Health-related Work Limitations Among Older Workers-the Role of Flexible Work Arrangements and Organizational Climate

Adult Burn Survivors and Burn Care Staff Perceptions Regarding Transitioning From the Burn Unit: A Cross-Country Qualitative Study in Ghana and China

Rehabilitative care for burn patients in developing countries is often wrought with several issues. Post-discharge support is equally challenging as there is often limited rehabilitative care as the burn survivors and their families transition. To inform practice, this study sought to explore the perspectives of adult burn survivors and burn care staff regarding transitioning from the burn unit and the development of a transitional rehabilitation programme. We employed interpretive description for this study. Semi-structured face-to-face interviews were conducted with adult burn survivors and burn care staff across two tertiary healthcare facilities in Lanzhou, Gansu Province of China, and Ghana. The thematic analytical approach was employed to analyse the data. Forty-six participants comprising 26 adult burn survivors and 20 burn care staff participated in this study. Two themes and five subthemes emerged from the data. Transitioning from the burn unit to the home was described as complex with varied biopsychosocial needs emerging. However, available support was not comprehensive to resolve these needs. Existing pre-discharge support is limited across both settings. Burn survivors expressed interest in taking on an active role in the rehabilitation process and being able to self-manage their post-burn symptoms following discharge. Transitional rehabilitative support should include an active follow-up system, ensure patient- and family-centred support, and offer a bundle of comprehensive rehabilitative services using locally available items which do not financially burden burn survivors and their families. In conclusion, transitioning from the burn unit is filled with varied health needs. Transitional rehabilitative care is required to bridge the pre-discharge and post-discharge periods.

Behind the times? Associations of working-time autonomy with health-related and occupational outcomes in health care personnel- a latent profile analysis

BACKGROUND

In the light of personnel shortage, the health care sector is facing the challenge to combine increasing employees' as well as patients' needs. The aim of this study was to investigate the association between working-time autonomy and health-related (fatigue, psychosomatic complaints and work ability), as well as occupational outcomes (job satisfaction and turnover intention) in a large sample of health care employees.

METHOD

Based on data of the BauA-Working Time survey, a sample of n = 1,093 employees working in the health care sector was analysed. Outcomes were assessed by the German Fatigue Scale, the Work Ability-Index and single-item measurements. Besides descriptive analyses, latent profile analysis (LPA) was used to determine clusters of employees based on working-time autonomy. Subsequently, regression analyses have been conducted to examine the association between autonomy clusters with health-related and occupational outcomes, controlling for sociodemographic characteristics and employment status.

RESULTS

LPA revealed that a three-cluster model was most suitable: high autonomy (cluster 1), medium autonomy (cluster 2) and low autonomy (cluster 3). The extracted profiles of working-time autonomy differed significantly in terms of sociodemographic and occupational characteristics, but not in terms of average working hours per week or monthly household income. The multivariate regression analysis revealed that being in the low-autonomy cluster was associated with more psychosomatic health complaints (IRR: 1.427, p = 0.008), lower work ability (OR 0.339, p < 0.001), as well as less job satisfaction (OR 0.216, p < 0.001).

DISCUSSION

Overall, the analyses indicate that it is crucial to prospectively consider working-time autonomy as an important factor of satisfaction, well-being and turnover intention in health care employees.

A systematic review of literature on occupational health and safety interventions for older workers

As the global population ages there is an imperative to enhance labour participation of older workers in ways that support good physical and psychological health. However, there is limited guidance for organisations on how to do this effectively. This systematic review examined literature identified through four databases and a targeted web-search, yielding 39 PRISMA records (32 scholarly, seven grey literature) reporting workplace interventions aimed at improving the injury outcomes of older workers. The review revealed that organisational and composite interventions may be most effective, although an absence of robust research in this area and a scarcity of empirical evidence-based interventions known to improve injury outcomes for older workers was noted. Responding to these shortcomings, this article presents 'A future research agenda for older worker health, safety and well-being interventions.' This systems-based approach has a dual focus on organisational and composite interventions combined with robust research design.Practitioner summary: We conducted a systematic literature review of studies focussed on workplace interventions to improve the physical and psychological safety of older workers. Within the existing literature, evidence for effective interventions and guidance for organisations is weak. We present a future research agenda with a systems approach to address these gaps.

