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Rugulies R, Aust B, Greiner BA, Arensman E, Kawakami N, LaMontagne AD, Madsen IEH. Work-related causes of mental health conditions and interventions for their improvement in workplaces. Lancet 2023; 402:1368-1381. [PMID: 37838442 DOI: 10.1016/s0140-6736(23)00869-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 02/11/2023] [Accepted: 04/27/2023] [Indexed: 10/16/2023]
Abstract
Mental health problems and disorders are common among working people and are costly for the affected individuals, employers, and whole of society. This discussion paper provides an overview of the current state of knowledge on the relationship between work and mental health to inform research, policy, and practice. We synthesise available evidence, examining both the role of working conditions in the development of mental disorders, and what can be done to protect and promote mental health in the workplace. We show that exposure to some working conditions is associated with an increased risk of the onset of depressive disorders, the most studied mental disorders. The causality of the association, however, is still debated. Causal inference should be supported by more research with stronger linkage to theory, better exposure assessment, better understanding of biopsychosocial mechanisms, use of innovative analytical methods, a life-course perspective, and better understanding of the role of context, including the role of societal structures in the development of mental disorders. There is growing evidence for the effectiveness of interventions to protect and promote mental health and wellbeing in the workplace; however, there is a disproportionate focus on interventions directed towards individual workers and illnesses, compared with interventions for improving working conditions and enhancing mental health. Moreover, research on work and mental health is mainly done in high-income countries, and often does not address workers in lower socioeconomic positions. Flexible and innovative approaches tailored to local conditions are needed in implementation research on workplace mental health to complement experimental studies. Improvements in translating workplace mental health research to policy and practice, such as through workplace-oriented concrete guidance for interventions, and by national policies and programmes focusing on the people most in need, could capitalise on the growing interest in workplace mental health, possibly yielding important mental health gains in working populations.
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Affiliation(s)
- Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland; National Suicide Research Foundation, University College Cork, Cork, Ireland; Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Norito Kawakami
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Junpukai Foundation, Okayama, Japan
| | - Anthony D LaMontagne
- School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
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2
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Noehammer E, Amler N, Fischmann W. Barrier profiles in workplace health promotion in Germany. Health Promot Int 2023; 38:6974797. [PMID: 36617298 DOI: 10.1093/heapro/daac125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Lay Summary
Workplace health promotion (WHP) is often faced with low-participation rates despite high relevance. This limits the potential for creating positive effects for the organization and its staff. Therefore, we investigated the barriers perceived by employees themselves using a representative sample (regarding age, gender and education) in Germany. Data were collected using a quantitative online questionnaire and then analyzed regarding underlying patterns. We found that there are different barrier types, and their importance differs depending on demographic criteria of the participants and the organizations they work for. These results can help organizations to reduce participation barriers to WHP for their staff.
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Affiliation(s)
- Elisabeth Noehammer
- Institute for Management and Economics in Healthcare, UMIT TIROL-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Nadja Amler
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Deutsche Gesellschaft für Arbeits- und Umweltmedizin (DGAUM), München, Germany
| | - Wolfgang Fischmann
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Manford W, Petersen GL, Willert MV. Improved perception of work following a stress management intervention. Occup Med (Lond) 2022; 72:629-635. [PMID: 36130174 DOI: 10.1093/occmed/kqac091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In the work and stress literature, surprisingly few studies of stress management interventions have evaluated effects on the perceived psychosocial work environment. Using data from a randomized controlled trial we investigated whether the perceived psychosocial work environment and overcommitment to work improved following a group-based, cognitive-behavioural stress management intervention. AIMS We hypothesized that the participants would experience less job demand, overcommitment and effort-reward imbalance (ERI) as well as higher job control following the intervention. METHODS Using a wait-list controlled design, 102 participants were randomized to either an intervention group or a wait-list control group. Outcome measures were assessed at baseline and follow-up after three, six and nine months, and analysed using mixed model univariate repeated measures analyses of variance. Results are presented as effect sizes using Cohen's d with confidence intervals (95% CI). RESULTS Changes from 0 to 3 months for the intervention group were significantly superior to changes for the wait-list control group on all outcomes. The controlled effect size for job demands was d = 0.42 (0.01-0.84 95% CI), for job control d = 0.39 (0.06-0.71 95% CI), for effort-reward imbalance d = 0.61 (0.22-1.01 95% CI) and for overcommitment d = 0.44 (0.06-0.81 95% CI). Improvements were maintained at three months follow-up after the end of treatment. CONCLUSIONS The intervention improved the perceived psychosocial work environment and attitude to work with small-medium effect sizes. To our knowledge, this is the first paper from a randomized controlled trial of a stress-management intervention reporting on these important outcomes.
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Affiliation(s)
- W Manford
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus N, Denmark
| | - G L Petersen
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus N, Denmark
| | - M V Willert
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus N, Denmark
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van Heijster H, van Berkel J, Boot CRL, Abma T, de Vet E. Stakeholder dialogue on dilemmas at work as a workplace health promotion intervention including employees with a low SEP: a Responsive Evaluation. BMC Public Health 2022; 22:407. [PMID: 35227228 PMCID: PMC8883621 DOI: 10.1186/s12889-022-12802-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 02/11/2022] [Indexed: 11/14/2022] Open
Abstract
Background The aim of this study was to evaluate the perceived changes of an innovative workplace health promotion intervention and evaluation. In this study, a bottom-up approach was taken to define the central themes and relevant outcomes of an intervention. These central themes and relevant outcomes of the intervention were defined together with stakeholders, including employees with a low socioeconomic position. Methods The intervention consisted of a series of structured stakeholder dialogues in which dilemmas around the – by employees defined —health themes were discussed. The intervention was implemented in a harbor service provider with approximately 400 employees. Over a two-year period, 57 participants engaged in eight dialogues of one hour. 15 interviews and six participant observations took place for the evaluation of the intervention. Results Together with the stakeholders, high workload and mental health were defined as central themes for the dialogue intervention in the male-dominated workplace. The dialogue intervention contributed to changes, on different levels: individual, team, and organization. Overall, the stakeholder dialogues advanced the understanding of factors contributing to high workload and mental health. In reply to this, several actions were taken on a organizational level. Conclusions Taking a bottom-up approach in WHP allows to understand the health issues that are important in the daily reality of employees with a low socioeconomic position. Through this understanding, workplace health promotion can become more suitable and relevant for employees with a low socioeconomic position. Trial registration Netherlands Trial Register (NRT): NL8051. Registration date: 28/09/2019, Retrospectively registered https://www.trialregister.nl Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12802-z.
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Affiliation(s)
- Hanneke van Heijster
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, Netherlands.
| | - Jantien van Berkel
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University, Amsterdam, Netherlands
| | - Tineke Abma
- Department Public Health, Leiden University Medical Centre, Leiden University, Leiden, Netherlands
| | - Emely de Vet
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, Netherlands
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Kuchenbaur M, Peter R. Assessing the Role of Collective Efficacy Beliefs During Participative Occupational Health Interventions. Front Public Health 2021; 9:797838. [PMID: 34900928 PMCID: PMC8655112 DOI: 10.3389/fpubh.2021.797838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/04/2021] [Indexed: 11/22/2022] Open
Abstract
Background: For group-based participatory interventions in the context of occupational health, no questionnaires exist to assess the participants' active engagement in the interventions. On the basis of the construct of collective efficacy beliefs, this study has developed a questionnaire with which the group-related efficacy beliefs can be assessed as a precondition for participants actively engaging in participative interventions. Methods: Participants were drawn from a two-arm cluster-randomized intervention study to fill out the questionnaire. A Factor analysis and an initial psychometric calibration were performed. In a second step, the group-related properties of the questionnaire were validated using a Multilevel analysis. Results: The factorial structure of the questionnaire is consistent with the theory of efficacy beliefs according to A. Bandura. Furthermore, the collective efficacy expectations of the interventions' participants are lowered in the absence of appreciation and support in the psychosocial environment of the worksite. Conclusions: Assessing participant's quality of interventional activity in participatory interventions by collective efficacy can be valuable in understanding the amount of interventional activity. In addition, it is recommended to consider the influence of the worksite's psychosocial environment on collective efficacy beliefs when implementing participatory interventions. Clinical Trial Registration: Registration trial DRKS00021138 on the German Registry of Clinical Studies (DRKS), retrospectively registered on 25 March, 2020.
