Influence of changes in the Spanish labor market during the economic crisis (2007-2011) on perceived health

Modifiable work stress factors and psychological health risk among nurses working within 13 countries

INTRODUCTION

Nurses are identified as having higher work stress and poor mental health risk among health care workforce globally. It remains unclear which modifiable stress factors pose the greatest risk for poor psychological health among nursing workforce and needed to inform targeted practice and policy change. To determine which occupation-related or personal stress factors precipitate higher risk for burnout, depression, anxiety, job satisfaction or intention to leave one's position among nurses globally.

DESIGN

A cross-sectional anonymous survey was administered via email using a snowball recruitment strategy.

METHODS

Academic researchers and clinical industry leaders across 3 global regions collaborated to generate an email listserv of professional nursing contacts for survey distribution. The survey included valid and reliable measures to scale stress factors (Work Stress Questionnaire), and screen for burnout (single item), depression (Patient Health Questionnaire-2), anxiety (Generalized Anxiety Disorder-2), resilience (Brief Resilience Scale) and intention to leave one's job (single item). We used logistic regression, first unadjusted and then adjusted for personal and professional characteristics, to determine associations between stress factors and psychological health risk.

RESULTS

The final sample consisted of responses from 2864 nurses working across 13 countries. Most respondents reported working as a clinical nurse in the Philippines (n = 2275), United States (n = 424) and Saudi Arabia (n = 104). One third of nursing respondents endorsed high burnout and intention to leave their job. Those reporting work conflict had significantly higher odds of burnout (odds ratio 3.18; 95% CI 2.22-4.54) and three times more likely to screen positive for depression (odds ratio 3.02; 95% CI 1.36-6.72) and anxiety (odds ratio 2.92; 95% CI 1.57-5.43). Those endorsing difficulty sleeping were 15 times more likely to screen positive for depression (odds ratio 15.63; 95% CI 2.09-117.06). Lack of social support was significantly associated to higher risk for burnout, job dissatisfaction, depression, anxiety, and intention to leave one's position.

CONCLUSIONS

Nurses remain at risk for burnout and poor psychological health stemming from work stress. Factors such as clear workplace goals and assignments, increased engagement, good sleep health and social support may serve as protective factors against suboptimal psychological health, and in-turn poor workforce retention.

CLINICAL RELEVANCE

Nurses reporting conflict in the workplace are three times more likely to screen positive for burnout, depression, and anxiety. Nurses reporting difficulty sleeping are 15 times more likely to screen positive for depression. Several modifiable factors can be targeted to reduce poor psychological health and high workforce turnover among nurses across countries.

Prevalence Of Sleep Disorders Among Physicians And Nurses During COVID-19 Pandemic

The objective of our review was to analyze studies of prevalence sleep disorders among medical workers during COVID-19 pandemic. Material and Methods — Overall, during the analyzed period, studying domestic and foreign databases, we identified 94 publications on the development of sleep disorders among medical personnel working during COVID–19 pandemic in 2000-2021. However, only 88 of these publications complied with the objective of the review. We included 75 full-text publications in this review. Results — Physicians and nurses during COVID-19 pandemic do not have the opportunity to take therapy aimed at combating the symptoms of sleep disorders, due to the need to maintain sufficient attention and the risk of developing excessive drowsiness while on duty in a COVID -19 hospital. The latter can have a negative impact on their professional activities. Thus, this problem certainly requires professional psychotherapeutic correction. Unfortunately, not all medical institutions have such specialists. Conclusion — Based on the literature review, we found out that health care workers have a high risk of developing sleep disorders. This can include violations of the circadian rhythm, a decrease in the quality and duration of night sleep, daytime hypersomnia caused by shift work in a hospital. An additional factor affecting the frequency and severity of sleep disorders in healthcare workers (physicians and nurses) is chronic stress, the importance of which has increased during the COVID-19 pandemic. Currently, the above problem has not been completely solved and requires research in this area and the development of new programs to help medical personnel.

