Psychosocial work environment and stress-related disorders, a systematic review

Expected Labor Market Affiliation: A New Method Illustrated by Estimating the Impact of Perceived Stress on Time in Work, Sickness Absence and Unemployment of 37,605 Danish Employees

As detailed data on labor market affiliation become more accessible, new approaches are needed to address the complex patterns of labor market affiliation. We introduce the expected labor market affiliation (ELMA) method by estimating the time-restricted impact of perceived stress on labor market affiliation in a large sample of Danish employees. Data from two national surveys were linked with a national register. A multi-state proportional hazards model was used to calculate ELMA estimates, i.e., the number of days in work, sickness absence, and unemployment during a 4-year follow-up period, stratified by gender and age. Among employees reporting frequent work-related stress, the expected number of working days decreased with age, ranging from 103 days lost among older women to 37 days lost among younger and middle-aged men. Young and middle-aged women reporting frequent work- and personal life-related stress lost 62 and 81 working days, respectively, and had more days of sickness absence (34 days and 42 days). In conclusion, we showed that perceived stress affects the labor market affiliation. The ELMA estimates provide a detailed understanding of the impact of perceived stress on labor market affiliation over time, and may inform policy and practice towards a more healthy and sustainable working life.

HSE Management Standards and burnout dimensions among rehabilitation professionals

BACKGROUND

The Health & Safety Executive Indicator Tool (HSE-IT) is a standard-based questionnaire commonly used to assess work-related stress in organizations. Although the HSE-IT validity has been well documented and significant relationships have been observed between its scales and several work-related outcomes, to date there is no evidence concerning the relationships between the HSE-IT and burnout among healthcare workers.

AIMS

To investigate the relationships between the HSE-IT subscales and burnout dimensions as measured by the Maslach Burnout Inventory (MBI) in a sample of Italian rehabilitation professionals employed in healthcare institutions.

METHODS

An anonymous cross-sectional questionnaire was administered to a sample of Italian rehabilitation professionals including physical therapists, occupational therapists, psychiatric rehabilitation technicians and developmental psychomotor therapists. Associations between the HSE-IT and the MBI were analysed with multiple linear regression models.

RESULTS

A total of 432 rehabilitation professionals completed the questionnaire and 14% of them showed high levels of burnout risk. Significant differences in the HSE-IT scores were found between workers at high risk of burnout and workers at low risk of burnout. Hierarchical regressions showed an association between the HSE-IT scales and the MBI factors: emotional exhaustion was associated with 'demands' and 'role', and both depersonalization and personal accomplishment were associated with 'control' and 'role'.

CONCLUSIONS

This preliminary study showed the HSE-IT subscales are sensitive to burnout risk as measured by the MBI. The association found between the HSE-IT 'demands', 'role' and 'control' subscales and the MBI dimensions is significant but small. These findings might inform targeted burnout prevention.

Mental Health Applications for Primary and Secondary Prevention of Common Mental Disorders: Attitudes of German Employees

Background: Web-based and mobile mental health applications for the prevention and treatment of common mental disorders (CMDs) are on the rise. Under certain circumstances they have proved to be effective for a range of conditions (e.g., depression). Objective: There is not sufficient evidence regarding the benefits and barriers especially for mobile phone apps and for programs in the field of primary prevention. Studies on the acceptance of potential users of mental health apps yielded mixed outcomes. In a large survey we investigated the attitudes of employees toward mental health apps and various traditional mental health services. Our main research question in this contribution focuses on the acceptance of apps compared to other measures and the moderating influence of individual characteristics. Methods: The standardized survey was completed by members of an online access panel with different job types. A set of 33 self-developed items, including three questions on e-health, captured the perceived relevance of prevention at the (A) occupational, (B) individual, and (C) societal level. On the basis of an exploratory factor analysis, mean scores for mapping seven (sub-)dimensions were constructed and compared using the Wilcoxon test. The influence of potential predictors was analyzed in linear regression models. Results: The data of 610 respondents were analyzed (response rate 75%). Support from mental health applications was rated significantly less important compared to all other dimensions at the levels (A) to (C). Respondents were more likely to use mental health apps if they felt literate with electronic devices, perceived a high relevance of work-related demands as causal factors for CMDs, stated they would be ashamed of having a CMD, and would be willing to begin psychotherapy if recommended. Discussion and Conclusions: The results confirm the critical attitudes of potential mental health app users found in other studies. Since users with a negative attitude toward e-health might have a higher risk for dropout and non-adherence as well as lower intervention effects, well-designed educational strategies should be carried out beforehand.

The Effects of the Civility, Respect, and Engagement in the Workplace (CREW) Program on Social Climate and Work Engagement in a Psychiatric Ward in Japan: A Pilot Study

Background: Good social climate and high work engagement are important factors affecting outcomes in healthcare settings. This study observed the effects of a program called Civility, Respect, and Engagement in the Workplace (CREW) on social climate and staff work engagement in a psychiatric ward of a Japanese hospital. Methods: The program comprised 18 sessions installed over six months, with each session lasting 30-min. Participation in the program was recommended to all staff members at the ward, including nurses, medical doctors, and others, but it was not mandatory. A serial cross-sectional study collected data at four time-points. Nurses (n = 17 to 22), medical doctors (n = 9 to 13), and others (n = 6 to 10) participated in each survey. The analysis of variance was used to evaluate the changes in the following dependent variables, the Essen climate evaluation schema (EssenCES), the CREW civility scale, and the Utrecht work engagement scale (UWES) over time. Result: We found no significant effects. The effect size (Cohen’s d) for EssenCES was 0.35 from baseline to post-installation for all staff members. Effect sizes for EssenCES for medical doctors and UWES for nurses were 0.79 and 0.56, respectively, from baseline to post-program. Conclusions: Differences in social climate and work engagement among Japanese healthcare workers between the baseline and post-installation of the CREW program were non-significant.

A Participatory Intervention to Improve the Psychosocial Work Environment and Mental Health in Human Service Organisations. A Mixed Methods Evaluation Study

Work-related stress is a global problem causing suffering and economic costs. In Sweden, employees in human service occupations are overrepresented among persons on sick leave due to mental health problems such as stress-related disorders. The psychosocial work environment is one contributing factor for this problem, making it urgent to identify effective methods to decrease stress at the workplace. The aim of the study is to evaluate a participatory intervention to improve the psychosocial work environment and mental health using an embedded mixed methods design. The study is a controlled trial with a parallel process evaluation exploring fidelity and participants' reactions to the intervention activities, experiences of learning and changes in behaviours and work routines. We collected data through documentation, interviews and three waves of questionnaires. Our results show small changes in behaviours and work routines and no positive effects of the intervention on the psychosocial work environment nor health outcomes. One explanation is end-users' perceived lack of involvement over the process causing the intervention to be seen as a burden. Another explanation is that the intervention activities were perceived targeting the wrong organisational level. A representative participation over both content and process can be an effective strategy to change psychosocial working conditions and mental health.

Associations of multiple occupational exposures with major depressive and generalized anxiety disorders: Findings from the French National Working Conditions Survey

BACKGROUND

There have been numerous studies on the associations between psychosocial work factors and mental health, but very few of them explored the cumulative effects of these factors. The objectives were to study the associations between multiple occupational exposures and two common mental disorders, major depressive episode (MDE) and generalized anxiety disorder (GAD), among employees in France.

METHODS

The data came from the 2016 French National Working Conditions Survey based on a representative sample of 20,430 employees (8579 men and 11,851 women) aged 15-65 years. MDE and GAD were assessed using the MINI (Mini International Neuropsychiatric Interview) standardized diagnostic interview. Occupational exposures included 21 psychosocial work factors grouped into five dimensions, four factors related to working time/hours, and four physical work exposures. Logistic regression modeling for weighted data was performed to evaluate the associations of occupational exposures with MDE and GAD in men and women separately.

RESULTS

The prevalence of MDE and GAD was higher among women (8.6% and 8.7%, respectively) than among men (4.3% and 4.6%). Most psychosocial work factors were associated with MDE and/or GAD. A linear increase in the risk of MDE/GAD with the number of psychosocial work factors was found for each dimension, except workplace violence. The risk of MDE also increased linearly with multiple physical work exposures.

