‘Management Standards’ and work-related stress in the UK: policy background and science

A better approach to mitigate the risk of airborne infections in workplaces

Although the worst of the coronavirus disease 2019 pandemic appears to be over, the burden of airborne infection in workplaces remains unacceptably high, leaving society vulnerable, and harming workers and others. A better approach is needed to mitigate the risk of infection as actively as other multifactorial ubiquitous risks such as workplace stress. Sources and pathways of transmission need much improved control, with special emphasis on ensuring the protection of the vulnerable and susceptible.

A mixed-methods stress audit with midwives in the United Kingdom

PROBLEM

UK midwives report high work-related stress, which can negatively impact their health and wellbeing, with many considering leaving the profession.

BACKGROUND

An occupational stress audit guides the implementation of stress management intervention, by identifying which stressors have the most negative impact and why, and highlighting "at risk" groups.

AIM

To conduct a concurrent mixed-methods stress audit with UK midwives in an NHS Trust.

METHODS

Seventy-one midwives (Mage= 39 years, SD = 11) completed a survey assessing stressors (e.g., relationships), stress appraisals (i.e., challenge vs. threat), coping strategies (e.g., avoidance-focused), and outcomes (i.e., mental health, performance, and intention to leave). Ten midwives (Mage = 42 years, SD = 10) participated in semi-structured interviews.

FINDINGS

Quantitative data revealed that more work-related demands, poorer peer support and relationships, and threat appraisals predicted worse mental health. Moreover, less control and more work-related demands predicted poorer performance, while less control, poorer manager support, more change-related demands, and threat appraisals predicted greater intention to leave. Qualitative data generated three themes: organisational pressures exacerbated by unexpected changes; individualised responses but largely debilitative emotions; and personal coping and power of social support.

DISCUSSION AND CONCLUSION

This study offered a comprehensive and novel insight into the stress experiences of UK midwives, highlighting targets for future stress management interventions, including key stressors (e.g., manager support), underlying mechanisms (e.g., stress appraisals), and "at-risk" groups (e.g., night shift workers). Practical recommendations are provided for stakeholders operating at multiple levels (e.g., midwife, trust, policy) to better support midwives with work-related stress.

Women's experiences of sexual harassment in the retail clothing industry: a grounded theory study

Introduction

Sexual harassment is a significant problem in workplaces all over the world. Women's reactions to sexual harassment are influenced by various factors. The aim of the current study was to investigate how women respond sexual harassment in the retail clothing industry.

Methods

In-depth face-to-face interviews were conducted with 16 women aged 23-44 years (mean 29.18 years) employed for at least 3 years in clothes shops in Shiraz, Iran. A grounded theory approach was used to analysis the data and raise hypotheses.

Results

The main perpetrators of sexual harassment for female saleswomen were male customers. The women experienced conflict-induced stimulation (core phenomenon) when they were faced with sexual harassing behaviors (causal conditions). Such stimulation prompted three types of coping strategies: silence, avoidance, or confrontation. Intervening factors like the characteristics of the Iranian society (including family mores, state-imposed hijab regulations, patriarchal culture, educational system, and regulatory monitoring) and contextual factors (including individual and environmental factors and particularly employer expectations) were found to influence the selection of strategies used as well as their potential consequences in challenging situations.

Conclusion

The current study used a grounded theory approach to produce an explanatory storyline that can be tested. Sexual harassment induces conflict-induced stimulation and responses are influenced by intervening conditions, contextual factors, selected strategies, and the perceived consequences of the response. The findings of the grounded theory study suggest that there are negative consequences, particularly in terms of lack of employer support and losing one's job, shame, and family disapproval which act as barriers for female saleswomen to counteracting sexual harassment from male customers. Such an understanding can also be applied to develop educational policies to support women as well as ameliorate the prevalence of this essentially illegal problem.

Causes and solutions to workplace psychological ill-health for nurses, midwives and paramedics: the Care Under Pressure 2 realist review

Background

Nurses, midwives and paramedics are the largest collective group of clinical staff in the National Health Service and have some of the highest prevalence of psychological ill-health. Existing literature tends to be profession-specific and focused on individual interventions that place responsibility for good psychological health with nurses, midwives and paramedics themselves.

Aim

To improve understanding of how, why and in what contexts nurses, midwives and paramedics experience work-related psychological ill-health; and determine which high-quality interventions can be implemented to minimise psychological ill-health in these professions.

Methods

Realist synthesis methodology consistent with realist and meta-narrative evidence syntheses: evolving standards' reporting guidelines.

Data sources

First round database searching in Medical Literature Analysis and Retrieval System Online Database ALL (via Ovid), cumulative index to nursing and allied health literature database (via EBSCO) and health management information consortium database (via Ovid), was undertaken between February and March 2021, followed by supplementary searching strategies (e.g. hand searching, expert solicitation of key papers). Reverse chronology screening was applied, aimed at retaining 30 relevant papers in each profession. Round two database searches (December 2021) targeted COVID-19-specific literature and literature reviews. No date limits were applied.

Results

We built on seven key reports and included 75 papers in the first round (26 nursing, 26 midwifery, 23 paramedic) plus 44 expert solicitation papers, 29 literature reviews and 49 COVID-19 focused articles in the second round. Through the realist synthesis we surfaced 14 key tensions in the literature and identified five key findings, supported by 26 context mechanism and outcome configurations. The key findings identified the following: (1) interventions are fragmented, individual-focused and insufficiently recognise cumulative chronic stressors; (2) it is difficult to promote staff psychological wellness where there is a blame culture; (3) the needs of the system often override staff well-being at work ('serve and sacrifice'); (4) there are unintended personal costs of upholding and implementing values at work; and (5) it is challenging to design, identify and implement interventions to work optimally for diverse staff groups with diverse and interacting stressors.

Conclusions

Our realist synthesis strongly suggests the need to improve the systemic working conditions and the working lives of nurses, midwives and paramedics to improve their psychological well-being. Individual, one-off psychological interventions are unlikely to succeed alone. Psychological ill-health is highly prevalent in these staff groups (and can be chronic and cumulative as well as acute) and should be anticipated and prepared for, indeed normalised and expected. Healthcare organisations need to (1) rebalance the working environment to enable healthcare professionals to recover and thrive; (2) invest in multi-level system approaches to promote staff psychological well-being; and use an organisational diagnostic framework, such as the NHS England and NHS Improvement Health and Wellbeing framework, to self-assess and implement a systems approach to staff well-being.

Future work

Future research should implement, refine and evaluate systemic interventional strategies. Interventions and evaluations should be co-designed with front-line staff and staff experts by experience, and tailored where possible to local, organisational and workforce needs.

Limitations

The literature was not equivalent in size and quality across the three professions and we did not carry out citation searches using hand searching and stakeholder/expert suggestions to augment our sample.

Study registration

This study is registered as PROSPERO CRD42020172420. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172420.

Funding

This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR129528) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information.