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Affiliation(s)
- Marco Kuchenbaur
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
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Weigl M, Schreyer J. [Is this the parallel pandemic? : Measures to improve working conditions and stress levels among health care personnel]. Internist (Berl) 2021; 62:928-936. [PMID: 34386829 PMCID: PMC8359916 DOI: 10.1007/s00108-021-01120-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 01/08/2023]
Abstract
Employee health and ability to perform is essential to a functioning health care system. Even before the coronavirus disease 2019 (COVID-19) pandemic, a substantial proportion of employees reported impaired mental health at work. This paper outlines the state of knowledge and evidence on interventions to promote mental health in the workplace, with particular focus on the organization of work and activities. In addition to an initial review of approaches, the factors facilitating successful and effective approaches are addressed.
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Affiliation(s)
- Matthias Weigl
- Institut für Patientensicherheit, Medizinische Fakultät, Universität Bonn, Gebäude 02 (Auenbruggerhaus), Venusberg-Campus 1, 53127, Bonn, Deutschland.
- Institut und Poliklinik für Arbeits‑, Sozial- und Umweltmedizin, Klinikum der Universität München, München, Deutschland.
| | - Julia Schreyer
- Institut und Poliklinik für Arbeits‑, Sozial- und Umweltmedizin, Klinikum der Universität München, München, Deutschland
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Framke E, Sørensen OH, Pedersen LRM, Pedersen J, Madsen IEH, Bjorner JB, Rugulies R. Effects of a participatory organisational, core work task focused workplace intervention on employees' primary healthcare consultations: secondary analysis of a cluster RCT. Occup Environ Med 2020; 78:oemed-2020-106558. [PMID: 33144358 PMCID: PMC8053318 DOI: 10.1136/oemed-2020-106558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 09/30/2020] [Accepted: 10/20/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We aimed to examine whether a participatory organisational workplace intervention focusing on core tasks at work resulted in lower primary healthcare utilisation of employees. METHODS The cluster randomised controlled trial included 78 preschools, 44 allocated to the intervention group (1745 employees) and 34 allocated to the control group (1267 employees). The intervention aimed to involve employees in improving the psychosocial work environment while focusing on core tasks at work. Using Poisson regression, we tested the rate ratios (RRs) of consultations in the intervention compared with the control group in terms of all consultations in primary healthcare and general practitioner (GP) consultations, respectively, per person-year during 31 months of follow-up. The fully adjusted model included adjustment for sex, age, job group, workplace type and size, and previous primary healthcare utilisation. RESULTS During the follow-up, intervention group employees had 11.0 consultations/person-year, while control group employees had 11.6 consultations/person-year (RR 0.97, 95% CI 0.92 to 1.01). Employees in the intervention group had 7.5 GP consultations/person-year, while control group employees had 8.2 GP consultations/person-year (RR 0.95, 95% CI 0.90 to 0.99). Post hoc analyses indicated that the effect of the intervention was particularly strong in employees in preschools with a moderate or high level of implementation. CONCLUSIONS The participatory organisational workplace intervention focusing on core tasks at work among preschool employees had a small, statistically non-significant effect on overall primary healthcare utilisation and a small, statistically significant effect on GP consultations. These results suggest a beneficial effect of the participatory organisational intervention on employees' health. TRIAL REGISTRATION NUMBER ISRCTN16271504.
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Affiliation(s)
- Elisabeth Framke
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Line R M Pedersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Jacob Pedersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Jakob B Bjorner
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- QualityMetric, Johnston, Ri USA
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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MENG A, BORG V, CLAUSEN T. Enhancing the social capital in industrial work teams: results from a participatory intervention. INDUSTRIAL HEALTH 2020; 58:433-442. [PMID: 32350169 PMCID: PMC7557408 DOI: 10.2486/indhealth.2020-0015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 04/22/2020] [Indexed: 06/11/2023]
Abstract
We investigated the effects of an intervention aiming at enhancing four types of team-level social capital (bonding, bridging and two types of linking social capital) in six dairy plants with a total of 60 teams. Social capital and work engagement was assessed in baseline and follow-up surveys. The follow-up period was approximately 20 months, comprising an intervention period of 12 months. Intervention effects were assessed by comparing changes in team-level mean-scores for teams that had developed action plans with teams that had not. Results show that teams that had developed action plans generally showed a larger increase in social capital and work engagement than other teams. Differences were statistically significant for linking social capital towards the workplace as a whole and work engagement. However, effect sizes indicate an effect of the action plans despite the lack of statistical significance. Moreover, the self-reported level of implementation of the action plans was associated with the size and direction of the observed change.
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Affiliation(s)
- Annette MENG
- National Research Centre for the Working Environment,
Denmark
| | - Vilhelm BORG
- National Research Centre for the Working Environment,
Denmark
| | - Thomas CLAUSEN
- National Research Centre for the Working Environment,
Denmark
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9
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Fridrich A, Bauer GF, Jenny GJ. Development of a Generic Workshop Appraisal Scale (WASC) for Organizational Health Interventions and Evaluation. Front Psychol 2020; 11:2115. [PMID: 33013537 PMCID: PMC7461960 DOI: 10.3389/fpsyg.2020.02115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 07/29/2020] [Indexed: 11/26/2022] Open
Abstract
This study presents the development of a generic workshop appraisal scale (WASC) for the evaluation of organizational health interventions. Based on the session evaluation questionnaire (SEQ) by Stiles (1980), we developed a short, generic 10-item scale with pairs of adjectives, covering five facets: comprehensibility, relevance, novelty, activation, and valence. Our study is based on N = 499 employees from four organizations who participated in 41 workshops and filled out an evaluation questionnaire on-site. The questionnaire contained the newly developed WASC, as well as items capturing satisfaction with the developed output and outcome expectancies. Results from confirmative factor analysis confirmed the hypothesized five-factor structure of the WASC. The factor structure was found to be nearly invariant across the four organizations, a result that needs to be replicated in larger samples. Analysis of intra-class correlations indicated that 25% of the variance in workshop appraisal can be explained at workshop level. Hereby, perceived relevance and novelty exhibited lower amounts of shared variance, indicating that corresponding workshop appraisals are influenced more by individual factors and less by group dynamics. Furthermore, results from mediation analysis revealed that participants’ workshop appraisals were significantly related to their outcome expectancies, and that this relationship was mediated by output satisfaction. Again, the facets showed differential effects: Relevance and comprehensibility seem to contribute most to the total effect on outcome expectancy, followed by activation, whereas valence and especially novelty play a minor role. Taken together, participants’ workshop appraisals – together with output satisfaction and outcome expectancy – may be helpful for monitoring the implementation process and allow for corrective action if necessary.
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Affiliation(s)
| | - Georg F Bauer
- Center of Salutogenesis, Division of Public and Organizational Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Gregor J Jenny
- Center of Salutogenesis, Division of Public and Organizational Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Genrich M, Worringer B, Angerer P, Müller A. Hospital Medical and Nursing Managers' Perspectives on Health-Related Work Design Interventions. A Qualitative Study. Front Psychol 2020; 11:869. [PMID: 32431651 PMCID: PMC7214727 DOI: 10.3389/fpsyg.2020.00869] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 04/07/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Research indicates that the active support of managers is essential for the sustainable implementation of health-related work design interventions in organizations. However, little is known about managers' perceptions of such health promotion measures. OBJECTIVE Our study aims to provide information that help to foster managers active support of health-related work design interventions in hospitals. Based on Ajzen's Theory of Planned Behavior (TPB) we explore the attitudes, perceived organizational norms, and perceived behavioral control of managers in the hospital regarding such interventions. METHODS Semi-structured interviews with 37 managers (chief physicians, senior physicians, and senior nurses) were carried out in one German hospital. A software aided qualitative content analysis was applied. RESULTS We observed that the majority of managers are aware of the importance of health-related work design. We found a high variation in the perception of organizational norms related to mental health promotion of employees. Behavioral control for supporting interventions is perceived more on an individual (e.g., appraisal interviews, professional development or support) and team level (e.g., fair work schedule, regular team meetings), less on an organizational level. CONCLUSION To enable and to motivate hospital medical and nursing managers to support health-related work design, hospitals need to establish clear organizational norms that the health promotion of their employees is an important organizational goal. Moreover, managers need to get more work-design competencies and decision latitude to get more control. Important arguments for the top hospital management could be that health-related work design is highly effective for economic success, for treatment quality, and that the middle management already has a positive attitude toward the implementation of measures that help promote the mental health of their staff.