CONCLUSIONS

Our results showed that a wide variety of occupational exposures were associated with clinical depression and anxiety, and that the risk of disease increased with multiple exposures to psychosocial and physical factors at work.

Key findings about hearing loss in the working-life: a scoping review from a well-being perspective

OBJECTIVE

This scoping review investigated key findings about hearing loss (HL) in the working life (WL) from a well-being perspective.

DESIGN

A scoping review protocol was used to search the literature and to explore and extract key findings. A narrative analysis of key findings was used to group the data into themes. Study sample: Fifty-three articles from 29 different journals were included in the analysis.

RESULTS

The narrative analysis identified three broad themes; individual aspects, work environment and work organisation. Individual aspects concerned problems that workers with HL experienced in their working lives, strategies they used to manage their working lives and different aspects of health in relation to WL. Work environment focussed on the physical, organisational and social work environment. Work organisation identified aspects related to division of labour and employment status.

CONCLUSIONS

Several of the included papers revealed lots of findings but did not substantially discuss the findings from a WL perspective. HL and well-being in WL is a multidimensional phenomenon due to the interplay between the individual and the environment. This interplay is rarely discussed in the included papers. Furthermore, intersectional aspects are infrequently highlighted and need to be further explored in future research.

The Role of Workplace on Work Participation and Sick Leave after a Terrorist Attack: A Qualitative Study

Returning to work after large-scale traumatic events is desirable for employees, their organization, and society. The aim of the present study was to identify work-related factors that are perceived as important for work participation versus sick leave after a terrorist attack. We conducted in-depth interviews of 98 employees in the Norwegian governmental ministries that were the target of the 2011 Oslo bombing. Participants were randomly selected from 2519 employees who had responded to a web-based survey. We used a stratified sampling procedure to ensure inclusion of a wide range of experiences in terms of exposure and stress reactions. Participants were asked what, if any, factors contributed to work participation or sick leave, and which factors made a difference in how quickly people on sick leave returned to work. Thematic analyses provided three themes that stimulate work participation and prevent sick leave: supportive management, the ability of a leader to accept individual needs and help people cope with stress; sense of cohesion, feelings of being close, caring for each other, and working well together; and working as a coping strategy, basic assumptions that it is best to stick to work and familiar routines, or a strong belief in one’s ability to master. A fourth theme, high demands and lack of acceptance, included experiences that promoted an absence from work, such as too much business as usual, management’s lack of priorities for which tasks could be left out, or a lack of recognition of individual needs. The findings point to key factors that workers perceive as important for work participation in the aftermath of a disaster. We suggest that health and productivity benefits can be achieved by organizing work and the work environment in line with these experiences.

Lang U. How a Depressive Medical Doctor Profited in the Long-Term from a New and Short Psychological Group-Treatment against Major Depressive Disorder

Background: Individuals suffering from major depressive disorder (MDD) often describe workplace-related stress as one of the main causes of their disorder. Here, we present the story of a 33 year old “Bob” (a pseudonym) who suffered from a moderate (Hamilton-21 = 18) major depressive episode. Workplace-related stress seemed to be the main stressor for Bob at the time. We were interested in long-lasting effects of a newly established group called “work-related interpersonal Psychotherapy, W-IPT”. W-IPT consists of eight weekly 90 min sessions. The follow-ups were 12 weeks after the group-treatment and 18 months later. Bob was chosen because he agreed in advance to participate in a follow-up. We were interested if the group-treatment of W-IPT also has a persistent positive effect. Case presentation: We present the case of a 33-year-old man “Bob”. He was included in our previous published pilot-study 2020 with diagnosed moderate MDD, and he attended the group treatment. This case report focuses on a follow-up period of 18 months. A structured clinical interview for DSM-IV was carried out in order to be included in the study, and no comorbid diagnoses were detected. Conclusions: However, the psychotherapeutic effects in this case seem enduring and prolonged. Of course, additional research to study the long-term effects of W-IPT is needed, and more patients need to be included.

Are depressive disorders caused by psychosocial stressors at work? A systematic review with metaanalysis

In the last decade, many studies have examined associations between poor psychosocial work environment and depression. We aimed to assess the evidence for a causal association between psychosocial factors at work and depressive disorders. We conducted a systematic literature search from 1980 to March 2019. For all exposures other than night and shift work and long working hours, we limited our selection of studies to those with a longitudinal design. We extracted available risk estimates for each of 19 psychosocial exposures, from which we calculated summary risk estimates with 95% confidence intervals (PROSPERO, identifier CRD42019130266). 54 studies were included, addressing 19 exposures and 11 different measures of depression. Only data on depressive episodes were sufficient for evaluation. Heterogeneity of exposure definitions and ascertainment, outcome measures, risk parameterization and effect contrasts limited the validity of meta-analyses. Summary risk estimates were above unity for all but one exposure, and below 1.60 for all but another. Outcome measures were liable to high rates of false positives, control of relevant confounding was mostly inadequate, and common method bias was likely in a large proportion of studies. The combination of resulting biases is likely to have inflated observed effect estimates. When statistical uncertainties and the potential for bias and confounding are taken into account, it is not possible to conclude with confidence that any of the psychosocial exposures at work included in this review is either likely or unlikely to cause depressive episodes or recurrent depressive disorders.

Factors Associated with Mental Health Problems among Malaysian Children: A Large Population-Based Study

Mental health problems are a major public health issue, particularly among children. They impair children’s development, academic achievement, and ability to live a productive life. The present study aimed to determine the prevalence and factors associated with mental health problems among children aged 5 to 15 years old in Malaysia. Data from the National Health and Morbidity Survey (NHMS) 2015 were analyzed. A validated Strengths and Difficulties Questionnaire (SDQ) was used. The overall prevalence of mental health problems among children in Malaysia was 11.1%. Multiple logistic regression analysis revealed that for every year increment in age, mental health problems decreased by 5%. Further analysis found that children who had fathers with a non-formal education and worked in the private sector, had parents who were widowed or divorced, and had either parent with mental health problems were more likely to have mental health problems themselves. Children from the lower socioeconomic group and who had either parent with mental health problems had higher odds of having mental health problems in Malaysia.

Temporary Refugee and Migration Visas in Australia: An Occupational Health and Safety Hazard

Employment and work-related exploitation and discrimination are important social determinants of health. However, little is known about the experiences of people on temporary visas in Australia, particularly those on refugee visas. This article reports on a study of people living on temporary visas in South Australia and their experiences of workforce exploitation and discrimination and impacts on health. Interviews were conducted with 30 people: 11 on non-refugee temporary visas and 19 on refugee temporary visas. Data was analyzed thematically. Analysis identified experiences of exploitation and discrimination in the Australian labor market that included difficulties securing work, underpayment, overwork, and hazardous workplaces. These experiences had negative health effects, particularly on mental health. None had made a formal complaint about their treatment, citing the precarity of their visas, difficulties finding an alternative job, and lack of knowledge about what to do. The impacts were especially evident for refugees who were also grappling with pre-settlement trauma and ongoing uncertainties about their future protection. Overall, these findings of discrimination and exploitation in the workplace and subsequent ill health highlight the pervasive impact of neoliberal agendas and stress the need for industrial, immigration, and welfare reform to protect workers on temporary visas.

How do employment conditions and psychosocial workplace exposures impact the mental health of young workers? A systematic review

PURPOSE

To assess the quality of the research about how employment conditions and psychosocial workplace exposures impact the mental health of young workers, and to summarize the available evidence.

METHODS

We undertook a systematic search of three databases using a tiered search strategy. Studies were included if they: (a) assessed employment conditions such as working hours, precarious employment, contract type, insecurity, and flexible work, or psychosocial workplace exposures such as violence, harassment and bullying, social support, job demand and control, effort-reward imbalance, and organizational justice; (b) included a validated mental health measure; and (c) presented results specific to young people aged ≤ 30 years or were stratified by age group to provide an estimate for young people aged ≤ 30 years. The quality of included studies was assessed using the Risk of Bias in Non-randomized Studies of Exposures (ROBINS-E) tool.

