Work-related Stress, Caregiver Role, and Depressive Symptoms among Japanese Workers

Maternal depression and early childhood development among children aged 24-59 months: the mediating effect of responsive caregiving

This study examined whether maternal depression is related to Early Childhood Developmental (ECD) delay among children by quantifying the mediating contribution of responsive caregiving. We used data from 1235 children (Children's mean age = 50.4 months; 582 girls, 653 boys, 93.9% were Han), selected through convenience sampling, in 2021. 4.7% of children had ECD delay, 34.3% of mothers had depression. Children with depressed mothers were less likely to receive responsive caregiving (OR 4.35, 95% CI 2.60-7.27), and those who did not receive responsive caregiving were more likely to experience ECD delay (OR 3.89, 95% CI 1.89-8.02). Responsive caregiving partly mediated the relationship between maternal depression and ECD. Early intervention for children with depressed mothers is worthy of further investigation.

Evaluation of the benefits of neutral bicarbonate ionized water baths in an open-label, randomized, crossover trial

We previously demonstrated that neutral bicarbonate ionized water (NBIW) bathing enhances blood flow by bicarbonate ions and described the underlying mechanism. However, additional clinical investigation was warranted to investigate the efficacy of NBIW bathing. Hence, we performed a randomized, open-label, crossover trial to examine the effects of NBIW bathing on mental stress, sleep, and immune function. Participants who regularly felt stressed were randomly assigned to NBIW or regular bathing for 4 weeks. Mental stress was assessed with the Brief Job Stress Questionnaire (BJSQ) and the Profile of Mood States Second Edition; sleep quality, with the Pittsburgh Sleep Quality Index Japanese version (PSQI-J) and actigraphy; and immune function, with laboratory tests. PSQI-J scores and actigraphy sleep latency and bed out latency improved significantly more with NBIW bathing than with regular bathing (p < 0.05). Furthermore, NBIW bathing reduced both stress-induced fluctuations in CD4+ and CD8+ T cell counts and fluctuations in the naive to memory T cell ratio and neutrophil phagocytosis, indicating improved immune function. These findings suggest that daily NBIW bathing could improve mental stress, sleep quality, and immune function and bring about positive health effects in those who experience stress in their daily lives.

Health-related Quality of Life and Determinants of the Mental Dimension Among Tunisian Nurses in Public Hospitals

BACKGROUND

The health-related quality of life (HR-QoL) has been in-creasingly investigated in health sciences. The Objectives of this study are to evaluate the HR-QoL among nurses in Tunisian public hospitals and to identify the determinants of its mental dimension.

METHODS

A cross-sectional, bi-centric study was conducted within a representative sample of the 1,179 nurses assigned to 28 departments of two Tunisian public hospitals. A structured inquiry (socio-professional characteristics, occupational perceived workload) and validated questionnaires (SF12, Job Content Questionnaire of Karasek, Work Ability Index) have been completed.

RESULTS

Response rate was equal to 97.34%. The mean age of nurses was 42.60 ± 21 years. Nearly half of caregivers (49.07%) had a poor mental quality of life. The multivariate analysis concluded that mental HR-QoL was correlated with the female gender (0.010), obesity and the non-practice of regular physical activity (0.027), musculoskeletal diseases (<10-3), the low ability to work (<10-3). This deterioration of the mental HR-QoL dimension was also associated with the job tenure (0.002), the perceived workload (0.015), and conflictual relationships with colleagues (0.006) the feeling of insecurity at work (0.034), and the intention to leave the profession early (0.007) Conclusion: The results of this study showed that a considerable number of nurses had a poor mental quality of life. This study also identified factors associated with this deterioration. Acting on these determining factors may improve the well-being and global health of nurses, as well as their work performance and quality of care provided.

A new ranking index to identify the work-related psychosocial factors most impacting mental health: a cross-sectional study

OBJECTIVES

In modern professional life, mental health prevention and promotion have become a major challenge for decision-makers. Devising appropriate actions requires better understanding the role played by each work-related psychosocial factor (WPSF). The objective of this study was to present a relevant tool to hierarchise WPSFs that jointly takes into account their importance (impact on mental health) and their prevalence (the proportion of the population exposed to WPSF).

DESIGN

A cross-sectional study was conducted in March 2018 among 3200 French workers which are representative of the French working population.

SETTING

France.

PARTICIPANTS

Individuals aged 18-80 years who declared currently having a job (even a part-time job) whatever their occupation or status (employee or self-employed) were eligible. We excluded students, unemployed individuals, housewives/husbands and retired people. The mental health level was assessed using the General Health Questionnaire-28 and 44 items were gathered from theoretical models of WPSFs. We assessed two distinct multivariate methods for calculating WPSF importance: (1) weifila (weighted first last) method in a linear regression context and (2) random forests in a non-linear context. Both methods were adjusted on individual, health and job characteristics.

RESULTS

The WPSF rankings obtained with the two methods to calculate importance are strongly consistent with each other (correlation coefficient=0.88). We highlighted nine WPSFs that are ranked high by both methods. In particular, irrespective of the chosen method, lack of communication, lack of social and hierarchy support and personal-professional life imbalance, emotional demands at work and dissatisfaction with the compensation received came out as top-ranking WPSFs.