Investigating the role of organizational stress in nurses' psychosomatic complaints: Evidence from a study in northeastern Italy

Background

Nursing is pivotal to healthcare delivery but is often associated with high levels of organizational stress. In this cross-sectional study, we aimed to investigate the associations between exposure to organizational stressors, measured using the Health and Safety Executive Management Standards Indicator Tool, and psychosomatic complaints among nurses in a medium-sized city hospital in northeastern Italy.

Methods

A total of 215 nurses participated in the study, completing self-report questionnaires assessing organizational stressors and the prevalence of psychosomatic complaints experienced over the preceding six months.

Results

Significant associations were observed between various organizational stressors and psychosomatic complaints among nurses. Specifically, the Relationships factor emerged as a significant predictor of palpitations, irritability, anxiety, physical and mental tiredness, and headache. Additionally, Demands and Managers' support were identified as significant predictors of specific psychosomatic complaints.

Conclusion

This study highlights the critical role of addressing organizational stressors, particularly those related to interpersonal relationships, in promoting nurse well-being and optimizing patient care delivery. Despite its strengths, including the use of a well-established measurement tool and a comprehensive assessment of psychosomatic complaints, limitations such as the cross-sectional design and self-report measures warrant consideration. By prioritizing supportive work environments and implementing targeted interventions, healthcare organizations can cultivate a culture of well-being among nurses, ultimately enhancing the quality and safety of healthcare delivery.

Occupational stress and musculoskeletal disorders in firefighters: the mediating effect of depression and job burnout

The firefighting profession carries a heightened risk of musculoskeletal disorders. A firefighter's job is physically demanding and includes activities such as running, climbing, dragging, and lifting. Often, these tasks are unpredictable, performed in harsh environments, and have been found to cause psychological stress. The purpose of this study was to investigate the effects of occupational stress on work-related musculoskeletal disorders (WRMSD) in firefighters. In addition, the mediating effects of depression and job burnout on proposed relationships were examined. Data informing this study were collected using a survey questionnaire. The survey questionnaire included the Beck Depression Inventory, the Center for Epidemiological Studies Depression Scale (CES-D), the Maslach Burnout Inventory, the Post Traumatic Stress Disorder Inventory (PCL), and the Nordic Musculoskeletal Questionnaire. Collected data were analyzed using structural equation modeling approach in AMOS. The results of the 2339 responding firefighters suggest that work related stress is positively related to WRMSDs in firefighters and can lead to musculoskeletal symptoms through four paths, being emotional exhaustion, personal accomplishment, CES-D total score, and depersonalization. Through depersonalization, job stress had the most significant impact on musculoskeletal symptoms (coefficient = 0.053). Furthermore, the results showed that post-traumatic stress disorders (PTSD) can affect musculoskeletal symptoms through ten paths, again through depersonalization, PTSD had the most significant impact on musculoskeletal symptoms (coefficient = 0.141). The results of this study suggest that organizations should design interventions and policies to prevent and manage occupational stress, depression, and job burnout to negate its undesired consequences on firefighters' health (i.e. WRMSD).

Relationships between job stress, post-traumatic stress and musculoskeletal symptoms in firefighters and the role of job burnout and depression mediators: a bayesian network model

INTRODUCTION

Job stress, post-traumatic stress disorder (PTSD), and negative psychological outcomes in firefighters can be caused, or aggravated, by their work. These mental disorders can impart musculoskeletal symptoms. This study aimed to investigate relationships between musculoskeletal and psychological disorders in a population of firefighters using a Bayesian network model.

METHODS

This cross-sectional study, conducted in 2022, included 2339 firefighters who completed questionnaires during their rest periods. The questionnaires comprised of demographical information, the Occupational Stress Questionnaire-HSE, the PTSD Checklist, Maslach Burnout Inventory, Center for Epidemiologic Studies - Depression scale (CES-D), and Nordic Musculoskeletal Questionnaire. GeNIe academic software was used to analyze the Bayesian network.

RESULTS

High job stress and high PTSD each increased the probability of musculoskeletal symptoms by 34%. When combined, high job stress and high PTSD increased the probability of musculoskeletal symptoms by 37%. Among the mediator's burnout and depression, depression had the highest association with musculoskeletal symptoms.

CONCLUSIONS

Job stress and PTSD can increase musculoskeletal symptoms and are influenced by psychological mediators (like burnout and depression). Adopting preventive and therapeutic measures to mitigate job stress and PTSD, mitigate and rehabilitate WMSD, and manage associated mediators are critical for the mental and physical health of firefighters.

Psychological well-being of hospice staff: systematic review

BACKGROUND

Poor psychological well-being among healthcare staff has implications for staff sickness and absence rates, and impacts on the quality, cost and safety of patient care. Although numerous studies have explored the well-being of hospice staff, study findings vary and the evidence has not yet been reviewed and synthesised. Using job demands-resources (JD-R) theory, this review aimed to investigate what factors are associated with the well-being of hospice staff.

METHODS

We searched MEDLINE, CINAHL and PsycINFO for peer-reviewed quantitative, qualitative or mixed-methods studies focused on understanding what contributes to the well-being of hospice staff who provide care to patients (adults and children). The date of the last search was 11 March 2022. Studies were published from 2000 onwards in the English language and conducted in Organisation for Economic Co-operation and Development countries. Study quality was assessed using the Mixed Methods Appraisal Tool. Data synthesis was conducted using a result-based convergent design, which involved an iterative, thematic approach of collating data into distinct factors and mapping these to the JD-R theory.

RESULTS

A total of 4016 unique records were screened by title and abstract, 115 full-text articles were retrieved and reviewed and 27 articles describing 23 studies were included in the review. The majority of the evidence came from studies of staff working with adult patients. Twenty-seven individual factors were identified in the included studies. There is a strong and moderate evidence that 21 of the 27 identified factors can influence hospice staff well-being. These 21 factors can be grouped into three categories: (1) those that are specific to the hospice environment and role, such as the complexity and diversity of the hospice role; (2) those that have been found to be associated with well-being in other similar settings, such as relationships with patients and their families; and (3) those that affect workers regardless of their role and work environment, that is, that are not unique to working in a healthcare role, such as workload and working relationships. There was strong evidence that neither staff demographic characteristics nor education level can influence well-being.

DISCUSSION

The factors identified in this review highlight the importance of assessing both positive and negative domains of experience to determine coping interventions. Hospice organisations should aim to offer a wide range of interventions to ensure their staff have access to something that works for them. These should involve continuing or commencing initiatives to protect the factors that make hospices good environments in which to work, as well as recognising that hospice staff are also subject to many of the same factors that affect psychological well-being in all work environments. Only two studies included in the review were set in children's hospices, suggesting that more research is needed in these settings.

PROSPERO REGISTRATION NUMBER

CRD42019136721 (Deviations from the protocol are noted in Table 8, Supplementary material).

