Sustainable employability in shiftwork: related to types of work schedule rather than age

Effects and implementation of an intervention to improve sleep, fatigue and recovery among healthcare workers with night shifts: A pre- and post-test study

BACKGROUND

Previous intervention studies among night workers mainly focused on single interventions and found inconclusive evidence for effectiveness. A comprehensive intervention approach that includes individual and environmental components has been argued as important. Gaining insight into contributing factors for the implementation of interventions for night workers and effectiveness is important to distinguish between theory and programme failure.

OBJECTIVES

To evaluate the effects and implementation of the PerfectFit@Night intervention to improve sleep, fatigue and recovery of night workers in healthcare, using the RE-AIM framework, which assesses reach, effectiveness, adoption, implementation and maintenance of interventions.

DESIGN

A prospective pre-post study design, with two measurements before and three and six months after the intervention.

SETTING

Twelve different departments of a university hospital in the Netherlands.

PARTICIPANTS

Healthcare workers working night shifts (n = 210).

METHODS

PerfectFit@Night consisted of environmental (provision of a powernap bed and healthy food, and workshop healthy rostering) and individual elements (e-learning and sleep coaching) and was implemented for three months in a phased manner. Questionnaires, logbooks and interview data were used. Effects of the intervention on sleep, fatigue and recovery were evaluated with mixed-effects models, and implementation factors of reach, adoption, implementation and maintenance were evaluated.

RESULTS

Night shift-related insomnia (-11 %-points, 95 % CI: -19 %, -4 % at three months), need for recovery (β: -2.45, 95 % CI: -4.86, -0.03 at six months) and fatigue (OR: 0.46, 95 % CI: 0.25, 0.86 at six months) decreased significantly after the intervention. No changes were found for subjective sleep quality and sleep duration. Barriers and facilitators for implementation were identified for each intervention element at individual (e.g., dietary preferences), organisational (e.g., responsibilities at work) and workplace levels (e.g., location of power nap bed), and for the intervention itself (e.g., useful information in e-learning). Although satisfaction was high and continuation was preferred, embedding of the intervention in the daily routine was limited. Facilitators for future implementation include a positive attitude towards the intervention, clear guidelines regarding intervention elements, appointment of night workers as ambassadors, and suitable conditions in terms of work demands and for the intervention elements.

CONCLUSIONS

The multi-faceted PerfectFit@Night intervention reduced insomnia, fatigue and need for recovery in night workers in healthcare. The most important facilitators to improve the implementation of PerfectFit@Night exist at the organisational level (e.g., positive attitude within the culture and suitable work demands). Combining effect and implementation evaluation is crucial to identify barriers and facilitators that hamper or enhance intervention effects.

TRIAL REGISTRATION

The study was registered in the Netherlands Trial Register on 17 January 2021 (trial number NL9224).

Indicators of Sustainable Employability among Older Finnish Postal Service Employees: A Longitudinal Study of Age and Time Effects

We first clarify the definition of sustainable employability, and then we study how the indicators of sustainable employability among older Finnish postal service employees have changed over time. Finally, we estimate the effect of age on these indicators in a two-year follow up. A questionnaire survey among the Finnish postal service employees was conducted in 2016, and a follow-up was conducted in 2018. We analyze data from 1262 subjects who replied to both the baseline and the follow-up surveys. Sustainable employability is defined as a multidimensional construct using nine indicators and covering three domains (health, well-being and employability) based on Fleuren and colleagues’ model. Measurement time (repeated measure) is used as a within-subjects factor, and age is used as a between-subjects factor. The estimated marginal means of the indicators of sustainable employability at the baseline and the follow-up by age in years are calculated. No significant change is found in eight indicators (work ability, time and resources, recovery after work, job satisfaction, motivation, perceived employment, enough training on the job and relevance of work) of sustainable employability after the two-year follow-up. We find a statistically significant effect of time on self-rated health (F = 6.56, p = 0.011). Six out of nine indicators (self-rated health, work ability, time and resources, recovery after work, job satisfaction, and perceived employment) have a statistically significant effect of age between subjects. Partial Eta Squared (ŋ2p) shows a very small difference in the indicators of sustainable employability during the follow-up, indicating that the employability of the workers was sustained throughout. We used the Fleuren model as the basis for our definition of sustainable employability. Although they are based on single items, these indicators of sustainable employability remain stable after the two-year follow-up. Significant effects of age between subjects are found for six out of nine indicators. The results suggest that age may be an important determinant of sustainable employability.

The MAastricht Instrument for Sustainable Employability - Italian version (MAISE-IT): a validation study

BACKGROUND

Governments and employers aim to promote sustainable employability (SE) in aging societies. In the Netherlands, an instrument for capturing the employee perspective on SE, the MAastricht Instrument for Sustainable Employability (MAISE-NL), has recently been developed. This study seeks to validate the Italian version of the MAISE (MAISE-IT).

