The role of cognitive resources for subjective work ability and health in nursing

Job demands and resources as drivers of exhaustion and leaving intentions: a prospective analysis with geriatric nurses

BACKGROUND

Nurses show a high prevalence of exhaustion and increased leaving intentions. With this study, we integrate established research about turnover intention with recent burnout literature and present a theoretical model that combines both. The aim of this study was to examine job demands (time pressure, social conflicts) and resources (job control, supervisor support, task identity, person-organisation fit) as drivers and health and age as moderators for the relationships between exhaustion and nurses' organisational and professional leaving intentions.

METHODS

We analysed data from a standardised paper-pencil questionnaire survey with a prospective, two-wave (12 months apart) study design. In total, 584 nurses participated at Time 1 (t1). The final sample at Time 2 (t2) was n = 222 nurses (38%; age: M = 41.1 years, SD = 11.0; 88% females).

RESULTS

We identified time pressure as job demand and job control, task identity, and person-organisation fit as resources that drive the relationships of exhaustion (mean between both times of measures) and organisational and professional leaving intentions. The relationships to organisational leaving intentions decreased with nurses' age and the relationships to professional leaving intentions increased for nurses who had poorer self-rated health. We found indirect effects of exhaustion for relationships between job demands and nurses' leaving intentions. Relationships to exhaustion remained significant after adjusting for depressive mood.

CONCLUSION

Insights from this study can be used both by employers and employees. Redesigning work might be a promising approach to improve nurses' well-being and retention in this profession. Geriatric care facilities should include the concept of person-organisation fit into their personnel selection process.

Feasibility of a Home-Based Task-Switching Training in Middle-Aged Caregivers

The current study aimed at investigating feasibility of a self-administered task-switching training in a middle-aged working population. Eighty-one caregivers (41–62 years old) were instructed to train at home 8 times either within a 7- or 14-day interval. Only 56.7% performed more than 50% of the instructed number of training sessions. However, compliant caregivers (who completed more than 4 training sessions) showed significant training gains and transfer to an untrained task-switching task. Although transfer effects to other cognitive tasks were not found, trained participants tended to report fewer everyday memory failures than a control group. In conclusion, the implementation of a home-based task-switching training in everyday life of caregivers is possible. However, there is only limited evidence for generalization of results of previous laboratory studies. Adherence and transfer to other cognitive tasks are discussed as important challenges in conveying laboratory findings into real life.

Aging and the Future of Decent Work

The United Nations identified decent work and economic growth as a sustainable development goal for 2030. Decent work is a term that sums up aspirations for people in their working lives. One of the factors that influences the achievement of decent work is aging. This article examines how aspects of aging and organizational factors affect work ability across the lifespan and throughout one's work career. Additionally, the critical issue of worker physical mobility was also addressed as a practical limitation to functional aging. Through our investigation, we identified gaps in the literature where research and interventions should be promoted. These include early disability studies; population dashboards of workers' health metrics; intervention and cost effectiveness in health promotion and prevention of early functional aging at work; policies for tailoring demands to individual needs and abilities; and inequities of social protection for aging workers.

Live longer, retire later? Developments of healthy life expectancies and working life expectancies between age 50–59 and age 60–69 in Europe

Europe’s population is ageing. Statutory retirement ages are commonly raised to account for continuous increases in life expectancy. In order to estimate the potential to increase statutory and consequently effective retirement ages further, in this study, we investigate the relationship between partial working life expectancy (WLE) and three health expectancies that represent health aspects important for work ability and employability between ages 50 and 59 as well as 60 and 69 for women and men in Europe. We also explore the association between these four indicators and the highest level of educational attainment. We apply Sullivan’s method to estimate WLE and three selected measures that capture general, physical, and cognitive health status of older adults for 26 European countries since 2004. Over time, WLEs increased significantly in the younger age group for women and in the older age group for both sexes. The expected number of years in good physical health have continuously been higher than any of the other three indicators, while the expected number of years in good cognitive health have shown a noticeable increase over time. The investigation of the relationship between education and each life expectancy confirms the well-established positive correlation between education and economic activity as well as good health. Our results indicate potential to extend working lives beyond current levels. However, significant differences in the expected number of years in good health between persons with different levels of education require policies that account for this heterogeneity.

Cognitive Reserve Moderates the Predictive Role of Memory Complaints for Subsequent Decline in Executive Functioning

Aims

We investigated whether the longitudinal relation between memory complaints and subsequent decline in executive functioning over 6 years differed by leisure activity engagement as major contributor to cognitive reserve in old age.

