The changing nature of work - Job strain, job support and sickness absence among care workers and in other occupations in Sweden 1991-2013

The role of job strain in the relationship between depression and long-term sickness absence: a register-based cohort study

PURPOSE

Though individuals with depression and those with poor working conditions are more likely to be on long-term sickness absence (LTSA), less is known about how working conditions may modify the associations between depression status and LTSA. This study aims to examine the association between depression and LTSA among Swedish workers with different levels of job strain and its individual components (job demands and job control).

METHODS

All Swedish workers 30 - 60 years old (N = 3,065,258) were studied in 2005. At baseline (2005-2010), workers were categorized as: without depression, being prescribed antidepressants, and being in inpatient/outpatient care. Job strain was measured using a Swedish Job Exposure Matrix, and data on LTSA were obtained from 2011 to 2021. The association between depression and LTSA was assessed using Cox proportional-hazards regression stratified by categories of job strain.

RESULTS

Compared to workers without depression, workers with depression had higher risk of LTSA across all job strain levels. Depression was associated with the highest hazards of LTSA in active jobs, but a similar population attributable fraction (PAF) was found across categories of job strain, indicating similarities between the different categories.

CONCLUSION

There was evidence of a moderating effect of job strain in the relationship between depression and LTSA, but also evidence that this was due to differences in baseline depression prevalence in the different job strain categories. Future research is needed to determine alternative factors which could be relevant for reducing LTSA among those who have already developed depression.

How does lowering psychosocial risks influence sickness absence? A prospective cohort study analyzed as a quasi-experiment

BACKGROUND

We examined how reducing work-related psychosocial stressors affected long-term sickness absence of younger and older employees.

METHODS

We used data from 43 843 public sector employees in Finland who participated in surveys in 2018 and 2020. We assessed psychosocial factors, such as job demands, job control, work effort, job rewards and worktime control. We obtained sickness absence data from registers for spells longer than 10 consecutive working days. We applied age-specific propensity score weighting and generalized linear models to estimate the effects of changes in psychosocial factors between 2018 and 2020 on sickness absence in 2020.

RESULTS

Among employees under 50 years, increasing job rewards by 1 SD reduced the risk of sickness absence by 17% [risk ratio (RR) 0.83, 95% CI 0.72-0.96]. Among employees aged 50 years or older, decreasing job demands by 1 SD reduced the risk of sickness absence by 13% (RR 0.87, 95% CI 0.78-0.98), and increasing job control by 1 SD reduced the risk by 12% (RR 0.88, 95% CI 0.76-1.01). Changes in efforts and worktime control had no significant associations with sickness absence.

CONCLUSIONS

Reducing psychosocial stressors can lower the occurrence of long-term sickness absence, but the associations differ by age group. Younger workers benefit more from enhancing job rewards, while older workers benefit more from lowering job demands and increasing job control. To establish the causal impact of psychosocial risk reduction on sickness absence across age groups, future research should employ randomized controlled trials as the methodological approach.

Determinants of sickness absence in police: Case study of Abu Dhabi police department, UAE

Sickness absence among employees is reported to reduce organization profits and performance and thus threaten the organization's existence in the market. The monitoring and reporting of data on sickness absence is considered a crucial element of reactive health and safety control systems in organizations. It is one of the major indicators of organizational continuous commitment to improving the quality of working conditions. However, sickness absence in Police in the United Arab Emirates (UAE) is less investigated. The Occupational Health and Safety Survey developed for this study was distributed to 1317 employees of the Capital Police Directorate of Abu Dhabi Police. The survey was answered by 760 employees (58 %). While 230 (17 %) refused to participate, 259 (20 %) did not return the surveys, and 68 (5 %) were not surveyed as they were on authorized long-term leave for various reasons (and did not receive the survey). This study analyzes if the psychosocial work factors, physical work exposure factors, and employee's perception of the health and safety management system predict sickness absence in the Abu Dhabi Police after taking into account the other covariates. This study found no association between job control and the risk of sickness absence, in contrast to findings from other studies. There was also no association between psychological job demand and the perception of health and safety management with the risk of sickness absence in this study. Officers who fit the 'job strain' category did not have a significant increase in the risk of sickness absence in this study. However, high levels of combined physical exposures reported a significant relation with sickness absence. In conclusion, this, being one of the first studies in the region, provides insights on work factors and perception of HSE on sickness absence and provides recommendations within the context of the region for future studies and address sickness absence among police in the UAE.