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Affiliation(s)
- Melanie Genrich
- Institute of Psychology, Work and Organizational Psychology, University of Duisburg-Essen, Essen, Germany
| | - Britta Worringer
- Institute of Occupational, Social and Environmental Medicine, Centre of Health and Society, Medical Faculty, Düsseldorf University, Düsseldorf, Germany
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre of Health and Society, Medical Faculty, Düsseldorf University, Düsseldorf, Germany
| | - Andreas Müller
- Institute of Psychology, Work and Organizational Psychology, University of Duisburg-Essen, Essen, Germany
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Kwak L, Lornudd C, Björklund C, Bergström G, Nybergh L, Elinder LS, Stigmar K, Wåhlin C, Jensen I. Implementation of the Swedish Guideline for Prevention of Mental ill-health at the Workplace: study protocol of a cluster randomized controlled trial, using multifaceted implementation strategies in schools. BMC Public Health 2019; 19:1668. [PMID: 31829186 PMCID: PMC6907332 DOI: 10.1186/s12889-019-7976-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 11/20/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Given today's high prevalence of common mental disorders and related sick leave among teachers, an urgent need exists for a more systematic approach to the management of social and organizational risk factors within schools. In 2015, we launched the first Swedish occupational health guideline to support a structured prevention of these risks at the workplace. The existence of guidelines does however not guarantee their usage, as studies show that guidelines are often underused. Knowledge is therefore needed on effective implementation strategies that can facilitate the translation of guidelines into practice. The primary aim of the randomized waiting list-controlled trial described in this study protocol is to compare the effectiveness of a multifaceted implementation strategy versus a single implementation strategy for implementing the Guideline for the prevention of mental ill-health at the workplace within schools. The effectiveness will be compared regarding the extent to which the recommendations are implemented (implementation effectiveness) and with regard to social and organisational risk factors for mental ill-health, absenteeism and presenteeism (intervention effectiveness). METHODS The trial is conducted among primary schools of two municipalities in Sweden. The single implementation strategy is an educational strategy (an educational meeting). The multifaceted strategy consists of the educational meeting, an implementation team and a series of workshops. The outcome measure of implementation effectiveness is guideline adherence. The primary outcome of intervention effectiveness is exhaustion. Secondary outcomes include demands at work, work organization and job contents, interpersonal relations and leadership, presenteeism, work performance, recovery, work-life balance, work-engagement, self-reported stress, self-perceived health, sickness absence and psychosocial safety climate. Process outcomes as well as barriers and facilitators influencing the implementation process are assessed. Data will be collected at baseline, 6, 12, 18 and 24 months by mixed methods (i.e. survey, focus-group interviews, observation). DISCUSSION The study described in this protocol will provide valuable knowledge on the effectiveness of implementation strategies for implementing a guideline for the prevention of common mental disorders within schools. We hypothesize that successful implementation will result in reductions in school personnel's perceived social and organizational risk factors, mental ill-health and sick-leave. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT03322839 (trial registration: 09/19/2017).
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Affiliation(s)
- Lydia Kwak
- Unit of Intervention and Implementation Research for worker health, Institute for Environmental, MedicineKarolinska Institutet, Stockholm, Sweden.
| | - Caroline Lornudd
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Christina Björklund
- Unit of Intervention and Implementation Research for worker health, Institute for Environmental, MedicineKarolinska Institutet, Stockholm, Sweden
| | - Gunnar Bergström
- Unit of Intervention and Implementation Research for worker health, Institute for Environmental, MedicineKarolinska Institutet, Stockholm, Sweden.,Department of Occupational and Public Health Sciences, Faculty of Health and Occupational Studies, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
| | - Lotta Nybergh
- Unit of Intervention and Implementation Research for worker health, Institute for Environmental, MedicineKarolinska Institutet, Stockholm, Sweden
| | - Liselotte Schäfer Elinder
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Stockholm, Sweden
| | - Kjerstin Stigmar
- Department of Health Sciences, Lund University, Lund, Sweden.,Skåne University Hospital, Lund, Sweden
| | - Charlotte Wåhlin
- Occupational and Environmental Medicine Center, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Irene Jensen
- Unit of Intervention and Implementation Research for worker health, Institute for Environmental, MedicineKarolinska Institutet, Stockholm, Sweden
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12
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Framke E, Sørensen OH, Pedersen J, Clausen T, Borg V, Rugulies R. Effect of a participatory organizational workplace intervention on workplace social capital: post-hoc results from a cluster randomized controlled trial. BMC Public Health 2019; 19:693. [PMID: 31170944 PMCID: PMC6554896 DOI: 10.1186/s12889-019-6903-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 04/26/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A high level of workplace social capital (WSC) may contribute to the protection of employees' health. We hypothesized that a participatory workplace intervention would increase the level of WSC defined as vertical WSC (i.e. WSC linking together employees and their leaders) and horizontal WSC (i.e. WSC bonding employees together). METHODS We conducted a secondary data analysis of a cluster randomized controlled trial that was implemented among all employees in 78 municipal Danish pre-schools (44 intervention and 34 control group schools). The study sample consisted of 606 employees, 386 in the intervention and 220 in the control group. The intervention aimed to improve the psychosocial working environment by using a participatory approach and focusing on core job tasks. Vertical and horizontal WSC was measured by five and four items, respectively, at baseline and at 24-months follow-up. We estimated intervention effect by calculating the interaction of change over time by group assignment (intervention versus control group) and included workplace identification number in a repeated statement to take into account that employees were nested within workplaces. We conducted post-hoc analyses to examine whether intervention effect differed by implementation degree. RESULTS WSC decreased in both groups. In the main analyses, there was no statistically significant difference between intervention and control group, neither for vertical nor horizontal WSC. However, when we excluded intervention workplaces with a low degree of implementation, we found a statistically significant difference between the intervention and the control group (estimate: 0.25, 95% CI: 0.00 to 0.50, p = 0.049), indicating that vertical WSC decreased in the control group and remained stable in the intervention group. CONCLUSIONS There was not a statistically significant difference between intervention and control group in the main analysis. Post-hoc analyses, however, suggest that the intervention may have prevented a decrease in vertical WSC among employees in workplaces with a high or a medium degree of implementation. A conference abstract with the key results of this study has been previously presented and published, European Journal of Public Health, Volume 28, Issue suppl_4, November 2018, cky260, https://academic.oup.com/eurpub/article/28/suppl_4/cky260/5187184 . TRIAL REGISTRATION ISRCTN16271504 , retrospectively registered on November 15, 2016.
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Affiliation(s)
- Elisabeth Framke
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100, Copenhagen, Denmark.
| | - Ole Henning Sørensen
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100, Copenhagen, Denmark
| | - Jacob Pedersen
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100, Copenhagen, Denmark
| | - Thomas Clausen
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100, Copenhagen, Denmark
| | - Vilhelm Borg
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353, Copenhagen, Denmark
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Meng A, Borg V, Clausen T. Enhancing the social capital in industrial workplaces: Developing workplace interventions using intervention mapping. EVALUATION AND PROGRAM PLANNING 2019; 72:227-236. [PMID: 30448625 DOI: 10.1016/j.evalprogplan.2018.11.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/21/2018] [Accepted: 11/08/2018] [Indexed: 06/09/2023]
Abstract
Social capital in the workplace has been found to be associated with employee wellbeing and work engagement. Yet, evidence of effects of interventions to enhance the social capital are lacking. The intervention mapping method has been described as a useful tool for developing workplace interventions but it is very resource consuming. We aimed to develop an adapted version of the intervention mapping method which is more practically feasible to apply. To get insight into strengths and weaknesses of the adapted method, we applied it and conducted interviews with staff at six companies. The interviews revealed that the action plans developed using the adapted intervention mapping method were generally perceived as relevant and that the action plans had a positive effect on the social capital. However, the implementation of the action plans had been a challenge. In conclusion, the adapted intervention mapping method appears to be suitable for developing interventions to enhance the social capital in the workplace. However, more attention to the implementation of the action plans needs to be incorporated into the method. Suggestions to enhance the implementation included the involvement of the management in the implementation and monitoring of the implementation of the action plans as well as integrating the action plans into existing procedures in the workplace.
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Affiliation(s)
- Annette Meng
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, Denmark.
| | - Vilhelm Borg
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, Denmark.
| | - Thomas Clausen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, Denmark.