Concurrent trajectories of part-time work and sickness absence: a longitudinal cohort study over 11 years among shift working hospital employees

OBJECTIVES

To investigate the concurrent changes in part-time work and sickness absence (SA) in healthcare. Another aim was to investigate the role of age and sex on different concurrent trajectory groups.

DESIGN

Prospective cohort study.

SETTING

Public hospital districts (n=10) and cities (n=11) in Finland.

PARTICIPANTS

Payroll-based objective working hour data of the healthcare sector in Finland for 28 969 employees in 2008-2019 were used. The final sample included those working shifts with 3 consecutive years of data and without baseline (≥14 days) SA.

PRIMARY OUTCOMES

Part-time work (yes or no) and months of SA.

MEASURES

Group-based trajectory modelling to identify concurrent changes in part-time work, and months of SA while controlling the time-variant amount of night work and multinomial regression models for relative risk (RR) with 95% CIs were used.

RESULTS

Four-group trajectory model was the best solution: group 1 (61.2%) with full-time work and no SA, group 2 (16.9%) with slowly increasing probability of part-time work and low but mildly increasing SA, group 3 (17.6%) with increasing part-time work and no SA, and group 4 (4.3%) with fluctuating, increasing part-time work and highest and increasing levels of SA. Men had a lower (RR 0.49-0.75) and older age groups had a higher likelihood (RRs 1.32-3.79) of belonging to trajectory groups 2-4.

CONCLUSIONS

Most of the sample were in the trajectory group with full-time work and no SA. The probability of part-time work increased over time, linked with concurrent low increase or no SA. A minor group of employees had both an increased probability of part-time work and SA. Part-time work and other solutions might merit attention to promote sustainable working life among healthcare employees.

Older Worker-Orientated Human Resource Practices, Wellbeing and Leave Intentions: A Conservation of Resources Approach for Ageing Workforces

At a time where there are ageing populations, global shortages of skilled labour, and migration pathways impacted by the COVID-19 pandemic, retaining older workers presents as a vital strategic initiative for organizations globally. This study examines the role of Human Resource Practices (HRPs), which are oriented towards accommodating the needs of an ageing workforce in mitigating psychological distress and turnover intentions. The study collected self-reported survey data from 300 Australian employees over the age of 45, over two time points. Using structural equation modelling, the study analyzed the extent to which Older Worker-oriented Human Resources Practices (OW-HRPs) translate into employee psychological health and retention within organizations, through the mediation of ageism and work-life conflict. The results support our hypothesis that OW-HRPs are associated with lower ageism, better work-life balance; and in combination these reduce psychological distress and help retain older workers in the workforce. We conclude that OW-HRPs can foster work environments conducive to older worker wellbeing, supporting the retention of talent and maintaining effectiveness, in the face of substantial labour supply challenges brought on by the COVID-19 pandemic and an ageing population.

Unmet Needs in Endometriosis: Lessons from COVID-19

BACKGROUND

One key challenge of the COVID-19 pandemic is health care access. Government-imposed restrictions and increased health care burden have induced considerable changes to health care services and their delivery. These are likely to have substantially impacted those with chronic conditions such as endometriosis, as they require sustained management.

AIMS

Our objective was to explore the impact of the COVID-19 pandemic on the experience of people with endometriosis, and to use this information to inform health care delivery for the management of chronic conditions in a COVID-normal future.

MATERIALS AND METHODS

Invitation to participate in an open-ended online survey through social media of Australian endometriosis organizations and the Royal Women's Hospital, Melbourne. Surveys were analyzed qualitatively through template analysis.

RESULTS

Of 576 surveys returned, 329 reported COVID-19 having an impact. Fifteen areas of impact were identified and grouped under three domains: impact on access to health care services, impact on daily life, and impact of isolation. Common impacts included reduced access to health care services, improved symptom management due to decreased day-to-day travel and work-from-home arrangements, and both positive and negative views of telehealth services.