CONCLUSIONS

A total of nine WPSFs were identified as key for decision-making. The easy-to-use tools we propose can help decision-makers identify priority WPSFs and design effective strategies to promote mental health in the workplace.

Work-related stress and associated factors among garment workers in Bole Lemi Industrial Park of Addis Ababa, Ethiopia: a multi-center institution-based cross-sectional study

BACKGROUND

Work-related stress (WRS) is a growing problem around the world that affects the health and well-being of employees. However, evidence of work-related stress in Ethiopia, particularly among garment industry employees, is scarce. This study aimed to assess the prevalence and associated factors of work-related stress among garment workers in the Bole Lemi industrial park in Addis Ababa, Ethiopia.

METHODS

A multi-center institutional-based cross-sectional study was conducted from February 01 to March 31, 2021. A total of 605 study participants were selected using a stratified random sampling technique. A pre-tested, interviewer-administered standardized questionnaire was used to collect data. The logistic regression model was employed to identify determinant factors for work-related stress, and statistical significance was declared at a p-value < 0.05.

RESULTS

The magnitude of work-related stress in garment workers was 44.1% (95% CI: 40.0, 48.0). Being within the age group of 25 - 34 years (AOR = 0.57, 95% CI: 0.36, 0.90) and receiving induction training (AOR = 0.35, CI: 0.20, 0.62) were protective factors with stress. Whereas lack of family support (AOR = 2.72, CI: 1.60, 4.64), lack of job satisfaction (AOR = 4.26, CI: 2.77, 6.57), and khat chewing (AOR = 3.14, CI: 1.35, 7.32) were positively associated with work-related stress.

CONCLUSION

Work-related stress is prevalent among garment workers in the study setting. Being between the ages of 25-34 years and receiving induction training were protective factors against stress, while a lack of family support, a lack of job satisfaction, and khat chewing practices were positively associated with work-related stress. Therefore, improving family support and job satisfaction, providing induction training during employment, and providing psychological support for substance users to bring about changes are mandatory in Bole Lemi Industrial Park, Ethiopia.

Association of Sources of Worry and Stress with Smoking in Japan: Findings from the Comprehensive Survey of Living Conditions 2010

Objectives

The purpose of this study is to examine which sources of worry and stress are associated with smoking behavior and if these associations are varied by gender.

Methods

The anonymous data of 28,588 men and 30,813 women aged 20-79 years old in Japan were analyzed. We defined the subjects who chose "smoking everyday" as "smokers." We also assessed 20 sources of worry and stress. Multivariable odds ratios (ORs) and 95% confidence intervals (CIs) of smoking for each source of worry and stress were calculated using logistic regression analysis.

Results

We found significant association of financial stress with smoking behavior in both genders. The multivariable OR (95% CI) of smoking according to stress from financial stress was 1.22 (1.15-1.31) in men and 1.66 (1.53-1.80) in women. Moreover, the OR of smoking according to stress from human relationships and job affairs was significantly higher for women.

Conclusion

We found that some sources of worry and stress were related to smoking behavior and these associations were found to be gender-specific.

Limited social support is associated with depression, anxiety, and insomnia in a Japanese working population

Background

Lack of social support is associated with depression, anxiety, and insomnia. This study aimed to determine the source of support related to depression, anxiety, and insomnia among Japanese workers.

Methods

As part of a cohort study, we conducted a questionnaire survey among city government employees in Koka City, Shiga Prefecture, Japan, from September 2021 to March 2022. We used the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Insomnia Severity Index (ISI) to assess depressive symptoms, anxiety symptoms, and insomnia, respectively. We used the Brief Job Stress Questionnaire (BJSQ) to assess job stressors and social support (from supervisors, colleagues, and family).

Results

A total of 1,852 Japanese employees (38.4% male, 45.9 ± 12.9 years) participated in the survey, with 15.5, 10.8, and 8.2% of the participants having depressive symptoms (PHQ-9 ≥ 10), anxiety symptoms (GAD-7 ≥ 10), and insomnia (ISI ≥ 15), respectively. The logistic regression analysis suggested that job stressors were associated with depressive symptoms (p < 0.001), anxiety symptoms (p < 0.001), and insomnia (p = 0.009). In contrast, support from co-workers (p = 0.016) and family members (p = 0.001) was associated with decreased depressive symptoms. Support from family members was associated with decreased insomnia (p = 0.005).

Conclusion

Social support from co-workers and family may be associated with reduced depressive symptoms, and family support may be associated with reduced insomnia in the Japanese working population.

Clinical trial registration

https://clinicaltrials.gov/ct2/show/NCT03276585.

