The influence of perceived stress and musculoskeletal pain on work performance and work ability in Swedish health care workers

Factors influencing healthcare workers' performance before and after the coronavirus disease 2019 pandemic: A bibliometric analysis with supplementary comparative analysis

BACKGROUND

The performance of healthcare workers directly impacts patient safety and treatment outcomes. This was particularly evident during the coronavirus disease 2019 (COVID-19) pandemic.

OBJECTIVE

This study aimed to analyze research trends on factors influencing work performance among healthcare workers through bibliometric analysis and conduct a comparative analysis from macro and micro perspectives before and after the COVID-19 pandemic to complement the existing research.

METHODS

This study involved a bibliometric analysis of 1408 articles related to work performance in the healthcare field published between 2010 and 2023, using the Web of Science, Scopus, and PubMed databases, and 37 articles were selected to determine the factors influencing work performance.

RESULTS

By conducting a bibliometric analysis of the articles based on country, institution, journal, co-cited references, and keywords, this study identified a significant growth trend regarding the factors influencing work performance in the healthcare field, and research hotspots shifted from organizational factors like standard towards psychological factors such as burnout, anxiety, and depression following the outbreak of the COVID-19 pandemic. Subsequently, this study extracted 10 micro-level and 9 macro-level influencing factors from the selected articles for supplementary analysis. Furthermore, this study conducted a comparative analysis of the impact of these factors on work performance before and after the COVID-19 pandemic.

CONCLUSIONS

This study addressed the limitations of previous studies regarding incomplete extraction of factors influencing work performance and unclear comparisons of parameters before and after the COVID-19 pandemic. The findings provide insights and guidance for improving the performance of healthcare workers.

Analysis of musculoskeletal pains and productivity impacts among hispanic construction workers

This study investigated the top three musculoskeletal pains (MSP) among Hispanic construction workers in Texas and the relationship between sleep hours, age, and MSPs on worker productivity. The study recruited 228 participants from 28 small construction companies and surveyed them on their occupation, age, sleep hours, MSP, and the impact of pain on productivity. The results indicated that Foot pain was the most common among these workers, followed by Back pain and others. Additionally, the study found that the Foot was the most common body part reported with MSP among roofers, drywall installers, laborers, and helpers. The study conducted a three-factor ANOVA test to analyze if there were any significant differences in productivity based on age, number of MSPs, and sleep hours. The study found that MSPs and sleep hours significantly impacted productivity. However, there was no significant effect of age. The results also showed that the number of MSPs significantly impacted productivity, with an increase in MSPs leading to a more severe impact on productivity. Additionally, those who slept less than 6 h per day had a more severe impact on productivity than those who slept more. The study suggests that targeted interventions to improve musculoskeletal health and productivity in this population are needed and highlights the importance of considering Hispanic construction workers' specific needs when implementing safety measures and addressing pain management in the workplace.

Examining the health and functioning status of medical laboratory professionals in Ontario, Canada: an exploratory study during the COVID-19 pandemic

OBJECTIVES

This study aims to explore the overall and specific aspects of the functioning of medical laboratory professionals (MLPs) in Ontario, Canada during the COVID-19 pandemic.

DESIGN

A cross-sectional analysis where a questionnaire was used to assess the mental status of MLPs.

SETTING

An online questionnaire administered in Ontario, Canada.

PARTICIPANTS

632 MLPs (medical laboratory technologists, technicians and assistants) were included.

MAIN OUTCOME MEASURES

We employed the WHO Disability Assessment Schedule V.2.0 (WHODAS V.2.0) Questionnaire to assess functioning/disability and Copenhagen Psychosocial Questionnaire, third edition for psychosocial workplace factors. Multiple regression analysis examined the relationship between overall and specific domain functioning scores and psychosocial workplace factors.

RESULTS

Of the total 632 participants, the majority were female gender and Caucasian. It was found that health (β=2.25, p<0.001, CI: 1.77 to 2.73), management of environmental conditions (β=0.65, p<0.001, CI: 0.33 to 0.98), fear of unemployment (β=-0.72, p<0.001, CI: -1.09 to -0.35) and frequency of stress (β=-1.86, p<0.001, CI: -2.33 to -1.40), in addition to bullying exposure (β=0.56, p<0.01, CI: 0.15 to 0.98) and threats of violence exposure (β=0.90, p<0.01, CI: 0.25 to 1.54), significantly decreased functioning overall and within the specific WHODAS V.2.0 functioning domains.

CONCLUSION

This study provides preliminary evidence of the overall and specific aspects of functioning among the MLPs during the COVID-19 pandemic. Besides, these findings can support and guide the improvement of workplace practices and policies among MLPs in the future.

Handgrip strength and work limitations: A prospective cohort study of 70,820 adults aged 50 and older

The purpose of the study was to investigate the association between handgrip strength and the incidence of work limitations in European adults aged 50 and older. We conducted a prospective cohort study among adults aged 50 and older from 27 European countries and Israel. Data were collected from the Survey of Health, Ageing and Retirement in Europe (SHARE) waves 1, 2, 4, 5, 6, and 7. Handgrip strength was measured using a hand dynamometer (Smedley, S Dynamometer, TTM) and participants replied to questions about work limitations. Cox regression was conducted for statistical analyses. A total of 70,820 older adults (mean age 61 ± 7.7 years; 54.3 % women) were followed during a mean of 3.8 ± 2.9 years. The fully adjusted model showed that participants with low handgrip strength (<16 kg in women and <27 kg in men) had a significantly higher risk of work limitations compared with participants with normal values of handgrip strength (hazard ratio: 1.36; 95 % confidence interval: 1.28-1.44). Kaplan-Meier trajectories revealed that the survival probability to experience work limitations in the normal handgrip category was 20 % lower than in the low handgrip category in most of the follow-up period. We identified low level of handgrip strength as a risk factor for work limitations in adults aged 50 years or older. This could be used as an accessible measure to screen workers at risk of developing work limitations.

Acceptability of the eHealth Intervention Sustainable Worker Digital Support for Persons With Chronic Pain and Their Employers (SWEPPE): Questionnaire and Interview Study

BACKGROUND

Sick leave and decreased ability to work are the consequences of chronic pain. Interdisciplinary pain rehabilitation programs (IPRPs) aim to improve health-related quality of life and participation in work activities, although implementing rehabilitation strategies at work after IPRPs can be difficult. Employers' knowledge about pain and the role of rehabilitation needs to be strengthened. The self-management of chronic pain can be improved through eHealth interventions. However, these interventions do not involve communicating with employers to improve work participation. To address this deficiency, a new eHealth intervention, Sustainable Worker Digital Support for Persons with Chronic Pain and Their Employers (SWEPPE), was developed.

OBJECTIVE

This study aimed to describe the acceptability of SWEPPE after IPRPs from the perspective of patients with chronic pain and their employers.

METHODS

This study included 11 patients and 4 employers who were recruited to test SWEPPE in daily life for 3 months after IPRPs. Data were collected using individual interviews at the end of the 3-month test period and questionnaires, which were completed when SWEPPE was introduced (questionnaire 1) and at a 3-month follow-up (questionnaire 2). Data were also collected on how often SWEPPE was used. Qualitative data were analyzed through a qualitative content analysis using an abductive approach. The framework used for the deductive approach was the theoretical framework of acceptability. Quantitative data were analyzed through descriptive statistics and the differences between the responses to questionnaires 1 and questionnaire 2 using the Wilcoxon signed rank test.

RESULTS

Both patients and employers reported that SWEPPE increased their knowledge and understanding of how to improve work participation and helped them identify goals, barriers, and strategies for return to work. In addition, participants noted that SWEPPE improved employer-employee communication and collaboration. However, experiences and ratings varied among participants and the different SWEPPE modules. The acceptability of SWEPPE was lower in patients who experienced significant pain and fatigue. A high degree of flexibility and choice of ratings in SWEPPE were generally described as helpful.