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Schneider A, Wehler M, Weigl M. Effects of work conditions on provider mental well-being and quality of care: a mixed-methods intervention study in the emergency department. BMC Emerg Med 2019; 19:1. [PMID: 30606124 PMCID: PMC6318954 DOI: 10.1186/s12873-018-0218-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 12/20/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Emergency departments (EDs) are highly dynamic and stressful care environments that affect provider and patient outcomes. Yet, effective interventions are missing. This study evaluated prospective effects of a multi-professional organizational-level intervention on changes in ED providers' work conditions and well-being (primary outcomes) and patient-perceived quality of ED care (secondary outcome). METHODS A before and after study including an interrupted time-series (ITS) design over 1 year was established in the multidisciplinary ED of a tertiary referral hospital in Southern Germany. Our mixed-methods approach included standardized provider surveys, expert work observations, patient surveys, and register data. Stakeholder interviews were conducted for qualitative process evaluation. ITS data was available for 20 days pre- and post-intervention (Dec15/Jan16; Dec16/Jan17). The intervention comprised ten multi-professional meetings in which ED physicians and nurses developed solutions to work stressors in a systematic moderated process. Most solutions were consecutively implemented. Changes in study outcomes were assessed with paired t-tests and segmented regression analyses controlling for daily ED workload. RESULTS One hundred forty-nine surveys were returned at baseline and follow-up (response at baseline: 76 out of 170; follow-up: 73 out of 157). Forty-one ED providers participated in both waves. One hundred sixty expert work observations comprising 240 observation hours were conducted with 156 subsequent work stress reports. One thousand four hundred eighteen ED patients were surveyed. Considering primary outcomes, respondents reported more job control and less overtime hours at follow-up. Social support, job satisfaction, and depersonalization deteriorated while respondents' turnover intentions and inter-professional interruptions increased. Considering the secondary outcome, patient reports indicated improvements in ED organization and waiting times. Interviews revealed facilitators (e.g., comprehensive approach, employee participation) and barriers (e.g., understaffing, organizational constraints) for intervention implementation. CONCLUSIONS To the best of our knowledge, this is the first study to report prospective effects of an ED work system intervention on provider well-being and patient-perceived quality of ED care. We found inconsistent results with partial improvements in work conditions and patient perceptions of care. However, aspects of provider mental well-being deteriorated. Given the lack of organizational-level intervention research in EDs, our findings provide valuable insights into the feasibility and effects of participatory interventions in this highly dynamic hospital setting.
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Affiliation(s)
- Anna Schneider
- Institute and Clinic for Occupational, Social, and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Markus Wehler
- Department of Emergency Medicine and Department of Medicine IV, Klinikum Augsburg, Augsburg, Germany
| | - Matthias Weigl
- Institute and Clinic for Occupational, Social, and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
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Magnavita N. Medical Surveillance, Continuous Health Promotion and a Participatory Intervention in a Small Company. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E662. [PMID: 29614831 PMCID: PMC5923704 DOI: 10.3390/ijerph15040662] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 03/29/2018] [Accepted: 03/30/2018] [Indexed: 12/23/2022]
Abstract
The workplace is an ideal setting for health promotion. The regular medical examination of workers enables us to screen for numerous diseases, spread good practices and correct lifestyles, and obtain a favourable risk/benefit ratio. The continuous monitoring of the level of workers' wellbeing using a holistic approach during medical surveillance enables us to promptly identify problems in work organisation and the company climate. Problems of this kind can be adequately managed by using a participatory approach. The aim of this paper is twofold: to signal this way of proceeding with medical surveillance, and to describe an organisational development intervention. Participatory groups were used to improve occupational life in a small company. After intervention we observed a reduction in levels of perceived occupational stress measured with the Effort/Reward Imbalance questionnaire, and an improvement in psychological wellbeing assessed by means of the Goldberg Anxiety/Depression scale. Although the limited size of the sample and the lack of a control group call for a cautious evaluation of this study, the participatory strategy proved to be a useful tool due to its cost-effectiveness.
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Affiliation(s)
- Nicola Magnavita
- Institute of Public Health, Università Cattolica del Sacro Cuore, Roma, Italy.
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Jimenez P, Bregenzer A. Integration of eHealth Tools in the Process of Workplace Health Promotion: Proposal for Design and Implementation. J Med Internet Res 2018; 20:e65. [PMID: 29475828 PMCID: PMC5845105 DOI: 10.2196/jmir.8769] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 12/12/2017] [Accepted: 12/18/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Electronic health (eHealth) and mobile health (mHealth) tools can support and improve the whole process of workplace health promotion (WHP) projects. However, several challenges and opportunities have to be considered while integrating these tools in WHP projects. Currently, a large number of eHealth tools are developed for changing health behavior, but these tools can support the whole WHP process, including group administration, information flow, assessment, intervention development process, or evaluation. OBJECTIVE To support a successful implementation of eHealth tools in the whole WHP processes, we introduce a concept of WHP (life cycle model of WHP) with 7 steps and present critical and success factors for the implementation of eHealth tools in each step. METHODS We developed a life cycle model of WHP based on the World Health Organization (WHO) model of healthy workplace continual improvement process. We suggest adaptations to the WHO model to demonstrate the large number of possibilities to implement eHealth tools in WHP as well as possible critical points in the implementation process. RESULTS eHealth tools can enhance the efficiency of WHP in each of the 7 steps of the presented life cycle model of WHP. Specifically, eHealth tools can support by offering easier administration, providing an information and communication platform, supporting assessments, presenting and discussing assessment results in a dashboard, and offering interventions to change individual health behavior. Important success factors include the possibility to give automatic feedback about health parameters, create incentive systems, or bring together a large number of health experts in one place. Critical factors such as data security, anonymity, or lack of management involvement have to be addressed carefully to prevent nonparticipation and dropouts. CONCLUSIONS Using eHealth tools can support WHP, but clear regulations for the usage and implementation of these tools at the workplace are needed to secure quality and reach sustainable results.
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Rezagholi M. Marginal socio-economic effects of an employer's efforts to improve the work environment. Ann Occup Environ Med 2018; 30:1. [PMID: 29435336 PMCID: PMC5793445 DOI: 10.1186/s40557-018-0212-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 01/12/2018] [Indexed: 11/25/2022] Open
Abstract
Background Workplace health promotion (WHP) strongly requires the employer’s efforts to improve the psychosocial, ergonomic, and physical environments of the workplace. There are many studies discussing the socio-economic advantage of WHP intervention programmes and thus the internal and external factors motivating employers to implement and integrate such programmes. However, the socio-economic impacts of the employer’s multifactorial efforts to improve the work environment need to be adequately assessed. Methods Data were collected from Swedish company Sandvik Materials Technology (SMT) through a work environment survey in April 2014. Different regression equations were analysed to assess marginal effects of the employer’s efforts on overall labour effectiveness (OLE), informal work impairments (IWI), lost working hours (LWH), and labour productivity loss (LPL) in terms of money. Results The employer’s multifactorial efforts resulted in increasing OLE, decreasing IWI and illness-related LWH, and cost savings in terms of decreasing LPL. Conclusion Environmental factors at the workplace are the important determinant factor for OLE, and the latter is where socio-economic impacts of the employer’s efforts primarily manifest.
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Affiliation(s)
- Mahmoud Rezagholi
- Department of Business and Economic Studies, Division of Economics, University of Gävle, -801 76 Gävle, SE Sweden
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Developing Sustainable Workplaces with Leadership: Feedback about Organizational Working Conditions to Support Leaders in Health-Promoting Behavior. SUSTAINABILITY 2017. [DOI: 10.3390/su9111944] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
This study investigated the relationships between seven workload factors and patient and nurse outcomes. (1) Background: Health systems researchers are beginning to address nurses’ workload demands at different unit, job and task levels; and the types of administrative interventions needed for specific workload demands. (2) Methods: This was a cross-sectional correlational study of 472 acute care nurses from British Columbia, Canada. The workload factors included nurse reports of unit-level RN staffing levels and patient acuity and patient dependency; job-level nurse perceptions of heavy workloads, nursing tasks left undone and compromised standards; and task-level interruptions to work flow. Patient outcomes were nurse-reported frequencies of medication errors, patient falls and urinary tract infections; and nurse outcomes were emotional exhaustion and job satisfaction. (3) Results: Job-level perceptions of heavy workloads and task-level interruptions had significant direct effects on patient and nurse outcomes. Tasks left undone mediated the relationships between heavy workloads and nurse and patient outcomes; and between interruptions and nurse and patient outcomes. Compromised professional nursing standards mediated the relationships between heavy workloads and nurse outcomes; and between interruptions and nurse outcomes. (4) Conclusion: Administrators should work collaboratively with nurses to identify work environment strategies that ameliorate workload demands at different levels.