Mediation of Self-Compassion on Pathways from Stress to Psychopathologies among Japanese Workers

As awareness of mental health increases worldwide, how to improve mental health has begun to be discussed in many countries. Stress is known to cause diverse physical and mental health problems, including psychopathologies. On the other hand, our previous studies identified that self-compassion, kindness and understanding towards oneself are key components for good mental health in many populations, including Japanese workers. The government reports that Japanese workers suffer from high rates of mental health problems. However, the mechanism of how self-compassion helps their mental health remains to be evaluated. Accordingly, this study aimed to elucidate how self-compassion intervenes in pathways from stress to psychopathologies, namely depression and anxiety. One hundred and sixty-five Japanese workers completed an online survey regarding self-compassion, depression, anxiety and stress. Correlation and path analyses were conducted. These four variables were significantly inter-related. While self-compassion mediated the pathway from stress to depression, it did not mediate the pathway from stress to anxiety. These exploratory insights assist in understanding the mechanism of how self-compassion improves mental health and inform effective methods to implement self-compassion interventions to the Japanese workforce.

Instruments to assess the burden of care for family caregivers of adult palliative care patients

BACKGROUND

A primary caregiver shares the illness experience of the patient and undertakes vital care work, alongside managing the patient's emotions, and is actively involved in care process without being paid. When faced with the palliative care patient's needs, caregivers are affected on multiple levels (physical, psychological and socio-economic), thereby experiencing a moderate or severe burden of care.

AIM

To identify assessment instruments for the burden of care for family caregivers that are suitable to be used in clinical practice.

METHOD

A narrative review was conducted using an electronic search in Pubmed, PsychINFO, CINAHL of articles published in English between 2009-2019, using the search terms: 'caregiver/family, caregiver/carer and burden and palliative care/hospice/end of life'. An assessment grid was developed to appraise the clinical use of identified instruments.

RESULTS

Of the 568 articles identified, 40 quantitative studies were selected using 31 instruments to measure the caregiver burden of cancer, noncancer and terminally ill patients. Most instruments 23 (74.11%) evaluate the psycho-emotional and, 22 (70.96%) the social domain, 12 instruments (38.7%) focused on the physical domain, three (9.67%) on the spiritual field and six instruments (19.35%) on economic aspects. For the multidimensional instruments, the assessment grid scored highest for the Burden Scale for Family Caregiver (BSFC).

CONCLUSION

The BSFC is the tool that seems to meet the most requirements, being potentially the most useful tool in clinical practice.

Women's wellbeing and the burden of unpaid work

Soraya Seedat and Marta Rondon examine how gender inequities in the time allocated to unpaid work, exacerbated by covid-19, are affecting women’s mental health

The COMET study: Examining the effects of COVID-19-related perceived stress on Los Angeles Mothers' dysregulated eating behaviors, child feeding practices, and body mass index

The COVID-19 pandemic and associated restrictions and mandates have had pronounced implications on the well-being of individuals. This study conducted exploratory analyses of the relationship between COVID-19-related life changes and COVID-19-related perceived stress and associations between COVID-19-related perceived stress and dysregulated maternal eating behaviors, child feeding practices, and body mass index (BMI) in Los Angeles mothers. Mothers (M_age = 37.6 ± 6.9) of children aged 5-11 (N = 197, response rate 92.5%) completed an online questionnaire assessing COVID-19-related life changes, COVID-19-related perceived stress, mechanisms used to cope with COVID-19, child feeding practices, their own eating behavior, demographics, and height and weight. The highest proportion of participants reported changes to work, disruptions due to childcare challenges, and increased home responsibilities. Higher COVID-19-related perceived stress was experienced by those who reported loss of work hours (29%), loss of job (15.2%), reduced ability to afford childcare (18.8%), and reduced ability to afford rent/mortgage (19.8%) (ps < 0.05) than those who did not. The most common strategy that mothers indicated using to cope with COVID-19 related stress was eating comfort foods (e.g., candy and chips) (58.7%). COVID-19-related perceived stress was positively associated with mother's BMI and emotional eating (ps < 0.05). Rewarding their child's eating and behavior with food were both positively associated with the number of COVID-19 related life changes (ps < 0.05). This study yields new knowledge of the effects of the COVID-19 pandemic on mothers' dysregulated eating behaviors and child feeding practices. The results highlight the importance of conducting further research to confirm these findings and understand the nature of associations between COVID-19-related perceived stress and health. This is crucial in order to explore ways in which lasting impacts of the pandemic on mental and physical health can be prevented.

Reliability and validity of the Japanese version of the Caregiving Interface Work Scale in employed Japanese family caregivers

AIM

This study aimed to develop a Japanese version of the Caregiving Interface Work Scale (J-CIWS) for use with employed Japanese family caregivers.

METHODS

Permission was obtained from the developer of the original CIWS. The CIWS contains 20 items: 10 measuring care interface work (CIW) and 10 measuring work interface care (WIC). Responses are measured on a five-point Likert scale. The J-CIWS was developed through forward- and back-translation and cognitive interviews of employed family caregivers. An internet survey was conducted with 116 employed family caregivers, and 78 participants answered a retest. Questionnaire items included the J-CIWS and demographic factors. Factor analysis was conducted to determine the J-CIWS factor structure. Validity was assessed based on known-groups, convergent and discriminant validity. Internal consistency was examined by calculating Cronbach's α. Test-retest reliability was examined by calculating the Pearson's correlation coefficient.