Psychosocial and organisational work factors as predictors of sickness absence among professionally active adults with common mental disorders

BACKGROUND

The incidence of sickness absence (SA) due to common mental disorders (CMDs) has increased in recent decades. It is hence important to elucidate how individuals with CMDs can maintain work. The aim was to analyse the relationship between psychosocial and organisational workplace factors and a spell of > 14 days of SA among persons with CMDs.

METHODS

Included were respondents of the Swedish Work Environment Survey (SWES) 1993-2013, diagnosed with a CMD up to five years before the interview in the SWES (n = 3,795). Relative Risk (RR) regression models with 95% Confidence Intervals (CIs) analysed associations between psychosocial-, and organisational workplace factors and a subsequent spell of SA > 14 days.

RESULTS

Low control over work (RR:1.16; CI:1.01-1.35), job strain (RR:1.25; CI:1.04-1.49), no flexible working hours (RR:1.25; CI:1.08-1.45) or no possibility to work from home (RR:1.37; CI:1.13-1.66) were significantly related to an increased risk of SA. Persons diagnosed with depression experiencing job strain had the highest increased risk of SA (RR:1.55; CI: 1.07-2.25).

CONCLUSIONS

A sustainable work-life among working individuals with CMDs can be provided by reducing job strain, and if possible, by increasing flexibility regarding workplace and working hours. This may prevent spells of SA, and hereby increase productivity.

Are psychosocial work factors and work-home interference associated with time to first full return-to-work after sick leave due to common mental disorders?

OBJECTIVE

To (1) examine the time to first full return-to-work (RTW), and (2) investigate whether psychosocial work factors and work-home interference are associated with time to first full RTW after sick leave due to common mental disorders (CMDs).

METHODS

The cohort study comprised 162 employees on sick leave due to CMDs participating in a two-armed cluster-randomised controlled trial in Sweden. Baseline data consisted of a web-based questionnaire and follow-up data of repeated text messages every fourth week for 12 months. The time to first full RTW was estimated using the Kaplan-Meier Estimator. Parametric Weibull survival models with interval-censored outcomes were used to determine associations between psychosocial work factors and work-home interference with time to first full RTW. In a post hoc analysis, time-interval differences in associations for 0- ≤ 6- versus > 6-12 months were tested.

RESULTS

During the 12-month follow-up, n = 131 (80.9%) reported a first full RTW. The median time to this RTW was 16 weeks (95% CI 12; 20). High psychological job demands, high emotional job demands, high work-to-home interference (WHI), and low social job support were independently associated with a longer time to first full RTW. Time-interval differences were found for job control and emotional job demands.

CONCLUSIONS

Psychosocial work demands and WHI are associated with a longer time to RTW after sick leave due to CMDs. Work organisations and rehabilitation practices should include accommodations for high psychological and emotional job demands during RTW, as well as pay attention to the risk of spill-over of high job demands into employees' private lives.

Psychosocial work conditions and prediabetes risks: a cross-sectional study in middle-aged men and women

Prediabetes is a condition between diabetes and normoglycemia, and is a state of major health concern, as a large proportion of people with prediabetes are likely to develop diabetes which is associated with high mortality and morbidity. The purpose of this study was to investigate whether adverse psychosocial work conditions, based on the Job Demand-Control-social support model, increases risk for early dysregulated glucose metabolism in 50-64-year-old men and women. Job conditions were measured with the Swedish Demand-Control-Support questionnaire. Impaired glucose metabolism was assessed by an oral glucose tolerance test. Differences between groups were analyzed with Chi-square test and one-way ANOVA with Bonferroni post-hoc test. Odds ratios (OR) and 95% confidence intervals (95% CI) between Job Demand-control-support and prediabetes outcome were calculated with multiple logistic regression. Results from an adjusted logistic regression model showed that in men and woman separately, an active work situation (high demands-high control) was associated with significantly lower prediabetes risk (OR 0.657, 95% CI 0.513-0.842). This finding is consistent through all logistic regression models with different levels of adjustments. Further, the current study does not lend support for the hypothesis that work conditions characterized by high demands-low control were associated with dysregulated glucose metabolism in men nor women despite accumulation of many life-style related risk factors in the high strain group. In conclusion, we could show that men and women assessing their work conditions as active, had lower risk for prediabetes.