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Guevara Bedoya LM, Londoño Londoño ME. Evaluación de un Método de Intervención del Clima Organizacional (CO) en una Empresa de Servicios Públicos Colombiana. REVISTA INTERAMERICANA DE PSICOLOGÍA OCUPACIONAL 2017. [DOI: 10.21772/ripo.v36n2a04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Mache S, Baresi L, Bernburg M, Vitzthum K, Groneberg D. Being prepared to work in Gynecology Medicine: evaluation of an intervention to promote junior gynecologists professionalism, mental health and job satisfaction. Arch Gynecol Obstet 2016; 295:153-162. [DOI: 10.1007/s00404-016-4223-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 10/14/2016] [Indexed: 02/02/2023]
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Weigl M, Stab N, Herms I, Angerer P, Hacker W, Glaser J. The associations of supervisor support and work overload with burnout and depression: a cross-sectional study in two nursing settings. J Adv Nurs 2016; 72:1774-88. [PMID: 26940820 DOI: 10.1111/jan.12948] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2016] [Indexed: 11/28/2022]
Abstract
AIMS To investigate the moderating effects of work overload and supervisor support on the emotional exhaustion-depressive state relationship. BACKGROUND Burnout and depression are prevalent in human service professionals and have a detrimental impact on clients. Work overload and supervisor support are two key job demands and job resources, whose role and interplay for the development and maintenance of burnout and depression are not fully understood yet. DESIGN Two consecutive cross-sectional surveys: survey 1 investigated 111 hospital nursing professionals and survey 2 examined 202 day care professionals. Data collection was completed in 2010. RESULTS After controlling for general well-being and sociodemographic characteristics, nurses' emotional exhaustion was associated with increased depressive state in both samples. We found a meaningful three-way interaction: our results show consistently that the relationship between emotional exhaustion and depressive state was strongest for nurses with high work overload and low supervisor support. Additionally, nurses with low work overload and low supervisor support were also found to have stronger associations between emotional exhaustion and depressive state. CONCLUSION The findings indicate that nurses' reported supervisor support exerts its buffering effect on the burnout-depression link differentially and serves as an important resource for nurses dealing with high self-reported work stress.
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Affiliation(s)
- Matthias Weigl
- Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University Munich, Germany
| | - Nicole Stab
- Department of Psychology, Technical University at Dresden, Germany
| | - Isabel Herms
- BAD Occupational Health and Safety Group, Munich, Germany
| | - Peter Angerer
- Institute for Occupational and Social Medicine, Medical Faculty, Düsseldorf University, Germany
| | - Winfried Hacker
- Department of Psychology, Technical University at Dresden, Germany
| | - Jürgen Glaser
- Institute of Psychology, University of Innsbruck, Austria
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Brandt M, Madeleine P, Ajslev JZN, Jakobsen MD, Samani A, Sundstrup E, Kines P, Andersen LL. Participatory intervention with objectively measured physical risk factors for musculoskeletal disorders in the construction industry: study protocol for a cluster randomized controlled trial. BMC Musculoskelet Disord 2015; 16:302. [PMID: 26474867 PMCID: PMC4609136 DOI: 10.1186/s12891-015-0758-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 10/07/2015] [Indexed: 01/20/2023] Open
Abstract
Background There is high prevalence of back pain and neck-shoulder pain among blue collar workers in Denmark. Excessive physical exposures such as heavy lifting or working with bended or twisted back are risk factors for back pain among workers in the construction industry. Technical evaluation of awkward postures and kinematics of upper/ lower extremities (accelerometry) during work combined with the level of muscular activity (EMG) and video recordings can improve quantification of physical exposure and thereby can facilitate designing preventive strategies. Participatory ergonomics potentially increase the success of interventions aimed at reducing excessive physical exposures. The objectives of this study are to; 1) determine which work-tasks in selected job-groups involve excessive physical load of the back and shoulders during a normal working day (measured with accelerometers, EMG and video recordings). And 2) investigate whether a participatory intervention can reduce the excessive physical workloads, drawing on measurements from phase 1. Methods/Design A two-armed parallel-group, single-blind, cluster randomized controlled trial with allocation concealment will be conducted in the Danish construction industry. Approximately 20 construction gangs (≈80 subjects) will be recruited and randomized at the cluster level (gang). We will record in situ physical workload using technical measurements (EMG, accelerometers and video recordings) during a working day before and after the intervention. Based on these measurements a physical load matrix for each worker will be developed. The participatory intervention consist of three workshops: 1) One at baseline, involving presentation of video clips of the work-tasks with excessive physical load customized for each gang, followed by a participatory development of solutions on how to reduce excessive workloads, leading to development of an action plan on how to implement these solutions at the workplace. 2) A second workshop where the implemented solutions will be further developed and qualitatively evaluated during group discussions. 3) A final workshop at follow-up to enhance long-time organizational sustainability of the implemented solutions. Discussion The results will provide knowledge about the level of physical exposure of the back and shoulders during specific work tasks in the construction industry, and will provide information on options to implement participatory interventions aiming at reducing excessive physical workload. Trial registration ClinicalTrials.gov (NCT02498197), registered 29 June 2015.
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Affiliation(s)
- Mikkel Brandt
- National Research Centre for the Working Environment, Lersø Park Allé 105, Copenhagen, Denmark. .,Department of Health Science and Technology, Physical Activity and Human Performance group, SMI, Aalborg University, Fredrik Bajers vej 7, 9220, Aalborg, Denmark.
| | - Pascal Madeleine
- Department of Health Science and Technology, Physical Activity and Human Performance group, SMI, Aalborg University, Fredrik Bajers vej 7, 9220, Aalborg, Denmark.
| | | | - Markus D Jakobsen
- National Research Centre for the Working Environment, Lersø Park Allé 105, Copenhagen, Denmark.
| | - Afshin Samani
- Department of Health Science and Technology, Physical Activity and Human Performance group, SMI, Aalborg University, Fredrik Bajers vej 7, 9220, Aalborg, Denmark.
| | - Emil Sundstrup
- National Research Centre for the Working Environment, Lersø Park Allé 105, Copenhagen, Denmark.
| | - Pete Kines
- National Research Centre for the Working Environment, Lersø Park Allé 105, Copenhagen, Denmark.
| | - Lars L Andersen
- National Research Centre for the Working Environment, Lersø Park Allé 105, Copenhagen, Denmark. .,Department of Health Science and Technology, Physical Activity and Human Performance group, SMI, Aalborg University, Fredrik Bajers vej 7, 9220, Aalborg, Denmark.
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Exploring Environment-Intervention Fit: A Study of a Work Environment Intervention Program for the Care Sector. ScientificWorldJournal 2015; 2015:272347. [PMID: 26380356 PMCID: PMC4562090 DOI: 10.1155/2015/272347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 05/10/2015] [Accepted: 05/13/2015] [Indexed: 11/17/2022] Open
Abstract
Targeting occupational health and safety interventions to different groups of employees and sectors is important. The aim of this study was to explore the environment-intervention fit of a Danish psychosocial work environment intervention program for the residential and home care sector. Focus group interviews with employees and interviews with mangers were conducted at 12 selected workplaces and a questionnaire survey was conducted with managers at all 115 workplaces. The interventions enhanced the probability of employees experiencing more "good" work days, where they could make a difference to the lives of clients. The interventions may therefore be characterized as culturally compelling and having a good fit with the immediate work environment of employees. The interventions furthermore seemed to fit well with the wider organizational environment and with recent changes in the societal and economic context of workplaces. However, some workplaces had difficulties with involving all employees and adapting the interventions to the organization of work. The findings suggest that flexibility and a variety of strategies to involve all employees are important aspects, if interventions are to fit well with the care sector. The focus on employees' conceptualization of a "good" work day may be useful for intervention research in other sectors.