Methods

We analyzed longitudinal data from 897 older adults (M = 74.33 years) tested on the Trail Making Test (TMT) in two waves 6 years apart. Participants reported information on memory complaints and leisure activity engagement.

Results

There was a significant interaction of memory complaints with leisure activity engagement on latent change in executive functioning. Specifically, only for individuals with less (but not those with greater) leisure activity engagement, memory complaints significantly predicted a steeper subsequent decline in executive functioning across 6 years (i.e., increases in TMT completion time).

Conclusion

The role of memory complaints as an early predictor of decline in executive functioning seems to vary by individuals' cognitive reserve.

Cognitive Reserve Attenuates 6-Year Decline in Executive Functioning after Stroke

AIMS

We investigated whether the longitudinal relationship between history of stroke and subsequent decline in executive functioning over 6 years differed by cognitive reserve.

METHODS

We analyzed longitudinal data from 897 older adults (mean age, 74.33 years) tested on the Trail Making Test (TMT) in two waves 6 years apart. Participants reported information on key frequently used proxies of lifelong cognitive reserve accumulation (i.e., education, occupation, and leisure activity engagement), and history of stroke.

RESULTS

There was a significant interaction of stroke with leisure activity engagement on latent change in executive functioning. Specifically, only for individuals with low (but not those with high) leisure activity engagement, history of stroke significantly predicted a steeper subsequent decline in executive functioning across 6 years (i.e., increases in TMT completion time).

CONCLUSION

The detrimental aftereffects of stroke on subsequent decline in executive functioning may be attenuated in individuals who have accumulated greater cognitive reserve through leisure activity engagement across their life.

Internet use in old age predicts smaller cognitive decline only in men

Internet use provides cognitive stimulation and thereby may contribute to the accumulation of cognitive reserve that is proposed to be instrumental for maintaining cognitive health in ageing. As the first study so far, we examined possible gender differences in the relationship between Internet use and subsequent cognitive decline over six years assessed through changes in Trail Making Test (TMT) accomplishment time in 897 older adults. Latent change score modelling (taking into account baseline cognitive level, chronic diseases, age, and central contributions to cognitive reserve through education, profession, and leisure engagement) revealed a significant interaction of frequency of Internet use and gender. More frequent Internet use in the first wave of data collection significantly predicted a smaller subsequent augmentation in TMT accomplishment time (i.e., a smaller subsequent cognitive decline) only in men, but not in women. In conclusion, frequent Internet use may contribute to the accumulation of cognitive reserve. The gender difference noted highlights an advantage for males. While this finding could be interpreted as gender-specific, it may be that the Internet activities males engage in differ from those of females, calling for a fine-grained investigation of Internet-based activities in future studies.

Prognostic effects of selection, optimization and compensation strategies on work ability: results from the representative lidA cohort study on work, age, and health in Germany

PURPOSE

Regarding the increased need for the retention of older employees in the workforce, this study investigates whether there are main and interactive longitudinal effects of selection, optimization, compensation and working conditions according to the job demand-control model on work ability in older employees.

METHODS

Longitudinal data of computer-assisted personal interviews with one follow-up after 3 years of 3961 participants (born in 1959 and 1965) of the representative German lidA cohort study was used. Multiple linear regressions were performed, analyzing prospective main and interactive effects of selection, optimization, compensation and working conditions during baseline on perceived work ability at follow-up.

RESULTS

Regarding selection, optimization and compensation, only compensation had a positive, but weak effect on work ability. Working conditions were more strongly related to work ability: decision authority and skill discretion had independent positive and job demands had independent negative effects on work ability. One interaction effect was observed between loss-based selection and decision authority, such that they mutually enhanced their positive effects on work ability. Only few and weak interactions among the sub-strategies, selection, optimization and compensation, were observed.

CONCLUSIONS

Results indicate that especially favorable working conditions in terms of high job control and low job demands, but also compensation might help older employees to maintain work ability.

Work-Anxiety Rather Than Cognitive Performance Contributes to Workability Decisions in Patients With Mental Disorders

BACKGROUND

Mental workability decisions must be based on information on person's symptom load, cognitive performance, and workplace conditions. This investigation explores in which way these factors contribute to workability in persons with common mental disorders (CMDs).

METHODS

One thousand five hundred seventy CMD-patients underwent multimodal medical diagnostic. Participants filled in questionnaires on work-phobic-anxiety and general mental symptom load. They were also investigated concerning their cognitive performance. Sick leave duration, workplace problems, and subjective workability were assessed. Physicians' decision on the persons' workability (fit or unfit for work) was given 5 weeks later.