CONCLUSIONS

This study shows promising results on the user acceptability of SWEPPE from both patient and employer perspectives. However, the variations among patients and modules indicate a need for further testing and research to refine the content and identify the group of patients who will best benefit from SWEPPE.

Perceived Stress Mediating the Association Between Mindfulness and Resilience Among Registered Nurses

Purpose

Resilience continues to be an important concept in the nursing profession due to its significant role in personal healthcare, patients' healthcare, and leadership. The present study examined the mediating role of perceived stress in the association between mindfulness and resilience among registered nurses in order to understand their importance among those in the Taiwanese nursing profession.

Materials and Methods

Between October and November 2021, a total of 816 registered nurses participated in a cross-sectional survey including psychometric measures assessing perceived stress (Chinese Perceived Stress Scale-10), mindfulness (Chinese Mindful Attention Awareness Scale), and resilience (Chinese Questionnaire of Resilience).

Results

Results indicated that perceived stress mediated the association between mindfulness and resilience (standardized coefficient = 0.251, p<0.001), although there was no significant association between mindfulness and resilience (standardized coefficient = 0.042, p=0.16). This suggests that perceived stress may function as both distress and eustress because mindfulness was not directly associated with resilience but indirectly via perceived stress.

Conclusion

Nurses and their administrators should focus on different ways of coping with stress so that they become more resilient in facing other stressors. Future studies may be conducted to examine the mediating role of perceived stress in the association between other coping strategies and resilience among registered nurses.

Work Interventions Within Interdisciplinary Pain Rehabilitation Programs (IPRP) - Frequency, Patient Characteristics, and Association with Self-Rated Work Ability

Background

Interdisciplinary pain rehabilitation programs (IPRPs) help people with chronic pain improve their health and manage their work; however, the way IPRPs address sick leave could be improved. Although work interventions can be a part of IPRP, it is not well known how and to what extent.

Aim

This study explores the frequency of work interventions and the characteristics of patients who participate in work interventions as part of IPRP at specialist pain rehabilitation departments in Sweden. In addition, this study explores the association between participation in work interventions and change in patients' self-rated work ability after IPRP.

Methods

Data from the Swedish quality registry for pain rehabilitation (SQRP), which includes 3809 patients between 2016 and 2018, were analysed with descriptive statistics and regression analyses.

Results

The results indicate a high participation rate in work interventions (90%). Some differences were evident concerning characteristics of patients who participated in different work interventions. The return-to-work (RTW) plan, the most frequently used work intervention, had the strongest association with change in self-rated work ability after IPRP. However, the effect sizes were small, and the initial score best explained the change. Furthermore, there were differences between employed and unemployed patients and employment had a positive association with change in self-rated work ability.

Conclusion

More research is needed to understand IPRP's mechanisms and work interventions to support patients with chronic pain, reduce sick leave, and manage work. Employment status needs to be considered and interventions should be tailored to match the individual needs.

SOphrology Intervention to Improve WELL-Being in Hospital Staff (SO-WELL): Protocol for a Randomized Controlled Trial Study

INTRODUCTION

Stress at work and psychosocial risks are a major public health problem. Sophrology and neurolinguistic programming (NLP) have demonstrated benefits in terms of mental, physical and social health, both in the general population and in patients, and both in and out of hospital settings. However, these approaches have never been provided at the hospital for the benefit of health professionals at risk of suffering at work. In general, we aim to demonstrate the effectiveness of a hospital sophrology/NLP intervention for health care professionals at risk of stress-related disorders. The secondary objectives are to study (i) within-group, and (ii) between-group): (1) effects on mental, physical, and social health; (2) persistence of effect; (3) relationships between job perception and mental, physical, and social health; (4) intervention success factors (personality and job perception, attendance and practice, other); (5) effects on other stress biomarkers (other measures of autonomic nervous system activity, DHEAS, cortisol, etc.).

METHODS

Our study will be a randomized controlled prospective study (research involving the human person of type 2). The study will be proposed to any health-care workers (HCW) or any non-HCW (NHCW) from a healthcare institution (such as CHU of Clermont-Ferrand, other hospitals, clinics, retirement homes). Participants will benefit from NLP and sophrology interventions at the hospital. For both groups: (i) heart rate variability, skin conductance and saliva biomarkers will be assessed once a week during the intervention period (6 to 8 sophrology sessions) and once by month for the rest of the time; (ii) the short questionnaire will be collected once a week during the whole protocol (1-2 min); (iii) the long questionnaire will be assessed only 5 times: at baseline (M0), month 1 (M1), month 3 (M3), month 5 (M5) and end of the protocol (M7).

ETHICS AND DISSEMINATION

The protocol, information and consent form had received the favorable opinion from the Ethics Committee. Notification of the approval of the Ethics Committee was sent to the study sponsor and the competent authority (ANSM). The study is registered in ClinicalTrials.gov under the identification number NCT05425511 after the French Ethics Committee's approval. The results will be reported according to the CONSORT guidelines.

STRENGTHS AND LIMITATIONS OF THIS STUDY

The psychological questionnaires in this study are self-assessed. It is also possible that responses suffer from variation. For the study, participants need to attend 6 to 8 sophrology sessions and one visit per month for 7 months, which might seem demanding. Therefore, to make sure that participants will complete the protocol, two persons will be fully in charge of the participants' follow-up.

Prevalence of musculoskeletal disorders among dental healthcare providers: A systematic review and meta-analysis

Background: Work-related musculoskeletal disorders (MSD) are common in dentistry due to the prolonged static work involved during patient care, making dental health care personnel vulnerable to musculoskeletal complaints. We aimed to pool the prevalence estimates of MSD among various dental healthcare providers, including dentists, dental students, dental hygienists, and auxiliaries. Methods: A systematic search of five databases was performed (Scopus, Embase, CINAHL, Web of Science, Dentistry & Oral Sciences Source). The studies that reported the prevalence of MSD among dental healthcare workers and those written in English were selected. Screening and data extraction were performed by two review authors independently. Discrepencies were resolved by another review author. Risk of bias assessment was done using a nine-item questionnaire developed by Hoy et al. Pooled estimates were calculated using meta-analysis of proportions (random effects model). Results: Among the 3090 publications screened, 234 publications were included for full-text screening. Meta-analysis was performed for 89 estimates from 88 publications. Females showed significantly higher prevalence [OR = 1.42 (95% CI = 1.09-1.84); I ² = 66.02; N = 32]. The analysis yielded a pooled estimate of 78.4% (95% CI = 74.8-82). The meta-regression showed similar prevalence over the years (Coefficient: 0.001; P-value: 0.762). Conclusions: A high prevalence of MSD was noted among dental healthcare providers, with about seven out of ten having experienced MSD in the past. This emphasizes the need for awareness and adoption of appropriate ergonomic postures by dental healthcare providers from early in their careers to minimize work-related MSD.

Longitudinal Effects of a sit-stand desk intervention - persistence, Fade-Out, and psychological momentum: a Randomized Controlled Trial

BACKGROUND

This study examined whether the effects of a sit-stand desk (SSD) intervention on employees' musculoskeletal complaints (i.e., intensity and prevalence) and activation (i.e., vigilance and vitality) persist or fade out and whether velocity and acceleration of health improvements can predict medium-term (six-month) and long-term (24-month) improvements. Drawing from dynamic models of self-regulation, as well as the psychological momentum theory, we hypothesized that velocity and acceleration of health improvements in the early stages of the intervention would predict medium-term health improvements, which sustain long-term.

METHODS

We used data from a six-month seven-wave randomized controlled trial with employees in mostly sedentary occupations and supplemented this by follow-up data from the same participants 18 months later, resulting in eight waves.