Development and Validation of a Resilience Skills Questionnaire for Health Sector Professionals Based on Social Cognitive Theory

Good resilience skills support effective and timely adjustment to demanding situations in the workplace. Existing tools are insufficient to develop and evaluate workplace interventions to improve employee's resilience skills. The aim of this study was to develop and validate a Resilience Skills Questionnaire (RSQ) using the key constructs of social cognitive theory-self-efficacy, self-regulation, and social support-as a theoretical framework. Following DeVellis' guidelines for scale development, first an expert panel of thirteen professors was recruited to support the item development stages and determine content validity. At this stage, the initial pool of 38 items was reduced to 25 items and CVR and CVI were calculated as 0.92 and 0.93, respectively, indicating good content validity. A second panel of ten health professionals confirmed face validity. An online survey comprised of the 25 developed items was then completed by 336 health professionals working in urban healthcare centers in Shiraz, Iran, in November 2021. The data were used to assess the psychometrics of the questionnaire according to its hypothesized three-dimensional structure. Confirmatory factor analysis yielded a final model of seventeen items in three dimensions, self-efficacy (six items), social support (six items), and self-regulation (five items), with good psychometric properties (χ2/df = 2.44 (p < 0.001), RMSEA = 0.06, GFI = 0.92, AGFI = 0.90, IFI = 0.93, CFI = 0.93). All standardized factor loadings were significant (p < 0.001). Internal consistency, as measured by Cronbach's alpha, was very good: RSQ (0.90), self-efficacy (0.86), social support (0.83), and self-regulation (0.86). Based on these results, the RSQ can be used as a standard and valid measure to develop and evaluate the effect of educational intervention programs to improve resilience skills and reduce job stress.

Role of demographic variables in investigating occupational stress of disaster and emergency medical management center

BACKGROUND

Emergency medical services face stressful environments such as departments dealing with injuries and sick patients that pose challenging situations for the healthcare staff. This present study investigates the role of demographic variables in investigating occupational stress of disaster and emergency medical management center in 2021.

MATERIALS AND METHODS

This present descriptive study selected a sample size of 200 medical personnel associated with disaster and emergency medical management center in Iran, according to the inclusion chosen criteria. The study used a tool consisting of two parts, including demographic information and a job stress Health and Safety Executive (HSE) standard questionnaire. The study selected respondents through Cochran's sample size formula using stratified random sampling with a cross-sectional research design for data collection. This present study has analyzed received data using performed the descriptive and inferential information (t-test and one-way ANOVA) at a significance level P < 0.05. The participants of the survey were males only.

RESULTS

The study results specified that the mean age of respondents was 30.14 ± 5.96. The study results exhibited that the mean score of total occupational stress was 3.41 ± 0.26. The results showed the highest (4.34 ± 0.35) and the lowest (2.72 ± 0.86) stress levels were related to role dimensions.

CONCLUSIONS

The study findings revealed a significant relationship between stress level and participants' age, marital status, educational level, type of base, workplace, and the number of work hours per month. Emergency medical personnel experience a high level of occupational stress. Senior managers can use similar studies to implement measures to reduce the experience of employees' stress.

Patterns of work-related stress and their predictors among emergency department nurses and emergency medical services staff in a time of crisis: a latent profile analysis

BACKGROUND

Previous studies have shown that a disease outbreak may cause high stress among healthcare workers. However, the vast majority of those studies applied a variable-centered approach, in which relationships between the variables are believed to be identical across the studied population. The main purpose of this study was to identify latent profiles of healthcare workers with similar combinations of levels of various work-related stressors during the coronavirus disease 2019 (COVID-19) pandemic and to examine their predictors.

METHODS

A cross-sectional paper-and-pencil study was conducted among a convenience sample of 297 emergency department (ED) nurses and 219 emergency medical services (EMS) staff members working in 10 hospital EDs and 52 EMS centers in Ardabil province, Iran. Data were collected using the Health and Safety Executive Management Standards Indicator Tool (HSE-MS IT).

RESULTS

Using the latent profile analysis (LPA), five work-related stress profiles were identified: "high stress with a good understanding of one's job role" (11.1%), "moderate stress" (41.9%), "relatively high stress with average demands and a very low understanding of one's job role" (23.8%), "low stress" (18.0%), and "generally low stress but with very high job demands and relational conflicts" (5.2%). Age, marital status, service location, workplace, and the number of overtime hours significantly predicted profile membership.

CONCLUSION

The results of the study suggest the importance of incorporating various sources of stress and using the person-centered approach when investigating the work-related stress of healthcare workers during disease outbreaks. Identifying sociodemographic and work-related predictors of profile membership may be useful for preparing interventions that will be better suited to healthcare workers' needs.

Effectiveness of a transactional model-based education programme for enhancing stress-coping skills in industrial workers: a randomized controlled trial

The aim of this study was to examine the effectiveness of a stress management educational intervention programme based on the Transactional Model of Stress and Coping (TMSC) among industrial workers. Participants were 106 employees of a power plant in Iran, randomly assigned into an intervention group and a control group. The intervention comprised active and participatory methods to enhance employees coping skills and it was delivered in six face-to-face sessions. Data was collected using the Ways of Coping Questionnaire, the Multidimensional Scale of Perceived Social Support, the Perceived Stress Scale, and the Spiritual Well-Being Scale at baseline and three months after the intervention. We found mean scores of distancing, self-controlling, seeking social support, escape-avoidance, planned problem-solving, positive reappraisal, total coping skills, perceived social support, and spiritual well-being significantly differed at follow-up compared to baseline in the intervention group, but not in the control group. There was also a significant difference in the mean score of perceived stress between the two groups. We conclude that the educational intervention based on the TMSC was effective in improving coping skills and reducing perceived stress. We suggest that interventions based on the TMSC model can be supportive in workplaces where job stress is common.

Psychometric properties of the HSE Indicator Tool: evidence from Argentina

BACKGROUND

The Health and Safety Executive's Management Standards Indicator Tool (MSIT) is a 35-item self-report questionnaire that assesses seven psychosocial risk factors associated with work-related stress. Although the instrument has been validated in the UK, Italy, Iran and Malta, no validation studies have been carried out in Latin America.

AIMS

To examine the factor structure, validity and reliability of the MSIT among Argentine employees.

METHODS

A sample of employees of different organizations from Rafaela and Rosario, Argentina, completed an anonymous questionnaire that included the Argentine MSIT and specific scales to measure job satisfaction, workplace resilience and perceived mental and physical health (12-item Short Form Health Survey). Confirmatory factor analysis was used to determine the factor structure of the Argentine MSIT.

RESULTS

A total of 532 employees participated in the study (74% response rate). After testing three measurement models, the final respecified model was composed of 24 items distributed in six factors (demands, control, manager support, peer support, relationships and role clarity), showing satisfactory fit indices. The original MSIT change factor was discarded. Composite reliability ranged from 0.70 to 0.82. Although all dimensions showed adequate discriminant validity, convergent validity for control, role clarity and relationships is a matter of concern (average variance extracted values ≤ 0.50). Criterion-related validity was demonstrated by significant correlations between the MSIT subscales and job satisfaction, workplace resilience and mental and physical health.

CONCLUSIONS

The Argentine version of the MSIT presents good psychometric properties for use among employees of the region. Further research is needed to provide more evidence on the convergent validity of the questionnaire.