Exploring reasons for sick leave due to common mental disorders from the perspective of employees and managers – what has gender got to do with it?

Purpose

The purpose of this study was to explore the employee and the managerial experience of reasons for sick leave due to CMDs in relation to work and private life, through the lens of a transactional perspective of everyday life occupation and gender norms.

Methods

Semi-structured interviews were conducted with 17 employees on sick leave due to CMDs and 11 managers. By using transactional and gender perspectives in a reflexive thematic analysis, themes were generated in a constant comparative process.

Findings

Four themes were identified: a) struggling to keep up with work pressure and worker norms; b) struggling with insecurity in an unsupportive work environment; c) managing private responsibilities through flexible work schedules, and d) managing emotions alongside unfavourable working conditions.

Conclusion

Sick leave due to CMDs was understood as related to experiences of accumulated events situated in different social, cultural, and societal contexts of everyday life. Practices and policies should encourage an open dialogue about work and private life and health between employees and managers. To build healthy and sustainable work environments practices should also aim for increased awareness of social norms. A better understanding may facilitate the identification of situations in work and private life that are problematic for the employee.

Development Work in Swedish Eldercare: Resources for Trustworthy, Integrated Managerial Work During the COVID-19 Pandemic

The extensive needs for developments of eldercare addressing working conditions, care quality, influence, and safety was highlighted during the pandemic. This mixed-method study contribute with knowledge about capability-strengthening development work and its importance for trustworthy managerial work, before and during the COVID-19 pandemic. Questionnaire data and narratives from first-line managers immediately before (n = 284) and 16 months into the pandemic (n = 189), structured interviews with development leaders (n = 25), and documents were analyzed. The results identify different focuses of development work. Strategic-level development leaders focused the strengthening of old adults' capabilities. While operational-level leaders approached strengthening employees' capability. First-line managers' rating of their trustworthy managerial work decreased during the pandemic and was associated with their workload, development support and capability-strengthening projects focusing employees' resources. The study demonstrates the gap between strategic and the operational levels regarding understanding of capability set and needed resources for strengthening capabilities and trustworthy, integrated managerial work regarding safety, influence, and quality conditions for old adults and employees.

Occupational Branch and Labor Market Marginalization among Young Employees with Adult Onset of Attention Deficit Hyperactivity Disorder-A Population-Based Matched Cohort Study

We compared labor market marginalization (LMM), conceptualized as days of unemployment, sickness absence and disability pension, across occupational branches (manufacturing, construction, trade, finance, health and social care, and education), among young employees with or without attention deficit hyperactivity disorder (ADHD) and examined whether sociodemographic and health-related factors explain these associations. All Swedish residents aged 19–29 years and employed between 1 January 2005 and 31 December 2011 were eligible. Individuals with a first ADHD diagnosis (n = 6030) were matched with ten controls and followed for five years. Zero-inflated negative binomial regression was used to model days of LMM with adjustments for sociodemographic and health-related factors. In total, 20% of those with ADHD and 59% of those without had no days of LMM during the follow-up. The median of those with LMM days with and without ADHD was 312 and 98 days. Having an ADHD diagnosis was associated with a higher incidence of LMM days (incident rate ratios (IRRs) 2.7–3.1) with no differences across occupational branches. Adjustments for sociodemographic and health-related factors explained most of the differences (IRRs: 1.4–1.7). In conclusion, young, employed adults with ADHD had a higher incidence of LMM days than those without, but there were no substantial differences between branches, even after adjusting for sociodemographic and health-related factors.