RESULTS

Bayesian structural equational modeling revealed no significant intervention effect after 24 months implying a fade-out. But more importantly, velocity and, partially, acceleration of health improvements at earlier stages predicted medium-term improvements in musculoskeletal complaints and long-term improvements in vigilance.

CONCLUSION

The findings of this study suggest that positive intervention effects fade out over time and health effects benefit from prompt progresses at the beginning of the intervention, warranting exploration in prolonged longitudinal studies.

Psychological distress and post-traumatic growth in France during the COVID-19 pandemic: A mediation model of psychosocial safety climate as a determinant of work performance

The psychosocial safety climate (PSC) reflects workers’ perceptions of senior management’s concern for mental health. Because the COVID-19 pandemic has exacerbated organizational issues, PSC could be a target for interventions attempting to preserve both the psychological health of employees and the economic health of companies. This study examines the direct and indirect relationships between PSC and work performance through two indicators of psychological health, psychological distress and post-traumatic growth, during a health crisis, i.e., prior to the second confinement in France. To this end, 2,004 participants from the French workforce completed a survey in October 2020. The results of mediation analyses indicate that PSC has a direct and positive influence on post-traumatic growth (PTG) and performance, as well as a direct negative influence on psychological distress. PSC also has an indirect positive influence on performance via psychological distress. Organizations that wish to jointly address mental health and performance at work would benefit from optimizing PSC.

Prevalence of musculoskeletal disorders among dental healthcare providers: A systematic review and meta-analysis

Background: Work-related musculoskeletal disorders (MSD) are common in dentistry due to the prolonged static work involved during patient care, making dental health care personnel vulnerable to musculoskeletal complaints. We aimed to pool the prevalence estimates of MSD among various dental healthcare providers, including dentists, dental students, dental hygienists, and auxiliaries. Methods: A systematic search of five databases was performed (Scopus, Embase, CINAHL, Web of Science, Dentistry & Oral Sciences Source). The studies that reported the prevalence of MSD among dental healthcare workers and those written in English were selected. Screening and data extraction were performed by two review authors independently. Discrepencies were resolved by another review author. Risk of bias assessment was done using a nine-item questionnaire developed by Hoy et al. Pooled estimates were calculated using meta-analysis of proportions (random effects model). Results: Among the 3090 publications screened, 234 publications were included for full-text screening. Meta-analysis was performed for 89 estimates from 88 publications. Females showed significantly higher prevalence [OR = 1.42 (95% CI = 1.09-1.84); I ² = 66.02; N = 32]. The analysis yielded a pooled estimate of 78.4% (95% CI = 74.8-82). The meta-regression showed similar prevalence over the years (Coefficient: 0.001; P-value: 0.762). Conclusions: A high prevalence of MSD was noted among dental healthcare providers, with about seven out of ten having experienced MSD in the past. This emphasizes the need for awareness and adoption of appropriate ergonomic postures by dental healthcare providers from early in their careers to minimize work-related MSD.

Can a workplace dialogue impact the perceived influence of neck and/or backpain on everyday activities and performance at work? A secondary analysis from the randomized controlled trial WorkUp

Background

Neck- and back- pain are highly prevalent conditions in Sweden and world-wide. Such pain often has consequences on everyday activities, work- and personal life. One consequence is work absence and decreased productivity at work. Adding a workplace dialogue to structured physiotherapy was recently found to lead to increased workability, i.e., not being on sick leave during the 12^th month of follow up.

Aim

The aim of the study was to explore the effect of a workplace dialogue intervention on secondary outcomes: perceived impact of neck and/or back pain on everyday activities and on performance at work, and total days of sick leave during 12 month follow up. A further aim was to examine associations between perceived influence of pain, and sick leave.

Method

Patients with neck and/or back pain in primary care in the south of Sweden were randomized into structured physiotherapy alone (n = 206) or with the addition of a workplace dialogue (n = 146). Data regarding the pain’s influence on everyday activities and on performance at work were collected using weekly text messages for 52 weeks. The pattern of change in perceived influence of neck and/or back pain on everyday activities and performance at work was compared between the groups with linear mixed models. Cross sectional correlations between perceived influence of neck and/or back pain on everyday activities and performance at work, and days of sick leave, during the preceding four weeks at months 3, 6, 9 and 12 were examined.

Result

We found no differences in change of perceived influence of neck and/or back pain on daily activities or perceived performance at work, or total days of sick leave during the 12 months of follow up between the groups with structured physiotherapy with or without a workplace dialogue. There was a weak to moderate positive correlation between days of sick leave and perceived influence of neck and/or back pain on everyday activities and performance at work (rho 0.28–0.47).

Conclusion

A workplace dialogue was not found to affect the perceived impact of neck and/or back pain on everyday activities and performance at work.

Trial registration

ClinicalTrials.gov ID: NCT02609750.

Importance of frequency and intensity of strength training for work ability among physical therapists

The aim of the study was to evaluate the association between frequency and intensity of strength training participation and work ability among physical therapists (PTs). The Work Ability Index questionnaire (WAI) and a questionnaire about participation in strength training during leisure time were administered to a sample of Spanish PTs. In addition, participants provided information on gender, age, body mass index, education, substance use, working experience and working hours per week. The odds for having excellent WAI (score 44-49) as a function of intensity or frequency of strength training participation were determined using binary logistic regression controlled for various confounders. Data from 981 PTs were analysed. High-intensity strength training (> 80% 1 RM) showed strong associations with excellent WAI (odds ratio = 9.7; 95% confidence interval, 2.9-31.6). In addition, performing strength training more than 3 times per week was associated with excellent WAI (odds ratio = 1.79; 95% confidence interval, 1.24-2.59), however, no significant associations were found with lower levels of frequency and intensities. High-intensity strength training 3 times per week is associated with excellent WAI among PTs. Training programs meeting these features may importantly contribute to maintain or improve WAI.

The relationship between occupational stress, mental health and work ability of coal chemical workers in Xinjiang

OBJECTIVE

To understand the current working ability of coal chemical workers in Xinjiang, and analyze the impact of occupational stress, mental disorders, and their interaction on work ability. To provide a scientific basis for improving the working ability and quality of life of coal chemical workers.

METHODS

In this study, a stratified random sampling method was used to conduct a questionnaire survey of 1,400 workers in six coal mining enterprises from June to December 2019. The Effort-Reward Imbalance Questionnaire (ERI), the Symptoms Checklist 90 (SCL-90), and the Work Ability Index Scale (WAI) were used to evaluate the level of occupational stress, mental disorders, and the ability to work as coal chemical workers.

RESULTS

The results showed that WAI scores had statistically significant differences between gender, age, length of service, shift, education, marital status, and monthly income (P < 0.05). The ability to work and its dimensions were inversely correlated with occupational stress, and mental disorders (P < 0.001). Occupational stress and mental disorders are risk factors affecting the ability to work. Workers with high occupational stress^* mental disorders (OR = 10.666, 95% CI: 6.443-17.658) are 10.666 times more likely to be at risk for developing poor work ability than low occupational stress^* no mental disorders. Structural equation models show that occupational stress and mental health conditions had a direct impact on work ability, and mental health conditions were the mediators of the relationship between occupational stress and work ability.

CONCLUSION

Occupational stress, mental disorders, and their interaction are risk factors affecting the ability of coal chemical workers to work. Occupational stress can indirectly affect the ability to work through mental health conditions.

