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Framke E, Alexanderson K, Sørensen JK, Pedersen J, Madsen IEH, Rugulies R, Farrants K. Emotional demands and all-cause and diagnosis-specific long-term sickness absence: a prospective cohort study in Sweden. Eur J Public Health 2023:7152427. [PMID: 37141461 DOI: 10.1093/eurpub/ckad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND High emotional demands at work require sustained emotional effort and are associated with adverse health outcomes. We tested whether individuals in occupations with high emotional demands, compared with low demands, had a higher future risk of all-cause long-term sickness absence (LTSA). We further explored whether the risk of LTSA associated with high emotional demands differed by LTSA diagnoses. METHODS We conducted a prospective, nationwide cohort study on the association between emotional demands and LTSA (>30 days) in the workforce in Sweden (n = 3 905 685) during a 7-year follow-up. Using Cox regression, we analyzed sex-stratified risks of all-cause and diagnosis-specific LTSA due to common mental disorders (CMD), musculoskeletal disorders (MSD) and all other diagnoses. Multivariable adjusted models included age, birth country, education, living area, family situation and physical work demands. RESULTS Working in emotionally demanding occupations was associated with a higher risk of all-cause LTSA in women [hazard ratio (HR) = 1.92, 95% confidence interval (CI): 1.88-1.96] and men (HR = 1.23, 95% CI: 1.21-1.25). In women, the higher risk was similar for LTSA due to CMD, MSD and all other diagnoses (HR of 1.82, 1.92 and 1.93, respectively). In men, risk of LTSA due to CMD was pronounced (HR = 2.01, 95% CI: 1.92-2.11), whereas risk of LTSA due to MSD and all other diagnoses was only slightly elevated (HR of 1.13, both outcomes). CONCLUSIONS Workers in occupations with high emotional demands had a higher risk of all-cause LTSA. In women, risk of all-cause and diagnosis-specific LTSA were similar. In men, the risk was more pronounced for LTSA due to CMD.
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Affiliation(s)
- Elisabeth Framke
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Neurology, The Danish Multiple Sclerosis Registry, Copenhagen University Hospital, Glostrup, Denmark
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Jacob Pedersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Kristin Farrants
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Asplund S, Lindgren BM, Åström S, Hedlund M, Åhlin J. Organizational and psychosocial environmental work factors associated with self-rated exhaustion disorder among municipal employees in rural northern Sweden. Work 2023; 75:1215-1229. [PMID: 36776096 PMCID: PMC10473146 DOI: 10.3233/wor-220225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 10/06/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Research indicates that good organizational and psychosocial environments are vital to well-functioning workplaces and employee health. Working in the municipal sector and in the rural context may contribute to more health problems, poorer organizational and psychosocial work environments, and higher sick-leave rates. OBJECTIVE The aim of this study was to explore organizational and psychosocial environmental work factors among municipal employees with or without self-rated exhaustion disorder (s-ED) in rural northern Sweden. METHODS The Modern Work Life Questionnaire and the Self-Rated Exhaustion Disorder Scale were used among 1093 municipal employees. RESULTS The results showed that there were significant differences between the s-ED and the non-s-ED group in all but one of the organizational and psychosocial environmental work factors. Various demands, i.e. quantitative, emotional, intellectual, and IT demands were some factors associated with the s-ED group. Social support, resources, and time for work and reflection were some factors associated with the non-s-ED group. Both the s-ED and the non-s-ED groups assessed significantly higher emotional demands and less resources compared to national reference values. CONCLUSION Findings from this study are relevant to a better understanding what organizational and psychosocial work environmental work factor the employer need to pay extra attention to. Addressing risk and protective factors in the work environment could tribute to promote occupational well-being, preventing exhaustion disorder and long-term sick leave among municipal employees in rural northern Sweden.