Impacto de la crisis económica sobre la percepción de la salud en la población española

Objetivo: analizar el impacto de la situación económica en la percepción del estado de salud y la capacidad explicativa de las características individuales en esta percepción. Método: estudio transversal con enfoque analítico. Se extrajeron datos de la Encuesta Nacional de Salud (ENSE) publicada en 2011-2012 (crisis económica) y en 2017 (recuperación). La variable dependiente fue la percepción de la salud recogida en una escala Likert de 1 (muy bueno) a 5 (muy malo). Las variables independientes fueron: el momento de recogida (crisis/recuperación), sociodemográficas, relacionadas con el estilo de vida, relativas al estado «objetivo» de salud y relacionadas con el uso de servicios. Se construyeron modelos lineales generalizados para dar respuesta a los objetivos. Para valorar la magnitud del tamaño del efecto de las asociaciones se valoró la dispersión de las distribuciones según la relación existente entre el efecto y la desviación estándar de la media (DS). Resultados: se encontró una mejoría en la percepción del estado de salud de -0,066 (intervalo de confianza [IC] 95%: entre -0,080 y -0,052) puntos en el período de recuperación. Se hallaron asociaciones de tamaño del efecto «moderado» entre una peor percepción de salud y las variables relacionadas con el estado «objetivo» de salud; y «pequeño», con las variables relacionadas con el estilo de vida poco saludable y la clase social más desfavorecida. Conclusión: los períodos de crisis económica se asocian a una peor percepción del estado de salud, impactando más en aquella población perteneciente a una categoría social baja, con hábitos de vida poco saludables y especialmente en los pacientes crónicos. Palabras clave: estado de salud, crisis económica, enfermedad crónica, España, clase social, características de la población.

Development of Burnout Syndrome in Non-university Teachers: Influence of Demand and Resource Variables

Psychosocial risks at work are an important occupational problem since they can have an impact on workers' health, productivity, absenteeism, and company profits. Among their consequences, burnout stands out for its prevalence and associated consequences. This problem is particularly noteworthy in the case of teachers. The aim of the study was to analyze the influence of some psychosocial factors (demand and resource variables) and risks in burnout development, taking into consideration the levels of burnout according to the Spanish Burnout Inventory (SBI). This paper contributes to advancing knowledge on this issue by analyzing the influence of work characteristics and personal characteristics on the progress of burnout. The sample consisted of 8,235 non-university teachers (2,268 men 27.5% and 5,967 women 72.5%), aged 22 to 70 (M = 45.16, SD = 9.18). For this purpose, statistical modeling by logistic regression was used. The results of this study showed that No burnout level was positively related with resources variables and negatively with demand variables. In the Medium-High levels and the higher levels of burnout (i.e., Profile 1 and Profile 2), there is a positive relation with demand variables and a negative one with resource variables. In conclusion, demand variables cause an increase in the burnout levels, influencing positively the movements between the levels of No burnout to Medium-High levels of burnout and Medium-High levels to Profile 1. At the same time, resource variables had a negative influence on burnout. However, the results in the movement between Profile 1 and Profile 2 were not expected. The variable Imbalance had a negative relationship with the movement between Profile 1 to Profile 2, and Social support and Autonomy at work had a positive relationship with this movement. Therefore, when professionals feel higher levels of burnout, lack of imbalance together with social support and autonomy could contribute to increased feelings of guilt and risk of higher burnout.