The Role of Physical and Sexual Assaults on the Ability to Complete Work Responsibilities

Sexual and physical assaults have many serious and persistent negative impacts on individual health. There is now a considerable literature base identifying and discussing these health outcomes. Less is known about the mediating mechanisms that link these types of assault with later outcomes. This study examines the role of sexual and physical assaults in self-perceptions of individual health on missing or cutting back on work responsibilities. In particular, perceptions of both mental and physical health are investigated to further refine understanding of the different impacts of assault on survivor health and behavior. Using a sample of 3,791 adults aged 30 to 84 from the Midlife in the United States (MIDUS) study, results of the analyses indicate that sexual and physical assaults do not have a direct effect on missing/cutting back on work responsibilities but do have an indirect effect through perceptions of health. The results can inform academic research, as important impacts of assault may be masked if mediating mechanisms are not investigated. In terms of policy, adults who have difficulty carrying out work responsibilities should be assessed for their overall health and survivors of violence should be offered health-related services following a victimization experience.

The Relationship Between Musculoskeletal Discomfort and Professional Quality of Life Among Nurses

BACKGROUND

Harsh working conditions lead nurses to experience musculoskeletal discomfort and impair their professional quality of life.

AIMS

The aim was to determine musculoskeletal discomfort of nurses and to compare its relationship with their professional quality of life in terms of their socio-demographic characteristics.

DESIGN

It is a cross-sectional, descriptive, and correlative study.

SETTINGS

Different units of a public hospital.

PARTICIPANTS

333 nurses working at different units.

METHODS

The data were collected from 333 nurses working at different units in a public hospital between July and December 2018. The data collection tools include an 8-question participant information form, Cornell Musculoskeletal Discomfort Questionnaire, and Professional Quality of Life Scale.

RESULTS

The nurses suffered mostly from lower back pain (90.4%) and their pain slightly interfered with their works (49.8%). There was a weak positive but significant correlation between musculoskeletal discomfort and professional quality of life of the nurses (r = 0.215; p < .001). The nurses, who were younger, were male, were working in executive positions, had less institutional and professional experience, and had higher mean score of musculoskeletal discomfort (p < .05).

CONCLUSIONS

The professional quality of life of the nurses experiencing musculoskeletal discomfort in their bodies was negatively affected. For example, as the musculoskeletal disorders increase, the levels of burnout and compassion fatigue, which constitute the quality of life, also increase.

Effectiveness of combined aerobic exercise and neck-specific exercise compared to neck-specific exercise alone on work ability in neck pain patients: a secondary analysis of data from a randomized controlled trial

OBJECTIVE

To compare the effect of combined aerobic exercise (AE) and neck-specific exercise to neck-specific exercise alone on the work ability of individuals complaining of neck pain.

METHOD

Secondary analysis of data from a previous randomized controlled trial was conducted to compare AE and neck-specific exercise (AE group, n = 69) to neck-specific exercise alone (control group, n = 70). The Work Ability Index (WAI) was administered after the 6-week intervention, and Global Rating of Change (GROC) was assessed after the 6-week intervention and at 12- and 24-week follow-ups.

RESULTS

Repeated-measure analyses of variance between groups indicated a significant time × group interaction on the GROC at 12- and 24-week follow-ups. The AE group showed better improvement on the GROC (mean ± SD) from 6 to 24 weeks than controls: 4.7(± 0.12) to 5.3 (± 0.13) vs. 4.4 (± 0.13) to 4.1(± 0.13), respectively, (P < 0.001). There was a significant group × time interaction on the WAI (P < 0.001): the AE group showed better improvement (mean ± SD) from baseline to 6-weeks than controls: 34.9 (± 4.4) to 39.2 (± 3.6) vs. 34.4 (± 4.9) to 35.8 (± 4.9), respectively, (P < 0.001). Work ability of participants with poor/moderate baseline scores improved more (P < 0.001) than those with good/excellent baseline scores (P = 0.48).

CONCLUSIONS

Combining moderate AE and neck-specific exercise improved the work ability of patients with NP more than neck-specific exercise alone. The combination should be recommended in health promotion programs, particularly for workers with low baseline work ability.

CLINICAL TRIAL

Registered at ClinicalTrial.gov: NCT02451267; date of registration: 21 May 2015. https://clinicaltrials.gov/ct2/home.

The Mediating Role of Perceived Stress in Associations Between Self-Compassion and Anxiety and Depression: Further Evidence from Chinese Medical Workers

Objective

Medical workers report high rates of stress, anxiety and depression, which need urgent attention. Providing evidence for intervention measures in the face of a mental health crisis, the present study validates the relation between self-compassion and anxiety and depression mediated by perceived stress amongst medical workers. The goal is also to replicate a similar mediation model though multigroup analysis.

Methods

Medical workers were randomly selected to investigate by paper-and-pencil survey among 1,223 medical workers from three hospitals in Shiyan, China. The measures were comprised of four parts: the Chinese version of the Goldberg Anxiety and Depression Scale (GADS), the Self-Compassion Scale-Short Form (SCS-SF), the Perceived Stress Questionnaire (PSQ) and a socio-demographic questionnaire. Applying structural equation modeling (SEM, single-group analysis), we estimated the effects of self-compassion on anxiety/depression through perceived stress. Furthermore, based on multigroup analysis, we used two sets of internal samples (gender groups, medical groups) and an external sample (nursing students) for testing multigroup invariance.

Results

The average scores of anxiety, depression, self-compassion and perceived stress in medical workers were 5.93 ± 2.46, 4.91 ± 2.62, 38.87 ± 4.66 and 71.96 ± 15.14, respectively. In some departments engaged in the research, the medical workers showed higher levels of anxiety and depression. The SEM results indicated that the original relationship between self-compassion and anxiety and depression was beta = -0.42 (P < 0.001) and reduced to beta = -0.17 (P < 0.001) while introducing perceived stress as a mediating variable. Perceived stress was positively associated with anxiety and depression (beta = 0.60, P < 0.001), and self-compassion was negatively associated with perceived stress (beta = -0.56, P < 0.001). Multigroup analysis showed acceptable changes in fit indices across gender (male and female), medical (clinician and non-clinician), and population (medical workers and nursing students) groups.

Conclusion

Medical workers were experiencing high levels of anxiety and depression and perceived stress. Perceived stress might have a partial mediating effect on self-compassion and anxiety and depression amongst medical workers, which was similar to a previous study in nursing students. The findings supported multigroup invariance across gender, medical and population groups. The study concluded that the mediation model may be generalized across these multiple samples. Psychological intervention could be used to improve levels of self-compassion of medical workers.

Association between physical activity and sickness absenteeism in university workers

BACKGROUND

Sedentary occupations have increased by more than 10% in Western countries over the last two decades, and the yearly global cost of physical inactivity has been estimated to be $53.8 billion. As workers tend to move less in the workplace, they are more likely to develop a sedentarism-related chronic condition and to be absent from work due to illness, although research evidence on the issue remains unclear.

AIMS

To investigate associations between physical activity (PA) and sickness absenteeism in the workplace among Spanish university workers.

METHODS

We conducted cross-sectional research with data from 1025 workers aged 18-65 years (43% women) from a Spanish university. Physical Activity Vital Sign (PAVS) and International Physical Activity Questionnaire (IPAQ) short versions were used to evaluate levels of PA. Workplace absenteeism was self-reported by participants. Written questionnaires distributed during medical checks included PAVS, IPAQ and the question about absenteeism among other information. The association between PA and sickness absenteeism was examined using adjusted multiple linear regression.

RESULTS

After adjusting for age, sex, job function, chronic conditions, sedentarism and smoking, each weekly hour of PA reduced sickness absence by -1.20 (95% confidence interval: -2.40-0.00) days per year.

CONCLUSIONS

The implementation of PA promotion strategies aimed at university employees may lead to a reduction of days off work due to illness.

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.

Acute and chronic musculoskeletal pain situations among the working population and their pain education needs: an exploratory study

BACKGROUND

Pain affects a person's physical and psychological well-being, work performance and productivity. Working population bear their pain and continue to work which may contribute to the worsening of their pain condition. However, their pain situation was not well-examined.