RESULTS

Nine studies were included in the review. Four were related to employment conditions, capturing contract type and working hours. Five studies captured concepts relevant to psychosocial workplace exposures including workplace sexual harassment, psychosocial job quality, work stressors, and job control. The quality of the included studies was generally low, with six of the nine at serious risk of bias. Three studies at moderate risk of bias were included in the qualitative synthesis, and results of these showed contemporaneous exposure to sexual harassment and poor psychosocial job quality was associated with poorer mental health outcomes among young workers. Longitudinal evidence showed that exposure to low job control was associated with incident depression diagnosis among young workers.

CONCLUSIONS

The findings of this review illustrate that even better studies are at moderate risk of bias. Addressing issues related to confounding, selection of participants, measurement of exposures and outcomes, and missing data will improve the quality of future research in this area and lead to a clearer understanding of how employment conditions and psychosocial workplace exposures impact the mental health of young people. Generating high-quality evidence is particularly critical given the disproportionate impact of COVID-19 on young people's employment. In preparing for a post-pandemic world where poor-quality employment conditions and exposure to psychosocial workplace exposures may become more prevalent, rigorous research must exist to inform policy to protect the mental health of young workers.

The potential of using hair cortisol to measure chronic stress in occupational healthcare; a scoping review

OBJECTIVES

Workplace-based selective prevention of mental health problems currently relies on subjective evaluation of stress complaints. Hair cortisol captures chronic stress responses and could be a promising biomarker for the early identification of mental health problems. The objective was to provide an overview of the state-of-the-art knowledge on the practical value of hair cortisol in the occupational setting.

METHODS

We performed a scoping review of cross-sectional and longitudinal studies in PubMed, Embase, and PsycINFO up to November 2019 assessing the relations of hair cortisol with work-related stressors, perceived stress, and mental health outcomes in healthy workers.

RESULTS

We found five longitudinal studies, of which two observed an increase in work-related stressors to be associated with higher hair cortisol, one found a relation with lower hair cortisol and one did not find a relationship. Findings of cross-sectional studies were also mixed. The one available longitudinal study regarding mental health showed that hair cortisol was not related to depressive symptoms.

CONCLUSIONS

Hair cortisol measurement within occupational health research is still in its early stage and more longitudinal studies are urgently needed to clarify its relationship with work-related stressors and perceived stress before hair cortisol can be used to identify workers at risk for mental health problems.

Health outcomes of psychosocial stress within firefighters: A systematic review of the research landscape

BACKGROUND AND OBJECTIVES

Much of the research surrounding firefighter health has concerned the hazards intuitively associated with the occupation, such as physical, thermal, and chemical risks. However, an additional aspect of their work environment, psychosocial stressors, has begun to attract a growing level of attention. Work-related psychosocial stress may best be described as mental and emotional strain caused by a combination of workplace events and characteristics, and the objective of our review was to identify the health outcomes associated with these stressors in firefighters.

METHODS

A systematic review was performed of studies reporting on the psychosocial stressors and the associated health outcomes experienced by firefighters. Data sources included the MEDLINE, PsychInfo, and CINAHL databases.

RESULTS

Twenty-nine studies met the inclusion criteria. Upon analysis, we found that firefighters experienced a range of psychosocial stressors (including interpersonal conflict and concerns over organizational fairness) and observed that these stressors were associated with a number of health-related outcomes that could be arranged into six areas: depression-suicidality, non-depressive mental health problems, burnout, alcohol use disorders, sleep quality, and physiological parameters and somatic disorders.

CONCLUSION

Our findings strongly suggest that work-related psychosocial stressors can affect the health and well-being of those in the fire service, and highlight that interventions meant to address these psychosocial risk factors should focus upon promoting self-esteem, enhancing self-efficacy, and strengthening social support.

Foliage colors improve relaxation and emotional status of university students from different countries

The therapeutic advantages of seeing plants have gained increasing consideration in stressful modern societies, however, evidence-based studies on how physiological and emotional states of individuals from different nationalities change when seeing different foliage colors are limited. The study was conducted to explore the physiological and psychological advantages of foliage colors as visual stimuli. The experiment included 40 men from two nations (age: 21.34 ± 3.50 years) and was carried out using five foliage colors including green, light green, green-yellow, green-red and green-white. Participants were exposed to each color for 2 min, when seeing the foliage colors, eye movements and oxy-Hb concentrations were continuously measured. Subjective evaluations of emotions were performed utilizing a semantic differential questionnaire. A significant decrease in oxy-Hb concentration in the frontal lobe was associated with the viewing of green and green-white plants by the Japanese participants and with viewing light green and green-yellow by the Egyptian participants. Participants spent higher fixation numbers and longer durations on these colors. The findings indicate that viewing of these plant colors was positively associated with physiological relaxation. Furthermore, these colors were associated with more positive feelings, such as calmness, comfort and naturalness. Therefore, the presence of these colors in spaces may have positive impacts on relaxation and emotional status.

Implementing Organizational WHP Into Practice: Obstructing Paradoxes in the Alignment and Distribution of Empowerment

Background: According to policy and theory, there is need for organizational workplace health promotion (WHP) to strengthen working conditions for all employees. However, earlier studies show it is hard to implement in practice. The aim was to critically analyze and identify interacting mechanisms and obstacles behind failures of organizational WHP projects from system perspectives. Methods: A holistic case study was performed, to critically analyze data from an organizational WHP project approach at a public health care organization. The qualitative data was collected over 5 years and included interviews with key actors (n = 80), focus groups (n = 59 managers), structured observations (n = 250 hours), continuous field observations and documents (n = 180). Questionnaires to employees (n = 2,974) and managers (n = 140) was complementing the qualitative-driven mixed method approach. Results: The analysis shows obstructing paradoxes of alignment and distribution of empowerment during the process of implementation into practice. The obstacles were interacting over system levels and were identified as: Governance by logics of distancing and detaching, No binding regulation of WHP, Separated responsibility of results, Narrow focus on delegated responsibilities, Store-fronting a strategic model, Keeping poor organizational preconditions and support for developments and Isolate WHP from other organizational developments. Conclusions: The following premises can be formulated regarding successful organizational WHP programs. Consider (1) the uncertainty a distributed empowerment to all system levels may create; (2) the distributed impact to define the target and allow broader areas to be included in WHP; and (3) the integration into other development processes and not reducing the organizational WHP to the form of a project.

Risk and Resilience Factors During the COVID-19 Pandemic: A Snapshot of the Experiences of Canadian Workers Early on in the Crisis

Research highlights several risk and resilience factors at multiple ecological levels that influence individuals’ mental health and wellbeing in their everyday lives and, more specifically, in disaster or outbreak situations. However, there is limited research on the role of these factors in the early days of the COVID-19 crisis. The present study examined if and how potential risk factors (i.e., reduction in income, job insecurity, feelings of vulnerability to contracting the virus, lack of confidence in avoiding COVID-19, compliance with preventative policies) and resilience factors (i.e., trait resilience, family functioning, social support, social participation, and trust in healthcare institutions) are associated with mental health and well-being outcomes, and whether these resilience factors buffer (i.e., moderate) the associations between risk factors and said outcomes. One to two weeks after the government recommended preventative measures, 1,122 Canadian workers completed an online questionnaire, including multiple wellbeing outcome scales in addition to measures of potential risk and resilience factors. Structural equation models were tested, highlighting that overall, the considered risk factors were associated with poorer wellbeing outcomes, except social distancing which was associated with lower levels of stress. Each of the potential resilience factors was found to have a main effect on one or more of the wellbeing outcomes. Moderation analysis indicated that in general these resilience factors did not, however, buffer the risk factors. The findings confirm that the COVID-19 crisis encompasses several stressors related to the virus as well as to its impact on one’s social, occupational, and financial situation, which put people at risk for lower wellbeing as early as one to two weeks after the crisis began. While several resilience factors emerged as positively related to wellbeing, such factors may not be enough, or sufficiently activated at that time, to buffer the effects of the numerous life changes required by COVID-19. From an ecological perspective, while mental health professionals and public health decision-makers should offer/design services directly focused on mental health and wellbeing, it is important they go beyond celebrating individuals’ inner potential for resilience, and also support individuals in activating their environmental resources during a pandemic.

