
don: Sage, 2001.
25. Lounsbury JW, Hoops LL.An investigation of factors asso-
ciated with vacation satisfaction. J Leisure Res 1985;
17(1):1–13.
26. Chamberlain K. On the structure of subjective well-being.
Soc Ind Res 1988; 20:581–604.
Downloaded from https://academic.oup.com/jtm/article/12/2/94/1863838 by guest on 25 June 2021
27. Westman M, Etzion D. The impact of vacation and job
stress on burnout and absenteeism. Psychol Health 2001;
16:595–606.
28. Strauss-Blasche G, Riedmann B, Schobersberger W, et al.Vaca-
tion at moderate and low altitude improves perceived health
in individuals with metabolic syndrome. J Travel Med 2004;
11:300–306.
29. Magnusson A, Boivin D. Seasonal affective disorder: an
overview. Chronobiol Int 2003; 20:189–207.
30. Eden D. Job stress and respite relief: overcoming high-tech
tethers. Explor Theoret Mech Perspect 2001; 1:143–194.
31. Sonnentag S.Work, recovery activities, and individual well-
being: a diary study. J Occup Health Psychol 2001; 6:196–210.
32. de Lange AH,Taris TW, Kompier MA, et al.“The very best
of the millennium”: longitudinal research and the demand-
control-(support) model. J Occup Health Psychol 2003;
8:282–305.
33. Hildebrandt G, Gutenbrunner C. Die Kur—Kurverlauf,
Kureffekt und Kurerfolg. [Spa therapy—its course, effects and
health improvements.] In: Gutenbrunner C, Hildebrandt G,
eds. Handbuch der Balneologie and medizinischen Klima-
tologie. Berlin: Springer, 1998:85–186.
34. Pilcher JJ, Ginter DR, Sadowsky B. Sleep quality versus sleep
quantity: relationships between sleep and measures of health,
well-being and sleepiness in college students. J Psychosom
Res 1997; 42:583–596.
35. Allison PJ, Locker D, Feine JS. Quality of life: a dynamic con-
struct. Soc Sci Med 1997; 45:221–230.
36. Repetti RL. The effects of workload and the social envi-
ronment at work and health. In: Goldberger L, Breznitz S,
eds. Handbook of stress. New York: The Free Press,
1993:368–385.
37. Strauss-Blasche G, Ekmekcioglu C, Marktl W. Moderating
effects of vacation on reactions to work- and domestic
stress. Leisure Sci 2002; 24:1–13.