OBJECTIVE

The aim of the study was to explore the prevalence of acute and chronic pain in the working population in Hong Kong, understand their pain management strategies and determine their preferences with regard to the use of electronic pain management materials.

METHODS

This was an exploratory online survey. The participants' pain history, their preferences in methods of pain management, the source of the pain management education that they had received, sources and preferences in relation to the use of the Internet for pain education, and the participants' demographic characteristics were collected.

RESULTS

A total of 210 participants joined the study, 67% of whom were experiencing pain. Of the group in pain, 71.6% were in chronic pain that has persisted for 3 months or more. Pain intensities ranged from 2.82 to 3.82 on a 10-point numeric scale. Of the participants, 85.7% reported not receiving adequate pain management education, and 91.4% of those agreed pain services were inadequate. Websites and health care professionals were the sources from which they obtained their pain management education.

CONCLUSIONS

The high prevalence of pain in the working population requires special attention. Health care professionals should be proactive and an online pain management programme can be a solution to address the critical problem of pain in the working population.

The effectiveness of an electronic pain management programme for the working population with chronic pain: study protocol for a randomized controlled trial

Background

Chronic pain is highly prevalent in the working population. People tend to attempt self-initiated treatments to manage their pain. The self-efficacy of behavioural change is a suitable model for guiding the development of an electronic pain management programme (ePain). The aim in this study is to develop ePain and to evaluate its effectiveness at improving pain self-efficacy, reducing pain intensity and negative emotions, and increasing quality of life.

Methods

This study will be a randomized controlled trial. ePain will take the form of a 6-week online pain management programme. Participants will be aged 15 years or above, have chronic pain, and be employed. They must complete the baseline questionnaire and will be randomized into intervention and control groups. They will receive notifications to encourage their participation in ePain and complete the evaluation questionnaires. They will complete the process evaluation at week 3, the post assessment at week 6, and the follow-up assessment at week 12. The study will focus on pain self-efficacy; pain situations; negative emotions including levels of depression, anxiety, and stress; and quality of life. The participants’ opinions of ePain will be collected as feedback. Data will be analysed on an intention-to-treat basis and generalized estimating equations will be used to investigate the time-averaged difference and differences at each follow-up time.

Discussion

The study will provide information about the pain situations of online users in the working population. The participants will benefit from improvements in pain self-efficacy, pain situations, emotional status, and quality of life. The study will illustrate whether online learning is an effective intervention for improving the pain self-efficacy of the working population.

Trial registration

ClinicalTrials.gov, NCT03718702. Registered on 23 October 2018.

Pain characteristics and quality of life of breast cancer survivors that return and do not return to work: an exploratory cross-sectional study

Purpose: the aim of this study is two-fold: 1) to explore the pain characteristics among breast cancer survivors that return to work and do not return to work; 2) to identify the factors associated with pain on the upper quadrant of the affected side.Materials and methods: Sixty-two breast cancer survivors were included. Quality of life was assessed using EORTC QLQ-C30 and QLQ-BR23. Pain characteristics were assessed with a body diagram and a numeric rating scale.Results: Thirty-five breast cancer survivors did not return to work. Ninety-one percent of women that did not return to work reported pain. The most frequent pain sites were the cervical spine and the axilla of the affected side. There were no significant differences in pain intensity between groups. The factors associated with pain on the upper quadrant of the affected side were perception of shoulder stiffness OR = 5.93 (1.38-44.87, 95%CI) and time since surgery of more than four years OR = 5.54 (1.36-20.97, 95% CI).Conclusions: Pain was highly prevalent among breast cancer survivors. Breast cancer survivors that returned to work presented better quality of life. Longer time since surgery and perception of shoulder stiffness were associated with pain on the upper quadrant of the affected side.Implications for rehabilitationPain is a major factor following breast cancer surgery preventing returning to work.This group reported more pain on the cervical spine and axilla of the affected side.Rehabilitation needs to focus specifically on pain management in order to improve quality of life.A multidisciplinary approach involving pain specialists and vocational support is recommended.

Mediating Factors for the Relationship between Stress and Work Ability over Time in Young Adults

Stress can affect work ability. The aim of this study was to identify how this pathway is mediated over time in young adults. Participants of the Work Ability in Young Adults cohort were selected. A theoretical framework was built, which lead to a statistical model. Selected dimensions of mediators were recovery, work demands affecting private life, feelings of control over private life, and physical activity in leisure time. A quadruple serial mediation model was built with four mediators. The total effect of stress on work ability was -0.3955, 95% CI [-0.4764, -0.3146]. The total indirect effect amounted to 81% with an effect of -0.3182, 95% CI [-0.3750, -0.2642]. The relationship between stress and Work Ability Score five years later in young adults was mediated by stress five years later, work demands affecting private life, feelings of control over private life and feeling well-rested upon waking. These results indicate that work demands affecting private life and feelings of control over private life are important mediators of the relationship between stress and work ability in young adults. A well-balanced relationship between work and private life can counteract the influence of stress on work ability in this age group.

Dose-response association between multi-site musculoskeletal pain and work ability in physical therapists: a cross-sectional study

PURPOSE

Multi-site musculoskeletal pain (MP) is common among health care professionals and is considered a threat to work ability and thereby a long and healthy working life. However, literature is scarce regarding these associations among physical therapists (PTs). This study aims to quantify the prevalence of local and multi-site MP among PTs, to investigate the associations between pain intensity and number of pain sites, respectively, with the level of work ability.

METHODS

We conducted a survey among 1006 PTs about pain the previous month in different body areas and work ability. Work ability was measured using the Work Ability Index (WAI) including its seven categories. The odds of having lower level of work ability as a function of pain intensity (0-10) and multi-site pain were determined using binary logistic regression controlled for relevant confounders.

RESULTS

The neck (36.3%) and the low back (32.3%) were the most commonly affected body areas. Furthermore, a dose-response relationship was observed between the number of pain sites and lower work ability (trend test, p < 0.001). With low pain intensity as reference, a moderate to strong association existed for lower levels of work ability in PTs who reported pain intensity of > 5 in one to two body regions (OR 2.14, 95% CI 1.27-3.60). This association was stronger when participants reported pain in three to four sites (OR 4.02, 95% CI 2.36-6.82) and even stronger when pain was experienced in five or more sites (OR 6.13, 95% CI 3.31-11.38).

CONCLUSIONS

Multi-site MP is strongly associated-in a dose-response fashion-with lower levels of work ability among PTs.

Long-term effects on function, health-related quality of life and work ability after structured physiotherapy including a workplace intervention. A secondary analysis of a randomised controlled trial (WorkUp) in primary care for patients with neck and/or back pain

Objective: To study the long-term effects of a workplace intervention in addition to structured physiotherapy regarding self-reported measures in patients with acute/subacute neck and/or back pain.Design: WorkUp - a cluster-randomised controlled trial in 32 primary care centers in Sweden, from January 2013 through December 2014 (ClinicalTrials.gov ID: NCT02609750).Intervention: Structured physiotherapy with the workplace dialogue 'Convergence Dialogue Meeting' (CDM), conducted by the treating physiotherapist as an add-on. Reference group received structured physiotherapy.Subjects: Adults, 18-67 years (mean 43.7, standard deviation (SD) 12.2), 65.3% women with acute/subacute neck and/or back pain who had worked ≥4 weeks past year, considered at risk of sick leave or were on short-term sick leave (≤60 days) were included (n = 352).Outcome measures: Self-reported function, functional rating index (FRI), health-related quality of life (EQ-5D-3L) and work ability (Work Ability Score, WAS) at 12 months follow-up.Results: The mean differences in outcomes between intervention and reference group were; -0.76 (95% confidence interval (CI): -2.39, 0.88; FRI), 0.02 (95% CI: -0.04, 0.08; EQ-5D-3L) and -0.05 (95% CI: -0.63, 0.53; WAS). From baseline to 12 months, the intervention group improved function from 46.5 (SD 19.7) to 10.5 (SD 7.3) on FRI; health-related quality of life from 0.53 (SD 0.29) to 0.74 (SD 0.20) on EQ-5D and work ability from 5.7 (SD 2.6) to 7.6 (SD 2.1) on WAS.Conclusion: Despite a clinically relevant improvement over time, there were no significant differences in improvement between groups, thus we conclude that CDM had no effect on self-reported measures in this study.Key pointsIn earlier analysis of the primary outcome (work ability measured by absenteeism) in this trial, a positive effect was found when the workplace intervention 'Convergence Dialogue Meeting' (CDM) was added to structured physiotherapy for patients with neck or back pain.By contrast, in this new analysis of secondary outcomes (self-reported function, health and perceived work ability), there was no added effect of CDM above structured physiotherapy alone, although patients in both the intervention and reference group improved over time.The addition of CDM to physiotherapy is therefore justified by its specific effect on behavior (work absence) rather than any effect on clinical outcomes.