RESULTS

The mean participant age was 50.3 years; 74 (63.8%) were male. The average weekly working and caregiving hours were 41.6 and 12.1 h, respectively. Confirmatory factor analysis supported the original two-factor model. High internal consistency (Cronbach's alpha >0.90) and sufficient test-retest reliability (weighted κ score >0.45) were demonstrated for both subscales. Convergent and discriminant validity were acceptable for the two subscales (CIW and WIC).

CONCLUSIONS

This study confirmed the usefulness of the CIWS within a Japanese context. The J-CIWS may be useful for evaluating the extent of the conflict between work and care among employed family caregivers. Geriatr Gerontol Int 2021; 21: 254-261.

Caregiver burden among informal caregivers in the largest specialized palliative care unit in Malaysia: a cross sectional study

BACKGROUND

Informal caregivers (IC) are often overshadowed by the attention required by the terminally ill. This study aims to reveal the estimated proportion of caregiver burden, psychological manifestations and factors associated with caregiver burden among IC in the largest specialized Palliative Care Unit (PCU) in Malaysia.

METHODS

This was a cross-sectional study involving IC attending a PCU. Caregiver burden and psychological manifestations were measured using previously translated and validated Zarit Burden Interview and DASS-21 questionnaires respectively. Two hundred forty-nine samples were selected for analysis.

RESULT

The mean ZBI score was 23.33 ± 13.7. About half of the population 118(47.4%) was found to experienced caregiver burden whereby majority have mild to moderate burden 90(36.1%). The most common psychological manifestation among IC is anxiety 74(29.7%) followed by depression 51(20.4%) and stress 46(18.5%). Multiple logistic regression demonstrated that women who are IC to patients with non-malignancy were less likely to experience caregiver burden. IC who were highly educated and spent more than 14 h per day caregiving were at least twice likely to experience caregiver burden. Finally, those with symptoms of depression and anxiety were three times more likely to suffer from caregiver burden.

CONCLUSION

Caregiver burden among IC to palliative patients is prevalent in this population. IC who are men, educated, caregiving for patients with malignancy, long hours of caregiving and have symptoms of depression and anxiety are at risk of developing caregiver burden. Targeted screening should be implemented and IC well-being should be given more emphasis in local policies.

Undiagnosed depression, persistent depressive symptoms and seeking mental health care: analysis of immigrant and non-immigrant participants of the Canadian Longitudinal Study of Aging

AIMS

Early diagnosis and treatment of depression are associated with better prognosis. We used baseline data of the Canadian Longitudinal Study on Aging (2012-2015; ages 45-85 years) to examine differences in prevalence and predictors of undiagnosed depression (UD) between immigrants and non-immigrants at baseline and persistent and/or emerging depressive symptoms (DS) 18 months later. At this second time point, we also examined if a mental health care professional (MHCP) had been consulted.

METHODS

We excluded individuals with any prior mood disorder and/or current anti-depressive medication use at baseline. UD was defined as the Center for Epidemiological Studies Depression 10 score ⩾10. DS at 18 months were defined as Kessler 10 score ⩾19. The associations of interest were examined in multivariate logistic regression models.

RESULTS

Our study included 4382 immigrants and 18 620 non-immigrants. The mean age (standard deviation) in immigrants was 63 (10.3) years v. 65 (10.7) years in non-immigrants and 52.1% v. 57.1% were male. Among immigrants, 12.2% had UD at baseline of whom 34.2% had persistent DS 18 months later v. 10.6% and 31.4%, respectively, among non-immigrants. Female immigrants were more likely to have UD than female non-immigrants (odds ratio 1.50, 95% confidence interval 1.25-1.80) but no difference observed for men. The risk of persistent DS and consulting an MHCP at 18 months did not differ between immigrants and non-immigrants.

CONCLUSIONS

Female immigrants may particularly benefit from depression screening. Seeking mental health care in the context of DS should be encouraged.

Work Stress and General Trust: The Mediating Effect of Depression and the Moderating Effect of the OXTR Gene rs53576

BACKGROUND

Work stress has been proved to be linked to depression, and both can decrease general trust. Likewise, OXTR gene is currently the gene that is most closely associated with trust. However, few empirical studies have explored the significant role of gene-environment interactions on general trust. In this study, we explored the mediating role of depression in the relationship between work stress and general trust, and the moderating role of the OXTR rs 53576 in the mediation model.

METHODS

364 healthy Han Chinese faculties were recruited from one university in Beijing. Work stress, depression, and general trust were assessed using the House and Rizzo's Work Stress Scale, Self-Rating Depression Scale (SDS), and the General Trust Questionnaire, respectively. Blood samples were collected for OXTR rs53576 genotyping.

RESULTS

Depression mediated the relationship between work stress and general trust. In the mediation model, OXTR rs53576 could only moderated the direct path from work stress to general trust. For AA and GA individuals, depression completely mediated the relationship between work stress and general trust. For GG individuals, depression partly mediated the relationship between work stress and general trust.

LIMITATIONS

This study used a cross-sectional design, only considered Han Chinese faculties, and the role of other genes should be explored.