The study protocol for the randomized controlled trial of the effects of a theory-based intervention on resilience, social capital, psychological wellbeing, and health-promoting lifestyle in healthcare workers

BACKGROUND

The workplace has been identified as a key determinant of health status. There is evidence of innumerable health problems among employees, particularly healthcare workers. Against this background, a holistic-systemic approach together with a good theoretical framework is required to reflect on this issue, and to support the design of effective interventions to promote the health and wellbeing of the given population. The present study aims to evaluate the effectiveness of an educational intervention in improving resilience, social capital, psychological wellbeing, and health-promoting lifestyle in healthcare workers, utilizing the Social Cognitive Theory integrated into the PRECEDE-PROCEED model.

METHODS

This randomized controlled trial will be performed on a large sample of the employees working in two healthcare centers in the city of Shiraz, Iran. The study will proceed with the healthcare workers of one city being given the educational intervention and the healthcare workers of the other city serving as a control group. Using a census method, all healthcare workers in the two cities will be informed of the trial and its purpose, and then invitations to join the study will be issued. The minimum sample size required has been calculated as 66 individuals in each healthcare centers. Recruitment to the trial will by systematic random sampling of eligible employees who submit an expression of interest in joining the trial, and subsequently give informed consent. Data will be collected through a self-administered survey instrument at three stages: at baseline, and both immediately and three months after the intervention. The experimental group members should participate in at least eight of the ten weekly educational sessions of the intervention and complete the surveys in the three stages. There is no educational intervention for the control group, and they simply experience some routine programs, and complete the surveys at the same three timepoints.

DISCUSSION

The findings will provide evidence for the possible effectiveness of a theory-based educational intervention to improve resilience, social capital, psychological wellbeing, and health-promoting lifestyle among healthcare workers. If the educational intervention is found to be effective, then its protocol will be exploited in other organizations to boost resilience. Trial registration IRCT20220509054790N1.

Caring in a crisis: Understanding the stressors and uplifts for National Health Service frontline staff through the lens of clinical psychologists

The unprecedented public health crisis of the Covid-19 pandemic resulted in a significant challenge to the delivery of healthcare that has rarely been experienced before. The stress already faced by healthcare staff working in the National Health Service (NHS) has been further exacerbated during Covid-19, putting them at risk of adverse mental health outcomes. Through the lens of clinical psychologists who had provided support to frontline healthcare staff during the Covid-19 pandemic, this study aimed to better understand the stressors and uplifts healthcare staff experienced during Covid-19, the impact of these on the wellbeing of staff and patient care, and to examine the support needed to deal with the impact of a crisis. A qualitative study design using a combination of diaries followed by semi-structured interviews was utilised. Data was analysed using thematic analysis. The following five themes represented the stressors and uplifts experienced by NHS frontline healthcare staff during Covid-19, the impact on staff wellbeing and patient care: facing change; risks of working in the NHS environment; transcending the negatives; challenging professional values and haunted by patient deaths. The findings also highlight the importance of providing psychological support and suggest the need to continue to provide this support service to help NHS staff manage through subsequent waves of the pandemic. These findings can contribute towards both the management of the current Covid-19 pandemic and other similar crises in the future.

Job stress and university faculty members' life satisfaction: The mediating role of emotional burnout

As one of the leading work-related health problems arising from increasingly fierce competition, work-related stress has become a significant predictor of the reduced wellbeing of university faculty members, especially for non-tenured junior faculty members. In light of this and based on a survey, this research seeks to examine how and why work-related stress impacts the life satisfaction level of university junior faculty members. The results indicate that the three subdivisions of university faculty members' work-related stress, namely, research stress, teaching stress, and administrative stress, are all negatively related to their life satisfaction level. In addition, emotional burnout has been confirmed to function as the psychological mechanism for the aforementioned main effects. The research contributes to the literature mainly by offering a new insight in which the three subdivisions of work-related stress are regarded as independent variables affecting the life satisfaction level of university junior faculty members.

Nurses' assessed self-efficacy levels to medical asepsis and their relation to structural empowerment, work engagement and work-related stress

BACKGROUND

Nurses' working conditions are important for their well-being at work and for their ability to provide patients with safe care. Self-efficacy can influence employees' behaviour at work. Therefore, it is valuable to study self-efficacy levels to medical asepsis in relation to working conditions.

OBJECTIVE

To investigate the relationship between nurses' assessed self-efficacy levels to medical asepsis in care situations and structural empowerment, work engagement and work-related stress.

METHODS

A cross-sectional study with a correlational design was conducted. A total of 417 registered nurses and licensed practical nurses at surgical and orthopaedic units responded to a questionnaire containing: the Infection Prevention Appraisal Scale, the Conditions of Work Effectiveness Questionnaire-II, the Utrecht Work Engagement Scale-9 and the Health & Safety Executive Management Standards Indicator Tool. Correlational analyses and group comparisons were performed.

RESULTS

The nurses rated high levels of self-efficacy to medical asepsis in care situations. The correlational analyses revealed that correlation coefficients between structural empowerment, work engagement, work-related stress and self-efficacy to medical asepsis were 0.254-0.268. Significant differences in self-efficacy were found in the grouped working conditions.

CONCLUSIONS

This study revealed that nurses rated high self-efficacy levels to medical asepsis and, to some extent, this seemed related to structural empowerment, work engagement and work-related stress. This valuable knowledge could enable improvements at the managerial and organisational levels, benefiting both nurses and patients in the long run.

Occupational Safety and Health Staging Framework for Decent Work

The 2030 United Nations Goal 8 for sustainable development focuses on decent work. There is utility in identifying the occupational safety and health aspects of Goal 8, as they pertain to the four pillars of decent work: job creation, social protection, rights of workers, and social dialogue. A workgroup of the International Commission on Occupational Health and collaborators addressed the issue of decent work and occupational safety and health (OSH) with the objective of elaborating a framework for guidance for practitioners, researchers, employers, workers, and authorities. This article presents that framework, which is based on an examination of the literature and the perspectives of the workgroup. The framework encompasses the intersection of the pillars of decent (employment creation, social protection, rights of workers, and social dialogue) work with new and emerging hazards and risks related to various selected determinants: new technologies and new forms of work; demographics (aging and gender); globalization; informal work; migration; pandemics; and OSH policies and climate change. The OSH field will need an expanded focus to address the future of decent work. This focus should incorporate the needs of workers and workforces in terms of their well-being. The framework identifies a starting point for the OSH community to begin to promote decent work.