Does Depression Mediate the Effect of Work Organization Conditions on Job Performance?

OBJECTIVE

The present study proposes to shed light on the impact of workers' depression on their work performance.

METHODS

We implemented a path analyses adjusted for design effects resulting from cluster sampling using MPlus software on a sample of 1957 workers. These analyses allowed us to evaluate direct and indirect effects (mediation) while taking into account the nonindependence of observations due to cluster sampling (workers nested in their workplace).

RESULTS

Results indicate that three indirect associations were found to be significant. Psychological demands, work schedule, and job insecurity were indirectly associated with lower levels of professional efficacy/job performance because of their positive associations with depression.

CONCLUSIONS

The results obtained suggest that interventions targeting specific work organization conditions could be warranted.

Stressful Factors in the Working Environment, Lack of Adequate Sleep, and Musculoskeletal Pain among Nursing Unit Managers

Background: Middle managers have not received enough attention within the healthcare field, and little is known how stressful factors in their work environment coupled with a lack of adequate sleep are related to musculoskeletal pain. The aim of this study was to examine the correlation between stressful factors in the work environment, lack of adequate sleep, and pain/discomfort in three body areas. Methods: Questionnaire was sent electronically to all female nursing unit managers (NUM) in Iceland through the outcome-survey system. The response rate was 80.9%. Results: NUM who had high pain/discomfort in the neck area also had very high pain/discomfort in the shoulder area and pain in the lower back. The results also revealed positive a medium-strong correlation between mental and physical exhaustion at the end of the workday and musculoskeletal pain. Stress in daily work, mental strain at work, and being under time-pressures had hardly any correlation with pain/discomfort in the three body parts. Adequate sleep had a significant negative correlation with all stressful factors in the work environment and all three body parts under review. Conclusion: The results will hopefully lead to a better consideration of stressful factors in the work environment, sleep, and musculoskeletal pain in middle managers.

Low back pain prevalence and risk factors among health workers in Saudi Arabia: A systematic review and meta-analysis

OBJECTIVES

Low back pain (LBP) has a major impact on health workers, and its prevalence and risk factors among them in Saudi Arabia have been investigated previously. However, the results have never been comprehensively reviewed. Therefore, the aim of this study was to perform a systematic review and meta-analysis of the available literature to identify the prevalence and risk factors of LBP among health workers in Saudi Arabia.

METHODS

MEDLINE/PubMed, Web of Science, Scopus, CINAHL, and Saudi peer-reviewed journals were searched for relevant literature. After quality assessment of the eligible articles, 18 studies targeting seven occupational categories, with a total number of 5345 health workers, were analyzed.

RESULTS

Pooled prevalence rates of 40.8% (n = 7 studies), 65.0% (n = 13 studies), and 81.4% (n = 2 studies) were obtained for week, year, and career, respectively, across all professional groups. Nurses and physical therapists were more susceptible to LBP, in that order, than the other categories considering week and career periods. Age, body mass index, and female gender were the most commonly reported individual risk factors. Occupational risk factors mainly included work-related activities requiring back bending and twisting, lifting and pulling objects, and manual patient-handling.

CONCLUSIONS

The results of this review indicate that LBP is highly prevalent among health workers in Saudi Arabia when compared with international rates. Proper prophylactic measures are necessary to reduce LBP and minimize its consequences. Further high-quality research is needed in different Saudi regions to achieve a broader understanding of LBP prevalence and causes.

Physical activity and perceived stress at work in university workers: a cross-sectional study

BACKGROUND

Previous research has suggested high levels of physical activity (PA), either in occupational or leisure-time, to be associated with low levels of perceived stress at work (PSW). However, because studies have been set in particular conditions, there is no possibility to generalize results on other populations of workers. This study investigated the association between PA and PSW in university workers.

METHODS

University employees (N.=757) aged from 26 to 65 years (47% female) at a large public Spanish university. Data were collected between January 2017 and December 2017. Physical Activity Vital Sign (PAVS) questionnaire and a single-item scale were used to assess PA levels and PSW. Associations were examined through an adjusted logistic regression.

RESULTS

Results showed the strongest association between high PSW and low PA levels after adjusting for age, gender and profession (odds ratio [OR] 2.60, 95% CI: 1.44-3.68). Around half of the employees (51.9%) performed at least 150 minutes of PA per week, which is higher than in most other Spanish and European worker populations.

CONCLUSIONS

Adequately high levels of PA may be beneficial for stress management in university workers as previously seen in other types of workers. Promoting PA strategies at the workplace could improve the working environment and the health of the workers.

Effect of Socioeconomic Factors on the Relationship Between Musculoskeletal Pain and Ill-Health Retirement in Korea: Results From the Korean Longitudinal Study of Aging

OBJECTIVE

To investigate the relationship between musculoskeletal pain (MSP) and ill-health retirement (IHR) and modifying role of socioeconomic factors.

METHODS

The data used were samples from the Korean Longitudinal Study of Aging from 2006 to 2014. IHR was defined as retirement due to health problems before regular retirement age. Hazard ratio (HR) was calculated using Cox proportional hazards model to determine the effects of MSP and covariance on IHR.

RESULTS

People who have "any site of pain" were more likely to experience IHR than people with no pain. In the subgroup analysis, risk of IHR due to MSP was higher in the 60s, white-collar, and high-income earners than the other groups.

CONCLUSIONS

MSP has a substantial negative impact on labor force participation, and there was a clear effect modification of socioeconomic status on IHR risk.

Work ability and productivity among dentists: associations with musculoskeletal pain, stress, and sleep

Purpose

Work ability can be measured by the work ability index (WAI), and work-related questions measuring productivity loss in terms of quality and quantity of work. Dentists have high occupational risk of musculoskeletal pain and the exposure of ergonomic strain is already high during dental education. The aim was to evaluate work ability and productivity among dentists, and to identify gender differences and associations with sleep, stress, and reported frequent pain.

Methods

The study population comprised 187 dentists (123 women and 64 men) who had been working as dentists between 5 and 12 years. Participants completed a questionnaire regarding sleep, stress, presence of pain at different sites, work ability assessed by WAI, and productivity in terms of quality and quantity of work.

Results

Poor sleep quality and high level of stress were reported by 31% and 48.1% of participants, respectively, with no gender differences and no association with age. The prevalence of frequent pain ranged 6.4–46.5% with shoulders being the most prevalent site. Thirty-three percent reported reduced work ability. Poor sleep, high amount of stress, and multi-site pain were associated with decreased work ability.

Conclusions

A high prevalence of pain was shown among dentists. Decreased work ability in terms of productivity loss was associated with poor sleep quality, high amount of stress, and multi-site pain. Preventive actions at the workplace should promote good musculoskeletal health, and measures taken, both individual and organizational, to minimize the risk of high, persistent stress and work-related pain.