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Beck D, Lenhardt U, Schmitt B, Sommer S. Patterns and predictors of workplace health promotion: cross-sectional findings from a company survey in Germany. BMC Public Health 2015; 15:343. [PMID: 25886159 PMCID: PMC4399416 DOI: 10.1186/s12889-015-1647-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 03/16/2015] [Indexed: 11/10/2022] Open
Abstract
Background Although the popularity of workplace health promotion (WHP) has considerably increased over the years, there are still concerns about the way this concept is being implemented by the companies. There is, however, a seeming lack of empirical knowledge about variations in WHP practice. Therefore, the aim of this study was to determine the prevalence of different patterns (and related quality levels) of WHP activity and the effect of organisational predictors on the chances of these WHP activity levels being implemented. Methods Data from an establishment survey (N = 6,500) were used to calculate the prevalences of four configurations of WHP among German companies. Furthermore, multinominal logistic regressions were performed to determine odds ratios for these WHP activity levels according to several organisational characteristics. Results 9% of companies exhibited the most comprehensive type of WHP including analysis, individual-directed prevention measures and participatory groups concerned with working conditions improvement (level A), 18% featured a combination of analysis and individual-directed prevention (level B), 29% had reported measures from only one of these categories (level C), and 44% showed no WHP activity at all (level D). In the multivariate analysis company size turned out to be the strongest predictor of WHP at all levels. WHP was also predicted by a good economic situation of the company, the availability of safety specialist assistance, the availability of specialist assistance in occupational health and the presence of an employee representative body. These effects usually became stronger when moving up in the hierarchy of WHP levels. For the two sector-level variables (private vs. public, production vs. services) no statistically significant associations with WHP were found. Conclusions WHP still shows great potential for improvement both in quantitative and qualitative terms. Especially required are additional efforts in developing and implementing WHP practice models and dissemination strategies which are tailored to the particular conditions and needs of small companies. However, findings suggest that the chances for achieving progress in WHP also depend on developments in adjacent policy areas such as labour relations or occupational safety and health.
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Affiliation(s)
- David Beck
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstraße 40-42, 10317, Berlin, Germany.
| | - Uwe Lenhardt
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstraße 40-42, 10317, Berlin, Germany.
| | - Britta Schmitt
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstraße 40-42, 10317, Berlin, Germany.
| | - Sabine Sommer
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstraße 40-42, 10317, Berlin, Germany.
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Gupta N, Wåhlin-Jacobsen CD, Henriksen LN, Abildgaard JS, Nielsen K, Holtermann A. A participatory physical and psychosocial intervention for balancing the demands and resources among industrial workers (PIPPI): study protocol of a cluster-randomized controlled trial. BMC Public Health 2015; 15:274. [PMID: 25886354 PMCID: PMC4378265 DOI: 10.1186/s12889-015-1621-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 03/08/2015] [Indexed: 11/26/2022] Open
Abstract
Background Need for recovery and work ability are strongly associated with high employee turnover, well-being and sickness absence. However, scientific knowledge on effective interventions to improve work ability and decrease need for recovery is scarce. Thus, the present study aims to describe the background, design and protocol of a cluster randomized controlled trial evaluating the effectiveness of an intervention to reduce need for recovery and improve work ability among industrial workers. Methods/Design A two-year cluster randomized controlled design will be utilized, in which controls will also receive the intervention in year two. More than 400 workers from three companies in Denmark will be aimed to be cluster randomized into intervention and control groups with at least 200 workers (at least 9 work teams) in each group. An organizational resources audit and subsequent action planning workshop will be carried out to map the existing resources and act upon initiatives not functioning as intended. Workshops will be conducted to train leaders and health and safety representatives in supporting and facilitating the intervention activities. Group and individual level participatory visual mapping sessions will be carried out allowing team members to discuss current physical and psychosocial work demands and resources, and develop action plans to minimize strain and if possible, optimize the resources. At all levels, the intervention will be integrated into the existing organization of work schedules. An extensive process and effect evaluation on need for recovery and work ability will be carried out via questionnaires, observations, interviews and organizational data assessed at several time points throughout the intervention period. Discussion This study primarily aims to develop, implement and evaluate an intervention based on the abovementioned features which may improve the work environment, available resources and health of industrial workers, and hence their need for recovery and work ability.
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Affiliation(s)
- Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | | | | | | | - Karina Nielsen
- Norwich Business School, University of East Anglia, Norwich, UK.
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark.
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Krajic K, Cichocki M, Quehenberger V. Health-promoting residential aged care: a pilot project in Austria. Health Promot Int 2014; 30:769-81. [PMID: 24682545 DOI: 10.1093/heapro/dau012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Long-term care for the aged is an area that has not been in the focus of health promotion so far. The paper describes context, concept and project plan of a 2-year pilot project of comprehensive health-promoting setting development in residential aged care in Austria, and provides an overview over main experiences and results. Austria's most relevant health promotion agencies, a specialized scientific institute and Austria's largest provider of aged care acted as partners. The project aimed at developing elements of a comprehensive approach, but also providing evidence for the effectiveness of health promotion. Therefore, the project combined an organizational development approach with a scientific, randomized controlled study on mobility enhancement for residents. A comprehensive settings approach turned out acceptable for the main stakeholders of aged care (owners and management, staff, residents and residents' relatives). Strategy development, based on a systematic needs assessment, found staff health to be of special interest for the organization (ergonomics, workability over life course), and residents' relatives, got more attention. The mobility study was able to achieve positive results on occupational performance, concerning quality-of-life indicators and reached also formerly inactive groups. After the end of the project, health promotion is still on the agenda of the organization; further developments will be monitored. Good support from the policy level and well-established networking between the aged care provider, health promotion agencies and a network for health promotion in health care seems to have been an important resource for success.
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Affiliation(s)
- Karl Krajic
- Ludwig Boltzmann Institut Health Promotion Research, Vienna, Austria
| | - Martin Cichocki
- Ludwig Boltzmann Institut Health Promotion Research, Vienna, Austria
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Roland-Lévy C, Lemoine J, Jeoffrion C. Health and well-being at work: The hospital context. EUROPEAN REVIEW OF APPLIED PSYCHOLOGY-REVUE EUROPEENNE DE PSYCHOLOGIE APPLIQUEE 2014. [DOI: 10.1016/j.erap.2014.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Schütte S, Chastang JF, Malard L, Parent-Thirion A, Vermeylen G, Niedhammer I. Psychosocial working conditions and psychological well-being among employees in 34 European countries. Int Arch Occup Environ Health 2014; 87:897-907. [PMID: 24526111 DOI: 10.1007/s00420-014-0930-0] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 02/02/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The aim of this study was to explore the associations between psychosocial working conditions and psychological well-being among employees in 34 European countries. Another objective was to examine whether these associations varied according to occupation and country. METHODS The study was based on data from the European Working Conditions Survey 2010 including 33,443 employees, 16,512 men and 16,931 women, from 34 European countries. Well-being was measured by the WHO-5 well-being index. Twenty-five psychosocial work factors were constructed including job demands, role stressors, work hours, job influence and freedom, job promotion, job insecurity, social support, quality of leadership, discrimination and violence at work, and work-life imbalance. The associations between these factors and well-being were examined using multilevel logistic regression analyses. Different models were performed including interaction tests. RESULTS When all 25 psychosocial work factors were studied simultaneously in the same model with adjustment variables, 13 showed a significant association with poor well-being among both genders: quantitative demands, demands for hiding emotions, low possibilities for development, low meaning of work, low role conflict, low quality of leadership, low social support, low sense of community, job insecurity, low job promotion, work-life imbalance, discrimination, and bullying. The association with low sense of community on poor well-being was particularly strong. CONCLUSIONS A large number of psychosocial work factors were associated with poor well-being. Almost no country and occupational differences were found in these associations. This study gave a first European overview and could be useful to inform cross-national policy debate.
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Affiliation(s)
- Stefanie Schütte
- INSERM, U1018-Team11, CESP Centre for Research in Epidemiology and Population Health, Epidemiology of Occupational and Social Determinants Of Health Team, Hôpital Paul Brousse, Bâtiment. 15/16, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif, France,
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Pronk NP. Integrated worker health protection and promotion programs: overview and perspectives on health and economic outcomes. J Occup Environ Med 2013; 55:S30-7. [PMID: 24284747 PMCID: PMC4155035 DOI: 10.1097/jom.0000000000000031] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To describe integrated worker health protection and promotion (IWHPP) program characteristics, to discuss the rationale for the integration of occupational safety and health and worksite health promotion programs, and to summarize what is known about the impact of these programs on health and economic outcomes. METHODS A descriptive assessment of the current state of the IWHPP field and a review of studies on the effectiveness of IWHPP programs on health and economic outcomes were undertaken. RESULTS Sufficient evidence of effectiveness was found for IWHPP programs when health outcomes were considered. Impact on productivity-related outcomes is considered promising, but inconclusive, whereas insufficient evidence was found for health care expenditures. CONCLUSIONS Existing evidence supports an integrated approach in terms of health outcomes but will benefit significantly from research designed to support the business case for employers of various company sizes and industry types.