The impact of national legislation on psychosocial risks on organisational action plans, psychosocial working conditions, and employee work-related stress in Europe

Work-related psychosocial hazards are recognised as a key priority in the future of work. Even though European Union (EU) legislation requires employers to assess and manage all types of risks to workers' health and safety associated with all types of hazards in the work environment, it does not include clear reference to psychosocial risks and work-related stress. In several EU member states, there is now more specific legislation on psychosocial risks that clarifies employer responsibilities. The aim of this study is to explore whether the introduction of specific legislation on psychosocial risks and/or work-related stress is related to organisations implementing action plans to prevent work-related stress, and in turn, better psychosocial working conditions (job demands and resources), and less reported work-related stress in the workforce. It does so by comparing EU member states and candidate countries that have introduced more specific legislation to those that have not, conducting multilevel modelling analysis by linking two representative European-level datasets, the 2014 employer European Survey of Enterprises on New & Emerging Risks and the 2015 employee European Working Conditions Survey. Findings indicate that the presence of specific national stress legislation is associated with more enterprises having a work-related stress action plan. The existence of action plans was found to be associated with increased job resources but not decreased job demands. Furthermore, only in those countries with specific national legislation on stress, job resources were found to be associated with less reported stress through the existence of organisational action plans. Findings lend support to the argument for more specific legislation on psychosocial risks/work-related stress in the EU. However, they also raise questions on whether current interventions implemented at organisational level to deal with work-related stress may be geared more towards the development of individual resources and less towards better work organisation and job design.

Occupational stress and its relationship with spiritual coping among emergency department nurses and emergency medical services staff

Introduction

Emergency Department (ED) nurses and Emergency Medical Services (EMS) Staff are faced with several stressors daily, such as the COVID 19 pandemic situation, which affects the health and the quality of services to patients. Spiritual coping with stress is an attempt to overcome the stress on the basis of what is transcendent. The use of spiritual coping strategies helps a person to overcome tensions caused by the work environment.

Objective

The current study aimed to investigate occupational stress and its relationship with spiritual coping among ED nurses and EMS staff.

Materials and methods

This study was descriptive-correlational research. Using convenience sampling methods, 516 ED nurses and EMS staff were enrolled in the study. The study instruments included demographic information, HSE Occupational Stress, and spiritual coping questionnaires. Data were analyzed using SPSSv.22 software and the descriptive statistics, Pearson correlation test, t-test, ANOVA, and multiple linear regression.

Results

The highest and lowest levels of occupational stress were the dimensions of “demand” (2.96 ± 0.65) and “role” (3.89 ± 0.81) respectively. Multiple linear regression analysis showed that positive spiritual coping, negative spiritual coping, workplace, service location, type of employment, and work position were important factors affecting the occupational stress of ED nurses and EMS staff, which accounted for 0.34% of the variance.

Conclusion

The findings showed the need to improve the work environment for ED nurses and EMS staff, including changes in physical working conditions, salaries, and better employment conditions. Training programs are recommended to reduce stress through the use of positive spiritual coping strategies.

Co-Design, Delivery, and Evaluation of Wellbeing Initiatives for NHS Staff: The HOW (Healthier Outcomes at Work) NHS Project

Stress and mental health are leading causes of sickness absence in the UK, responsible for over 50% of sickness absence across the country. Healthcare sector workers play a vital role in the life of everyone across the country but have among the highest levels of sickness absence of any sector. The aim of this project, therefore, was to work with UK healthcare workers to co-develop, implement, and evaluate a series of mental health and wellbeing interventions delivered via a smartphone app and associated toolkit. A participatory action research methodology, consisting of individual interviews, focus group discussions, and oversight by an expert action learning group, was used to develop primary (i.e., those associated with the workplace) and secondary (improving individual resilience and coping) stress management interventions. Pre-post-intervention analysis demonstrated improvements in work engagement and working conditions, although significant improvements were only found in mean scoring on demands, control, managerial support, and peer support working condition measures. The project therefore demonstrates that co-produced initiatives which focus on improving either the organisation or resilience of the workforce may be useful in supporting employee health and wellbeing. Future studies should build upon these findings through a full RCT to determine utility of the interventions.

Is the health-awareness of leaders related to the working conditions, engagement, and exhaustion in their teams? A multi-level mediation study

Background

Research shows that leaders influence the health and well-being of employees, by being either a buffer or major source of employee’s work stressors. Various leadership behaviors and their relation to employee outcomes have been examined. Yet, a satisfactory explanation of how leaders’ behavior influences health has not been found. A new line of research investigates the construct of “health-oriented leadership”, that is, the health awareness of leaders towards themselves (“self-care”) and towards their employees (“staff-care”). It is hypothesized that this health-orientation has a direct effect on both leader’s and employees’ health, as well as an indirect effect mediated by their working conditions.

Methods

Data were derived from four company research projects, that involved employee and leader surveys on work, health, and well-being. The sample consisted of 50 teams, with 191 leaders and 604 team members. To test the relation between a leader’s self-care and his/her engagement, exhaustion, as well as staff-care, multiple regression analyses and mediation analyses were conducted. The relation between a leader’s staff-care, the team’s job resources and demands, and the individual employee outcomes engagement and exhaustion were tested with multilevel analyses.

Results

Regression analysis showed that the stronger a leader’s health-orientation towards him/−herself (“self-care”), the stronger was the health-orientation towards his/her employees (“staff-care”). A leader’s self-care was also associated with higher work engagement and lower exhaustion and this relation was mediated by his/her job resources and demands, respectively. Multilevel analysis showed that a leader’s staff-care was associated with employee work engagement and exhaustion, and that this relation was mediated by team-level job resources and demands, respectively.

Conclusions

The health-orientation of leaders relates to their own as well as their teams’ engagement and exhaustion, which is partly mediated by job demands and resources. Thus the construct of health-orientation may prove worthy of further exploration. For practical conclusions, this study provides support for researching not different leadership styles with very specific facets, but a general orientation towards health, which can be implemented into coaching and consulting sessions for organizations.

The Perceived Occupational Stress Scale

Abstract. This article aims to present the development and test the psychometric properties of the Perceived Occupational Stress (POS) scale, a new brief instrument aimed at rating a worker’s perception of feeling stressed at work. Six studies are conducted on an overall sample of 1,805 Italian workers, to examine both the construct and concurrent validity of the POS scale. The results demonstrate the high internal consistency (α = .82) and test-retest reliability ( r = .86) of the POS scale, as well as its structural validity and concurrent validity with the Maslach Burnout Inventory ( r = .68 with Emotional Exhaustion) and the Effort-Reward Imbalance Questionnaire ( r = .62 with Imbalance and r = .51 with Overcommitment). Moreover, the POS scale is determined to uniquely contribute toward predicting stress-related health complaints, over and above indicators of workplace stressors, as measured by the Health and Safety Executive Management Standards Indicator Tool ( R2change = .06). Overall, the present findings indicate that the POS scale is a valid and reliable instrument for self-reporting occupational stress levels, and it could be used together with existing risk assessment measures of stress, to obtain a comprehensive evaluation of work-related stress.

Understanding job stress in The Iranian oil industry: A qualitative analysis based on the work systems model and macroergonomics approach

The aim of this study was to understand why and how working in the oil industry causes job stress. Using the work-systems model as a guiding framework, we conducted 15 in-depth interviews with employees of an oil company located on an island in the Persian Gulf to investigate work system-related stressors. The interviews were audio-taped, and qualitative content data analysis was carried out continuously and simultaneously with data collection over a 12-month period. 1118 meaning codes were extracted which could be understood though fourteen categories of stressor associated with the five themes of the work system. Employees reported the job was stressful primarily because of organizational structural problems and management attributes, although aspects of living and working on the small island were also difficult. These results provide direction for intervention that can dovetail with risk assessment of occupational health of workers.

