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Brämberg E, Åhsberg E, Fahlström G, Furberg E, Gornitzki C, Ringborg A, Thoursie PS. Effects of work-directed interventions on return-to-work in people on sick-leave for to common mental disorders-a systematic review. Int Arch Occup Environ Health 2024; 97:597-619. [PMID: 38710801 PMCID: PMC11245426 DOI: 10.1007/s00420-024-02068-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/23/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE To evaluate the body of evidence of the effects of work-directed interventions on return-to-work for people on sick leave due to common mental disorders (i.e., mild to moderate depression, anxiety, adjustment disorders and reactions to severe stress). METHODS The systematic review was conducted in accordance with an a priori developed and registered protocol (Prospero CRD42021235586). The certainty of evidence was assessed by two independent reviewers using the Grading of Recommendations, Assessment, Development and Evaluations. RESULTS We reviewed 14,794 records published between 2015 and 2021. Of these, eight RCTs published in eleven articles were included in the analysis. POPULATION Working age adults (18 to 64 years), on sick leave due to mild to moderate depression, anxiety, adjustment disorders or reactions to severe stress. INTERVENTION Work-directed interventions. COMPARATOR No comparator, Standard care, or other measures. OUTCOME return to work, number of days on sick leave, income. Overall, the effects of work-focused CBT and work-focused team-based support on RTW resulted in increased or faster return-to-work compared with standard care or no intervention (low certainty of evidence). The effects of Individual Placement and Support showed no difference in RTW compared with standard care (very low certainty of evidence). CONCLUSION Interventions involving the workplace could increase the probability of RTW. Areas in need of improvement in the included studies, for example methodological issues, are discussed. Further, suggestions are made for improving methodological rigor when conducting large scale trials.
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Affiliation(s)
- Elisabeth Brämberg
- Unit of Intervention- and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Elizabeth Åhsberg
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Gunilla Fahlström
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden
| | - Elisabet Furberg
- Department of Philosophy, Stockholm University, Stockholm, Sweden
| | - Carl Gornitzki
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden
| | - Anna Ringborg
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden
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Fannin A, Hooley C, Nelson EJ. Greater Emotional and Psychological Well-being Are Associated With Reduced Employee Self-report Illness-Related Absenteeism: A Multi-Industry, Cross-sectional Study Conducted During COVID-19 Pandemic. J Occup Environ Med 2024; 66:310-315. [PMID: 38234095 DOI: 10.1097/jom.0000000000003042] [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: 01/19/2024]
Abstract
OBJECTIVE The purpose of this study is to determine the relationship that emotional, psychological, and social well-being has with self-reported illness-related absenteeism. METHODS This study examines the relationship between three dimensions of well-being (emotional, psychological, and social) and self-report illness-related absenteeism among 133 workers spanning multiple industries across 16 different companies. This secondary, cross-sectional data were analyzed using multiple linear regression. RESULTS As hypothesized, emotional well-being and psychological well-being were found to be negatively associated with absenteeism, with emotional well-being being the stronger predictor. Contrary to our hypothesis, we found that social well-being was not associated with absenteeism among workers. CONCLUSIONS Employee emotional well-being and psychological well-being are associated with self-reported illness-related absenteeism. Future work should explore causal relationships between these constructs.
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Affiliation(s)
- Austin Fannin
- From the University of Tulsa, Tulsa, Oklahoma (A.F.); and Brigham Young University, Provo, Utah (C.H., E.J.N.)
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Goldfarb Y, Assion F, Begeer S. Where do autistic people work? The distribution and predictors of occupational sectors of autistic and general population employees. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241239388. [PMID: 38497251 DOI: 10.1177/13623613241239388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
LAY ABSTRACT Studies on employment of autistic individuals mainly assessed if they work and what their working conditions are (e.g. weekly hours, salary) while less is known about where they work. We explore this issue in our study, by examining which employment sectors do autistic adults work in, and comparing them to the general workforce in the Netherlands. We also explored the possibility that gender, age, age at diagnosis, level of education, degree of autistic traits and presence of focused interests could lead to a higher likelihood of working in specific sectors. We assessed data from a survey filled in by 1115 employed autistic adults (476 male; 627 female; 12 other; mean age: 40.75). Dutch workforce information was based on data form the Central Bureau of Statistics. Results showed that a higher proportion of autistic employees worked in healthcare & welfare, information technology, and the public-army-charity sectors. These were the three most-common sectors for this group. A lower proportion of autistic employees worked in economics & finances, and industry & construction, compared to the general workforce. Most autistic employees in the healthcare & welfare sector were females while having a higher educational degree and being male increased the chance of working in information technology. In addition to the common impression that most autistic individuals have interests or abilities that align with employment in information technology and technology sectors, we found that autistic employees worked in various sectors. It is important to address individual characteristics and needs of autistic individuals, while encouraging diverse employment opportunities.