CONCLUSIONS

Depression has a mediating effect between work stress and general trust. The general trust levels of GG genotype individuals are more prone to be affected by work stress than AA and GA individuals.

Working status of caregivers for people with dementia: Analysis data from a Japanese Nationwide Survey

BACKGROUND

The prevalence of dementia has increased rapidly in Japan, while the proportion of the population accounted for by working-age individuals is facing a sharp decline. Optimizing the balance between work and caregiving for persons with dementia is a major public health issue.

AIMS

Using a nationally representative sample, this study investigated the working status of caregivers (CGs) for elderly people (care recipients) with dementia (CRDs) and assessed the effects of sociodemographic factors on this status.

METHODS

Data were obtained from the 2013 Comprehensive Survey of the Living Conditions for CRDs and CGs (the latter aged 65 years or less). Individual data of CRDs and CGs were linked, and 452 pairs were extracted. The Japanese version of the Kessler 6 (K6) with a cut-off point of 13 was used to assess general psychological distress among CGs. Multivariable logistic regression analysis with the forward selection method was used to identify the predictors of their working status.

RESULTS

Overall, the mean age of CGs was 57.1 ± 6.8 years, with 57.5% (260/452) performing paid work. Male sex, higher educational attainment, and having their own house were associated with having paid work for CGs, while higher age, spending almost all day performing nursing care, and participation in helping with toilet activities and laundry were associated with not performing paid work.

CONCLUSIONS

Several sociodemographic factors, including nursing care-related factors, are associated with the employment status of CGs. Further research should examine detailed information on CRDs' activities of daily living, behavioral and psychological symptoms, medical service use, and social support to strengthen the system of supportive services for both CRDs and their CGs.

I'll Be a Caregiver-Employee: Aging of the Workforce and Family-to-Work Conflicts

Background

The double role of caregiver-employee (CE) defines those workers who simultaneously serve as an informal, unpaid care provider for sick, disabled, or elderly relatives, and it is a situation that is on the increase in most western countries. Providing informal caregiving can lead to detrimental effects on emotional well-being and several physical and psychological diseases (e.g., caregiver-burden). CEs can suffer double discomfort (at work and at home), but, first of all, they can be exposed to a high level of home-to-work conflict (HWI). In this study, we analyzed the CE phenomenon in a typical Italian public company, where the mean age of workers is particularly high.

Methods

An online questionnaire related to the perception of HWI, well-being, and discomfort at work (depression, emotional exhaustion, job engagement) in relation to the family load (none, parents with <12 children to care for, caregiver to other adults, or children and older adults to care for/old/children to care for employees) was answered by 1704 administrative workers.

Results

More than 20% of our sample was included in the elder caregiver condition or in the double role or “sandwiched” condition with older adults and children to care for. The family load changed significantly between the different age groups: for workers aged between 55 and 64 years, the percentage was nearly 27%. CEs had higher levels of HWI and of personal and job discomfort and lower levels of engagement, when compared with non-CEs. Having “only” older adults to care for (the typical CE condition) was associated with having the most negative results.

Conclusion

This study confirms and underlines the increasing number of CEs in western organizations and their higher levels of HWI, work disengagement, emotional exhaustion, and depression. As the general population and workforce experience increased “graying,” and many more workers become CEs out of necessity, stable caregiver-friendly workplace policies (CFWPs) should be developed.

Association of socioeconomic and lifestyle-related risk factors with mental health conditions: a cross-sectional study

Background

There is rising public concern over the widening health inequalities in many countries. The aim of this study was to clarify the associations of socioeconomic status (SES)-related variables, such as levels of household disposable income and employment status, and lifestyle factors with mental health conditions among Japanese adults aged 40 to 69.

Methods

A cross-sectional study of 3085 participants (1527 males and 1558 females) was undertaken by using a self-administered questionnaire that included the Japanese version of the 12-item General Health Questionnaire (GHQ-12) and questions related to socioeconomic and lifestyle factors.

Results

The prevalence of poor mental health conditions, represented by a GHQ-12 score of 4 or more, was 33.4% among males and 40.4% among females. Males whose annual household disposable income was less than 2 million yen had significantly higher GHQ-12 scores than those with an annual household disposable income above 2 million yen. As per binary logistic regression analyses, short sleep duration and the absence of physical exercise were significantly related to poor mental health conditions among both males and females. Among females, a household disposable income of less than 2 million yen could be a risk factor for poor mental health conditions. Age and habitual drinking were inversely associated with poor mental health conditions.

Conclusions

Low levels of household disposable income and unhealthy lifestyle factors were significantly associated with mental health conditions. These results suggest the importance of improving unhealthy lifestyle behaviours and developing effective health promotion programmes. In addition, there is a need for social security systems for people from different socioeconomic backgrounds.