CONCLUSIONS

This study provides in-depth insight into the experiences of people with endometriosis during the COVID-19 pandemic, confirming previous studies' findings and offering insight into discrepancies between the Australian Healthcare system categorization of surgeries as "non-essential," and patient views of these procedures as "essential" to their well-being. Results may inform future adjustments to health care services and delivery to improve the lives of people with endometriosis, and by extension, other chronic conditions.

Night Work and Sustainable Working Life-A Prospective Trajectory Analysis of Swedish Twins

The aim was to investigate the changes in sustainable working life over 10-13 years of follow-up and the effect of baseline night work. Data from the Swedish national registers were used to define sustainable working life. Survey data in the 1998-2003 "SALT" with 34,680 twins or in the 2004-2006 "STAGE" with 19,637 twins were utilized to assess night work at baseline. Group-based trajectory and multinomial regression models were applied. The results of the SALT cohort yielded five trajectory solutions: stable sustainable working life (40%), stable lack of sustainable working life (25%), later decreasingly sustainable working life (15%), increasingly sustainable working life (14%), and early decreasingly sustainable working life (7%). In the STAGE cohort, four trajectories were detected: stable sustainable working life (83%), decreasingly sustainable working life (7%), stable lack of sustainable working life (5%), and increasing sustainable working life (5%). Night work was associated with the decreasing or increasing sustainable working life in the trajectory groups. To conclude, the largest parts of both cohorts followed trajectories of stable sustainable working lives. Night work was associated with both the trajectories of decreasing and increasing sustainable working lives.

How Do Newly Diagnosed Chronic Health Conditions Affect Older Workers' Vitality and Worries About Functional Ability?

With increasing retirement ages, older workers are working longer while being newly diagnosed with chronic health conditions (CHCs). Our knowledge on how newly diagnosed CHCs influence older workers' vitality and worries is limited. We examine how four newly diagnosed CHCs affect older workers' vitality and worries about physical and mental functional ability. We used data from a Dutch pension panel survey. A sample of 1,894 older workers (60-62 years) was analyzed using conditional change OLS regression models. Having CHCs decreased vitality and increased worries. This effect was worse for older workers newly diagnosed with CHCs. Being newly diagnosed with physically disabling conditions increased worries about physical functioning, while being newly diagnosed with mentally disabling conditions increased worries about mental functioning. These findings aid the identification of vulnerable groups of older workers, thereby informing interventions that could improve quality of life, while promoting healthy aging at work.

Age Diversity Management in Organizations Scale: Development and Evidence of Validity

Abstract This study aimed to develop the Age Diversity Management in Organizations scale for the Brazilian context and verify its evidence of validity. The process included five steps: proposal of its definition and development of the items according to the literature; content and semantic validity by judges; semantic validity by the target population; exploratory factorial analysis (EFA); and confirmatory factorial analysis (CFA). The EFA sample consisted of 674 workers from different organizations and the CFA of 722 workers. The final version of the scale was composed of 20 items (α =.91), divided into four factors: retirement preparation practices (5 items, α =.93); equal treatment for workers of different ages (6 items, a=.85), training to promote age diversity (5 items, α =.81), and management practices for older workers (4 items, α =.72). The theoretical and practical implications as well as the limitations of this measure are discussed.

Responding to Disability Onset in the Late Working Years: What do Older Workers do?

This study uses occupational data from the Health and Retirement Study to document the link between disability onset and occupational transitions among older adults who are working and do not report a disabling condition at age 55. We find that one-quarter of workers go on to experience new disabilities before full-retirement age. Relative to their peers who do not report disabilities, stopping work and significant occupational changes are more common among workers who experience new disabilities. Our results suggest that policies to support labor force attachment might consider the importance of new disability onset and whether employer accommodations might help workers with new disabling conditions remain in the jobs they held when their health began to limit their work.