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Affiliation(s)
| | - Franziska Assion
- Section Clinical Developmental Psychology, Vrije Universiteit Amsterdam and the Netherlands and Amsterdam Public Health Research Institute, The Netherlands
| | - Sander Begeer
- Section Clinical Developmental Psychology, Vrije Universiteit Amsterdam and the Netherlands and Amsterdam Public Health Research Institute, The Netherlands
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Nawata K. Evaluation of physical and mental health conditions related to employees' absenteeism. Front Public Health 2024; 11:1326334. [PMID: 38274521 PMCID: PMC10808730 DOI: 10.3389/fpubh.2023.1326334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/12/2023] [Indexed: 01/27/2024] Open
Abstract
Background Employees' health conditions are issues for not only employees themselves but also companies and society to keep medical costs low and productivity high. Data and methods In this analysis, 15,574 observations from 2,319 employees at four operational sites of a large corporation were used. The dataset contained physical and mental health conditions obtained from annual mandatory medical checkups, the Brief Job Stress Questionnaire (BJSQ), and work record information. Health and other factors related to long-term absenteeism (over three days in a quarter) were analyzed. Data were collected between February 2021 and January 2022, and we converted into quarterly observations. A logit (logistic regression) model was used in the analysis. Results Age and gender were identified as important basic characteristics. The estimates for these variables were positive and negative and significant at the 1% level. Among the variables obtained from the medical checkups, the estimates for diastolic blood pressure, HbA1c, anamnesis, heart disease history, smoking, increased weight, and frequency of alcohol consumption were positive and significant at the 1% level, further those for taking antihypertensive medications and kidney disease history were positive and significant at the 5% level. In contrast, the estimates for systolic blood pressure and amount of alcohol consumption were negative and significant at the 1% level. The estimate for taking antihyperglycemic medications and health guidelines were negative and significant at the 5% level. Among the variables obtained from the BJSQ, the estimates for amount of work felt, fatigue and support from family and friends were positive and significant at the 1%, and the estimate for irritation was positive and significant at the 5% level. The estimates for controlling job and physical complaints were negative and significant at the 1% level, and those for usage of employee's ability to work and suitability of the work were negative and significant at the 5% level. As all four operational sites were located in the northeastern region of Japan (cold and snowy in winter), the seasonal effects were significant at the 1% level. The effect of year was also significant and significant differences were observed among the sites at the 1% level. Conclusion Some physical and mental health conditions were strongly associated with long-term absenteeism. By improving these conditions, corporations could reduce the number of employee absence days. As absenteeism was costly for corporations due to replacement employees and their training costs to maintain operations, employers must be concerned about rising healthcare (direct and indirect) costs and implement investments to improve employees' health conditions. Limitations This study's results were based on only one corporation and the dataset was observatory. The employees were primarily operators working inside the building and most of them are healthy. Therefore, the sample selection biases might exist, and the results cannot be generalized to other types of jobs, working conditions, or companies. As medical checkups and the BJSQ are mandatory for most companies in Japan, the framework of this study can be applied to other companies. Although we used the BJSQ results, better mental measures might exist. Similar analyses for different corporations are necessary.
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Affiliation(s)
- Kazumitsu Nawata
- Hitotsubashi Institute for Advanced Study (HIAS), Hitotsubashi University, Kunitachi, Japan
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Melo BF, Santos KOB, Fernandes RDCP, de Lima VMC, Stock S. Mental disorders in judicial workers: analysis of sickness absence in a cohort study. Rev Saude Publica 2023; 57:72. [PMID: 37878858 PMCID: PMC10547382 DOI: 10.11606/s1518-8787.2023057004737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 10/18/2022] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE To analyze risk factors for sickness absence due to mental disorders among judicial workers in Bahia, Brazil. METHODS Retrospective cohort with follow-up from 2011 to 2016 with 2,660 workers of a judicial sector in Bahia, Brazil. The main outcome measures were survival curves estimated for the independent variables using the Kaplan-Meier product limit estimator and risk factors for the first episode of sickness absence calculated based on the Cox regression model. RESULTS The survival estimate of the population of this study for the event was 0.90 and from the Cox model the risk factors for the first episode of sickness absence due to mental disorders were: female (HR = 1.81), occupation of magistrate (HR = 1.80), and age over 30 years old (HR = 1.84). In addition, the risk for new cases of sickness absence among women reached 4.0 times the risk for men, in 2015. The estimated relative risks of sickness absence and the observed survival reduction behavior over time add information to the literature on sociodemographic and occupational factors associated with sickness absence due to mental disorders in the public sector. CONCLUSION These results highlight the need for further research to more precisely identify vulnerable groups at risk of preventable mental health-related sickness absence in the workplace, better identify the workplace organizational factors that contribute to these disorders as well as studies on the effectiveness of workplace interventions to improve mental health among judicial and other public sectors workers.