HSE Management Standards and burnout dimensions among rehabilitation professionals

BACKGROUND

The Health & Safety Executive Indicator Tool (HSE-IT) is a standard-based questionnaire commonly used to assess work-related stress in organizations. Although the HSE-IT validity has been well documented and significant relationships have been observed between its scales and several work-related outcomes, to date there is no evidence concerning the relationships between the HSE-IT and burnout among healthcare workers.

AIMS

To investigate the relationships between the HSE-IT subscales and burnout dimensions as measured by the Maslach Burnout Inventory (MBI) in a sample of Italian rehabilitation professionals employed in healthcare institutions.

METHODS

An anonymous cross-sectional questionnaire was administered to a sample of Italian rehabilitation professionals including physical therapists, occupational therapists, psychiatric rehabilitation technicians and developmental psychomotor therapists. Associations between the HSE-IT and the MBI were analysed with multiple linear regression models.

RESULTS

A total of 432 rehabilitation professionals completed the questionnaire and 14% of them showed high levels of burnout risk. Significant differences in the HSE-IT scores were found between workers at high risk of burnout and workers at low risk of burnout. Hierarchical regressions showed an association between the HSE-IT scales and the MBI factors: emotional exhaustion was associated with 'demands' and 'role', and both depersonalization and personal accomplishment were associated with 'control' and 'role'.

CONCLUSIONS

This preliminary study showed the HSE-IT subscales are sensitive to burnout risk as measured by the MBI. The association found between the HSE-IT 'demands', 'role' and 'control' subscales and the MBI dimensions is significant but small. These findings might inform targeted burnout prevention.

The Role of Occupational Health Services in Psychosocial Risk Management and the Promotion of Mental Health and Well-Being at Work

The development and enhancement of occupational health services (OHS) at the national level is central to ensuring the sustainable health, well-being and work engagement of the working population. However, due to differences in national health, social security and occupational safety and health systems, the content, capacity, coverage and provisions of OHS vary considerably across national contexts. Obtaining a better understanding in terms of such similarities and variations internationally is essential as such comparative information can help inform evidenced-based decision-making on OHS at both policy and practice levels. This paper therefore reviews and analyses the key policies, standards and approaches in OH systems and services, using both academic and grey literature, across 12 industrialised countries (Australia, Canada, Finland, France, Germany, Ireland, Italy, Japan, The Netherlands, Poland, United Kingdom and the United States of America). It provides a detailed overview and categorization of OHS in these selected countries in terms of the legal and policy context, organisation and financing and coverage and staffing while specifically discussing variations aimed at psychosocial risk management and the promotion of mental health and well-being at work. It draws conclusions on key development needs of OHS internationally to ensure psychosocial risk management and mental health promotion are prioritised effectively in a preventive manner.

Measuring Well-Being in Sport Performers: Where are We Now and How do we Progress?

The importance of optimal well-being and mental health in elite athletes has received increasing attention and debate in both the academic and public discourse. Despite the number of challenges and risk factors for mental health and well-being recognised within the performance lifestyle of elite athletes, the evidence base for intervention is limited by a number of methodological and conceptual issues. Notably, there exists an increasing emphasis on the development of appropriate sport-specific measures of athlete well-being, which are required to underpin strategies targeted at the protection and enhancement of psychosocial functioning. Therefore, the purpose of this article is to review psychometric issues in well-being research and discuss the implications for the measurement of well-being in sport psychology research. Drawing on the broader literature in related disciplines of psychology, the narrative discusses four key areas in the scale development process: conceptual and theoretical issues, item development issues, measurement and scoring issues, and analytical and statistical issues. To conclude, a summary of the key implications for sport psychology researchers seeking to develop a measure of well-being is presented.

Prediction of metabolic syndrome based on sleep and work-related risk factors using an artificial neural network

BACKGROUND

Metabolic syndrome (MetS) is a major public health concern due to its high prevalence and association with heart disease and diabetes. Artificial neural networks (ANN) are emerging as a reliable means of modelling relationships towards understanding complex illness situations such as MetS. Using ANN, this research sought to clarify predictors of metabolic syndrome (MetS) in a working age population.

METHODS

Four hundred sixty-eight employees of an oil refinery in Iran consented to providing anthropometric and biochemical measurements, and survey data pertaining to lifestyle, work-related stressors and sleep variables. National Cholesterol Education Programme Adult Treatment Panel ІІI criteria was used for determining MetS status. The Management Standards Indicator Tool and STOP-BANG questionnaire were used to measure work-related stress and obstructive sleep apnoea respectively. With 17 input variables, multilayer perceptron was used to develop ANNs in 16 rounds of learning. ANNs were compared to logistic regression models using the mean squared error criterion for validation.

RESULTS

Sex, age, exercise habit, smoking, high risk of obstructive sleep apnoea, and work-related stressors, particularly Role, all significantly affected the odds of MetS, but shiftworking did not. Prediction accuracy for an ANN using two hidden layers and all available input variables was 89%, compared to 72% for the logistic regression model. Sensitivity was 82.5% for ANN compared to 67.5% for the logistic regression, while specificities were 92.2 and 74% respectively.

CONCLUSIONS

Our analyses indicate that ANN models which include psychosocial stressors and sleep variables as well as biomedical and clinical variables perform well in predicting MetS. The findings can be helpful in designing preventative strategies to reduce the cost of healthcare associated with MetS in the workplace.

Work Stress in NHS Employees: A Mixed-Methods Study

The United Kingdom’s National Health Service (NHS) has a higher-than-average level of stress-related sickness absence of all job sectors in the country. It is important that this is addressed as work stress is damaging to employees and the organisation, and subsequently impacts patient care. The aim of this study was to gain an in-depth understanding of working conditions and wellbeing in NHS employees from three employing NHS Trusts through a mixed-methods investigation. First, a cross-sectional organisational survey was completed by 1644 respondents. Questions examined working conditions, stress, psychological wellbeing, job satisfaction, and presenteeism. This was followed by 33 individual semistructured interviews with NHS staff from a variety of clinical and nonclinical roles. Quantitative findings revealed that working conditions were generally positive, although most staff groups had high levels of workload. Regression outcomes demonstrated that a number of working conditions influenced mental wellbeing and stress. Three themes were generated from thematic analysis of the interview data: wellbeing at work, relationships, and communication. These highlight areas which may be contributing to workplace stress. Suggestions are made for practical changes which could improve areas of difficulty. Such changes could improve staff wellbeing and job satisfaction and reduce sickness absence.

Implementation and effectiveness of the Stress Check Program, a national program to monitor and control workplace psychosocial factors in Japan: a systematic review. Translated secondary publication

Purpose

The purpose of this paper is to conduct a comprehensive review on the implementation and the effect of Japan's Stress Check Program, a national program to monitor and control workplace psychosocial factors that was initiated in December 2015.