The retention of older employees and core work activities: Evidence from Denmark

BACKGROUND AND OBJECTIVES

Retention of older employees in the labour market is crucial to cope with ageing populations. Retention of older employees can appear in different forms, such as phased retirement, bridge jobs, career development, or health promotion. However, little is known about how the offering of these retention strategies may vary across workplaces with different core work activities because the opportunities to implement different types of retention strategies are preconditioned by differences in the economic and labour market climate.

RESEARCH DESIGN AND METHODS

The study utilises data from a survey conducted among Danish workplaces in 2018, which is linked to administrative register data to conduct KHB-corrected logistic regression models. The study distinguishes among production workplaces, service and welfare workplaces, and information workplaces.

RESULTS

Phased retirement is most prevalent in service and welfare workplaces, whereas job bridging is most prevalent in both service and welfare and production workplaces. Career development and health promotion strategies are most prevalent in information workplaces. These retention differences between workplaces with different core work activities are in most cases explained by differences in trade union influence, physical working demands, and knowledge intensity.

DISCUSSION AND IMPLICATIONS

Although the type of retention strategy offered in the workplace largely matches the core work activity within the workplace, particularly production workplaces could feasibly take more advantage of using career development or health promotion strategies since the employees of these workplaces are more likely to retire early due to poor health and physical working conditions.

Midlife Work Limitations are Associated with Lower Odds of Survival and Healthy Aging

OBJECTIVES

Health conditions that limit work are associated with myriad socioeconomic disadvantages and around half of Americans could face a work limitation at some point in their working career. Our study examines the relationship between midlife work limitations and two aging outcomes: longevity and healthy aging.

METHODS

Using longitudinal data from the Panel Study of Income Dynamics and restricted mortality data, multivariate logistic regressions estimate the odds of desirable aging outcomes around age 65 for individuals with various midlife work limitation histories in samples of around 2,000 individuals.

RESULTS

Midlife work limitations are consistently linked with a lower likelihood of desirable aging outcomes. Temporary limitations are associated with 59% and 69% lower survival and healthy aging odds, respectively. Chronic limitations are associated with approximately 80% lower survival odds and 90% lower healthy aging odds at age 65.

DISCUSSION

Even temporary work limitations can be highly disadvantageous for aging outcomes, emphasizing the need to understand different work limitation histories. Future research should identify underlying mechanisms linking midlife work limitations and less desirable aging outcomes.

Do older manual workers benefit in vitality after retirement? Findings from a 3-year follow-up panel study

Vitality is the feeling of physical and mental aliveness. Vitality benefits individual, organizational and societal well-being. However, we know much less about the dynamics in the levels of vitality and its' precursors. This study investigates the effects of retirement on vitality and how this effect differs between manual and non-manual workers and by baseline levels of vitality. We used two waves of the NIDI Pension Panel Survey, collected in the Netherlands in 2015 and 2018. Data from 4156 older workers (N = 4156), of whom 1934 (46.5%) retired between waves, were analysed. Vitality is assessed in three ways, as: (1) a composite measure of vitality, and its subcomponents (2) energy and (3) fatigue. Conditional Change OLS Regression models demonstrated that retirement is associated with improved vitality and decreased fatigue. Older workers who retire from manual work at wave 1 experienced the largest gains in vitality and highest declines in fatigue at wave 2, compared to those who remained employed. Retirement was more advantageous for older workers who experienced poor vitality and high fatigue at wave 1. No such effects were found for energy. Older workers in manual work, those experiencing low vitality and high fatigue at wave 1, may benefit most from early retirement. Since opportunities for early retirement are highly restrictive, it is essential to provide these groups of workers with effective work accommodations and interventions that may not only improve their vitality and quality of working life, but also extend their participation in the labour market.

Helpfulness of Workplace Accommodations in Maintaining Health and Work Ability in Older Employees with Poor Health in Germany

OBJECTIVE

Supporting employees with health impairments to stay at work through workplace accommodation is a well-researched topic. However, research on workplace accommodations for older employees is lacking.

METHODS

Cross-sectional data from the German lidA cohort study in 2018 focusing on older employees who reported poor health (n = 421) was analyzed. A multiple logistic regression analysis was conducted to asses a potential association between the accommodation type and perceived helpfulness of workplace accommodations in older employees with poor health.