Dementia care-giving and employment: a mixed-studies review on a presumed conflict

Many persons with dementia live at home and are cared for by their relatives. If the relatives are still employed, this can lead to higher burden and losses in their work-life. The interplay between informal care-giving and working is complex. Different studies have explored this issue, but the results have not been yet synthesised. In this mixed-studies review, we elucidate the underlying complexity. Our objective is to identify the factors related to care-giving that influence employment, and to describe their impact on dementia care-givers’ employment. We performed a literature search of primary studies using four databases and one meta-database, and retrieved English- and German-language articles. We used the Mixed Methods Appraisal Tool to assess their methodological quality. Evidence identified was synthesised by a parallel-results convergent synthesis design. We included 55 qualitative, quantitative and mixed-method studies published up to January 2018. The emerging model identified factors linked to the care recipient with dementia, the informal care-giver and the care-giving context. The impacts of these factors on care-givers’ employment are mostly negative (e.g. stopped/reduced work, decreased job performance). Nevertheless, the results provide encouraging insights as working can counterbalance care-giving strain, and managing both roles can enhance care-givers’ wellbeing. Practical efforts should focus on enabling informal care-givers to better manage the balance between care-giving and work responsibilities.

Mental health of working-age populations in Japan who provide nursing care for a person at home: A cross-sectional analysis

OBJECTIVES

This study investigated potential associations between having a person in need of nursing care at home and psychological distress amongst the Japanese working population, using a nationally representative sample.

METHODS

We extracted data from the 2013 Comprehensive Survey of Living Conditions conducted by the Ministry of Health, Labour and Welfare of Japan. The original survey was conducted amongst 295,367 households in 5,530 randomly selected municipalities. We analyzed participants aged 25-65 years who headed a household. The original questionnaire included questions about the specific qualifications required to receive long-term care insurance benefits, about psychological distress (measured using the K6 scale), and other covariates. If a family contained a member in need of nursing care at home, the person who headed that household was recognized as the participant who had a person in need of nursing care at home. Multiple logistic regression analysis was conducted to investigate the association between having a person in need of nursing care at home and psychological distress.

RESULTS

A total of 36,193 men and 2,765 women were included in the analysis, 2.9% of whom had a person in need of nursing care at home. Statistical analysis revealed an association between having a care-requiring older relative at home and psychological distress (odds ratio: 1.40, 95% confidence interval: 1.01-1.93).

CONCLUSIONS

Having a person in need of nursing care at home appears to be positively correlated with worsening mental health of working populations in Japan.

Which work-related characteristics are most strongly associated with common mental disorders? A cross-sectional study

OBJECTIVES

Studies exploring work-related risk factors of common mental disorders (CMDs), such as major depressive disorder (MDD), generalised anxiety disorder (GAD) or alcohol abuse, have generally focused on a limited set of work characteristics. For the first time in a primary care setting, we examine simultaneously multiple work-related risk factors in relation to CMDs.

METHOD

We use data from a study of working individuals recruited among 2027 patients of 121 general practitioners (GPs) representative of the Nord-Pas-de-Calais region in the North of France (April-August 2014). CMDs (MDD; GAD; alcohol abuse) were assessed using the Mini-International Neuropsychiatric Interview. Six worked-related factors were examined (work intensity, emotional demands, autonomy, social relations at work, conflict in values and job insecurity). Several covariates were considered (patient, GP and contextual characteristics). To study the association between workplace risk factors and CMDs, we used multilevel Poisson regression models adjusted for covariates.

RESULTS

Among study participants, 389 (19.1%) met criteria for MDD, 522 (25.8%) for GAD and 196 (9.7%) for alcohol abuse. In multivariable analyses adjusted for covariates, MDD/GAD was significantly associated with work intensity (RR 1.16, 95% CI 1.06 to 1.27) (absolute risk=52.8%), emotional demands (RR 1.24, 95% CI 1.13 to 1.35) (absolute risk=54.9%) and social relations at work (RR 0.78, 95% CI 0.70 to 0.87) (absolute risk=15.0%); alcohol abuse was associated with social relations at work (RR 1.25, 95% CI 1.01 to 1.53) (absolute risk=7.6%) and autonomy (OR 0.82, 95% CI 0.67 to 0.99) (absolute risk=8.9%).

CONCLUSIONS

Several workplace factors are associated with CMDs among working individuals seen by a GP. These findings confirm the role of organisational characteristics of work as a correlate of psychological difficulties above and beyond other sources of risk.

Identification of high risk groups with shorter survival times after onset of the main reason for suicide: findings from interviews with the bereaved in Japan

Objectives

We sought to (1) measure survival lengths after the onset of the main reason for the target’s suicide, (2) identify the highest-risk groups and the contributors to early death, in Japan, and (3) clarify peculiar traditional Japanese values concerning suicide.

Results

Data for 523 deceased individuals (median age 43.0 years) were collected from bereaved persons. Average survival time from the onset of the main reason for suicide was 1956 days (5.4 years). After controlling for confounding factors, being middle-aged, male, self-employed, and a founding company president were identified as the highest-risk groups. Half of the self-employed founding presidents died within 2 years. Many of the bereaved had observed some signs of the suicide 2 weeks ago. The traditional Japanese idea is that one means of compensating for a serious mistake is to commit suicide, and we observed that many Japanese people still regard suicide as a respectable death, even among the interviewed. The possible intervention time is quite limited; however, those who have contact with the high-risk groups should be alert to behavioral changes or signals of impending suicide.