Workplace-related stress among oncologists: Egyptian single-centered observational study

Background

The oncologists are facing more challenges than ever before in their work with cancer patients. The aim of the study is to assess the level of work-related stress among oncology clinicians and to compare it with non-oncologists. Thirty oncologists working at clinical oncology department at Menoufia University hospitals, Egypt, were compared to an equal number of non-oncologists matched for the same gender and work duration. After consent, all the participants were interviewed using a structured questionnaire to collect background information and the workplace stress scale (WSS) was used to ascertain their stress level.

Results

The percentage distribution of different grades of WSS among the two groups did not show any significant difference (P = 0.84). Gender had no significant association to the mean score of WSS (P > 0.05). All the juniors (residents) in this study with work duration ≤ 3 years had significantly higher levels of WSS than seniors (> 3 years), P < 0.001. Among oncologists or non-oncologists, juniors showed significantly higher levels of WSS than seniors (P = 0.003 and < 0.001 respectively). However, junior oncologists had no significant difference than junior non-oncologists and seniors in both groups did not show any significant difference regarding the mean score of WSS.

Conclusion

All the workers within the two groups had experienced work-related stress. However, there was no statistically significant difference among them regarding the different grades of work place stress scale.

Prevalence of Workaholism Among Egyptian Healthcare Workers With Assessment of Its Relation to Quality of Life, Mental Health and Burnout

Introduction: Work is a social double edged weapon activity that may have positive and negative effects on individual's quality of life and health. Objectives: To estimate workaholism prevalence and to determine its effects on quality of life, mental health, and burnout among healthcare workers (HCWs). Methods: Using a cross-sectional study, 1,080 Egyptian participants distributed as HCWs and non-HCWs were recruited. The study included 4 questionnaires to assess workaholism, quality of life (QoL), Psychological capital questionnaire (PCQ), and General health questionnaire (GHQ). Maslach Burnout Inventory (MBI) was applied to critical specialty HCWs in addition to pro-inflammatory markers including Il6, TNFα, and CoQ10. Results: This study revealed that 24.4 and 24.8% of HCWs were workaholic and hardworking, respectively, in comparison to 5.9 and 28.1% among non-HCWs (P < 0.001). Somatic symptoms and anxiety/ insomnia domains of GHQ were higher among HCWs than non-HCWs (P < 0.001 and 0.002, respectively). QoL was significantly lower among HCWs than non-HCWs (P < 0.001). Workaholism was reported among 43.2% of HCWs with critical specialty (P < 0.001). Components of PCQ components were significantly higher among HCWs with critical specialty than non-critical HCWs while QoL showed the reverse (P < 0.05). Working excessively was a predictor to burnout [Emotional exhaustion (β = -0.23) and depersonalization (β = -0.25)] and TNFα (β = 0.41). Emotional exhaustion was a predictor to Il6 (β = 0.66), TNFα (β = 0.73), and CoQ10 (β = -0.78). Conclusion: There is a significant association between workaholism and psychologically poor-health and poor quality of life among HCWs. Critical specialty healthcare workers showed association between workaholism, burnout and pro-inflammatory markers. Addressing of personal characteristics, supporting factors in the work environment and periodic examination of the healthcare workers and responding accordingly is required.

Cumulative impact of high job demands, low job control and high job insecurity on midlife depression and anxiety: a prospective cohort study of Australian employees

OBJECTIVE

There is a lack of evidence concerning the prospective effect of cumulative exposure to psychosocial job stressors over time on mental ill-health. This study aimed to assess whether cumulative exposure to poor quality jobs places employees at risk of future common mental disorder.

METHODS

Data were from the Personality and Total Health Through Life project (n=1279, age 40-46 at baseline). Data reported on the cumulative exposure to multiple indicators of poor psychosocial job quality over time (ie, a combination of low control, high demands and high insecurity) and future common mental disorder (ie, depressive and/or anxiety symptom scores above a validated threshold) 12 years later. Data were analysed using logistic regression models and controlled for potential confounders across the lifespan.

RESULTS

Cumulative exposure to poor-quality work (particularly more secure work) on multiple occasions elevated the risk of subsequent common mental disorder, independent of social, health, verbal intelligence and personality trait confounders (OR=1.30, 95% CI 1.06 to 1.59).

CONCLUSIONS

Our findings show that cumulative exposure to poor psychosocial job quality over time independently predicts future common mental disorder-supporting the need for workplace interventions to prevent repeated exposure of poor quality work.

Manual occupations with high all-cause mortality: The contribution of socioeconomic and occupational characteristics

AIMS

Most high mortality-risk occupations are manual occupations. We examined to what extent high mortality of such occupations could be explained by education, income, unemployment or industry and whether there were differences in these effects among different manual occupations.

METHODS

We used longitudinal individual-level register-based data, the study population consisting of employees aged 30-64 at the end of the year 2000 with the follow-up period 2001-2015. We used Cox proportional hazard regression models in 31 male and 11 female occupations with high mortality.

RESULTS

There were considerable differences between manual occupations in how much adjusting for education, income, unemployment and industry explained the excess mortality. The variation was especially large among men: controlling for these variables explained over 50% of the excess mortality in 23 occupations. However, in some occupations the excess mortality even increased in relation to unadjusted mortality. Among women, these variables explained a varying proportion of the excess mortality in every occupation. After adjustment of all variables, mortality was no more statistically significantly higher than average in 14 occupations among men and 2 occupations among women.

CONCLUSIONS

The high mortality in manual occupations was mainly explained by education, income, unemployment and industry. However, the degree of explanation varied widely between occupations, and considerable variation in mortality existed between manual occupations after controlling for these variables. More research is needed on other determinants of mortality in specific high-risk occupations.

Relationships Between Job Satisfaction and Job Demand, Job Control, Social Support, and Depression in Iranian Nurses

BACKGROUND

Nurses often experience a wide variety of stressful situations. Excessive work stress influences the physical and mental health of nurses and decreases their life quality and professional efficacy. In addition, high levels of psychological stress may cause job dissatisfaction and job strain.

PURPOSE

The objective of this study was to explore the relationship between several work-related risk factors and job satisfaction in Iranian nurses.

METHODS

A cross-sectional study was conducted on 730 nurses from four public hospitals in, respectively, northern, southern, eastern, and western Iran. Variables in the job demand-control-support (JDCS) model were measured using the Job Content Questionnaire, and job satisfaction was measured using the Minnesota Satisfaction Questionnaire.

RESULTS

The mean score for job satisfaction was 62.94 ± 14.24, which is considered moderate. Nurses with a low level of job satisfaction had significantly higher psychological and physical job demands (p < .05). Significant relationships were found between job satisfaction and several dimensions of the JDCS model, including psychological job demands (β = -0.11, p < .001), physical job demands (β = -0.86, p = .004), skill discretion (β = 0.48, p = .033), decision authority (β = 0.43, p = .028), and supervisor support (β = 1.85, p = .004). The sociodemographic and JDCS model variables used in this study explained 42% of the variation in job satisfaction (R2 = .42).

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Enhancing the job satisfaction of nurses is possible by creating a balance between job demands, job control, and social support.

Process Evaluation of a Participative Organizational Intervention as a Stress Preventive Intervention for Employees in Swedish Primary Health Care

This study is a process evaluation of a trial examining the effects of an organizational intervention (Productivity Measurement and Enhancement System or ProMES) on employee stress. The aims were to explore the implementation process and fidelity to the intervention guidelines, examine the influence of contextual factors (hindrances and facilitators) and explore participants' experience of working with ProMES. We used the UK Medical Research Council (MRC) guidance to guide the process evaluation. The recruitment, reach and dose delivered were satisfactory and participation high. The employees felt ProMES clarified priorities, gave control and increased participation in decision-making. However, difficulty in obtaining statistical productivity data from the central administration office (a central feature of the intervention) hindered full implementation and regular feedback meetings. Staffing shortages interfered with the implementation process, while having seven design teams and one consultant prevented all occupational groups from working simultaneously. A detailed examination of access to necessary organizational data should be undertaken before implementing ProMES. We recommend a better introduction for new employees, more work on design and packaging and giving employees more training in how to use the software program. The study contributes to our understanding of process evaluations in research into organizational stress management interventions.