METHODS

The MAISE-IT (a translated and culturally adapted version of the MAISE for the Italian population), the Work-Health Balance questionnaire and a demographic survey (age, gender, education, and occupational activity) were completed online by 455 respondents (328 public administration workers and 127 respondents recruited from social networks). Construct and criterion validity were tested by CFA; reliability, correlational analyses and subgroup differences with ANOVAs.

RESULTS

The CFA analysis revealed that the MAISE-IT consists of 12 scales distributed in four areas: (1) Meaning of SE; (2) Level and Factors affecting SE; (3) Overall responsibility for SE; and (4) Responsibility for factors affecting SE. Construct and criterion validity and reliability were good. Italian workers reported a moderately high level of SE. They regarded employers to be somewhat more responsible for SE than employees.

CONCLUSIONS

This study showed the validity of the MAISE-IT in the Italian context. The MAISE-IT is valuable for tapping employees' needs in order to develop SE interventions tailored to the employee perspective.

Unshrouding the Sphere from the Clouds: Towards a Comprehensive Conceptual Framework for Sustainable Employability

Sustainable employability refers to individuals’ long-term abilities to work and remain employed. Despite its societal importance in the light of aging populations and rapidly changing skill demands, sustainable employability still requires further definition and conceptualization. As such, the present paper aims to define and conceptualize sustainable employability comprehensively by reviewing existing studies on the concept. Additionally, the paper discusses and integrates sustainable employment, sustainable work, and sustainable work ability into our broad framework of sustainable employability. The resulting conceptual framework positions sustainable employability as an inherently longitudinal multidimensional individual characteristic that is the outcome of complex interactions between individual-, work- and work environmental characteristics. This framework enables researchers to identify the employment characteristics that promote sustainable employability and thereby comprise sustainable employment. Finally, the framework links to notions of person-environment fit, and job- and organizational design to create a basis for future research on sustainable employability.

Shift work and sickness absence at a Norwegian hospital: a longitudinal multilevel study

OBJECTIVE

Shift work is known to be related to several negative health consequences and sickness absence. Research results regarding the relationship between types of shift schedules and sickness absence and whether and how individual factors moderate this relationship, are mixed though. The present paper aims to provide more insight in these relationships.

METHODS

We used registry data from a large Norwegian hospital gathered for the years 2012-2016, for >14 000 employees. With random effects at the individual and unit levels, we analysed the relationship between shift schedule worked and sickness absence in the same year.

RESULTS

The results showed increased risk of short-term sickness absence for two-shift and three-shift rotations, as well as fixed night shifts compared with fixed-day shifts. We also found an increased number of absence periods for two-shift rotations without nights and three-shift rotations. Results for long-term sickness absence were mixed, with increased odds for two-shift rotations without nights, but reduced odds for three-shift rotations. We found partial support for a moderating influence of age, gender and parental status.

CONCLUSIONS

There is a clear relationship between working shifts and increased risk of short-term sickness absence. The relationship persists across gender, age group and parental status. The relationship between shift work and long-term sickness absence appears to be schedule and population specific. These findings may have implications for HR policies and the organisation of shift work in healthcare organisations.

The Modified International Standard Classification of Occupations defined by the clustering of occupational characteristics in the Korean Working Conditions Survey

The modified International Standard Classification of Occupations (ISCO) has been used empirically to report or investigate working conditions or worker status. We used principal component analysis and k-means clustering to analyze the working population based on 67 occupational characteristics among 23,060 workers from the fourth Korean Working Conditions Survey in 2014. The three-cluster approach classified workers into major groups 1-4 (managers, professionals, technicians, and clerical support workers), 5-6 (service, sales, agricultural, forestry, and fishery workers), and 7-9 (crafts, trades, machine operators, assemblers, and elementary occupations) based on the ISCO-08. The results of the current study suggest a well-defined clustered occupational classification that can be used to report or investigate workers.

Tapping the Employee Perspective on the Improvement of Sustainable Employability (SE): Validation of the MAastricht Instrument for SE (MAISE-NL)

Background: Sustainable employability (SE) is top priority for employers. Measures based on the employee perspective of SE that would give direction to interventions to be initiated by employers currently fall short. This study aims to develop and validate an instrument that captures these issues: the MAastricht Instrument for Sustainable Employability (MAISE). Methods: MAISE items were generated from an extensive literature review and interviews with employers and employees. A questionnaire containing these items as well as proxy variables (health and vitality) and demographics was answered online by 632 employees (response rate 50.3%). Construct validity, reliability, and criterion validity were tested through Principal Component Analysis (PCA), Confirmatory Factor Analysis (CFA), Cronbach’s alpha, and correlational analyses. Results: The MAISE comprises 12 scales divided over five areas: (1) Meaning of SE; (2) Level of SE; (3) Factors affecting my SE; (4) Overall responsibility for SE; and (5) Responsibility for factors affecting my SE. Reliability, construct, and criterion validity were adequate to good. SE of the employees was relatively high, and SE was considered a shared responsibility of the employee and employer. Conclusions: This study showed the MAISE to be reliable and valid in various employee groups. More validation studies are needed. We recommend that employers use the MAISE as a needs assessment in order to develop SE interventions that will be readily accepted.