Design/methodology/approach

We comprehensively reviewed articles published in Japanese and English, assessed the performance of the Stress Check Program and summarized future challenges. We also discussed the implications for practice.

Findings

The available literature presented a scientific basis for the efficiency and validity of predictions using the Brief Job Stress Questionnaire, which is the instrument recommended to screen workers with high stress in the program. No study has verified the effect of the program on workers' mental health by using group analysis of stress check results. There is room for improvement in tools that contribute to identifying workers with high stress and in measures for improving the work environment. The Stress Check Program contrasts with risk management of psychosocial factors at work, widely adopted in European countries as a strategy for improving workers' mental health by focussing on the psychosocial work environment.

Practical implications

Although the effectiveness of the Japanese program needs further evaluation, future developments of the program would provide insight for national policies on psychosocial risks/psychosocial stress at work.

Originality/value

This paper is the first systematic review on the implementation and effects of Japan's Stress Check Program.

Assessing the Risk of Stress in Organizations: Getting the Measure of Organizational-Level Stressors

Great Britain's Health and Safety Executive (HSE) developed the Management Standards Indicator Tool to help organizations to assess and monitor organizational risks of work-related stress through surveying employees about the psychosocial risks for stress in their jobs. The use of employee-level data for deriving an organizational-level measure of psychosocial risks assumes that the constructs have equivalent meanings at different levels. However, this isomorphic condition has never been tested and this study fills this gap. Using data collected by the Italian Workers' Compensation Authority (INAIL) from 66,188 employees nested in 775 organizations, we demonstrate that the organizational-level measure representing the seven dimensions of the Management Standards Indicator Tool is equivalent, though not identical, to the individual-level measure. This implies that the organizational level is not a mirror of the aggregation of the individual level, and that the risk of work-related stress in an organization may derive not simply from bottom-up processes, but may be generated by top-down influences (e.g., organizational policies). Interventions may then be meaningfully targeted at the organizational level in the expectation that they will reduce the risk of work-related stress among the entire workforce, the valid measurement of which can be performed through the HSE's Management Standards Indicator Tool.

Dealing With Death in Custody: Psychosocial Consequences for Correctional Staff

This study investigated experiences of trauma and psychosocial mediators in correctional staff who had dealt with a death in custody within the previous year. A total of 211 participants completed the Trauma Symptom Index as well as measures of self-efficacy, optimism, problem-solving style, social support, and growth. The data showed that around 32% of participants were exhibiting symptoms at a clinical level. Prior experience with suicide and level of involvement in the incident were direct predictors of symptom level. Support, optimism, self-efficacy, and confidence in problem-solving seemed to be potential protective factors and were also predictive of trauma-related growth. Although the study was cross sectional, the data suggest that it may be possible to predict factors that are protective and therefore offer some hope in terms of developing preventive strategies.

A measure to assess the workplace well-being of psychological practitioners

The well-being of psychological practitioners is a key factor in the effective delivery of psychological therapies and the effectiveness of mental health services. Despite this, there are no measures of well-being for this professional group. The 26-item psychological practitioner workplace well-being measure (PPWWM) measures psychological well-being for psychological practitioners and was informed by a qualitative study. Items were generated and then verified by groups of practitioners using sorting tasks. The items reflect a broad range of issues relevant to the workplace well-being of psychological practitioners. The PPWWM was validated with a sample of 400 psychological practitioners recruited through professional networks. Internal consistency (α = .92) and test-retest reliability (r = .94) were high. Construct validity was indicated by positive correlations with the Health and Safety Executive Management Standards Indicator Tool and Satisfaction with Life Scale and negative correlation with the General Health Questionnaire. Exploratory factor analysis produced six factors, explaining 61.2% of the variance: professional and organizational; support and flexibility; professional role; physical environment; clinical supervision; and external personal. PPWWM scores were not significantly associated with a range of demographic variables (gender, health/disability, profession, and type of organization), but it did correlate significantly and negatively with age. The PPWWM has potential application as a brief measure, suitable for large-scale surveys that specifically measures workplace well-being in psychological practitioners. Future research could include cross validation with new samples and validation with subgroups of psychological practitioners.

Consideration of psychosocial factors in workplace risk assessments: findings from a company survey in Germany

PURPOSE

Work-related psychosocial risks are an increasingly important issue in occupational safety and health (OSH) policy. In Germany, as in many other European countries, employers are legally required to carry out workplace risk assessments (WRAs) and to account for psychosocial factors when doing this. The aim of this study was to expand the still scarce and sketchy empirical evidence on the extent to which employers comply with these obligations, as well as on possible determinants of compliance behaviour.

METHODS

Survey data from 6500 German companies were used to calculate the prevalence of workplace risk assessments that include psychosocial factors. Furthermore, multinomial logistic regressions were performed to explore which company characteristics influence the chance of psychosocial risk assessment occurrence.

RESULTS

The prevalence of psychosocial risk assessments was 21%. Next to company size (OR = 5.7, 95% CI 3.0-11.0), availability of safety specialist assistance (OR = 3.5, 95% CI 2.6-4.6), availability of occupational health specialist assistance (OR = 3.4; 95% CI 2.6-4.4) and inspection by OSH authority (OR = 3.4, 95% CI 2.4-4.7) were the strongest predictors of psychosocial risk assessment occurrence. Smaller (but still significant) effect sizes were found for the level of knowledge about legal OSH requirements, training of managers in OSH, economic situation of the company, presence of a works council, positive view on the benefit of OSH, affiliation with the production sector and magnitude of psychosocial risks within the company.

CONCLUSIONS

The study results indicate large deficiencies in the implementation of psychosocial risk assessments, especially for small companies. Findings suggest that enhancing companies' utilisation of professional OSH experts and strengthening the advisory and control capacities of the OSH inspection authorities in the area of psychosocial risks would be beneficial for improving the current situation.

Sickness presenteeism at work: prevalence, costs and management

INTRODUCTION

Presenteeism is defined as continuing to attend work during illness. As a growing health concern, awareness of the factors that encourage presenteeism and the risks of this behaviour is needed.

SOURCES OF DATA

A narrative review of research obtained via several databases, including Medline and Psycinfo, was conducted.

AREAS OF AGREEMENT

A range of contextual and individual factors is associated with presenteeism. Workers in some sectors, such as healthcare, appear to be at greater risk. Presenteeism may facilitate rehabilitation and recovery but it can exacerbate existing health problems and increase the risk of subsequent illness and absence as well as impair workability.

AREAS OF CONTROVERSY

The incidence of sickness presenteeism is rising, alongside reductions in absenteeism. The growing awareness of the costs of presenteeism, especially in safety-critical environments, suggests that it should be considered a risk-taking behaviour and carefully measured and managed.

GROWING POINTS AND AREAS FOR DEVELOPING RESEARCH

Measuring presenteeism as well as absenteeism will provide more accurate information about employee health. Raising awareness of the risks of working while sick and the economic, moral, cultural and social pressures on employees to do so appears crucial. Systemic interventions to manage presenteeism based on research evidence are required.