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Affiliation(s)
- Sofia Asplund
- Department of Nursing, Umeå University, Umeå, Sweden
| | | | - Sture Åström
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Mattias Hedlund
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Johan Åhlin
- Department of Nursing, Umeå University, Umeå, Sweden
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Framke E, Sørensen JK, Alexanderson K, Farrants K, Kivimäki M, Nyberg ST, Pedersen J, Madsen IEH, Rugulies R. Emotional demands at work and risk of long-term sickness absence in 1·5 million employees in Denmark: a prospective cohort study on effect modifiers. LANCET PUBLIC HEALTH 2021; 6:e752-e759. [PMID: 34563282 DOI: 10.1016/s2468-2667(21)00185-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/01/2021] [Accepted: 07/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND High emotional demands at work can affect employees' health and there is a need to understand whether such an association might be modified by other working conditions. We aimed to examine emotional demands at work as a risk factor for long-term sickness absence and analyse whether influence, possibilities for development, role conflicts, and physical demands at work might modify this risk. METHODS We did a nationwide, population-based, prospective cohort study in Denmark and included employed individuals who were residing in Denmark in 2000, aged 30-59 years, who had complete data on age, sex, and migration background, with information on emotional demands and possible effect modifiers from job exposure matrices, and covariates and outcome (sickness absence) from population registers. Individuals with long-term sickness absence (≥6 weeks of consecutive sickness absence) between Jan 1, 1998, and Dec 31, 2000, and self-employed individuals were excluded. We assessed long-term sickness absence during a 10-year period from Jan 1, 2001, to Dec 31, 2010. Using Cox regression, we estimated hazard ratios (HRs) and 95% CIs and tested interaction as departure from additivity, estimating relative excess risk due to interaction (RERI). Multivariable adjusted models included sex, age, cohabitation, migration background, and income. FINDINGS 1 521 352 employed individuals were included and contributed data between Jan 1, 2000, and Dec 31, 2010. During 11 919 021 person-years (mean follow-up 7·8 years), we identified 480 685 new cases of long-term sickness absence. High emotional demands were associated with increased risk of long-term sickness absence compared with low emotional demands, after adjusting for age, sex, cohabitation, migration background, income, and the four possible effect modifiers (adjusted HR 1·55 [95% CI 1·53-1·56]). The association between high emotional demands and risk of long-term sickness absence was stronger in a synergistic way when individuals were also exposed to low possibilities for development (RERI 0·35 [95% CI 0·22-0·47]; 28·9 additional cases per 1000 person-years) and high role conflicts (0·13 [0·11-0·15]; 22·0 additional cases per 1000 person-years). No synergy was observed for influence and physical demands at work. INTERPRETATION People in occupations with high emotional demands were at increased risk of long-term sickness absence. Our findings on synergistic interactions suggest that, in emotionally demanding occupations, increasing possibilities for development and reducing work-related role conflicts might reduce long-term sickness absence. Further interventional studies are needed to confirm or refute this hypothesis. FUNDING Danish Work Environment Research Fund, NordForsk.
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Affiliation(s)
- Elisabeth Framke
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | | | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kristin Farrants
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK; Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Finnish Institute of Occupational Health, Helsinki, Finland
| | - Solja T Nyberg
- Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jacob Pedersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Public Health and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Sato N, Watanabe K, Kawakami N. Mediating Effects of Work Eudemonic Well-being for the Association Between Psychosocial Work Environment and Overall Eudemonic Well-being Among Japanese Workers: A Cross-sectional Study. J Occup Environ Med 2021; 63:e542-e548. [PMID: 34050096 DOI: 10.1097/jom.0000000000002276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to investigate the mediating effects of eudemonic well-being (EWB) at work for the associations between psychosocial work environment and overall EWB among Japanese workers. METHODS We conducted a cross-sectional study using data from a 2018 survey. psychosocial work environment measures included: job demands, job control, and supervisor and coworker support. Path analysis using structural equation modeling and mediation analysis were applied to examine the mediating effects of work EWB. RESULTS A total of 834 workers were analyzed. Work EWB completely mediated the associations of job control (β = 0.288, P < 0.001) and coworker support with overall EWB (β = 0.178, P < 0.001). CONCLUSIONS The effects of job control and coworker support associated with overall EWB were fully mediated by work EWB.