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Affiliation(s)
- Nicolaas P Pronk
- From the HealthPartners Institute for Education and Research, Bloomington, Minn, and Harvard School of Public Health, Boston, Mass
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Weigl M, Hornung S, Angerer P, Siegrist J, Glaser J. The effects of improving hospital physicians working conditions on patient care: a prospective, controlled intervention study. BMC Health Serv Res 2013; 13:401. [PMID: 24103290 PMCID: PMC3851860 DOI: 10.1186/1472-6963-13-401] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 10/02/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physicians, particularly in hospitals, suffer from adverse working conditions. There is a close link between physicians' psychosocial work environment and the quality of the work they deliver. Our study aimed to explore whether a participatory work-design intervention involving hospital physicians is effective in improving working conditions and quality of patient care. METHODS A prospective, controlled intervention study was conducted in two surgical and two internal departments. Participants were 57 hospital physicians and 1581 inpatients. The intervention was a structured, participatory intervention based on continuous group meetings. Physicians actively analyzed problematic working conditions, developed solutions, and initiated their implementation. Physicians' working conditions and patients' perceived quality of care were outcome criteria. These variables were assessed by standardized questionnaires. Additional data on implementation status were gathered through interviews. RESULTS Over the course of ten months, several work-related problems were identified, categorized, and ten solutions were implemented. Post-intervention, physicians in the intervention departments reported substantially less conflicting demands and enhanced quality of cooperation with patients' relatives, compared to control group physicians. Moreover, positive changes in enhanced colleague support could be attributed to the intervention. Regarding patient reports of care quality of care, patient ratings of physicians organization of care improved for physicians in the intervention group. Five interviews with involved physicians confirm the plausibility of obtained results, provide information on implementation status and sustainability of the solutions, and highlight process-related factors for re-design interventions to improve hospital physicians work. CONCLUSIONS This study demonstrates that participatory work design for hospital physicians is a promising intervention for improving working conditions and promoting patient quality of care.
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Affiliation(s)
- Matthias Weigl
- Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University Munich, Ziemssenstrasse 1, D-80336 Munich, Germany.
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Lamy S, de Gaudemaris R, Sobaszek A, Caroly S, Descatha A, Lang T. Améliorer les conditions de travail à l'hôpital : ORSOSA, de la démarche de recherche à l'action de prévention. SANTÉ PUBLIQUE 2013. [DOI: 10.3917/spub.134.0389] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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García-Herrero S, Mariscal MA, Gutiérrez JM, Ritzel DO. Using Bayesian networks to analyze occupational stress caused by work demands: preventing stress through social support. ACCIDENT; ANALYSIS AND PREVENTION 2013; 57:114-123. [PMID: 23672926 DOI: 10.1016/j.aap.2013.04.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 02/20/2013] [Accepted: 04/09/2013] [Indexed: 06/02/2023]
Abstract
Occupational stress is a major health hazard and a serious challenge to the effective operation of any company and represents a major problem for both individuals and organizations. Previous researches have shown that high demands (e.g. workload, emotional) combined with low resources (e.g. support, control, rewards) are associated with adverse health (e.g. psychological, physical) and organizational impacts (e.g. reduced job satisfaction, sickness absence). The objective of the present work is to create a model to analyze how social support reduces the occupational stress caused by work demands. This study used existing Spanish national data on working conditions collected by the Spanish Ministry of Labour and Immigration in 2007, where 11,054 workers were interviewed by questionnaire. A probabilistic model was built using Bayesian networks to explain the relationships between work demands and occupational stress. The model also explains how social support contributes positively to reducing stress levels. The variables studied were intellectually demanding work, overwork, workday, stress, and social support. The results show the importance of social support and of receiving help from supervisors and co-workers in preventing occupational stress. The study provides a new methodology that explains and quantifies the effects of intellectually demanding work, overwork, and workday in occupational stress. Also, the study quantifies the importance of social support to reduce occupational stress.
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Nielsen K, Abildgaard JS. Organizational interventions: A research-based framework for the evaluation of both process and effects. WORK AND STRESS 2013. [DOI: 10.1080/02678373.2013.812358] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Baethge A, Rigotti T. Interruptions to workflow: Their relationship with irritation and satisfaction with performance, and the mediating roles of time pressure and mental demands. WORK AND STRESS 2013. [DOI: 10.1080/02678373.2013.761783] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Weigl M, Hornung S, Glaser J, Angerer P. Reduction of Hospital Physicians' Workflow Interruptions: A Controlled Unit-Based Intervention Study. JOURNAL OF HEALTHCARE ENGINEERING 2012. [DOI: 10.1260/2040-2295.3.4.605] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ladou J. The European influence on workers' compensation reform in the United States. Environ Health 2011; 10:103. [PMID: 22151643 PMCID: PMC3267658 DOI: 10.1186/1476-069x-10-103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Accepted: 12/07/2011] [Indexed: 05/31/2023]
Abstract
Workers' compensation law in the United States is derived from European models of social insurance introduced in Germany and in England. These two concepts of workers' compensation are found today in the federal and state workers' compensation programs in the United States. All reform proposals in the United States are influenced by the European experience with workers' compensation. In 2006, a reform proposal termed the Public Health Model was made that would abolish the workers' compensation system, and in its place adopt a national disability insurance system for all injuries and illnesses. In the public health model, health and safety professionals would work primarily in public health agencies. The public health model eliminates the physician from any role other than that of privately consulting with the patient and offering advice solely to the patient. The Public Health Model is strongly influenced by the European success with physician consultation with industry and labor.
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Affiliation(s)
- Joseph Ladou
- Division of Occupational and Environmental Medicine, University of California School of Medicine, San Francisco, CA 94143-0924, USA.
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A Longitudinal Study on the Effects of Health Policy in Organizations on Job Satisfaction, Burnout, and Sickness Absence. J Occup Environ Med 2011; 53:1251-7. [DOI: 10.1097/jom.0b013e318234e2b0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Anderson P, Harrison O, Cooper C, Jané-Llopis E. Incentives for health. JOURNAL OF HEALTH COMMUNICATION 2011; 16 Suppl 2:107-133. [PMID: 21916718 DOI: 10.1080/10810730.2011.601531] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This article discusses incentives to help make healthy choices the easy choices for individuals, operating at the levels of the individual, producers and service providers, and governments. Whereas paying individuals directly to be healthier seems to have a limited effect, offering financial incentives through health insurance improves health. Changing the environment to make healthier choices more accessible acts as an incentive to improve health. Employers can provide incentives to improve the health of their employees. Producers and service providers can take voluntary action to make their products less harmful, and they can be nudged into marketing healthier products within a regulatory environment. International agreements and monitoring systems can incentivize governments to do more for health. Lessons from climate change adaptation suggest that multilevel governance and policy integration are greater obstacles to policy change and implementation than knowing what has to be done. Policy change and implementation are triggered by many drivers, many of which are side effects of other policy pressures rather than of the direct policy goal itself. Effective action to reduce noncommunicable diseases will require leveraging social networks into a new ways of thinking about health; making better health prestigious and aspirational, and giving health and wellness a brand that encourages positive behavior change.
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Affiliation(s)
- Peter Anderson
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
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Hauke A, Flintrop J, Brun E, Rugulies R. The impact of work-related psychosocial stressors on the onset of musculoskeletal disorders in specific body regions: A review and meta-analysis of 54 longitudinal studies. WORK AND STRESS 2011. [DOI: 10.1080/02678373.2011.614069] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Aust B, Rugulies R, Finken A, Jensen C. When workplace interventions lead to negative effects: learning from failures. Scand J Public Health 2011; 38:106-19. [PMID: 21172776 DOI: 10.1177/1403494809354362] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS To investigate if workplace interventions resulted in changes in the psychosocial work environment. Process evaluation was conducted to study the implementation process and to use this knowledge to understand the results. METHODS Seven intervention units (n = 128) and seven non-randomized reference units (n = 103) of a large hospital in Denmark participated in an intervention project with the goal of improving the psychosocial working conditions. The intervention consisted of discussion days for all staff, employee working groups, leader coaching, and activities to improve communication and cooperation. Measures of the psychosocial work environment were conducted before the start of the intervention and again after 16 months using 13 scales from the Copenhagen Psychosocial Questionnaire, version I (COPSOQ I). RESULTS In the intervention units there was a statistically significant worsening in six out of 13 work environment scales. The decrease was most pronounced for three scales that measure aspects of interpersonal relations and leadership. In addition, all three scales that measure aspects of work organization and job content decreased. In comparison, the reference group showed statistically significant changes in only two scales. Process evaluation revealed that a large part of the implementation failed and that different implicit theories were at play. CONCLUSIONS Without the insights gained from process data the negative effects of this intervention could not be understood. Sometimes--as it seems happened in this study--more harm can be done by disappointing expectations than by not conducting an intervention.
