[Work, age, health, and work participation. A theoretical model]

Working conditions of healthcare workers and clients' satisfaction with care: study protocol and baseline results of a cluster-randomised workplace intervention

BACKGROUND

In the present investigation the study protocol and the results at baseline of a workplace intervention are reported. It is hypothesised that the reduction of the physical and psychosocial workload of healthcare workers increases 1 their self-assessed physical and mental work ability, and 2. clients' satisfaction with care.

METHODS

Two-arm, cluster-randomised trial. Outcome data on workers and clients are collected in questionnaires at baseline, and two follow-ups between 2019 and 2021. Participants of the interventions are healthcare workers of 11 healthcare providers in Germany. At baseline, the intervention arm comprised 22 clusters (n = 174 workers); the control arm, 47 clusters (n = 276). The intervention consists of interviews and workshops, in which employees propose measures aiming to reduce the physical and psychosocial load, and strengthen resources at work. The primary outcome is the workers' physical and mental work ability. The secondary outcome is the clients' satisfaction with care.

RESULTS

There was no evidence of substantial differences between trial arms at baseline concerning the outcomes. The design effect estimates for physical and mental work ability were 1.29 and 1.05, respectively. At the end of the trial, effect sizes of at least 0.30 and 0.27 at the 80% power and 5% significance levels can be attained.

CONCLUSIONS

The results suggest that the implementation of the study design has been satisfactory. The intervention is expected to provide evidence of relatively small to medium-size effects of the intervention activities on the work ability of healthcare workers and the clients' satisfaction with care.

TRIAL REGISTRATION

Registration trial DRKS00021138 on the German Registry of Clinical Studies (DRKS), retrospectively registered on 25 March, 2020.

The Impact of Work Ability on Work Motivation and Health: A Longitudinal Study Based on Older Employees

OBJECTIVE

Work participation is determined by work motivation and work ability with health as a significant component. Within the lidA-study, we explore the impact of work ability on work motivation and health with consideration of further influencing factors.

METHODS

Four thousand one hundred nine older employees were interviewed two times (t0 = 2011, t1 = 2014). Two multivariate analyses were performed regarding the influence of work ability on work motivation (Model 1) and health (Model 2).

RESULTS

Within the multivariate analysis, of all the influencing factors, work ability has the strongest effect on work motivation (F = 37.761) and health (F = 76.402). It appears as a decisive determinant for both dimensions.

CONCLUSION

Regarding the results, it is useful to focus on the work ability of older employees in order to maintain and boost their work motivation and health.

[Social inequality in reduced earning capacity among older employees : An analysis of routine data of the German statutory pension insurance]

BACKGROUND

The efforts to extend working lives are accompanied by the question of whether it is possible for all employees to work longer for health reasons. Existing studies show for example that particularly workers in a lower socioeconomic position have a comparatively higher risk to prematurely retire. It is therefore likely that an increase of the state pension age puts particular pressure on such workers; however, studies on socioeconomic differences of disability retirement focusing on older workers in Germany are missing.

OBJECTIVE

The aim of this study was to investigate whether social inequality exists for reduced earning capacity also for older workers.

MATERIAL AND METHODS

The study relied on administrative data of the German pension insurance (DRV). Detailed information on the course of insurance was available for a random sample of all insured persons born in the years 1947 and 1961 (aged 59 and 45 years respectively at the beginning of the observational period; n = 160,688). Using Cox regressions (adjusted for working hours, national citizenship and location of workplace) associations between three socioeconomic features (education, occupation and income) and the risk of disability retirement in the observational period were investigated. The analysis was carried out separately for both cohorts (born 1947 and 1961) of younger and older employees and separately for men and women.

RESULTS AND CONCLUSION

The results showed an increased risk of reduction in earning capacity even for older workers with a low socioeconomic position compared to those in a higher position. For men this is true for all three socioeconomic features investigated and both cohorts. For women the association was also observed with the exception of education and occupational position for those born in 1947. In the efforts to extend working lives, special attention should be paid to persons in lower socioeconomic positions in order to protect them from new disadvantages.

Developing an Extended Model of the Relation between Work Motivation and Health as Affected by the Work Ability as Part of a Corporate Age Management Approach

Due to demographic changes, the employee structure in companies is changing dramatically. It will be necessary to offer employees suitable, age-adequate jobs. As one of its foremost goals, optimized business management strategies must create conditions for guaranteeing a person’s health, work ability, and work motivation. In the context of corporate age management concepts, the literature recommends to retain and integrate older employees in the organization. This paper aims at developing an extended model of the relation between work motivation and health as affected by work ability and at deriving a host of measures that enterprises can apply as part of a corporate age management policy to counteract the impact of demographic changes. The model also takes into consideration factors influencing the relation between work motivation and health as affected by work ability (socio-demographic parameters, occupation, work-related stress). Additionally, the extended model translates the literature-based results into a corporate setting by way of a corporate age management program. The model comprises a process focusing on retaining and promoting work ability in order to maintain or boost work motivation and health. The host of measures presented serves as a basis to preventively counter demographic change on an individual, interpersonal, and structural level.

Cohort profile: the lidA Cohort Study-a German Cohort Study on Work, Age, Health and Work Participation

The lidA Cohort Study (German Cohort Study on Work, Age, Health and Work Participation) was set up to investigate and follow the effects of work and work context on the physical and psychological health of the ageing workforce in Germany and subsequently on work participation. Cohort participants are initially employed people subject to social security contributions and born in either 1959 (n = 2909) or 1965 (n = 3676). They were personally interviewed in their homes in 2011 and will be visited every 3 years. Data collection comprises socio-demographic data, work and private exposures, work ability, work and work participation attitudes, health, health-related behaviour, personality and attitudinal indicators. Employment biographies are assessed using register data. Subjective health reports and physical strength measures are complemented by health insurance claims data, where permission was given. A conceptual framework has been developed for the lidA Cohort Study within which three confirmatory sub-models assess the interdependencies of work and health considering age, gender and socioeconomic status. The first set of the data will be available to the scientific community by 2015. Access will be given by the Research Data Centre of the German Federal Employment Agency at the Institute for Employment Research (http://fdz.iab.de/en.aspx).

[Perspectives of work, age, health, and labor market participation in Germany]

The German population is aging and shrinking. This will have a significant impact on the labor market, because labor supply will start to shrink. Consequently, there is a need to develop additional labor market resources. In this setting, a crucial issue is the health and employment of the older working population. This article discusses--on the basis of nine articles in this special issue--the health of the working population in the context of work, age, and labor participation. It shows the diversity of morbidity in the work force in general and particularly in older age, and it identifies older labor force groups with good health and those with bad health. The latter shows that "working while having a bad state of health" is today's reality. Labor market participation is less dependent on health than on the "work ability" and/or the "motivation to work" of older workers. The employment dynamics of an aging population will be a key issue in future political debate. A reliable knowledge base is needed for proper discussion, judgment, and action in the economic, political, and social fields. Current research is often focused on subtopics or on subgroups; however, a network of all the related scientific disciplines and the establishment of new comprehensive research approaches are needed in this area.