Changes in Accident & Emergency Visits and Return Visits in Relation to the Enforcement of Daylight Saving Time and Photoperiod

Daylight saving time (DST) is a source of circadian disruption impinging on millions of people every year. Our aim was to assess modifications, if any, in the number, type, and outcome of Accident & Emergency (A&E) visits/return visits over the DST months. The study included 366,527 visits and 84,380 return visits to the A&E of Padova hospital (Northern Italy) over 3 periods between the years 2007 and 2016: period 1 (2 weeks prior to DST to 19 weeks after), period 2 (2 weeks prior to the return to "winter time" to 4 weeks after), and period 3 (5 consecutive non-DST weeks). For each A&E visit/return visit, information was obtained on triage severity code, main medical complaint, and outcome. Data were aggregated by day, cumulated over the years, and analyzed by generalized Poisson models. Generalized additive models for Poisson data were then used to include photoperiod as an additional covariate. An increase in A&E visits and return visits (mostly white codes, resulting in discharges) was observed a few weeks after the enforcement of DST and was significant over most weeks of period 1 (increase of ≈30 [2.8%] visits and ≈25 [10%] return visits per week per year). After the return to winter time, a decrease in absolute number of return visits was observed (mostly white codes, resulting in discharges), which was significant at weeks 3 and 4 of period 2 (decrease of ≅25 [10%] return visits per week per year). When photoperiod was taken into account, changes in A&E visits (and related white codes/discharges) were no longer significant, while changes in return visits (and related white codes/discharges) were still significant. In conclusion, changes in A&E visits/return visits were observed in relation to both DST and photoperiod, which are worthy of further study and could lead to modifications in A&E organization/staffing.

Sickness Absence of Nurses Working in Residential Elder Care: The Essential Role of Psychosocial Job Resources and Home Demands

OBJECTIVES

To elucidate the role and pathways of psychosocial home demands, psychosocial home resources, and psychosocial job resources in relation to sickness absence among nurses working in residential elder care.

METHODS

Longitudinal (SEM) analyses with bootstrapping with a 1 year follow-up among 365 nurses were performed. Survey data and registered sickness absence data were used.

RESULTS

A complete mediation model showed the best fit. More psychosocial job resources (β = -1.50) like "work schedule fit with private life" predicted less and more psychosocial home demands (β = 0.62) predicted more psychosomatic health complaints. The job resources and home demands predicted sickness absence duration and episodes 1-year later mediated through nurses' health.

CONCLUSIONS

More attention is needed for nurses' work schedule fit with private life and their home demands to potentially reduce health-related sickness absence among nurses working in residential elder care.

Proposta de gestão do absenteísmo da enfermagem hospitalar: uma revisão sistemática

Resumo Objetivo: Investigar na literatura o conhecimento disponível sobre a interdependência dos agentes desencadeantes do absenteísmo da enfermagem hospitalar para inferir, a partir de uma perspectiva multicausal, possíveis ações de gestão e controle. Métodos: Revisão sistemática compreendendo o recorte temporal de 2013 à 2017, utilizando descritores operacionalizados em bases de dados indexadas do portal da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). A busca seguiu a metodologia Statement Preferred Reporting items For Systematic Reviews And Meta-Analyses (PRISMA) auxiliada pelo software EndNote®. Resultados: Finalizado o processo de depuração dos 269 artigos recuperados, 39 atenderam aos critérios de inclusão estabelecidos e, deles, 23,08% atribuiu a origem do absenteísmo a causas diversas não específicas. A organização do trabalho foi identificada como causa em 20,51% do material analisado, os adoecimentos musculoesqueléticos 15,38% e, os transtornos mentais e comportamentais totalizaram 10,26%. A síndrome de Burnout, 7,69% dos artigos, a satisfação no trabalho e os aspectos psicossociais 5,13% cada, relacionamento com demais membros das equipes, assédio e resiliência, ambiente laboral, fadiga e conflitos com o paciente, cada um, com 2,56% dos artigos analisados na revisão sistemática. Conclusão: Pelos resultados obtidos, concluiu-se que o absenteísmo deve ser tratado a partir de uma perspectiva múltipla, holística, epidemiológica e prospectiva através de variáveis organizacionais, físicas e cognitivas compatíveis com as análises multicausais.