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Affiliation(s)
- Bruna Ferreira Melo
- Universidade Federal da BahiaFaculdade de Medicina da BahiaSalvadorBABrasil Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil
| | - Kionna Oliveira Bernardes Santos
- Universidade Federal da BahiaFaculdade de Medicina da BahiaSalvadorBABrasil Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil
| | - Rita de Cássia Pereira Fernandes
- Universidade Federal da BahiaFaculdade de Medicina da BahiaSalvadorBABrasil Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil
| | - Verônica Maria Cadena de Lima
- Universidade Federal da BahiaFaculdade de Medicina da BahiaSalvadorBABrasil Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil
| | - Susan Stock
- University of MontrealDepartment of Social & Preventive MedicineMontréalQCCanada University of Montreal. Department of Social & Preventive Medicine. Montréal, QC, Canada
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Li B, Liao G, Lee PMY, Huss A, Ma YTJ, Chan JWY, Wing YK, Tse LA. Association between matched chronotype and poor mental health among shift workers: a systematic review and meta-analysis. J Epidemiol Community Health 2023:jech-2022-220280. [PMID: 37258217 DOI: 10.1136/jech-2022-220280] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 05/16/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Nearly 0.7 billion workers are involved in the shift work system, leading to concerns about its potential impacts on the large-scale population mental health. This study aimed to synthesise evidence of the associations between matched chronotype and the risk of poor mental health among shift workers. METHODS Six computerised databases were searched from inception to September 2022. Observational studies were selected if they reported any association between common mental health parameters and chronotype scores/types of shift workers. The Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist was followed. We extracted adjusted risk estimates to calculate pooled effect sizes and explore sources of heterogeneity. The study was registered in PROSPERO: CRD42022357437. RESULTS Fourteen studies including 49 909 workers were identified. Ever shift workers had a higher risk of poor mental health than the day workers (pooled OR 1.15, 95% CI 1.03 to 1.28; I2=14%, p=0.29), with the evening chronotype ever shift workers having a 1.47 times higher risk than those who worked during the day (pooled OR 1.47, 95% CI 1.13 to 1.91; I2=42%, p=0.16). Sensitivity analysis excluding studies with the highest risk of bias of each group demonstrated consistent findings. CONCLUSIONS Evening chronotype ever shift workers have poorer mental health than shift workers with other chronotypes. Chronotype remains unrecognised in the contemporary rostering system, making it a hidden contributor to occupational mental health. Work-related physical and mental stresses may be prevented/mitigated with further investigation on optimising shift work schedule combined with individual chronotype preference.
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Affiliation(s)
- Beixi Li
- JC School of Public Health and Primary Care, The Chinese University, Hong Kong SAR, People's Republic of China
| | - Gengze Liao
- JC School of Public Health and Primary Care, The Chinese University, Hong Kong SAR, People's Republic of China
| | - Priscilla Ming Yi Lee
- JC School of Public Health and Primary Care, The Chinese University, Hong Kong SAR, People's Republic of China
- Department of Clinical Medicine-Department of Clinical Epidemiology, Aarhus Universitet, Aarhus, Denmark
| | - Anke Huss
- Department of Population Health Sciences, Utrecht University, Utrecht, Netherlands
| | - Yuen Ting Julie Ma
- JC School of Public Health and Primary Care, The Chinese University, Hong Kong SAR, People's Republic of China
| | - Joey Wing-Yan Chan
- Department of Psychiatry, The Chinese University, Hong Kong SAR, People's Republic of China
| | - Yun Kwok Wing
- Department of Psychiatry, The Chinese University, Hong Kong SAR, People's Republic of China
| | - Lap Ah Tse
- JC School of Public Health and Primary Care, The Chinese University, Hong Kong SAR, People's Republic of China
- Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, People's Republic of China
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de Medeiros AM, Lobo MF, Vieira MDT, Duarte L, Carvalho JPM, Teodoro AC, Claro RM, Gomes NR, Freitas A. Social Vulnerability of Brazilian Metropolitan Schools and Teachers' Absence from Work Due to Vocal and Psychological Symptoms: A Multilevel Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2972. [PMID: 36833667 PMCID: PMC9966546 DOI: 10.3390/ijerph20042972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Teachers' voices and psychological symptoms are the main reasons for absence from work. The objectives of this study were: (i) to spatially represent, through a webGIS, the standardized rates of teachers' absences due to voice (outcome 1) and psychological symptoms (outcome 2) in each Brazilian Federative Unit (FU = 26 states plus Federal District) and (ii) to analyze the relationship between each national outcome rate and the Social Vulnerability Index (SVI) of the municipality where urban schools are located, adjusted for sex, age, and working conditions. This cross-sectional study comprised 4979 randomly sampled teachers working in basic education urban schools, of which 83.3% are women. The national absence rates were 17.25% for voice symptoms and 14.93% for psychological symptoms. The rates, SVI, and school locations in the 27 FUs are dynamically visualized in webGIS. The multilevel multivariate logistic regression model showed a positive association between voice outcome and high/very high SVI (OR = 1.05 [1.03; 1.07]), whereas psychological symptoms were negatively associated with high/very high SVI (OR = 0.86 [0.85 0.88]) and positively associated with intermediate SVI (OR = 1.15 [1.13; 1.16]), in contrast with low/very low SVI. Being a woman (voice: OR = 1.36 [1.35; 1.38]; psychological: 1.22 [1.21; 1.24]) and working in schools with various precarious conditions (17 variables) increased the odds of being absent due to voice and psychological symptoms. The results confirm the need for investments to improve working conditions in schools.