Musculoskeletal pain in multiple body sites and work ability in the general working population: cross-sectional study among 10,000 wage earners

Background and aims Musculoskeletal pain may negatively affect work ability, especially when work demands are high and/or physical capacity of the worker is low. This study investigated the association between intensity of musculoskeletal pain in multiple body regions and work ability among young and old workers with sedentary and physical demanding jobs. Methods Currently employed wage earners (n=10,427) replied to questions about pain intensity, work ability, and physical work demands. The odds ratio (OR) for having a lower level of work ability in relation to the physical demands at work were modeled using logistic regression controlled for various confounders. Results The OR for lower work ability increased with higher pain intensity in all regions among workers with sedentary and physical work. The same pattern was observed among workers <50 years and ≥50 years in both work types. The association was quite consistent across age and work activity groups, although it tended to be more pronounced among those with physically demanding work in some of pain regions. Conclusions This study shows that increasing pain intensity in multiple sites of the body is associated with lower work ability. This was seen for both younger and older workers as well as those with sedentary and physical work. Implications Physical workers with multiple-site pain may especially be at increased risk of the consequences of reduced work ability. Therefore, extra attention is needed and this group may benefit from better targeted preventive measures.

Perceived stress and sickness absence: a prospective study of 17,795 employees in Denmark

Objectives

The aims were to examine (1) the prospective association between perceived stress and sickness absence, and if this association (2) differed by sex, and (3) was stronger when only long-term sickness absence (≥ 31 days) instead of all-length sickness absence (≥ 1 day) was included. Moreover, different cut-points for the length of the sickness absence periods were applied.

Methods

We followed respondents (10,634 women and 7161 men) from the ‘Work Environment and Health in Denmark’ 2014-survey for up to 18 months in the ‘Register of Work Absences’ from Statistics Denmark. Perceived stress was measured by a single question: “In the last 2 weeks, how often have you felt stressed?” We used Cox-regression with repeated events, adjusted for age, sector, education, and previous sickness absence.

Results

The hazard ratio (HR) for all-length sickness absence (≥ 1 day) for “Often/Always” stress compared to “Seldom/Never” stress was statistically significant among both men (HR = 1.25 [1.13–1.38]) and women (HR = 1.43 [1.34–1.51]). The HR was statistically significant for women (HR = 2.26 [1.89–2.70]), but not for men (HR = 1.22 [0.86–1.73]), when the analyses were restricted to long-term sickness absence (≥ 31 days). The sex-difference was statistically significant. Additional analyses with cut-points at ≥ 2, ≥ 4, ≥ 6, ≥ 8, ≥ 11, ≥ 15, ≥ 20, and ≥ 25 sickness absence days showed that among women, the HR increased gradually with increasing lengths of the sickness absence periods.

Conclusions

The prospective association of perceived stress with risk of sickness absence was stronger among women than men. Among women, perceived stress was more strongly associated with long-term sickness absence than with all-length sickness absence.

Gender assessment of job stress in healthcare workers. Implications for practice

Background:

Work-related stress (WRS) in the healthcare sector is a major issue for both workers and organizations. To date, no consensus exists regarding differences in gender susceptibility to WRS in healthcare workers (HCWs).

Objectives:

The purpose of this study was to analyze how male and female HCWs employed in emergency departments experienced WRS.

Methods:

A cross-sectional study was conducted regarding the perception of WRS in registered nurses employed in emergency departments. The Italian version of the Job Content Questionnaire and the Rapid Stress Assessment scale were administrated to 710 registered nurses.

Results:

The WRS assessment showed that significantly more females than males were in a situation of isostrain (18.5% vs 9.8% p<0,05). In females, low social support was associated with high levels of job strain (18,5% vs 4,4% p<0,05).

Conclusion:

This study reflects the need for a gender-specific approach in the evaluation of WRS in the healthcare sector, and is consistent with literature that evidenced gender differences in the perception of WRS. Lack of social support proved to be a determinant of WRS in female HCWs. Organizational interventions aimed at providing a more suitable workgroup design are required in order to minimize WRS in female HCWs.

Teamwork and Safety Climate in Homecare: A Mixed Method Study

A rapidly changing homecare service sector implies difficulties to control safety and health risks for staff and to guarantee standardised deliveries of services to recipients. This study aimed to describe staff perceptions of safety climate and practices in homecare service teams, and suggestions for improvements. A second aim was to identify if and how the appraisals of safety climate were related to individual perceptions of safety, mental strain and adverse events/injury. A convergent parallel mixed methods design was used. Nursing assistants and care aides (133 in total, representing 11 work teams) in the north of Sweden replied to a survey and participated in focus group interviews. Results were analysed with ANOVA (inter-team differences) and by qualitative content analysis. Significant diversity was identified between the teams in five of seven dimensions of safety climate. Important areas for improvement were: a need to define and agree on criteria for a safe working environment; leadership prioritising safety at work; and management able to provide trust, support and time. A prerequisite for these agreements was improved authority and communication between all parties involved. The safety climate dimensions were related to personal perceptions of safety and mental strain and, partly, to adverse events/injuries.

Factors related to work ability and well-being among women on sick leave due to long-term pain in the neck/shoulders and/or back: a cross-sectional study

BACKGROUND

Musculoskeletal pain is one of the leading causes of sick leave, especially among women, in Western countries. The aim of the present study was to identify factors associated with work ability and well-being, respectively, among women on sick leave due to long-term pain in the neck/shoulders and/or back.

METHODS

A cross-sectional study with a correlational design was conducted on women who were sick-listed due to long-term pain in the neck/shoulders and/or back. A total of 208 participants responded to a survey comprising eight instruments: Multidimensional Pain Inventory scale, General Self-Efficacy scale, Sense of Coherence scale, Coping Strategies Questionnaire, Demand-Control-Support Questionnaire, Hospital Anxiety and Depression Scale, Work Ability Index and Life Satisfaction questionnaire. Multiple linear regression analyses were performed to identify factors associated with work ability and well-being, respectively.

RESULTS

Women who more strongly believed they would return to the same work had greater work ability (β = 0.39, p < 0.001), whereas women with higher pain intensity (β = - 0.30, p < 0.001) and higher job strain (β = - 0.12, p < 0.05) had lower work ability. Women with higher self-efficacy rated greater well-being (β = 0.14, p < 0.05). As the women's scores for depression increased, their well-being decreased by 48%, which was statistically significant (p < 0.001). The regression models for work ability and well-being were significant (p < 0.001), and their adjusted R- square values were 48% and 59%, respectively.

CONCLUSIONS

The study suggests that the factors beliefs to be back at the same work, pain intensity and job strain are predictive of work ability. Moreover, the factors self-efficacy and depression seem to be predictive of well-being. The findings highlight factors that should be considered by health care professionals and policy-makers to guide attempts to reduce sick leave.

Impact of Workplace Exposure and Stress on Neck Pain and Disabilities in Women-A Longitudinal Follow-up After a Rehabilitation Intervention

Introduction

The aim was to evaluate if pain, disability, and work productivity are influenced by physical and psychosocial work exposures as well as by stress, up to 1 year after a randomized controlled trial treatment intervention, and to determine whether any such association differed between treatment and control groups.

Methods

Ninety-seven working women suffering non-specific neck pain (n = 67 treatment group, n = 30 control group) were followed from end of treatment intervention and at 9- and 15-month follow-ups, respectively. Physical and psychosocial exposures, as well as perceived stress, were assessed after the treatment intervention. Pain, neck disability, and work productivity were assessed at baseline, after intervention 3 months later and at 9- and 15-month follow-ups. Longitudinal assessment was conducted using the exposure level at 3 months as predictor of pain, disability, and work productivity at 3, 9, and 15 months, respectively. Mixed models were used to estimate longitudinal associations, accounting for within-individual correlation of repeated outcome measures by incorporation of a random intercept. Age and duration of neck pain were adjusted for in all models. To evaluate group differences, interactions between exposures and treatment groups were estimated.