Determinants of emergency physician wellness in Belgium

OBJECTIVES

This cross-sectional study examines first whether emergency physicians differ from a comparison group of surgeons, more specifically general surgeons and orthopedic surgeons, in terms of job and organizational characteristics and second to what extent these characteristics are determinants of professional well-being outcomes in emergency physicians.

METHODS

Belgian emergency physicians (n = 346) were invited to participate in this study. Forty-three percent of the eligible participants completed a questionnaire. The survey instrument contained 48 questions on determinants (personal characteristics, job conditions [Job Demand Control Support], organizational and environmental work conditions) as well as 39 questions on outcomes (job satisfaction, turnover intention, subjective fatigue, psychological distress, work-home interference, work engagement) by means of the Leiden Quality of Work Questionnaire for Medical Doctors, the Checklist Individual Strength, the Brief Symptom Inventory, and the Utrecht Work Engagement Scale. Hierarchical multiple regression analyses were used to examine the association between the determinants and each of the outcomes.

RESULTS

Emergency physicians reported higher job demands, lower job control, and less adequate work conditions compared with the group of surgeons. High job demands increased turnover intention, subjective fatigue, psychological distress, work-home interference in emergency physicians, but lack of job control, lack of social support from the supervisor, and inadequate communication also contributed in an unfavorable way to some of these outcomes.

CONCLUSION

Emergency medicine departments must reduce the constant exposure to high job demands by allowing emergency physicians to have enough time for both physical and mental recovery. Work motivation and work conditions might be improved by increasing job control over job demands by giving emergency physicians more decision latitude and autonomy, improving good communication and teamwork and adequate social support from the supervisor and providing good material resources. These interventions can improve professional well-being outcomes in emergency physicians.

Workers With Different Employment Status Have Different Exposures to Work Stressors and Different Responses to Identical Work Stressors

INTRODUCTION

This study evaluated the relationship between exposure to diverse work-related stressors and psychological well-being in workers with precarious employment.

METHODS

This was a secondary analysis of data from the fifth Korean Working Conditions Survey, conducted in 2017.

RESULTS

Daily workers were more likely to report poor psychological well-being than regular or temporary workers. Furthermore, higher proportions of daily workers reported exposure to the nine analyzed work stressors. However, only three of nine workplace stressors (lack of decision latitude, lack of reward, and lack of support from workplace managers) affected male and female daily workers.

CONCLUSION

A strategy designed to improve the psychological well-being of workers with precarious employment that is based on typical job stressor evaluation tools, may have limited effects.

Association between Presenteeism, Psychosocial Aspects of Work and Common Mental Disorders among Nursing Personnel

Presenteeism is the term used to describe going in to work even with a health problem. The phenomenon has been identified as one prior factor in sickness absence and, accordingly, the better it is understood, the better will be the prevention strategies. This study aimed to examine the mediating role of presenteeism (the ability to concentrate on work and to complete work despite a health problem) in the association between psychosocial factors at work and common mental disorders (CMD). This cross-sectional study included 1218 nursing personnel at a public hospital in Brazil. Structural equation modelling was performed. The sample comprised mostly women (85.4%), and the mean age was 44.1 (SD = 11.3; range: 24–70) years. Prevalence of presenteeism was 32.8%. Among presenteeist workers (n = 400), a relationship was observed between presenteeism and higher CMD scores. Furthermore, being able to concentrate on work even with a health problem mediated the relationship between social support and CMD and between psychological demands and CMD. Working when sick impairs both the work and the worker’s health. Interventions designed to improve working conditions and interpersonal relations can be effective strategies against presenteeism.

Perceived job strain among Swedish occupational therapists with less than 10 years of work experience

BACKGROUND

Occupational therapists with less than 10 years of work experience have been shown to be at higher risk of work-related stress. There is a need for further research on the level of job strain they perceive.

AIMS

To investigate the perceived level of job strain among Swedish occupational therapists with less than 10 years of work experience and differences between groups who have worked for 0-5 years and 6-10 years.

MATERIAL AND METHODS

In this cross-sectional study, a web-based survey was sent to 345 occupational therapists with less than 10 years of work experience, with 252 responding. Data was collected using the Swedish Demand-Control-Support Questionnaire and questions on job strain and sociodemographics.

RESULTS

The participants scored 19.68 points on the control scale and 20.01 points on the support scale, indicating high levels of control and support, and 13.33 points on the demand scale (high demand ≤ 14 points). Twelve percent worked in high strain jobs. Most (75%) worked in low strain and active jobs.

CONCLUSIONS AND SIGNIFICANCE

The participants reported low levels of job strain. However, to prevent mental health problems, employers need to identify those in active jobs to ensure that they have time to exercise control over their work situation.

Servant Leadership in Japan: A Validation Study of the Japanese Version of the Servant Leadership Survey (SLS-J)

PURPOSE

The purpose of this study is to develop and validate a Japanese version of the Servant Leadership Scale and to clarify the relationship between servant leadership (SL) and well-being among Japanese workers.

METHODS

After the Japanese version of the SLS (SLS-J) and of its short form (SLS-J-short) were developed in conformity with the guidelines (Wild et al., 2005), a web-based survey was administered to 516 Japanese employees (20 or older and have a supervisor). Confirmatory factor analysis (CFA) was conducted to evaluate a construct validation of the SLS-J and the SLS-J-short. Convergent validity was estimated with theoretically related constructs (e.g., transformational leadership, supervisory support, and interpersonal justice) and potential consequences of SL (e.g., affective commitment, work engagement, job satisfaction, organizational citizenship behavior (OCB), psychological distress, and work performance). Intraclass correlation coefficient (ICC) using the test-retest method was conducted with 104 of the initial respondents to assess internal consistency reliability. Additionally, the effects of SL on employees' work engagement and the mediating role of employees' affective commitment were estimated.

RESULTS

CFA confirmed that an eight-factor model (SLS-J) and a five-factor model (SLS-J-short) had the most satisfactory fits for the two scales with Japanese workers. Tests of convergent validity and reliability showed sufficiency for each of the dimensions of SLS-J and SLS-J-short. Additionally, it was revealed that SL has an impact on employees' work engagement through a mediation of affective commitment at a cross-sectional level, and the indirect association between SL and work engagement via affective commitment remained afterward.

CONCLUSION

SLS-J and SLS-J-short were confirmed to have good reliability and validity for Japanese workers. Also, this study found that SL has an important role in enhancing the engagement of workers.

Crescimento Pós-Traumático em Profissionais de Emergências: Uma Revisão Sistemática de Estudos Observacionais

Resumo A exposição a eventos traumáticos pode gerar Crescimento Pós-Traumático (CPT). O objetivo do presente estudo foi realizar uma revisão sistemática das publicações sobre prevalência de CPT e sua associação com estressores ocupacionais entre profissionais de emergências. A revisão foi baseada no método PRISMA e previamente registrada no PROSPERO. A busca foi realizada nas bases de dados Medical Literature Analysis and Retrieval System Online (Medline), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e Scientific Electronic Library Online (ScIELO). Dentre os resultados, não foi possível identificar a prevalência de CPT. Estressores operacionais foram associados ao CPT. Estressores organizacionais foram raramente investigados. Concluiu-se que o CPT é um dos focos em estudos sobre reações pós-traumáticas entre profissionais de emergências e está associado a estressores ocupacionais. Por isso, trata-se de um construto importante para compreender a saúde mental desses profissionais, dada a organização e a natureza de suas tarefas no trabalho.