Psychosocial Risks, Work Engagement, and Job Satisfaction of Nurses During COVID-19 Pandemic

Context: COVID-19 pandemic is a serious health emergency that has affected countries all over the world. Health emergencies are a critical psychosocial risk factor for nurses. In general, psychosocial risks constitute serious problems as they impact workers' health, productivity, and efficiency. Despite their importance, few studies analyze nurses' psychosocial risks during a health emergency caused by a pandemic or analyze their perception of the emergency and its relation to such risks. Objectives: To analyze the perception of COVID-19 by nurses, especially about measures, resources, and impact on their daily work. Also, to analyze these professionals' psychosocial risks and the relationship between perception of COVID-19 and these risks. Methods: A descriptive correlational study was performed in a convenience sample of 92 nurses from two public hospitals in the Valencian Community (Spain), (74 women, 79.1%), aged 24-63 (M = 43.37, SD = 11.58). Data were collected via an online self-completed questionnaire during the rise of the pandemic from March 29 to April 8, when the number of infections went from 78,797 to 146,690. Results: The measures and resources available about COVID-19 are relatively low, and the impact on their work is high. Similarly, the most prominent psychosocial risks appear to be emotional work and workload. In contrast, nurses' work engagement is medium, and their satisfaction is high. Finally, there seems to be a negative and significant relationship between the information available to nurses, the measures implemented, and resources with some of their psychosocial risks, and a positive one with job satisfaction and work engagement. There is also a positive and significant relationship only between the impact of COVID-19 and their work inequality, but not for other risks. Conclusions: The resources, measures, and information can be a protective factor facing nurses' psychosocial risks, especially during a pandemic. Studying the relationships between psychosocial risk and perception of a health emergency would be relevant and fundamental to protecting and caring for nurses, health professionals, and society.

Effect of Emotional Intelligence and Psychosocial Risks on Burnout, Job Satisfaction, and Nurses' Health during the COVID-19 Pandemic

Nurses are exposed to psychosocial risks that can affect both psychological and physical health through stress. Prolonged stress at work can lead to burnout syndrome. An essential protective factor against psychosocial risks is emotional intelligence, which has been related to physical and psychological health, job satisfaction, increased job commitment, and burnout reduction. The present study aimed to analyze the effect of psychosocial risks and emotional intelligence on nurses' health, well-being, burnout level, and job satisfaction during the rise and main peak of the COVID-19 pandemic in Spain. It is a cross-sectional study conducted on a convenience sample of 125 Spanish nurses. Multiple hierarchical linear regression models were calculated considering emotional intelligence levels, psychosocial demand factors (interpersonal conflict, lack of organizational justice, role conflict, and workload), social support and emotional work on burnout, job satisfaction, and nurses' health. Finally, the moderating effect of emotional intelligence levels, psychosocial factors, social support, and emotional work on burnout, job satisfaction, and nurses' health was calculated. Overall, this research data points to a protective effect of emotional intelligence against the adverse effects of psychosocial risks such as burnout, psychosomatic complaints, and a favorable effect on job satisfaction.

Stay at Home and Teach: A Comparative Study of Psychosocial Risks Between Spain and Mexico During the Pandemic

Context:

The emergency situation caused by coronavirus disease 2019 (COVID-19) has affected different facets of society. Although much of the attention is focused on the health sector, other sectors such as education have also experienced profound transformations and impacts. This sector is usually highly affected by psychosocial risks, and this could be aggravated during the current health emergency. Psychosocial risks may cause health problems, lack of motivation, and a decrease of effectiveness at work, which in turn affect the quality of teaching. Despite their importance, there are hardly any studies that analyze psychosocial risks of non-university teachers during a health emergency such as that caused by COVID-19.

Objectives

The aim of this study was to analyze the perception of COVID-19 and the psychosocial risks of non-university teachers comparing Spain and Mexico during the state of alarm caused by COVID-19.

Methods

Data were collected from 421 non-university teachers (80.2% women; 56.3% from Mexico, 43.7% from Spain) aged 24–60 (M = 39.32, SD = 10.21) via a self-completed questionnaire during the pandemic from March to April 2020.