RESULTS

Changes in working times (OR 6.59), in work tasks (OR 3.50) and in the workplace (OR 2.57) were perceived as most helpful.

CONCLUSION

The results indicate that workplace accommodations can be helpful in older employees with health impairments and that this is not by chance, but that the perceived effectiveness has determinants and can be influenced.

A New Path to Address Multimorbidity? Longitudinal Analyses of Retirement Sequences and Chronic Diseases in Old Age

Chronic disease and multimorbidity are growing health challenges for aging populations, often coinciding with retirement. We examine late-life predictors of multimorbidity, focusing on the association between retirement sequences and number of chronic diseases. We modeled the number of chronic diseases as a function of six types of previously identified 10-year retirement sequences using Health and Retirement Study (HRS) data for 7,880 Americans observed between ages 60 to 61 and 70 to 71. Our results show that at baseline, the adjusted prevalence of multimorbidity was lowest in sequences characterized by late retirement from full-time work and highest in sequences characterized by early labor-force disengagement. Age increases in multimorbidity varied across retirement sequences, though overall differences in prevalence persisted at age 70 to 71. Earlier life disadvantages did not moderate these associations. Findings suggest further investigation of policies that target health limitations affecting work, promote continued beneficial employment opportunities, and ultimately leverage retirement sequences as a novel path to influence multimorbidity in old age.

Job Demands and Job Resources of Academics in Higher Education

Too many job demands and not enough job resources can negatively influence the well-being of employees. Currently, limited information exists surrounding the job demands and resources as experienced by academic employees in the higher education sector. Therefore, the aim of this study was to identify the job demands and job resources experienced by academic employees using qualitative methods. Semi-structured interviews were conducted with 23 academic employees, using an Interpretative Phenomenological Approach. Thematic analysis, specifically template analysis was used to categorize the themes. Job demands were divided into three categories: quantitative (publication pressure, overburdened with the load, and competing time demands), qualitative (work/home balance, complexity of student support, organizational politics, and lack of mental health support) and organizational demands (using technology-mediated learning and lack of structural resources). Job resources were organized into two categories: organizational (social support) and personal resources (autonomy, meaningful work, and personal support). Participant experiences are highlighted to provide a better understanding of the job demands and job resources encountered. The framework of job demands and job resources gleaned from the study could be used for further research to manage and monitor motivational processes for academic staff, and to reduce strain due to high job demands.

Motivation and Healthy Aging at Work

The goals of this paper are to review theoretical and empirical research on motivation and healthy aging at work and to outline directions for future research and practical applications in this area. To achieve these goals, we first consider the World Health Organization's (WHO) definition of healthy aging in the context of paid employment and lifespan development in the work domain. Second, we describe contemporary theoretical models and cumulative empirical findings on age, motivation, and health and well-being at work, and we critically discuss to what extent they are consistent with the WHO definition of healthy aging. Finally, we propose several directions for future research in the work context that are aligned with the WHO definition of healthy aging, and we describe a number of interventions related to the design of work environments and individual strategies to promote the motivation for healthy aging at work.

The Proactive Shift in Managing an Older Workforce 2009-2017: A Latent Class Analysis of Organizational Policies

Background and Objectives

Longitudinal perspectives on how organizations react to workforce aging are missing in the literature. In this study, we fill this gap and ask how organizations deal with older workers, how their approaches change over time, and in which sectors of the economy and types of organizations the changes were most profound.

Research Design and Methods

Data come from two large-scale employer surveys: 2009 (n = 1,077) and 2017 (n = 1,358), representative for the Netherlands. We use a three-step group-comparison latent class analysis combined with a multinomial logistic model.

Results

We found four clusters of organizations based on their practices regarding older workers—those trying to activate and develop their employees (active), focusing solely on exit measures (exit), implementing a combination of development, accommodating and exit measures (all), and practicing no age management (none). We find a major shift in employers’ approaches to aging workforces between 2009 and 2017, with strong decreases in those that offered no age management (47%–30%) and those focusing on exit measures (21%–6%), and an increase in active organizations (19%–52%). Active age management is no longer concentrated in large and developing organizations, but has become a standard human resources tool economy-wide.