Development of Prediction Models for Sickness Absence Due to Mental Disorders in the General Working Population

Purpose This study investigated if and how occupational health survey variables can be used to identify workers at risk of long-term sickness absence (LTSA) due to mental disorders. Methods Cohort study including 53,833 non-sicklisted participants in occupational health surveys between 2010 and 2013. Twenty-seven survey variables were included in a backward stepwise logistic regression analysis with mental LTSA at 1-year follow-up as outcome variable. The same variables were also used for decision tree analysis. Discrimination between participants with and without mental LTSA during follow-up was investigated by using the area under the receiver operating characteristic curve (AUC); the AUC was internally validated in 100 bootstrap samples. Results 30,857 (57%) participants had complete data for analysis; 450 (1.5%) participants had mental LTSA during follow-up. Discrimination by an 11-predictor logistic regression model (gender, marital status, economic sector, years employed at the company, role clarity, cognitive demands, learning opportunities, co-worker support, social support from family/friends, work satisfaction, and distress) was AUC = 0.713 (95% CI 0.692-0.732). A 3-node decision tree (distress, gender, work satisfaction, and work pace) also discriminated between participants with and without mental LTSA at follow-up (AUC = 0.709; 95% CI 0.615-0.804). Conclusions An 11-predictor regression model and a 3-node decision tree equally well identified workers at risk of mental LTSA. The decision tree provides better insight into the mental LTSA risk groups and is easier to use in occupational health care practice.

Restoring confidence in return to work: A qualitative study of the experiences of persons with exhaustion disorder after a dialogue-based workplace intervention

Background

Stress-induced exhaustion disorder (SED) is a primary cause for sickness absence among persons with mental health disorders in Sweden. Interventions involving the workplace, and supporting communication between the employee and the supervisor, are proposed to facilitate return to work (RTW). The aim of this study was to explore experiences of persons with SED who participated in a dialogue-based workplace intervention with a convergence dialogue meeting performed by a rehabilitation coordinator.

Methods

A qualitative design based on group interviews with 15 persons with SED who participated in a 24-week multimodal rehabilitation program was used. The interviews were analyzed with the methodology of grounded theory.

Results

The analysis resulted in a theoretical model where the core category, restoring confidence on common ground, represented a health promoting process that included three phases: emotional entrance, supportive guidance, and empowering change. The health promoting process was represented in participant experiences of personal progress and safety in RTW.

Conclusions

The intervention built on a health-promoting pedagogy, supported by continuous guidance from a rehabilitation coordinator and structured convergence dialogue meetings that enhanced common communication and collaboration with the supervisor and others involved in the RTW process. The intervention balanced relationships, transferred knowledge, and changed attitudes about SED among supervisors and colleagues in the workplace. The inclusion of a rehabilitation coordinator in the intervention was beneficial by enhancing RTW and bridging the gaps between healthcare, the workplace, and other organizational structures. In addition, the intervention contributed to a positive re-orientation towards successful RTW instead of an endpoint of employment. In a prolonged process, a dialogue-based workplace intervention with convergence dialogue meetings and a rehabilitation coordinator may support sustainable RTW for persons with SED.

Work-related psychosocial risk factors for stress-related mental disorders: an updated systematic review and meta-analysis

OBJECTIVE

The objective was to conduct an update of a previously published review and meta-analysis on the association between work-related psychosocial risk factors and stress-related mental disorders (SRD).

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Medline, Embase and PsycINFO were searched for articles published between 2008 and 12 August 2019 and references of a systematic review performed for the period before 2008 were included. Primary prospective studies were included when outcome data were described in terms of SRD assessment or a dichotomous outcome, based on a validated questionnaire, and at least two levels of work-related exposure were reported (exposed vs less or non-exposed). We used GRADE to assess the evidence for the associations between risk factors and the onset of SRD.

RESULTS

Seventeen studies met the inclusion criteria. In total, a population of 73 874 workers from Belgium, Denmark, England, Finland, Japan, the Netherlands and Sweden were included in the meta-analysis of 14 prospective cohort studies. This meta-analysis revealed moderate evidence for associations between SRD and effort reward imbalance (OR=1.9, 95% CI 1.70 to 2.15), high job demands (OR=1.6, 95% CI 1.41 to 1.72), organisational justice (ORs=1.6 to 1.7, CIs 1.44 to 1.86), social support (ORs=1.3 to 1.4, CIs 1.16 to 1.69), high emotional demands (OR=1.6, 95% CI 1.35 to 1.84) and decision authority (OR=1.3, CI 1.20 to 1.49). No significant or inconsistent associations were found for job insecurity, decision latitude, skill discretion and bullying.

CONCLUSION

Moderate evidence was found that work-related psychosocial risk factors are associated with a higher risk of SRD. Effort-reward imbalance, low organisational justice and high job demands exhibited the largest increased risk of SRD, varying from 60% to 90%.

My job, my child, my house: the predictive value of job- and housework-related factors on depressive symptoms during the postpartum period

BACKGROUND

Many mothers combine two sides of their life: They are both educated employees and family organizers. The aim of this study is to investigate risk and protective factors of depressive symptoms during the postpartum period (PPD symptoms) on both those sides of mothers' life, including education, job-, and housework-related factors.

METHODS

Data (n = 689) were drawn from the prospective-longitudinal cohort study "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Education, job satisfaction, job burden, and the housework-related factor ministering to family needs (MTFN) were measured during pregnancy. Depressive symptoms were measured 8 weeks postpartum. Multiple linear regression analyses were conducted.

RESULTS

While education was not significantly associated with PPD symptoms, low job satisfaction, high job burden, and low MTFN levels were significant risk factors for PPD symptoms. When controlling for further potential confounders, job satisfaction and job burden remained significant predictors.

LIMITATIONS

Generalization of findings might be limited due to participation bias and some systematic dropout.

CONCLUSIONS

Job characteristics should be considered in future research on postpartum mental health. For the prevention of PPD symptoms, it seems important to ensure satisfying and less burdensome working conditions during pregnancy. Additionally, the results indicate that further research on the effects of housework-related factors on PPD symptoms is worthwhile.

Emotional Changes and Protective Factors of Emotional Workers in the Public and Private Sector

OBJECTIVE

Emotional labor is known to be a risk factor for emotional distress. This study aimed to evaluate specific stressors according to the type of occupation and identify protective and adverse factors.

METHODS

We recruited 349 workers engaged in emotional labor in a suburban city. They were assessed using scales regarding emotional status, job stress, resilience, and job satisfaction. Correlation and regression analyses were performed to evaluate their emotional state according to their stress level. A mediation model using structural equation modeling was utilized to identify the mediating effects of resilience and workplace satisfaction.

RESULTS

The correlation analysis indicated that the level of workplace stress was statistically correlated with depressed mood and anxiety and showed a significant inverse correlation with individuals' resilience and job satisfaction. According to the regression analysis, in private institution workers, "emotional disharmony and hurt" had a statistically significant negative effect on their emotional state, and in public institution workers, "emotional demands and regulation" were prominent. Resilience partially mediated the relationship between emotional stress and anxiety/depressive symptoms.

CONCLUSION

Our findings indicate that the causes of stress differed according to the working environment. Preventive strategies such as resilience training and relieving stress on individual factors are needed to promote mental health.

Ankle Sprains Risk Factors in a Sample of French Firefighters: A Preliminary Prospective Study

Context: Firefighters participating in mandatory physical exercise sessions are exposed to a high risk of ankle sprain injury. Although both physiological and psychological risk factors have been identified, few prospective studies considered the complex interaction of these factors in firefighters. Objective: To prospectively determine whether intrinsic physical risk factors and work-related environments predict ankle sprains occurring during on-duty physical exercise in firefighters during an 8-month follow-up period. Design: Prospective. Setting: Fire Department and Rescue Service. Participants: Thirty-nine firefighters were selected based on convenience sampling. Intervention: Participants performed physical tests and completed questionnaires. Main Outcome Measures: Lower Quarter Y-Balance Test, Weight-Bearing Lunge Test, anthropometric measures, postural stability, chronic ankle instability (Cumberland Ankle Instability Tool) scores, previous injuries, and perceived psychosocial work environment (Copenhagen Psychosocial Questionnaire [COPSOQ]). Results: During the follow-up, 9 firefighters sustained an injury. Lower Quarter Y-Balance Test and Weight-Bearing Lunge Test performances, Cumberland Ankle Instability Tool scores, history of previous ankle sprain, and specific dimensions of the COPSOQ significantly differed between injured and uninjured firefighters. Lower-limbs asymmetries of the Lower Quarter Y-Balance Test (ie, anterior, posteromedial, and posterolateral directions) and the Weight-Bearing Lunge Test were predictors of ankle sprains. Conclusions: These findings originally provide evidence that intrinsic factors mainly contribute to ankle sprains, although psychosocial work environment assessment could also characterize firefighters at risk.