Assessing Objective and Verifiable Indicators Associated With Work-Related Stress: Validation of a Structured Checklist for the Assessment and Management of Work-Related Stress

Risk assessment represents an essential part of any successful intervention in health and safety at work. The most prominent European methodologies propose multi-method approaches for identifying the risks associated with work-related stress. Nevertheless, the most widely used method is the self-administered questionnaire. By adapting the UK Management Standards approach, the Italian National Workers Compensation Authority (INAIL) developed a checklist for the assessment of objective and verifiable indicators of work-related stress. This checklist is filled in by a steering group composed of homogenous groups of workers. Through a web-platform developed by INAIL, a considerable amount of data over the last 5 years has been collected throughout Italy. The aims of this study are to examine the psychometric properties as well as the practical validity of the checklist in a wide sample of Italian companies. The sample comprised 5,301 homogeneous groups of workers nested within 1,631 organizations. The checklist measures two main areas: (1) the organizational indicators of work-related stress (sentinel events) and (2) four and six factors related respectively to content and context of work. Multilevel and multivariate analyses revealed that the checklist shows adequate factor structure and criterion validity. Results also demonstrate that small companies and the public and healthcare sector show higher risk levels. These results support the use of the checklist as a structured and generalizable tool for assessing and monitoring the risks associated with work-related stress.

A Prospective Cohort Study of the Impact of Return-to-Work Coordinators in Getting Injured Workers Back on the Job

Purpose To assess the impact of workplace-based return-to-work (RTW) Coordinators' interpersonal and functional activities on RTW outcomes. Methods Multivariable logistic regression analyses of cross-sectional and longitudinal survey responses of 632 injured workers with at least 10 days of work absence in Victoria, Australia, adjusting for demographic and other workplace factors. Outcome was being back at work for at least 1 month, measured at both baseline and 6 month follow-up survey. Participant responses to stressfulness of Coordinator interactions were dichotomised into good and poor and evaluated as a proxy for Coordinators' interpersonal activities, while having a RTW plan was evaluated as a proxy for functional activities. Results At baseline, RTW plans doubled the odds of RTW (OR 2.02; 95% CI 1.40-2.90) and attenuated the impact of good Coordinator interactions (1.14; 0.77-1.70). At 6-month follow-up, the opposite was observed: good interactions nearly doubled odds of RTW (1.90; 1.22-2.95) while RTW plans were non-significant (1.02; 0.68-1.54). Conclusions Differences between when the two Coordinator activities were effective may be due to the nature of claimants who RTW in each survey period. Length of shorter-duration claims are influenced by injury related factors, while psychosocial factors tend to be more important for longer-duration claims. Such factors may determine whether a claimant is more likely to respond to Coordinators' functional or interpersonal activities. The findings have important implications for increasing Coordinator effectiveness.

Job demands, resources and mental health in UK prison officers

Background

Research findings indicate that working as a prison officer can be highly stressful, but the aspects of work that predict their mental health status are largely unknown.

Aims

To examine, using elements of the demands-resources model, the extent to which work pressure and several potential resources (i.e. control, support from managers and co-workers, role clarity, effective working relationships and positive change management) predict mental health in a sample of UK prison officers.

Methods

The Health and Safety Executive Management Standards Indicator Tool was used to measure job demands and resources. Mental health was assessed by the General Health Questionnaire-28. The effects of demands and resources on mental health were examined via linear regression analysis with GHQ score as the outcome.

Results

The study sample comprised 1267 prison officers (86% male). Seventy-four per cent met 'caseness' criteria for mental health problems. Job demands, poor interpersonal relationships, role ambiguity and, to a lesser extent, low job control and poor management of change were key predictors of mental health status.

Conclusions

The findings of this study can help occupational health practitioners and psychologists develop structured interventions to improve well-being among prison officers.

Effect of the National Stress Check Program on mental health among workers in Japan: A 1-year retrospective cohort study

Objectives:

This retrospective cohort study evaluated the impact of the Stress Check Program, a recently introduced national policy and program aimed at reducing psychological distress among Japanese workers.

Methods:

A baseline survey was conducted from November 2015 to February 2016, the period when Japan began enforcing the Stress Check Program. A one-year follow-up survey was conducted in December 2016. In the follow-up survey, two exposure variables were collected: having taken the annual stress survey, and experiencing an improvement in the psychosocial work environment. Psychological distress was assessed using the Brief Job Stress Questionnaire (BJSQ) at baseline and 1-year follow-up. The two exposure variables were used to define four groups: "Neither", "Stress survey (SS) only", "Psychosocial work environment improvement (WI) only", and "Both". BJSQ results were analyzed using repeated measures general linear modeling (GLM).

Results:

The study included 2,492 participants: 1,342 in the "Neither" group, 1,009 in the "SS only" group, 76 in the "WI only" group, and 65 in the "Both" group. Overall time-group interaction effects were not significant. The "Both" group showed significantly greater improvements in psychological distress than the "Neither" group (p = 0.02) at the 1-year follow-up, although the effect size was small (d = -0.14).

Conclusions:

Combination of the annual stress survey and improvement in psychosocial work environment may have been effective in reducing psychological distress in workers, although the effect size was small.

A comparison of work stressors in higher and lower resourced emergency medicine health settings

OBJECTIVES

The study compares experiences of workplace stressors for emergency medicine trainees and specialists in settings where the specialty is relatively well resourced and established (Canada), and where it is newer and less well resourced (South Africa, (SA)).

METHODS

We conducted an online cross-sectional survey of emergency medicine trainees and physicians in both countries for six domains (demands, role, support, change, control, and relationships) using the validated Management Standards Indicator Tool (MSIT, Health, and Safety Executive, United Kingdom).

RESULTS

74 SA and 430 Canadian respondents were included in our analysis. SA trainees (n=38) reported higher stressors (lower MSIT scores) than SA specialists (n=36) for demands (2.2 (95%CI 2.1-2.3) vs. 2.7 (2.5-2.8)), control (2.6 (2.4-2.7) vs. 3.5 (3.3-3.7)) and change (2.4 (2.2-2.6) vs. 3.0 (2.7-3.3)). In Canada, specialists (n=395) had higher demands (2.6 (2.6-2.7) vs. 3.0 (2.8-3.1)) and manager support stressors (3.3 (3.3-3.4) vs. 3.9 (3.6-4.1)) than trainees (n=35). Canadian trainees reported higher role stressors (4.0 (95%CI 3.8-4.1) vs. 4.2 (4.2-4.3)) than Canadian specialists. SA trainees had higher stressors on all domains than Canadian trainees. There was one domain (control) where Canadian specialists scored significantly lower than SA specialists, whereas SA specialists had significantly lower scores on peer support, relationships and role.

CONCLUSIONS

Work related stressor domains were different for all four groups. Perceived stressors were higher in all measured domains among SA trainees compared with Canadian trainees. The differences between the SA and Canadian specialists may reflect the developing nature of the specialty in SA, although the Canadian specialists reported less control over their work than SA counterparts.