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Affiliation(s)
- Adriane Mesquita de Medeiros
- Postgraduate Program in Speech-Language Sciences, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil
- Postgraduate Program in Public Health, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil
| | - Mariana Fernandes Lobo
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, 4200-450 Porto, Portugal
| | - Marcel de Toledo Vieira
- Department of Statistics and Graduate Program in Economics, Federal University of Juiz de Fora, Juiz de Fora 36036-900, Brazil
| | - Lia Duarte
- Institute of Earth Sciences, FCUP Pole, Rua do Campo Alegre, 4169-007 Porto, Portugal
- Department of Geosciences, Environment and Spatial Planning, Faculty of Sciences of the University of Porto (FCUP), Rua do Campo Alegre, 4169-007 Porto, Portugal
| | - João Paulo Monteiro Carvalho
- Department of Geosciences, Environment and Spatial Planning, Faculty of Sciences of the University of Porto (FCUP), Rua do Campo Alegre, 4169-007 Porto, Portugal
| | - Ana Cláudia Teodoro
- Institute of Earth Sciences, FCUP Pole, Rua do Campo Alegre, 4169-007 Porto, Portugal
- Department of Geosciences, Environment and Spatial Planning, Faculty of Sciences of the University of Porto (FCUP), Rua do Campo Alegre, 4169-007 Porto, Portugal
| | - Rafael Moreira Claro
- Postgraduate Program in Public Health, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil
| | - Nayara Ribeiro Gomes
- Postgraduate Program in Speech-Language Sciences, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil
| | - Alberto Freitas
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, 4200-450 Porto, Portugal
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Crawford J, Spence J, Lovegrove T, Tam E, Collins D, Harvey SB, Deady M. Pilot Trial of Workable: A Therapist-Supported Digital Program for Injured Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2460. [PMID: 36767833 PMCID: PMC9916348 DOI: 10.3390/ijerph20032460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 06/18/2023]
Abstract
Workplace sickness absence is a major public health and economic problem, and common mental disorders (CMDs) such as anxiety and depression are associated with particularly high rates of long-term sickness absence. Effective return-to-work (RTW) interventions are required. This pilot study investigates the feasibility, acceptability, and potential effectiveness of a new therapist-assisted Web-based RTW intervention (Workable) for injured workers on sick leave for a psychological or physical injury. A single-group open pilot trial design was used, with assessments at pre-treatment and post-treatment. The intervention consisted of 6 weeks of online modules and 6 coaching calls from a psychologist. A total of 13 participants were recruited and 9 completed all questionnaires. Program adherence was high, with 92% of participants completing the 6-week intervention. Participants reported high levels of intervention satisfaction and ease of use. There were large and significant reductions between pre- and post-treatment on measures of depression, anxiety, stress, and workdays missed over the past four weeks, along with a significant increase in self-reported work ability. These results suggest that Workable is a feasible and acceptable intervention for injured workers, with the potential to improve mental health and RTW outcomes. A randomized controlled trial is required to determine the efficacy of the intervention.
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Affiliation(s)
- Joanna Crawford
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
| | - Jay Spence
- Uprise Services Pty Ltd., Sydney, NSW 2000, Australia
| | | | - Edman Tam
- Uprise Services Pty Ltd., Sydney, NSW 2000, Australia
| | - Daniel Collins
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
| | - Samuel B. Harvey
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
| | - Mark Deady
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
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