Artificial intelligence: opportunities and implications for the health workforce

Healthcare involves cyclic data processing to derive meaningful, actionable decisions. Rapid increases in clinical data have added to the occupational stress of healthcare workers, affecting their ability to provide quality and effective services. Health systems have to radically rethink strategies to ensure that staff are satisfied and actively supported in their jobs. Artificial intelligence (AI) has the potential to augment provider performance. This article reviews the available literature to identify AI opportunities that can potentially transform the role of healthcare providers. To leverage AI's full potential, policymakers, industry, healthcare providers and patients have to address a new set of challenges. Optimizing the benefits of AI will require a balanced approach that enhances accountability and transparency while facilitating innovation.

How Do Hospital Medical and Nursing Managers Perceive Work-Related Strain on Their Employees?

Health-oriented supportive leadership behavior is a key factor in reducing work stress and promoting health. Employees in the health sector are subject to a heavy workload, and it has been shown that 40% of them show permanent health problems. A supportive leadership behavior requires the manager's awareness of the employees' well-being. However, little is yet known about how medical and nursing managers perceive the well-being of their staff. To explore this issue, we conducted a total of 37 semi-standardized interviews with 37 chief physicians (CPs), senior physicians (SPs), and senior nurses (SNs) in one German hospital. The interviews were content-analyzed based on the definitions of strain of the 'Federal Institute for Occupational Safety and Health'. Results show that hospital managers are aware of fatigue and further consequences such as deterioration of the team atmosphere, work ethics, treatment quality, and an increased feeling of injustice among employees. Most managers reported sick leaves as a result of psychosomatic complaints due to the permanent overstrain situation at work in the hospital. Results of this qualitative study are discussed in the light of health-oriented management relating to relevant stress models and to findings concerning staff shortages.

Taking a Stand for Office-Based Workers' Mental Health: The Return of the Microbreak

There is evidence that movement-based microbreaks can improve the cardiovascular health of desk-based employees, but their effect on mood states is yet to be investigated. As daily work tasks can potentially result in the loss of physical and psychological resources, the objective of this study was to measure the effect of movement microbreaks during formal work time on mood states. In a randomized-controlled pilot study with repeated measures (baseline, post-test, washout) of self-reported job stress and mood states (fatigue and vigor), police officers (N = 43) were exposed to movement microbreaks during work hours. A multivariate significant difference between groups was noted after the intervention period. Further analysis revealed that the experimental group reported a latent reduction in job-related stress after the 3-months washout period. Although the study was conducted with a small sample, our preliminary findings suggest that interrupting sedentary work with movement microbreaks may have beneficial effects on employee mental health. The implications of movement microbreaks for mitigating work-related stress of first responders, including police, is discussed, along with directives for future research.

Social support as protective factor of the effects of part-time work on psychological health: a moderated mediation model

Purpose

The purpose of this study is to examine the protective effect of social support on psychological health and how it differs by gender in the context of part-time employment.

Design/methodology/approach

The sample consisted of 22,786 employees from four service sector organisations. Structural equation modelling was used to test a moderated mediation model assessing the relationship between employment status (part-time vs full-time) and psychological health mediated by social support (from management and colleagues) and moderated by gender.

Findings

Social support from management and colleagues was associated with fewer symptoms of stress, anxiety and depression. Notably, management support had a stronger association than that of colleagues’ support on each of the three health-related variables. Social support was also found to be a mediator of part-time working on health such that lower social support led to increased health symptoms. Moreover, we found moderating gender effects between social support and psychological health such that colleague support had a stronger effect on reduced depression and stress among men than women whilst management support had a stronger effect on reduced anxiety for women. Finally, significant moderated mediating paths were found, but further research is needed to identify other potential moderators of the mediating effects.

Originality/value

The findings suggest complex relationships between part-time employment, social support, psychological health and gender not examined in previous studies. It highlights the value of diverse sources of support and the necessity of addressing specific gender's needs for enhancing psychological health of part-time employees.

The Association Between Coworker Support and Work-Family Interference: A Test of Work Environment and Burnout as Mediators

Coworker support has been hypothesized to enhance work-life outcomes. However, the mechanisms underlying this association are unclear. Two studies examined how coworker support predicted work-life outcomes through positive work environment and burnout. It was hypothesized that coworker support enhances work environment, and that better work environment is associated with less burnout; in turn, reduced burnout is associated with less negative work-life interference. In two large studies of working adults (total N = 5,666), we found support for our model – coworker support predicted work-family outcomes and this association was mediated by more positive work environments and reduced burnout. Study 2 was a short-term lagged confirmation of the model. Results are discussed in the context of efforts to improve workplace climate, reduce turnover, and improve workers’ job satisfaction.

Work- and stress-related musculoskeletal and sleep disorders among health professionals: a cross-sectional study in a hospital setting in Switzerland

Background

Musculoskeletal and sleep disorders have been reported to be very common among health care and hospital workers and particularly nurses. They are assumed or found to be a result of psychological stress and/or physical strain or pain. However, no other study so far – at least in a hospital setting and for Switzerland – has considered and investigated musculoskeletal as well as sleep disorders in consequence of or rather in association with both physical workload and psychological stress.

Methods

Cross-sectional survey data of 1232 health professionals were used and analysed. Data were collected in 2015/16 among the health care workforces of three public hospitals and two rehabilitation clinics in the German-speaking part of Switzerland. Musculoskeletal and sleep disorders were assessed by three items taken from the Swiss Health Survey, a 2-item measure of accumulated low back, back, neck and shoulder pain and a single-item measure of problems in getting to sleep or sleeping through. Stratified and adjusted bivariate logistic and multivariate linear regression analyses were performed to calculate measures of association (adjusted odds ratios, z-standardized beta coefficients), to control for potential confounders, and to compare different health professions (nurses, physicians, therapists, other).

Results

Almost every fourth of the studied health professionals reported severe or even very severe musculoskeletal disorders (MSDs) and nearly every seventh severe sleep disorders (SDs). These prevalence rates were significantly or at least slightly higher among nurses than among physicians and other health care workers. General stress, work stress, physical effort at work, and particularly a painful or tiring posture at work were found to be clear and strong risk factors for MSDs, whereas only general and work-related stress were found to be significantly associated with SDs. There was no or only weak association between MSDs and SDs.

Conclusions

This study found MSDs to be largely a result of physical workload or rather poor posture at work and only secondarily a consequence of (general) stress, whereas SDs were revealed to be primarily a consequence of stress on and particularly off the job. Preventive strategies therefore have to differentiate and combine measures for the reduction of both psychological stress and physical strain.

Rx risk or resistance? Psychotropic medication use in relation to physiological and psychosocial functioning of psychiatric hospital workers

To avoid methodological biases, psychoneuroendocrine studies have generally excluded psychotropic medication users. In workplace stress research, this has limited our ability to understand how psychotropic medication use affects many stress-related measures of interest. In this exploratory study, the effects of psychotropic medication use on stress physiology, occupational stress, and mental health were measured in a sample of healthy adult psychiatric hospital workers (N = 203, 70 % women). Diurnal cortisol was assessed on two non-consecutive work-days at five time-points (e.g., awakening, thirty minutes after awakening, 2 P M, 4 P M and bedtime). Cortisol reactivity was assessed by exposing participants to the Trier Social Stress Test. An allostatic load index was constructed using 19 neuroendocrine, immune, cardiovascular, and metabolic biomarkers. Occupational stress (e.g., job strain, effort-reward imbalance) and psychiatric symptoms (e.g., depression, burnout) were assessed with well-validated self-reports. Results showed that psychotropic medication use had no significant effects on diurnal cortisol profiles; however, psychotropic users had significantly decreased cortisol reactivity to the Trier Social Stress Test and higher allostatic load. Psychotropic users also had decreased effort-reward imbalance, but not job strain. Depressive symptoms did not differ between psychotropic medications users and non-users; however, burnout symptoms were higher among psychotropic medication users than non-users. Taken together, our findings do not warrant the systematic exclusion of psychotropic medication users from psychoneuroendocrine studies if insights into individual differences are sought among workers and other populations exposed to elevated stress.