Results

High perceived stress was associated with more neck pain, more neck disability, and decreased work productivity in both cross-sectional and longitudinal analyses. High 'control of decision' was associated with less neck pain, less neck disability, and higher work productivity in cross-sectional analyses but only to less disability and higher productivity in longitudinal analyses. Shoulder/arm load was the only physical exposure variable that was significantly associated with work productivity in the univariate analyses. Only small differences were observed between treatment and control groups.

Conclusion

High perceived stress and low 'control of decision' were associated with more neck pain, increased neck disability, and decreased work productivity. Treatment interventions for individuals with neck pain should take into account psychosocial workplace exposures and stress to improve intermediate and long-term results.

MTHFR gene methylation is associated with perceived stress in healthy young adults

BACKGROUND

Epigenetic factors have been identified in the past years as interesting candidates for psychiatric disorders and related endophenotypes. It has been found that the methylenetetrahydrofolate reductase (MTHFR) gene is associated with major depressive disorder, and the aim of the current study was to examine the possible association between perceived stress and MTHFR methylation, taking into account depressive symptoms as a covariate.

PARTICIPANTS AND METHODS

Seventy-eight healthy Colombian participants (mean age=20.9 years; SD=3.0) were evaluated with the Perceived Stress Scale and with the Patient Health Questionnaire-9 for depressive symptomatology. MTHFR methylation levels were measured with a methylation-sensitive high-resolution melting method. A multiple regression analysis (adjusting for age, sex, and depressive symptoms) was carried out to assess the association between MTHFR methylation and perceived stress scores.

RESULTS

We found a significant inverse correlation between MTHFR methylation levels and perceived stress scores (r=-0.502; P=5.9×10(-5)), which remained significant after being adjusted for age, sex, and depressive symptomatology.

CONCLUSION

To our knowledge, this is the first study that reports an association between perceived stress and MTHFR methylation levels. This report adds evidence to the emerging role of epigenetic changes in endophenotypes related to affective disorders.

Work ability, effort-reward imbalance and disability pension claims

Background

Effort-reward imbalance (ERI) and self-rated work ability are known independent correlates and predictors of intended disability pension claims. However, little research has focused on the interrelationship between the three and whether self-rated work ability mediates the relationship between ERI and intended disability pension claims.

Aims

To investigate whether self-rated work ability mediates the association between ERI and intended disability pension claims.

Methods

Baseline data from participants of the Third German Sociomedical Panel of Employees, a 5-year cohort study that investigates determinants of work ability, rehabilitation utilization and disability pensions in employees who have previously received sickness benefits, were analysed. We tested direct associations between ERI with intended disability pension claims (Model 1) and self-rated work ability (Model 2). Additionally, we tested whether work ability mediates the association between ERI and intended disability pension claims (Model 3).

Results

There were 2585 participants. Model 1 indicated a significant association between ERI and intended disability pension claims. Model 2 showed a significant association between ERI and self-rated work ability. The mediation in Model 3 revealed a significant indirect association between ERI and intended disability pension claims via self-rated work ability. There was no significant direct association between ERI and intended disability pension claims.

Conclusions

Our results support the adverse health-related impact of ERI on self-rated work ability and intended disability pension claims.

"Blue flags", development of a short clinical questionnaire on work-related psychosocial risk factors - a validation study in primary care

Background

Working conditions substantially influence health, work ability and sick leave. Useful instruments to help clinicians pay attention to working conditions are lacking in primary care (PC). The aim of this study was to test the validity of a short “Blue flags” questionnaire, which focuses on work-related psychosocial risk factors and any potential need for contacts and/or actions at the workplace.

Methods

From the original“The General Nordic Questionnaire” (QPS_Nordic) the research group identified five content areas with a total of 51 items which were considered to be most relevant focusing on work-related psychosocial risk factors. Fourteen items were selected from the identified QPS_Nordic content areas and organised in a short questionnaire “Blue flags”. These 14 items were validated towards the 51 QPS_Nordic items. Content validity was reviewed by a professional panel and a patient panel. Structural and concurrent validity were also tested within a randomised clinical trial.

Results

The two panels (n = 111) considered the 14 psychosocial items to be relevant. A four-factor model was extracted with an explained variance of 25.2%, 14.9%, 10.9% and 8.3% respectively. All 14 items showed satisfactory loadings on all factors. Concerning concurrent validity the overall correlation was very strong r_s = 0.87 (p < 0.001).). Correlations were moderately strong for factor one, r_s = 0.62 (p < 0.001) and factor two, r_s = 0.74 (p < 0.001). Factor three and factor four were weaker, bur still fair and significant at r_s = 0.53 (p < 0.001) and r_s = 0.41 (p < 0.001) respectively. The internal consistency of the whole “Blue flags” was good with Cronbach’s alpha of 0.76.

Conclusions

The content, structural and concurrent validity were satisfactory in this first step of development of the “Blue flags” questionnaire. In summary, the overall validity is considered acceptable. Testing in clinical contexts and in other patient populations is recommended to ensure predictive validity and usefulness.

Stressors influence work ability in different age groups of nursing professionals: 2-year follow-up

Work stressors influence work ability - WA - and increasing age is associated with functional aging. We sought to establish whether work stressors differentially influence WA in young and aging nursing professionals. A cohort (2009-2011) composed of 304 workers at a hospital in Sao Paulo responded questionnaires Effort-Reward Imbalance (ERI), Job Stress Scale (JSS), Work-Related Activities That May Contribute To Job-Related Pain and/or Injury (WRAPI) and Work Ability Index (WAI). Changes in perceived exposure to stressors in each age group (< 45 and ≥ 45 years old) were compared to delta-WAI (difference between initial and final WAI score) by means of the Mann-Whitney test. There was a worsening in WAI (p = 0.609) without difference between the groups. WA impairment was associated with intensification of stressors ERI (p = 0.004), overcommitment (p = 0.002), social support (p = 0.014) and WRAPI (p = 0.004) among the younger workers, but with poorer ERI (p = 0.047) only among the older ones. While among the younger workers WA was influenced by the intensification of various stressors, in the case of the older ones it was influenced by effort-reward imbalance only, indicating that interventions should be differentiated according to age groups.

Relationships between work-related factors and musculoskeletal health with current and future work ability among male workers

PURPOSE

The purpose was to increase job-specific knowledge about individual and work-related factors and their relationship with current and future work ability (WA). We studied cross-sectional relationships between mental demands, physical exertion during work, grip strength, musculoskeletal pain in the upper extremities and WA and the relationships between these variables and WA 11 years later.

METHODS

We used a dataset of a prospective cohort study (1997-2008) among employees of an engineering plant (n = 157). The cohort was surveyed by means of tests and written questions on work demands, musculoskeletal health, WA score (WAS; 0-10), and mental and physical WA. Spearman correlation coefficients and logistic regression analysis were used.

RESULTS

Among manual workers, we found weak correlations between grip strength and current and future physical WA. We did not find predictors for future poor WA among the manual workers. Among the office workers, we found that musculoskeletal pain was moderately and negatively related to current WAS and physical WA. More handgrip strength related to better future WAS and physical WA. Musculoskeletal pain (OR 1.67 p < 0.01) and lower handgrip strength (OR 0.91 p < 0.05) predicted future poor WA among office workers.

CONCLUSIONS

Our results showed cross-sectional and longitudinal relationships between musculoskeletal health and work ability depending on occupation. However, the present implies that predicting work ability in the far future based on health surveillance data is rather difficult. Testing the musculoskeletal system (grip strength) and asking workers' about their musculoskeletal health seems relevant when monitoring work ability.