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Affiliation(s)
- Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark.
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Westgaard RH, Winkel J. Occupational musculoskeletal and mental health: Significance of rationalization and opportunities to create sustainable production systems - A systematic review. APPLIED ERGONOMICS 2011; 42:261-296. [PMID: 20850109 DOI: 10.1016/j.apergo.2010.07.002] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Revised: 07/09/2010] [Accepted: 07/11/2010] [Indexed: 05/29/2023]
Abstract
This literature review aims to identify occupational musculoskeletal and mental health effects of production system rationalization as well as organizational-level measures that may improve health outcome ("modifiers" in this review). A short review of the effect of ergonomic interventions is included as background and rationalization is discussed as a theoretical concept. Indicator variables for occupational musculoskeletal and mental health and related risk factors are presented. Variables with a generalized format were allowed in the literature searches (e.g., job satisfaction and absenteeism were accepted as risk factor and health indicator, respectively), suitable for the research fields of work sociology, organization science, human resource management (HRM) and economics research. One hundred and sixty-two studies of rationalization effects on health and risk factors and 72 organization-level modifier results were accepted into the final database. Entries were sorted by rationalization strategy and work life sector, and trends in outcome (positive, mixed, no effect, or negative effect on health and risk factors) were determined. Rationalizations have a dominant negative effect on health and risk factors (57% negative, 19% positive); the most negative effects were found for downsizing and restructuring rationalizations in general (71 studies negative, 13 positive) and for the health care sector in particular (36 studies negative, 2 positive). The rationalization strategy High Performance Work System (HPWS) was associated with the highest fraction positive outcome studies (6 of 10 studies). Other rationalization strategies (lean practices, parallel vs. serial production and mechanization level) reported intermediate results, in part dependent on work life sector, but also on the year when studies were carried out. Worker participation, resonant management style, information, support, group autonomy and procedural justice were modifiers with favourable influence on outcome. It is concluded that production system rationalization represents a pervasive work life intervention without a primary occupational health focus. It has considerable and mostly negative influence on worker health, but this can be reduced by attention to modifiers. The results create a basis for new priorities in ergonomic intervention research.
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Affiliation(s)
- R H Westgaard
- Department of Industrial Economics and Technology Management, Norwegian University of Science and Technology, Trondheim, Norway.
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DeJoy DM, Wilson MG, Vandenberg RJ, McGrath-Higgins AL, Griffin-Blake CS. Assessing the impact of healthy work organization intervention. JOURNAL OF OCCUPATIONAL AND ORGANIZATIONAL PSYCHOLOGY 2010. [DOI: 10.1348/096317908x398773] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Krampen G. Evaluation of a Program on Systematic Self-Monitoring and Reflection of Health Behavior in Organisations: Results of Two Randomised Controlled Studies on Well-Being and Absenteeism of Employees and Skilled Workers. Appl Psychol Health Well Being 2010. [DOI: 10.1111/j.1758-0854.2009.01025.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Distribution of effort-reward imbalance in Denmark and its prospective association with a decline in self-rated health. J Occup Environ Med 2009; 51:870-8. [PMID: 19620893 DOI: 10.1097/jom.0b013e3181a9086c] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To analyze the distribution of effort-reward imbalance (ERI) and to investigate its impact on self-rated health in a representative sample of the Danish workforce. METHODS We studied 4977 employees who responded to a questionnaire in 2000, of which 3470 responded to a follow-up survey in 2005. RESULTS The highest (ie, most unfavorable) ERI ratio was found in executives in the public sector, social workers, managing clerks in the public sector, and medical secretaries. A one standard deviation increase of the ERI ratio predicted a 12% (95% confidence intervals = 1.01 to 1.24) decline in self-rated health after adjustment for all covariates. CONCLUSIONS This is the first study that identified job groups with a high exposure to ERI in a representative sample of a national workforce. ERI was a risk factor for a decline in self-rated health.
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Bambra C, Gibson M, Sowden A, Wright K, Whitehead M, Petticrew M. Tackling the wider social determinants of health and health inequalities: evidence from systematic reviews. J Epidemiol Community Health 2009; 64:284-91. [PMID: 19692738 PMCID: PMC2921286 DOI: 10.1136/jech.2008.082743] [Citation(s) in RCA: 344] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background There is increasing pressure to tackle the wider social determinants of health through the implementation of appropriate interventions. However, turning these demands for better evidence about interventions around the social determinants of health into action requires identifying what we already know and highlighting areas for further development. Methods Systematic review methodology was used to identify systematic reviews (from 2000 to 2007, developed countries only) that described the health effects of any intervention based on the wider social determinants of health: water and sanitation, agriculture and food, access to health and social care services, unemployment and welfare, working conditions, housing and living environment, education, and transport. Results Thirty systematic reviews were identified. Generally, the effects of interventions on health inequalities were unclear. However, there is suggestive systematic review evidence that certain categories of intervention may impact positively on inequalities or on the health of specific disadvantaged groups, particularly interventions in the fields of housing and the work environment. Conclusion Intervention studies that address inequalities in health are a priority area for future public health research.
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Affiliation(s)
- C Bambra
- Department of Geography, Wolfson Research Institute, Durham University Queen's Campus, Stockton on Tees TS17 6BH, UK.
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Henning R, Warren N, Robertson M, Faghri P, Cherniack M. Workplace health protection and promotion through participatory ergonomics: an integrated approach. Public Health Rep 2009; 124 Suppl 1:26-35. [PMID: 19618804 PMCID: PMC2708654 DOI: 10.1177/00333549091244s104] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A multidisciplinary team of researchers at the Center for the Promotion of Health in the New England Workplace (CPH-NEW) developed an evidence-based approach to address three recognized challenges to workplace programs designed to improve employee health: establishing employee ownership, integrating with work organization, and sustainability. The two main innovations being introduced in combination were (1) integrating traditional workplace health protection (e.g., ergonomics, industrial hygiene) with health promotion (e.g., assisting workers in improving health behaviors) and (2) introducing a bottom-up participatory model for engaging employees in innovative iterative design efforts to enhance both components of this integrated program. In the program, which was modeled after participatory ergonomics programs, teams of workers engage in the iterative design of workplace interventions to address their prioritized health concerns with the support of a multilevel steering committee. The integrated approach being tested can complement existing worksite safety and health initiatives and promote organizational learning, with expected synergistic effects.
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Affiliation(s)
- Robert Henning
- Center for the Promotion of Health in the New England Workplace, Psychology Department, University of Connecticut, 406 Babbidge Rd., Storrs, CT 06269-1020, USA.
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Participatory Intervention for Workplace Improvements on Mental Health and Job Performance Among Blue-Collar Workers: A Cluster Randomized Controlled Trial. J Occup Environ Med 2009; 51:554-63. [DOI: 10.1097/jom.0b013e3181a24d28] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bambra C, Gibson M, Sowden AJ, Wright K, Whitehead M, Petticrew M. Working for health? Evidence from systematic reviews on the effects on health and health inequalities of organisational changes to the psychosocial work environment. Prev Med 2009; 48:454-61. [PMID: 19162064 DOI: 10.1016/j.ypmed.2008.12.018] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2008] [Revised: 12/21/2008] [Accepted: 12/22/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To map the health effects of interventions which aim to alter the psychosocial work environment, with a particular focus on differential impacts by socio-economic status, gender, ethnicity, or age. METHODS A systematic approach was used to identify, appraise and summarise existing systematic reviews (umbrella review) that examined the health effects of changes to the psychosocial work environment. Electronic databases, websites, and bibliographies, were searched from 2000-2007. Experts were also contacted. Identified reviews were critically appraised and the results summarised taking into account methodological quality. The review was conducted in the UK between October 2006 and December 2007. RESULTS Seven systematic reviews were identified. Changes to the psychosocial work environment were found to have important and generally beneficial effects on health. Importantly, five reviews suggested that organisational level psychosocial workplace interventions may have the potential to reduce health inequalities amongst employees. CONCLUSION Policy makers should consider organisational level changes to the psychosocial work environment when seeking to improve the health of the working age population.
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Affiliation(s)
- C Bambra
- Department of Geography, Wolfson Research Institute, Durham University Queen's Campus, Stockton on Tees, UK.
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