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Affiliation(s)
- Nana Sato
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan (Ms Sato and Prof Kawakami), Department of Public Health, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0374, Japan (Dr Watanabe)
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Miranda AR, Scotta AV, Méndez AL, Serra SV, Soria EA. Public Sector Workers' Mental Health in Argentina: Comparative Psychometrics of the Perceived Stress Scale. J Prev Med Public Health 2020; 53:429-438. [PMID: 33296583 PMCID: PMC7733755 DOI: 10.3961/jpmph.20.229] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Given that Argentinian public-sector workers are highly exposed to stressful conditions, and that the psychometric properties of the widely used Perceived Stress Scale (PSS) should be evaluated in different settings, this work aimed to compare the psychometric properties of the Latin American Spanish PSS-10 and PSS-4 and to identify the optimal scale for stress assessment. METHODS A sample of 535 participants was randomly divided into 2 groups to evaluate dimensionality by exploratory and confirmatory factor analyses. The reliability of both scales was also evaluated. Convergent validity was estimated using the Executive Complaints Questionnaire, the average variance extracted, and the composite reliability. Discriminant validity was based on the correlation with the Utrecht Work Engagement Scale and the phi-square correlation between the components. RESULTS The factor analyses supported bidimensionality of the PSS-10 (stress and coping), which showed a better fit than the PSS-4. Moreover, the reliability of the PSS-10 was higher, whereas the PSS-4 did not achieve adequate values of internal consistency. The PSS-10 was also correlated significantly with all validation scales, and presented proper internal convergent and divergent validity. CONCLUSIONS The PSS-10 is a reliable and structurally valid instrument to measure perceived stress and coping in a Latin American Spanish-speaking population with high work demands, and the findings of this study expand our knowledge on the geographical and sociocultural applicability of the PSS.
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Affiliation(s)
- Agustín Ramiro Miranda
- School of Phonoaudiology, Faculty of Medical Sciences, National University of Córdoba, Córdoba, Argentina
- National Scientific and Technical Research Council, CONICET, INICSA, Córdoba, Argentina
| | - Ana Veronica Scotta
- School of Phonoaudiology, Faculty of Medical Sciences, National University of Córdoba, Córdoba, Argentina
- National Scientific and Technical Research Council, CONICET, INICSA, Córdoba, Argentina
| | - Ana Lucía Méndez
- School of Phonoaudiology, Faculty of Medical Sciences, National University of Córdoba, Córdoba, Argentina
| | - Silvana Valeria Serra
- School of Phonoaudiology, Faculty of Medical Sciences, National University of Córdoba, Córdoba, Argentina
| | - Elio Andrés Soria
- National Scientific and Technical Research Council, CONICET, INICSA, Córdoba, Argentina
- Institute of Cell Biology, Faculty of Medical Sciences, National University of Córdoba, Córdoba, Argentina
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Framke E, Sørensen JK, Nordentoft M, Johnsen NF, Garde AH, Pedersen J, Madsen IEH, Rugulies R. Perceived and content-related emotional demands at work and risk of long-term sickness absence in the Danish workforce: a cohort study of 26 410 Danish employees. Occup Environ Med 2019; 76:895-900. [PMID: 31662424 PMCID: PMC6902065 DOI: 10.1136/oemed-2019-106015] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/26/2019] [Accepted: 10/04/2019] [Indexed: 11/13/2022]
Abstract
Objectives This study aimed to examine whether high emotional demands at work predict long-term sickness absence (LTSA) in the Danish workforce and whether associations differ by perceived and content-related emotional demands. Methods We included 26 410 individuals from the Work Environment and Health in Denmark Study, a nationwide sample of the Danish workforce. Emotional demands at work were measured with two items: one assessing perceived emotional demands (asking how often respondents were emotionally affected by work) and one assessing content-related emotional demands (frequency of contact with individuals in difficult situations). LTSA was register based and defined as spells of ≥6 weeks. Respondents with LTSA during 2 years before baseline were excluded. Follow-up was 52 weeks. Using Cox regression, we estimated risk of LTSA per one-unit increase in emotional demands rated on a five-point scale. Results During 22 466 person-years, we identified 1002 LTSA cases. Both perceived (HR 1.20, 95% CI 1.12 to 1.28) and content-related emotional demands (HR 1.07, 95% CI 1.01 to 1.13) predicted risk of LTSA after adjustment for confounders. Further adjustment for baseline depressive symptoms substantially attenuated associations for perceived (HR 1.08, 95% CI 1.01 to 1.16) but not content-related emotional demands (HR 1.05, 95% CI 1.00 to 1.11). Individuals working in occupations with above-average values of both exposures had an increased risk of LTSA (HR 1.32, 95% CI 1.14 to 1.52) compared with individuals in all other job groups. Conclusions Perceived and content-related emotional demands at work predicted LTSA, also after adjustment for baseline depressive symptoms, supporting the interpretation that high emotional demands may be hazardous to employee’s health.
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Affiliation(s)
- Elisabeth Framke
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Mads Nordentoft
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Nina Føns Johnsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Anne Helene Garde
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jacob Pedersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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