Discussion and Implications

Overall, there is a long-term trend away from exit measures toward the application of proactive age management measures. More involvement of employers in retaining older adults in the workplace may signal a growing awareness of the changing demographic reality.

Age Differences in Return-to-Work Following Injury: Understanding the Role of Age Dimensions Across Longitudinal Follow-up

OBJECTIVES

To examine the overall association between chronological age and return-to-work (RTW), and understand if existing data could be used to better understand the role of age-related dimensions (functional, psychosocial, organizational, life-stage) in explaining these associations.

METHODS

We used survey data from a prospective cohort of injured workers in Victoria, Australia. Path models examined the relationship between chronological age and RTW, and the proportion mediated via age dimensions.

RESULTS

Older chronological age was associated with non-RTW, although the pattern was not observed consistently across follow-up surveys. A proportion of the overall relationship between chronological age and non-RTW was explained by functional and life-stage age and RTW status at previous time points.

CONCLUSIONS

Findings underscore the importance of moving beyond age measured only in chronological years, towards more complex conceptual and analytical models that recognize age as a multidimensional construct.

Why do older workers with chronic health conditions prefer to retire early?

Background

older workers experiencing chronic health conditions (CHCs) are more likely to retire early. The different pathways through which CHCs stimulate retirement preferences, however, remain largely unexplored.

Objective

we present a more comprehensive model in which we test the different pathways through which four specific CHCs—arthritis, cardiovascular disease, sleep disorders and psychological disorders—influence early retirement preferences. We hypothesize that the association between CHCs and early retirement preferences is differentially mediated by subjective life expectancy (SLE), perceived health-related work limitations (HRWL) and vitality.

Methods

we collected data from 5,696 wage-employed older workers (60 to 64 years) in the Netherlands in 2015. Regression models were estimated to examine the associations between CHCs and early retirement preferences. Mediation analysis with the Karlson, Holm and Breen method was used to examine potential mediation pathways.

Results

SLE, HRWL and vitality mediated the association between CHCs and older workers’ early retirement preferences. The dominant mediator differed depending on the CHC. Severe HRWL predominantly guided the retirement preferences of older workers with arthritis and cardiovascular disease. Lower vitality mainly mediated retirement preferences of older workers with sleep and psychological disorders. Lower SLE was a significant mediation pathway for older workers with cardiovascular diseases.

Conclusions

HRWL and vitality play a major role in determining retirement preferences of older workers experiencing CHCs. Since both mediators are modifiable, targeted interventions may not only extend older workers’ working lives, but also improve the quality of their working lives.

Chronic health conditions and work-related stress in older adults participating in the Dutch workforce

The proportion of workers with chronic health conditions (CHCs) will increase over the years as pension reform is increasing the age of retirement in many European countries. This will increase the percentage of older adults with CHCs performing highly demanding work. This study sought to examine the association between common CHCs [cardiovascular disease (CVD), diabetes, arthritis, respiratory and sleep disorders] and three domains of work stress in older Dutch workers. This study used data from the first wave of the NIDI Pension Panel Study for working adults aged 60–65 years (n = 6793). Logistic regression models examined the strength of association between CHCs and (1) general work stress, (2) emotional, and (3) physical demands. All five CHC were independently associated with one or more domains of stress. After including all CHCs in the model, CVD, sleep disorders, and arthritis were significantly associated with general stress. Respiratory disorders, sleep disorders, and arthritis were significantly associated with physical demands. Diabetes (1.25, 95% CI 1.01–1.53), sleep disorders (1.99, 95% CI 1.72–2.31), and arthritis (1.18, 95% CI 1.06–1.31) were significantly associated with emotional demands. Our findings demonstrate that work stress is associated with prevalent CHCs, and these conditions are differentially associated with several domains of work stress in adults approaching retirement. More research is needed to understand the causal relationship between CHCs and work stress. Such research may provide insights for effective workplace and public health interventions to ensure that older workers remain physically and mentally healthy, and productive through their working years.