Results

Data analysis suggests that inequity is the most important risk, followed by work overload. Teachers appear to be moderately satisfied with the information on COVID-19 and the measures taken, while their satisfaction with the available resources is lower. When comparing the two countries, significant differences can be observed in every risk considered except for social support, with lower levels in Mexican teachers compared to Spanish ones. In the case of the perception of COVID-19 and its impact, the perception in general of levels of information, measures, and resources is better among Mexican teachers than among Spanish ones, who present higher scores of the impact of the health emergency.

Conclusion

The results underline the importance of the professional’s perception of resources during a health emergency, which could prevent to some extent burnout and possible alterations associated with it. The measures taken by the responsible entities and the provision of information do affect teachers not only directly but also indirectly by making them more vulnerable to psychosocial risks that could affect their health and professional performance, thus affecting students as well.

Self-Perceived Health, Objective Health, and Quality of Life among People Aged 50 and Over: Interrelationship among Health Indicators in Italy, Spain, and Greece

It is well known that self-perceived health (SPH), even if it is a subjective health indicator, is significantly associated with objective health and quality of life (QoL) in the general population. Whether it can be considered an indicator of cognitive functioning and quality of life in the elderly is still an open issue. This study used a data-driven approach to investigate the interrelationship among SPH, non-communicable diseases (NCDs), QoL, and cognitive functioning to answer this question. The study sample included information about 12,831 people living in Italy, Spain, and Greece, extracted from the Survey on Health, Aging, and Retirement in Europe, in the year 2015. The additive Bayesian networks methodology was used to identify the best directed acyclic graphs (DAG) for SPH, QoL, and NCDs. Results were given as posterior estimates of generalized linear models (GLM) coefficients, with 95% credibility intervals. Good SPH was associated with a decreasing number of chronic diseases in Italy (coeff = −0.52, 95%CI: [−0.59, −0.44]), Spain (coeff = −0.53, 95%CI: [−0.60, −0.46]) and Greece (coeff = −0.57, 95%CI: [−0.64, −0.50]). Age and Body Mass Index were determinants of NCDs in all countries. QoL of elderly was associated with SPH in Italy (coeff = 0.12, 95%CI: [0.10, 0.14]), Spain (coeff = 0.16, 95%CI: [0.15, 0.18]), and Greece (coeff = 0.18, 95%CI: [0.16, 0.20]). The number of NCDs was higher for people who were not employed in Spain (coeff = 0.45, 95%CI: [0.37, 0.53]) and was decreasing for a unitary increase in years of education in Greece (coeff = −0.12, 95%CI: [−0.14, −0.09]). As a general rule, the framework of the interrelationship among NCDs, SPH, and QoL was similar for Italy, Spain, and Greece. The connections found among indicators could be proposed to identify strategies for health promotion and healthy aging among people aged 50 and above, which are viable in general and at a country level. Reinforcing strategies targeted at some health indicators could have relevant effects on other related indicators.

Evaluation of the Biases in the Studies that Assess the Effects of the Great Recession on Health. A Systematic Review

BACKGROUND

Our main objective was to evaluate the fundamental biases detected in studies assessing the effects the Great Recession had on health for the case of Spain. As secondary objectives we presented methods to control these biases and to discuss the results of the studies in question if they had controlled for them.

METHODS

We carried out a systematic review of the literature published up to June 2018. We evaluated the biases that could have happened in all the eligible studies.

RESULTS

From the review, we finally selected 53 studies. Of the studies we reviewed, 60.38% or 32 out of 53, were evaluated as having a high risk of bias. The main biases our review revealed were problems with evaluation, time bias, lack of control of unobserved confounding, and non-exogeneity when defining the onset of the Great Recession.

CONCLUSIONS

The results from the studies that controlled the biases were quite consistent. Summing up, the studies reviewed found that the Great Recession increased the risk of declaring poor self-rated health and the deterioration of mental health. Both the mortality rate and the suicide rate may well have increased after the Great Recession, probably after a three- to four-year delay.