Expressive social support buffers the impact of care-related work interruptions on caregivers' depressive symptoms

OBJECTIVE

To assess if expressive and instrumental social support from family and friends moderate the association of care-related work interruptions (e.g. leaving work for the older adult's doctor appointment) with depressive symptoms among working family caregivers of older adults.

METHODS

Data were from the Singapore Survey on Informal Caregiving (SSIC). A subsample of 662 dyads, each comprising an older care-recipient [home-dwelling Singaporean aged 75 and older receiving human assistance for at least one activity of daily living (ADL)] and his/her working family caregiver, was analysed. Caregiver depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale. Care-related work interruptions were scaled through the Mokken scaling procedure. Expressive social support was assessed using a scale by Pearlin and co-workers. Instrumental social support was based on the hours of ADL help provided to the care-recipient by any family member or friend, on behalf of the primary caregiver. A linear regression model, with interaction terms, assessed expressive and instrumental social support as moderators of the association of care-related work interruptions with caregiver depressive symptoms.

RESULTS

More care-related work interruptions were associated with more caregiver depressive symptoms. And, this association was moderated by expressive, but not instrumental, social support.

CONCLUSION

Our findings conform to previous qualitative work suggesting that caregivers' mental health may not benefit from instrumental support, but from receiving expressive support instead. Initiatives for improving the care experience of working caregivers of older adults should focus on promoting expressive support from their friends and family.

A comparison of Geriatric Depression Scale scores in older Australian and Japanese women

AIMS

The aim of this study was to compare the prevalence of depressive symptoms in Australian and Japanese populations of community-dwelling older women using the Geriatric Depression Scale (GDS-15). In addition, the relationship between lifestyle and health factors and higher ratings of depressive symptoms was also examined to determine if there were culturally consistent risk factors associated with higher depressive symptom scores.

METHODS

A total of 444 community based women aged between 65 and 77 years completed a depressive symptom measure (GDS-15) and provided information on common lifestyle factors. The Australian sample (n = 222) were drawn from the Women's Healthy Ageing Project and the age-matched, Japanese sample from the Kumamoto Ageing Study of Mental Health (n = 222). The GDS was chosen to; (1) reduce the impact of physical symptoms associated with old age and, (2) reduce the inflation in scores that may result from the Japanese tendency to endorse somatic items more often than Western adults.

RESULTS

Mean GDS total scores were significantly higher for the Japanese population 3.97 ± 3.69 compared with 1.73 ± 2.7 for Australian women. The percentages of women scoring in the normal; mild and moderate ranges for depression were 91, 7 and 2% for Australia and 67, 24 and 9% for Japan. Scores remained significantly higher for the Japanese cohort when controlling for lifestyle and health factors associated with depression. The analysis of lifestyle and health characteristics showed that the greatest difference between cohorts was in the area of living status, with more Australian women living with their partner and more than three times as many Japanese women living with their children. When the data for the countries was considered independently employment status affected the likelihood of higher depression scores in the Australian sample while heart disease and poor sleep impacted the risk for the Japanese population.

CONCLUSIONS

Significantly more Japanese women scored within the mild and moderate ranges on the GDS compared with their Australian peers, even when controlling for possible confounding factors. Of the lifestyle and health factors assessed in this analysis no single variable was a common risk factor for higher depressive scores for both countries. The presence of cultural influences that may impact the risk of experiencing depressive symptoms, and culture specific patterns of item endorsement on depressive symptom measures, needs to be explored in more detail.

Caregiving and mental health among workers: Longitudinal evidence from a large cohort of adults in Thailand

BACKGROUND

As people in middle and lower income countries live longer, more people become sick, disabled, and frail and the demand for family caregiving grows. Thailand faces such challenges. This study investigates the relationship between caregiving and mental health among workers drawn from a large longitudinal cohort of Thai adults.

METHODS

Participants were drawn from the Thai Health-Risk Transition Study, a cohort study since 2005 of distance-learning adult Open University students residing nationwide. Caregiving status and binary psychological distress outcome (score 19-30 on Kessler 6) were recorded in 2009 and 2013 among cohort members who were paid workers at both years (n=33,972). Multivariate logistic regression was used to estimate the relationship between four-year longitudinal caregiving status and psychological distress in 2013, adjusting for potential covariates.

RESULTS

Longitudinal analyses revealed the transitional nature of care with 25% exiting and 10% entering the caring role during the four-year follow-up. Based on multivariate logistic regression, 2009-2013 caregiving status was significantly associated with psychological distress. Cohort members transitioning into caregiving and those who were caregivers in both 2009 and 2013 had a higher risk for psychological distress than non-caregivers (Adjusted Odds Ratios 1.40 [1.02-1.96] and 1.64 [1.16-2.33], respectively).

CONCLUSION

Our findings provide evidence on caregiving and associated risk for psychological distress among working Thais. This adds to the limited existing literature in middle-income countries and highlights the potential pressure among caregivers in balancing work and care while preserving their own mental health.

The associations between lifestyles and mental health using the General Health Questionnaire 12-items are different dependently on age and sex: a population-based cross-sectional study in Kanazawa, Japan

OBJECTIVES

The aim of this study was to examine potential differences of the associations between mental health and lifestyle factors across a wide range of age.