RESULTS

Negative workability perception, long previous sick leave duration, and high work phobic anxiety explained unfitness for work, whereas general symptom load and general cognitive performance did not.

CONCLUSION

Work-directed diagnostics and interventions must address work-phobic anxiety and subjective workability perception.

Work Ability and Employment in Rheumatoid Arthritis: A Cross-Sectional Study on the Role of Muscle Strength and Lower Extremity Function

Objective

The aim of the present study was to assess the association between muscle strength, lower extremity function, employment status, and work ability in RA patients.

Methods

One hundred seropositive RA outpatients of working age were included in this cross-sectional study. Employment status was assessed by interview and work ability by the Work Ability Index-Single Item Scale (WAS). Muscle strength was determined using dynamometer measurement of isometric hand grip and knee extensor strength. Lower extremity function was measured using the short physical performance battery (SPPB). Regression models estimate the association between unemployment, work ability and muscle strength, and lower extremity function, controlling for sociodemographic and disease-related factors.

Results

Forty-one percent of the RA patients were not gainfully employed, and their median work ability had a good WAS value (7.00 [4.00-7.00]). Patients with better knee extensor strength (OR=1.07, 95% CI [1.02-1.12) and better physical performance (OR=1.71, 95% CI [1.18-2.49]) had a significantly better chance of gainful employment. The odds for hand grip strength remained significant when adjusted for sociodemographic (OR=1.5, 95% CI [1.00-1.09]), but not for disease-specific variables. Better hand grip strength (β=0.25, p=0.039) and better knee extensor strength (β=0.45, p=0.001) as well as better lower extremity function (SPPB) (β=0.51, p<0.001) remained significantly associated with work ability following adjustment for sociodemographic and disease-specific variables.

Conclusions

The association of employment status and work ability with parameters of physical fitness suggests that improvement in muscle strength and lower extremity function may positively influence work ability and employment in individuals with RA.

The association of educational attainment, cognitive level of job, and leisure activities during the course of adulthood with cognitive performance in old age: the role of openness to experience

BACKGROUND

The relevance of mental health for everyday life functioning and well-being is crucial. In this context, higher educational attainment, higher cognitive level of one's occupation, and more engaging in stimulating leisure activities have been found to be associated with better cognitive functioning in old age. Yet, the detailed pattern of the potential interplay of such a cognitively engaged lifestyle with personality dimensions, such as openness to experience, in their relations to cognitive functioning remains unclear.

METHODS

Two thousand eight hundred and twelve older adults served as sample for the present study. Psychometric tests on verbal abilities and processing speed were administered. In addition, individuals were retrospectively interviewed on their educational attainment, occupation, and regarding 18 leisure activities that had been carried out in mid-life. Moreover, openness to experience was assessed.

RESULTS

We found that the effect of openness to experience on cognitive functioning was mediated by educational attainment, cognitive level of job, and engaging in different leisure activities. Data were not better described by alternative moderation models testing for interactive (i.e. dependent) effects of openness to experience and cognitively stimulating engagement.

CONCLUSIONS

To explain interindividual differences in cognitive functioning in old age, present data are in line with a mechanism in which individuals with high openness to experience may have been more engaged in stimulating activities in early and mid-life. Possibly by increasing their cognitive reserve throughout adulthood, this may finally enhance their cognitive performance level later in old age.

Uncovering the care setting-turnover intention relationship of geriatric nurses

In times of global demographic changes, strategies are needed for improving nursing staff retention. We examined the association of care setting (nursing homes and home care) with geriatric nurses' intention to leave their job and their profession. Thus far, it is unclear why nurses' turnover intention and behaviour do not differ between care settings, although working conditions tend to be better in home care. We used the Job Demands-Resources model to explain indirect and buffering effects by job demands (time pressure, social conflicts) and resources (task identity, supervisor support, and co-worker support) via nurses' perceived health and job satisfaction on nurses' leaving intentions. The present cross-sectional questionnaire study was conducted with a sample of N = 278 registered nurses and nursing aides in German geriatric care. As expected, there was no direct relationship between care setting and leaving attitudes. Demands and resources predicted the intention to leave with job satisfaction as mediator. We found more demands in nursing homes but no differences in resources. Serial mediation effects of care setting on intentions to leave via demands/resources and health/job satisfaction as mediators were found only for time pressure and social conflicts. Unexpectedly, there were no clear differences between intention to leave the job and the profession. As hypotheses were only partly confirmed, other buffering and detrimental effects on leaving intentions are discussed. The present data suggest that detailed concepts for personnel and career planning in geriatric care are needed.