Introducing plant biology graduate students to a culture of mental well-being

Currently, an estimated 20%-40% of graduate students have depression and anxiety. In addition, more than half report experiencing high chronic stress. Thus, organizations such as the Plant Science Research Network have highlighted the need to prioritize trainee well-being. This has led to a search for strategies to introduce this cultural change into scientific training. However, for faculty who do not have experience with this topic area, there are few readily available resources from which to draw. In this paper, we describe how two graduate groups, one focused on plant biology and the other on genomics and genetics approached this challenge together by introducing a course on mental and emotional well-being to their incoming first-year graduate students. We describe the research on workplace mental and emotional well-being and disability prevention which served as the basis for the course content. We review the course curriculum, student reflections about what they learned, and implications for future classes.

Associations between cognitive and affective job insecurity and incident purchase of psychotropic drugs: A prospective cohort study of Swedish employees

BACKGROUND

Previous research suggests that job insecurity is associated with poor mental health, but research examining how different aspects of job insecurity relate to clinical measures of poor mental health are lacking. We aimed to investigate the association between cognitive and affective job insecurity and incident purchases of psychotropic drugs.

METHODS

We included 14,586 employees participating in the Swedish Longitudinal Occupational Survey of Health (SLOSH), who answered questions on cognitive and/or affective job insecurity in 2010, 2012 or 2014. Respondents were followed in the Swedish Prescribed Drug Register (2.5 years on average). We investigated the association between job insecurity and incident psychotropic drugs with marginal structural Cox models.

RESULTS

Affective job insecurity was associated with an increased risk of purchasing any psychotropic drugs (Hazard Ratio (HR) 1.40 (95% Confidence Interval (CI) 1.04-1.89)) while cognitive job insecurity was not (HR 1.15 (95% CI 0.92-1.43)). Cognitive and affective job insecurity were both associated with antidepressants, affective job insecurity with anxiolytics, but no association was found with sedatives. Women and younger workers seemed to have higher risk compared to men and older workers, but differences were not statistically significant.

LIMITATIONS

Although job insecurity and psychotropic drugs were assessed through independent sources and several covariates were considered, unmeasured confounding cannot be ruled out.

CONCLUSIONS

The findings support that affective job insecurity is a risk factor for psychotropic drug treatment, that it may be relevant to distinguish between different types of job insecurity, and to consider sex and age as moderating factors.

Interventions to enhance recovery in healthy workers; a scoping review

Background

Faster recovery from work may help to prevent work-related ill health.

Aims

To provide a preliminary assessment of the range and nature of interventions that aim to improve recovery from cognitive and physical work.

Methods

A scoping review to examine the range and nature of the evidence, to identify gaps in the evidence base and to provide input for systematic reviews. We searched for workplace intervention studies that aimed at enhancing recovery. We used an iterative method common in qualitative research to obtain an overview of study elements, including intervention content, design, theory, measurements, effects and cost-effectiveness.

Results

We found 28 studies evaluating seven types of interventions mostly using a randomized controlled study design. For person-directed interventions, we found relaxation techniques, training of recovery experiences, promotion of physical activity and stress management. For work-directed interventions, there were participatory changes, work-break schedules and task variation. Most interventions were based on the conservation of resources and affect-regulation theories, none were based on the effort-recovery theory. The need for recovery (NfR) and the recovery experiences questionnaires (REQ) were used most often. Study authors reported a beneficial effect of the intervention in 14 of 26 published studies. None of the studies that used the NfR scale found a beneficial effect, whereas studies that used the REQ showed beneficial effects. Three studies indicated that interventions were not cost-effective.

Conclusions

Feasible and possibly effective interventions are available for improving recovery from cognitive and physical workload. Systematic reviews are needed to determine their effectiveness.

The burden of high workload on the health-related quality of life among home care workers in Northern Sweden

Objective

Previous studies have shown that high workload affects health negatively. However, studies are lacking among home care workers. The aim of this study is to examine the burden of perceived workload on health-related quality of life (HRQoL) among home care workers and to determine whether psychosocial factors modify such a relationship.

Methods

A cross-sectional study was conducted in which 1162 (58% response rate) home care workers participated. The psychosocial factors were measured by QPSnordic. HRQoL was measured by EuroQol 5 dimensions, from which responses were translated into quality-adjusted life year scores (QALY). Propensity scores were used with absolute risk differences (RD). Stratified analysis was used to test the buffer hypothesis of the demand–control–support model.

Results

Personnel with a high workload had a statistically significant 0.035 lower QALY than personnel with a normal workload. This difference was also statistically significant for the Visual Analogue Scale (RD 5.0) and the mobility (RD 0.033) and anxiety/depression scales (RD 0.20) dimensions of EQ-5D. For QALY, the effect of a high workload compared to a normal workload was higher, with low (RD 0.045, significant) compared with high (RD 0.015, non-significant) social support; while it was similar, and non-significant results, for low and high control.

Conclusions

Our study shows that lowered work burden would be beneficial for home care personnel. Furthermore, our results suggest that interventions aimed at increasing social support could reduce work-related illness.

High mortality in manual occupations and the role of alcohol in 2001–15

Background

The aim was to identify specific manual occupations with high mortality and to examine whether there are differences in the role of alcohol in explaining the excess mortality among manual occupations with high all-cause mortality.

Methods

A register-based study of employees aged 30–64 years, followed for mortality 2001–15. Age standardized mortality ratios (SMRs) were calculated to compare the mortality rates of manual occupations. The contribution of alcohol-related mortality to excess mortality was obtained by comparing the excess mortality in all deaths and deaths not related to alcohol.

Results

Men had 31 and women 11 manual occupations with SMR statistically significantly over 120 compared with all employees. Mortality rates were highest among building construction labourers (SMR 180) among men and building caretakers (SMR 155) among women. With few exceptions, high mortality was a combination of high alcohol-related and high non-alcohol-related mortality. Among men, the contribution of alcohol-related mortality to the excess all-cause mortality compared with all employees was over 10% in half of the high-mortality occupations. The contribution was highest among welders and flame cutters (50%) and lowest among farmer’s locums (−50%). Among women the contribution was highest among building caretakers (15%).

Conclusions

High-mortality occupations had high mortality even without alcohol-related deaths. However, alcohol-related mortality was generally higher than mortality for other causes; therefore, alcohol-related mortality increased further the excess mortality. Diminishing the alcohol-related mortality would level excess mortality of these occupations but not eliminate it.

Facilitators, barriers and support needs for staying at work with a chronic condition: a focus group study

BACKGROUND

Working with a chronic condition can be challenging. Providing support to workers with a chronic condition can help them to stay at work and prevent work-related problems. Workers with a chronic condition who successfully stay at work can provide valuable input for the development of effective supportive interventions to prevent exit from work and facilitate sustainable employment. The aim of this study is to explore the lived experiences of workers with a chronic condition and identify existing barriers, facilitators and possible support needs for staying at work.

METHODS

Four focus groups were conducted between August and December 2017 with workers with one or more chronic conditions (n = 30). Participants included employees and (partially) self-employed workers. All focus group data were transcribed verbatim and thematically analyzed.

RESULTS

Disclosure and expressing one's needs were considered important personal facilitators for staying at work. Environmental facilitators included receiving practical information on working with a chronic condition and social and employer support. Environmental barriers were identified in the work environment, the health care system and service provision, e.g., manager and co-worker's lack of knowledge about working with a chronic condition, a lack of focus on work in the course of treatment for a chronic condition, dissatisfaction with occupational physician support, and the absence of support for self-employed workers. Provided support should be available to all workers, and be proactive and tailored to the workers' specific support needs.

CONCLUSIONS

A variety of facilitators, barriers and support needs were identified in various domains. By addressing environmental barriers (e.g., by integrating work in the course of treatment and creating supportive work environments), sustainable employment by workers with a chronic condition can be promoted.