METHODS

In August/September 2011, data were collected from 4693 males (age 51.6 ± 19.5) and 5678 females (age 52.4 ± 19.4) living in Kanazawa, Japan. A cross-sectional community-based survey was conducted with self-administered questionnaire including the General Health Questionnaire (GHQ) 12-item version, sociodemographic, and lifestyle factors. Associations between the GHQ scores and other variables were examined using two-way analysis of variance (ANOVA) followed by multiple comparisons and logistic regression stratified by age and gender.

RESULTS

Multiple comparisons indicated that people aged 20-39 or 40-64 had higher GHQ scores than older aged. The two-way ANOVA revealed significant interaction between body mass index and age group, and between exercise and age group. Overweight or underweight males aged 40-64 had poorer mental health than those at normal weight. In the elderly, being underweight was significantly associated with poor mental health. There were no significant effects of exercise on mental health for young adults. The logistic regression showed significant negative effects of short-time sleep in adults.

CONCLUSIONS

The associations between mental health and lifestyles differ across age groups. Further study is needed to reveal effects of aging on lifestyle and mental health with a longitudinal design.

Analysis of structural relationship among the occupational dysfunction on the psychological problem in healthcare workers: a study using structural equation modeling

Purpose. The purpose of this study is to demonstrate the hypothetical model based on structural relationship with the occupational dysfunction on psychological problems (stress response, burnout syndrome, and depression) in healthcare workers.

Method. Three cross sectional studies were conducted to assess the following relations: (1) occupational dysfunction on stress response (n = 468), (2) occupational dysfunction on burnout syndrome (n = 1,142), and (3) occupational dysfunction on depression (n = 687). Personal characteristics were collected through a questionnaire (such as age, gender, and job category, opportunities for refreshment, time spent on leisure activities, and work relationships) as well as the Classification and Assessment of Occupational Dysfunction (CAOD). Furthermore, study 1 included the Stress Response Scale-18 (SRS-18), study 2 used the Japanese Burnout Scale (JBS), and study 3 employed the Center for Epidemiological Studies Depression Scale (CES-D). The Kolmogorov–Smirnov test, confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and path analysis of structural equation modeling (SEM) analysis were used in all of the studies. EFA and CFA were used to measure structural validity of four assessments; CAOD, SRS-18, JBS, and CES-D. For examination of a potential covariate, we assessed the correlation of the total and factor score of CAOD and personal factors in all studies. Moreover, direct and indirect effects of occupational dysfunction on stress response (Study 1), burnout syndrome (Study 2), and depression (Study 3) were also analyzed.

Results. In study 1, CAOD had 16 items and 4 factors. In Study 2 and 3, CAOD had 16 items and 5 factors. SRS-18 had 18 items and 3 factors, JBS had 17 items and 3 factors, and CES-D had 20 items and 4 factors. All studies found that there were significant correlations between the CAOD total score and the personal factor that included opportunities for refreshment, time spent on leisure activities, and work relationships (p < 0.01). The hypothesis model results suggest that the classification of occupational dysfunction had good fit on the stress response (RMSEA = 0.061, CFI = 0.947, and TLI = 0.943), burnout syndrome (RMSEA = 0.076, CFI = 0.919, and TLI = 0.913), and depression (RMSEA = 0.060, CFI = 0.922, TLI = 0.917). Moreover, the detected covariates include opportunities for refreshment, time spent on leisure activities, and work relationships on occupational dysfunction.

Conclusion. Our findings indicate that psychological problems are associated with occupational dysfunction in healthcare workers. Reduction of occupational dysfunction might be a strategy of better preventive occupational therapies for healthcare workers with psychological problems. However, longitudinal studies will be needed to determine a causal relationship.

The Impact of Multiple Roles on Psychological Distress among Japanese Workers

Background

There has been considerable interest in Japanese society in the problem of work-related stress leading to depressive symptoms, and an increasing number of primary houseworkers maintain paid employment. The purpose of this study was to examine the differential impact of multiple roles associated with psychological distress among Japanese workers.

Methods

We studied 722 men and women aged 18–83 years in a cross-sectional study. The K10 questionnaire was used to examine psychological distress.

Results

The proportion of participants with psychological distress was higher in women (17.8%) compared with men (11.5%). Having three roles significantly decreased the risk of psychological distress [women: odds ratio (OR), 0.37-fold; men: OR, 0.41] compared with only one role. In working married women, there was significantly less psychological distress (OR, 0.27), and those with childrearing or caregiving responsibilities for elderly parents had significantly less psychological distress (OR, 0.38) than those with only an employment role. Similarly, working married men who had childrearing or caregiving responsibilities for elderly parents had significantly less psychological distress (OR, 0.41) than those who had only an employment role.

Conclusion

The present study demonstrated that participants who had only an employment role had an increased risk of psychological distress. The degree of psychological distress was not determined solely by the number of roles. It is important to have balance between work and family life to reduce role conflict and/or role submersion, which in turn may reduce the risk of psychological distress.